Trauma Department, Hannover Medical School, Hannover, Germany.
J Innate Immun. 2010;2(5):469-77. doi: 10.1159/000284369. Epub 2010 Feb 11.
Sepsis with subsequent multiorgan dysfunction remains the leading cause of mortality in trauma patients. A gender dimorphism in the host response after trauma and sepsis has been revealed. Dehydroepiandrosterone (DHEA), one of the most abundant adrenal sexual steroid hormones, seems to have a protective immunological effect in sepsis. Knowledge of the pathway is sparse; however, a cellular modulation mediated by interleukin-6 (IL-6) has been proposed.
The effect of DHEA on survival, clinical parameters and the cellular immune system (T lymphocytes and NK cells) was examined in a model of polymicrobial sepsis induced by cecal ligation and puncture. For clarification of the role of IL-6 in the protective effect of DHEA, we used IL-6 knockout mice (IL-6(-/-)). As controls, experiments were performed on wild-type mice (WT).
The administration of DHEA in IL-6(-/-) mice did not affect mortality, as it was not significantly different from WT mice without DHEA application. The cellular immune response was influenced, as seen by a significant reduction in the percentage of CD8+ and NK cells in WT animals.
Mortality rates in IL-6(-/-) mouse strains were not lowered by DHEA; therefore, a limited effect of IL-6 on this pathway has to be proposed. NK cells may be one of the effector cells of the protective mechanisms of DHEA, whilst the role of CD8+ lymphocytes remains unclear. Consequently, DHEA might be presented as a possible adjuvant therapy after septic insult for modulation of the dysregulated immune system.
创伤后并发多器官功能障碍的脓毒症仍然是创伤患者死亡的主要原因。创伤和脓毒症后宿主反应存在性别二态性。脱氢表雄酮(DHEA)是最丰富的肾上腺性激素之一,似乎在脓毒症中具有保护免疫作用。尽管对其作用机制知之甚少,但已经提出了一种由白细胞介素-6(IL-6)介导的细胞调节机制。
通过盲肠结扎和穿刺诱导多微生物脓毒症模型,研究了 DHEA 对生存、临床参数和细胞免疫系统(T 淋巴细胞和 NK 细胞)的影响。为了阐明 IL-6 在 DHEA 保护作用中的作用,我们使用了 IL-6 基因敲除小鼠(IL-6(-/-))。作为对照,在野生型小鼠(WT)上进行了实验。
在 IL-6(-/-)小鼠中给予 DHEA 并没有影响死亡率,因为与未给予 DHEA 的 WT 小鼠相比,死亡率没有显著差异。细胞免疫反应受到影响,WT 动物的 CD8+和 NK 细胞百分比显著降低。
IL-6(-/-)小鼠的死亡率没有因 DHEA 而降低;因此,必须提出 IL-6 对该途径的影响有限。NK 细胞可能是 DHEA 保护机制的效应细胞之一,而 CD8+淋巴细胞的作用仍不清楚。因此,DHEA 可能作为一种潜在的辅助治疗方法,用于调节失调的免疫系统。