DEHYDROEPIANDROSTERONE, AN ENDOGENOUS IMMUNE MODULATOR, AFTER TRAUMATIC SHOCK
作者:
Michael Schurr,
Timothy Fabian,
Martin Croce,
Lisa Varnavas,
Kenneth Proctor,
期刊:
Shock
(OVID Available online 1997)
卷期:
Volume 7,
issue 1
页码: 55-59
ISSN:1073-2322
年代: 1997
出版商: OVID
数据来源: OVID
摘要:
Dehydroepiandrosterone (DHEA), an endogenous immune modulator, reduces mortality after endotoxin (lipopolysaccharide (LPS)) administration in rodents. However, there have been no studies in clinically relevant large-animal models. A unique experimental model is used to study the effects of DHEA in resuscitated trauma and to evaluate the protective effect of DHEA on the systemic inflammatory response induced by a delayed LPS challenge. Anesthetized, ventilated pigs were instrumented and then subjected to local hind-limb trauma and 35% hemorrhage. After 1 h, animals were resuscitated with shed blood, supplemental Ringers solution, and in a randomized, blinded fashion, 4 mg/kg of DHEA or vehicle. Two additional groups received 10 mg/kg or 20 mg/kg of DHEA. Animals were dosed again at 24, 48, and 72 h. After 75 h,Escherichia coliLPS was administered. LPS caused a fall in DHEA levels (0.23 ± .05 ng/mL (60 min post-LPS) versus .94 ± 35 ng/mL (72 h), p = .01). DHEA levels 60 min post-LPS were significantly higher in treated animals (p < .002). After LPS, all groups manifested progressive septic symptoms with a hyperdynamic state and pulmonary failure. These symptoms were not blunted by the administration of DHEA. DHEA levels are suppressed by LPS in this two-stage model of trauma and delayed sepsis; however, exogenous DHEA administration fails to blunt the associated systemic inflammatory response and pulmonary failure.
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