The effect of dehydroepiandrosterone on hemorrhage-induced suppression of cellular immune function
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- Oberbeck, R., Nickel, E., von Griensven, M. et al. Intensive Care Med (2002) 28: 963. doi:10.1007/s00134-002-1292-8
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Objective. To determine whether the steroid hormone dehydroepiandrosterone (DHEA) improves cellular immune functions after hemorrhagic shock.
Design and setting. Prospective controlled study in a research laboratory at an university medical center.
Subjects. Male NMRI mice.
Interventions. Animals received 0.9% saline or DHEA (20 mg/kg subcutaneously) before induction of a volume-controlled hemorrhagic shock (55% of estimated circulating blood volume) by retro-orbital puncture. One hour after hemorrhage mice underwent fluid resuscitation by intravenous infusion of lactated Ringer's solution (300% of the shed blood). Separate groups of mice were killed to obtain whole blood and spleen 1 h after hemorrhage, 1 h after fluid resuscitation, and 24 h after hemorrhage to determine lymphocyte distribution (CD4+, CD8+, NK1.1-AG+), splenocyte apoptosis, and plasma concentrations of tumor necrosis factor-α and interleukin-10.
Measurements and results. Hemorrhage in control mice was associated with a rapid increase in circulating NK cell numbers. Elevated splenocyte apoptosis, an increased CD4/CD8 ratio, and decreased number of circulating CD8+ T-cells was observed 24 h after hemorrhagic shock. DHEA administration was accompanied by a normalization of splenocyte apoptosis and lymphocyte migration. Induction of hemorrhagic shock did not affect TNF-α or IL-10 plasma concentrations in either treatment group.
Conclusions. DHEA administration improves cellular immune function after hemorrhage and may therefore be beneficial in patients with hemorrhagic shock.