Evidence map›Paper›PMID 42232584›Full record

ArticleCurrent trends in immunology2025

Rebalancing immunity: The emerging role of selective estrogen receptor modulators in immunity and autoimmunity.

Rachael J Werner, Jena R Wirth, Melissa A Cunningham

Abstract read
In one paragraph

Article in Current trends in immunology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Rachael J WernerDepartment of Medicine, Division of Rheumatology and Immunology, Medical University of South Carolina, 96 Jonathan Lucas St, Charleston, SC, 29425, USA.
Jena R WirthDepartment of Medicine, Division of Rheumatology and Immunology, Medical University of South Carolina, 96 Jonathan Lucas St, Charleston, SC, 29425, USA.
Melissa A CunninghamDepartment of Medicine, Division of Rheumatology and Immunology, Medical University of South Carolina, 96 Jonathan Lucas St, Charleston, SC, 29425, USA.

Funding

Training Grant in Inflammatory and Fibrosing DiseasesT32AR050958 · NIAMS · MEDICAL UNIVERSITY OF SOUTH CAROLINA · PI DIANE L KAMEN · 2005 to 2026
$4.2M
The Role of Estrogen Receptor Alpha Variant Size and Localization in Modulating TLR7-Induced InflammationR01AR078545 · NIAMS · MEDICAL UNIVERSITY OF SOUTH CAROLINA · PI Melissa A Cunningham · 2022 to 2026
$1.9M
BLRD VA I01 BX000470NIAMS NIH HHS R01 AR078545NIAMS NIH HHS T32 AR050958
6 · The paper itself

Abstract

Selective estrogen receptor modulators (SERMs) are tissue- and context-specific regulators of estrogen receptor (ER) signaling, originally developed to treat breast cancer and osteoporosis. Increasing recognition of the roles of ERα and ERβ in modulation of immune cell development, tolerance, inflammation and antiviral defense has led to growing interest in SERMs as potential therapies for autoimmune disease. This review summarizes current mechanistic, preclinical, and clinical evidence on SERMs and related ER-directed agents across autoimmune and immune-mediated conditions. Preclinical studies demonstrated that select SERMs can generate anti-inflammatory or tissue-protective effects of endogenous estrogen without negatively impacting reproductive tissue. In inflammatory arthritis, SERMs reduced synovial inflammation, modulated Th17-associated responses, and protected against bone loss in murine models. In systemic lupus erythematosus (SLE), where estrogen signaling contributes to disease susceptibility and activity, SERMs and SERDs showed variable but encouraging findings: raloxifene improved bone mineral density without increasing lupus flares, bazedoxifene preserved trabecular bone in lupus-prone mice, and fulvestrant reduced disease activity and T-cell activation markers in a randomized trial. In multiple sclerosis, ERα-dependent mechanisms mediate estradiol's protective effects in experimental autoimmune encephalomyelitis (EAE), illustrating the broader immunologic relevance of estrogen pathways. Given the high burden of glucocorticoid exposure, premature ovarian insufficiency, and osteoporosis among individuals with autoimmune diseases, SERMs may offer dual benefit as both immunomodulatory and bone-protective agents. However, available human studies remain small and short-term. Future work should define cell-specific ER signaling in human immunity and autoimmunity, identify patient subgroups most likely to benefit, and evaluate long-term safety in adequately powered clinical trials.

Indexed as

antiviral therapyautoimmune diseasedehydroepiandrosteroneestrogen receptor alphafulvestrantmultiple sclerosisrheumatoid arthritisselective estrogen receptor modulatorsSERMssystemic lupus erythematosus

Identifiers

PMID42232584
PMCPMC13225871

What Socratic holds

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LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.