Department of Neurology, Medical Faculty, RWTH Aachen University, 52074, Aachen, Germany.
Institute of Biochemistry and Molecular Immunology, Medical Faculty, RWTH Aachen University, 52074, Aachen, Germany.
Reprod Sci. 2021 Oct;28(10):2823-2829. doi: 10.1007/s43032-021-00541-2. Epub 2021 Mar 26.
Neuroactive steroids such as dehydroepiandrosterone (DHEA), estradiol (E2), and progesterone (P4) are associated with structural and functional changes in the central nervous system (CNS). Measurement of steroid levels in the CNS compartments is restricted in accessibility. Consequently, there is only limited human data on the distributional equilibrium for steroid levels between peripheral and central compartments. While some neuroactive steroids including DHEA and E2 have been reported to convey excitatory and proconvulsant properties, the opposite was demonstrated for P4. We aimed to elucidate the correlation between peripheral and central DHEA, E2, and P4 levels in women at term pregnancy. CSF and serum samples of 27 healthy pregnant women (22-39 years) at term pregnancy were collected simultaneously under combined spinal and epidural anesthesia and used for DHEA ELISA and E2, and P4 ECLIA. All three neuroactive steroids were detected at markedly lower levels in CSF compared to their corresponding serum concentrations (decrease, mean ± SD, 97.66 ± 0.83%). We found a strong correlation for DHEA between its serum and the corresponding CSF levels (r = 0.65, p = 0.003). Serum and CSF levels of E2 (r = 0.31, p = 0.12) appeared not to correlate in the investigated cohort. DHEA serum concentration correlated significantly with E2 (r = 0.58, p = 0.0016) in CSF. In addition, a strong correlation was found between DHEA and E2, both measured in CSF (r = 0.65, p = 0.0002). Peripheral DHEA levels might serve as an indicator for central nervous levels of the neuroactive steroids DHEA and E2 in pregnant women.
神经活性甾体，如脱氢表雄酮（DHEA）、雌二醇（E2）和孕酮（P4），与中枢神经系统（CNS）的结构和功能变化有关。中枢神经系统隔室中甾体水平的测量在可及性方面受到限制。因此，关于甾体水平在周围和中枢隔室之间的分布平衡，仅有有限的人类数据。虽然一些神经活性甾体，包括 DHEA 和 E2，被报道具有兴奋和致惊厥特性，但 P4 则相反。我们旨在阐明足月妊娠妇女外周和中枢 DHEA、E2 和 P4 水平之间的相关性。在脊髓和硬膜外联合麻醉下同时采集 27 名健康足月妊娠妇女（22-39 岁）的 CSF 和血清样本，并用于 DHEA ELISA 和 E2、P4 ECLIA。与相应的血清浓度相比，所有三种神经活性甾体在 CSF 中的浓度明显较低（降低，均值±SD，97.66±0.83%）。我们发现 DHEA 在其血清与其相应 CSF 水平之间存在很强的相关性（r=0.65，p=0.003）。在研究队列中，E2 的血清和 CSF 水平（r=0.31，p=0.12）似乎没有相关性。DHEA 血清浓度与 CSF 中的 E2 显著相关（r=0.58，p=0.0016）。此外，在 CSF 中测量的 DHEA 和 E2 之间也发现了很强的相关性（r=0.65，p=0.0002）。外周 DHEA 水平可能是孕妇中枢神经中神经活性甾体 DHEA 和 E2 水平的一个指标。
