Dehydroepiandrosterone restores depressed peripheral blood mononuclear cell function following major abdominal surgery via the estrogen receptors

Abstract

DHEA stimulates proinflammatory cytokine release capacities of human PBMCs following major abdominal surgery. The estrogen receptor appears to be involved in mediating the immunomodulatory effect of DHEA. Thus, DHEA might be a useful adjunct for preventing immunosuppression in surgical patients.

Surgical trauma and immunosuppression: pathophysiology and potential immunomodulatory approaches

“…The immunomodulatory effects were most pronounced on postoperative cells in the presence of postoperative plasma [73]. DHEA appears to mediate its effect in part via the estrogen receptor because tamoxifen blocked the immunostimulatory effects of DHEA in vitro on T cells and PBMCs [72,73]. Because no adverse effects of short-term therapy with the steroid hormone DHEA are known, administration of this agent should also be considered a novel and useful adjunct for the treatment of immune depression that is encountered in patients after major surgery.…”

“…Recently, DHEA has been shown to enhance the depressed LPS-induced cytokine release by peripheral blood mononuclear cells (PBMCs) after major abdominal surgery in vitro [73]. The immunomodulatory effects were most pronounced on postoperative cells in the presence of postoperative plasma [73]. DHEA appears to mediate its effect in part via the estrogen receptor because tamoxifen blocked the immunostimulatory effects of DHEA in vitro on T cells and PBMCs [72,73].…”

“…Treatment of male mice with DHEA prevented the depression of T-cell and monocyte responsiveness after trauma-hemorrhage and significantly improved the survival rate of animals subjected to subsequent sepsis [9,72]. Recently, DHEA has been shown to enhance the depressed LPS-induced cytokine release by peripheral blood mononuclear cells (PBMCs) after major abdominal surgery in vitro [73]. The immunomodulatory effects were most pronounced on postoperative cells in the presence of postoperative plasma [73].…”

Immune response of severely injured patients – influence of surgical intervention and therapeutic impact

“…Recently, first experiences with DHEA in surgical patients have been reported. DHEA applied in vitro could restore depressed pro-inflammatory cytokine production after major abdominal surgery [91]. These data can be regarded as "proof of principle" for the immunostimulatory effects of DHEA in human patients.…”

Dehydroepiandrosterone improves the ovarian reserve of women with diminished ovarian reserve and is a potential regulator of the immune response in the ovaries

“…Estrone can shift the female immune system to a Th2-type response in the luteal phase, whereas postmenopausal women often exhibit enhanced Th1 cytokines (66). As mentioned previously, DHEA can restore PBMC function and increase the ability of human PBMCs to release pro-inflammatory cytokines after surgery via the estrogen receptor; this immunomodulatory effect of DHEA appears to be connected to estrogen receptors (55). Although total androgen concentrations were not associated with pregnancy during DHEA supplementation in women with POI, interaction between DHEA and total and free testosterone also significantly affected pregnancy rates at the start of an IVF cycle (67).…”