Dehydroepiandrosterone in relation to other adrenal hormones during an acute inflammatory stressful disease state compared with chronic inflammatory disease: role of interleukin-6 and tumour necrosis factor

Abstract

Objective: Serum levels of dehydroepiandrosterone (DHEA) and DHEA sulphate (DHEAS) are low in chronic inflammatory diseases, although the reasons are unexplained. Furthermore, the behaviour of serum levels of these hormones during an acute inflammatory stressful disease state is not well known. Subjects and methods: In this study in patients with an acute inflammatory stressful disease state (13 patients undergoing cardiothoracic surgery) and patients with chronic inflammation (61 patients with inflammatory bowel diseases (IBD)) vs 120 controls, we aimed to investigate adrenal hormone shifts looking at serum levels of DHEA in relation to other adrenal hormones. Furthermore, we tested the predictive role of serum tumour necrosis factor (TNF) and interleukin-6 (IL-6) for a change of serum levels of DHEA in relation to other adrenal hormones. Results: The molar ratio of serum levels of DHEA/androstenedione (ASD) was increased in patients with an acute inflammatory stressful disease state and was decreased in patients with chronic inflammation. The molar ratio of serum levels of DHEAS/DHEA was reduced during an acute inflammatory stressful disease state and was increased in patients with chronic inflammation. A multiple linear regression analysis revealed that elevated serum levels of TNF were associated with a high ratio of serum levels of DHEA/ASD in all groups (for IL-6 in patients with an acute inflammatory stressful disease state only), and, similarly, elevated serum levels of TNF were associated with a high ratio of serum levels of DHEAS/DHEA only in IBD (for IL-6 only in healthy subjects). Conclusions: This study indicates that changes of serum levels of DHEA in relation to serum levels of other adrenal hormones are completely different in patients with an acute inflammatory stressful disease state compared with patients with chronic inflammation. The decrease of serum levels of DHEAS and DHEA is typical for chronic inflammation and TNF and IL-6 play a predictive role for these changes.

Low Serum Levels of Dehydroepiandrosterone and Cortisol in Human Diffuse Cutaneous Leishmaniasis by Leishmania Mexicana

“…A decrease in serum levels of dehydroepiandrosterone sulfate (DHEAS) and DHEA is typical for noninfectious chronic inflammation where TNF and IL-6 have a predictive role for such changes 30,31 as in autoimmune disorders, including inflammatory bowel disease, 32 rheumatoid arthritis, 33,34 systemic lupus erythematosus, 35 and pemphigus. 36 These low levels are also seen in infectious diseases with chronic inflammation, such as tuberculosis, where DHEA prevents experimental infection in mice when given within the first few days or before M. tuberculosis inoculum.…”

Interleukin-6 inhibits adrenal androgen release from bovine adrenal zona reticularis cells by inhibiting the expression of steroidogenic proteins

“…The plasma concentration of adrenal androgens increases during acute stress [6]. In contrast, prolonged stress decreases the plasma concentration of these steroids in humans, cattle, and cats [6][7][8][9][10][11].…”

“…The plasma concentration of adrenal androgens increases during acute stress [6]. In contrast, prolonged stress decreases the plasma concentration of these steroids in humans, cattle, and cats [6][7][8][9][10][11]. This decrease in adrenal androgens coupled with the increase in cortisol may have a role in the diminished vigor of cattle with inflammatory conditions or chronic stress and thus may contribute to the decreased food consumption, poor digestive function, decreased weight gain, and diminished milk production of stressed cattle [8].…”

Serum dehydroepiandrosterone sulfate concentration as an indicator of adrenocortical suppression during inhaled steroid therapy in adult asthmatic patients

“…It must be emphasized that there are situations where adrenal androgen production decreases while cortisol secretion is maintained or even elevated. This steroid pattern can be seen in chronic inflammatory diseases and chronic stress situations (20,21).…”