Department Trauma Surgery, University Hospital of Essen, Hufeland Str. 55, 45141 Essen, Germany.
Curr Med Chem. 2010;17(11):1039-47. doi: 10.2174/092986710790820570.
DHEA is the major circulating steroid in human blood and it is a central intermediate in the metabolic pathway of sex steroid hormone formation. Although the specific effect of DHEA is still unclear it was demonstrated that DHEA modulates several physiologic processes including metabolism and cardiovascular function. Furthermore, a profound immunomodulatory effect of DHEA was reported. Several data demonstrate the beneficial effect of DHEA in situations of critical illness including trauma hemorrhage and sepsis. Accordingly DHEA improved the survival rate and clinical situation in several animal models of trauma hemorrhage and systemic inflammation. This effect was paralleled by profound changes of immunologic parameters, organ function, and heat shock protein production. Therefore, it was claimed that DHEA may be a new alternative/additive in the treatment of trauma and sepsis. In line, DHEA is a frequently used drug in the field of anti-aging medicine, it is an over-the-counter drug in several countries, and it was reported that DHEA medication is free of major side effects. Therefore, DHEA could easily be used in a clinical trial investigating its effects in critical ill patients. This article reviews the reported effects of DHEA on the base of the literature with the specific focus on trauma and sepsis/critical illness including its clinical perspectives.
脱氢表雄酮（DHEA）是人体血液中主要的循环类固醇，也是性激素激素形成代谢途径中的中心中间产物。尽管 DHEA 的具体作用尚不清楚，但已证明 DHEA 可调节多种生理过程，包括代谢和心血管功能。此外，还报道了 DHEA 具有深远的免疫调节作用。有几项数据表明，在创伤、出血和败血症等危急病症中，DHEA 具有有益作用。因此，DHEA 改善了创伤和全身炎症的几种动物模型中的存活率和临床状况。这种作用伴随着免疫参数、器官功能和热休克蛋白产生的深刻变化。因此，有人声称 DHEA 可能是创伤和败血症治疗的一种新的替代/附加物。同样，DHEA 是抗衰老医学领域中常用的药物，在几个国家是一种非处方药物，据报道 DHEA 药物治疗没有重大副作用。因此，DHEA 可以很容易地用于研究其在重症患者中的作用的临床试验。本文根据文献综述了 DHEA 在创伤和败血症/危重病方面的报道效果，包括其临床观点。
