Tomo Sojit, Banerjee Mithu, Sharma Praveen, Garg Mahendra
Department of Biochemistry, All India Institute of Medical Sciences, Jodhpur, India.
Department of Medicine, All India Institute of Medical Sciences, Jodhpur, India.
Endocr Regul. 2021 Sep 13;55(3):174-181. doi: 10.2478/enr-2021-0019.
The pathophysiology of COVID comprises an exaggerated pro-inflammatory response. Hypothalamic-pituitary-adrenal (HPA) axis has a crucial role in various inflammatory conditions and modulated immunological response. Limited evidence is available regarding the incidence and the effect of HPA dysfunction in COVID-19. Although the cortisol levels have only been estimated in a few studies, the dehydroepiandrosterone sulfate (DHEAS) release from the adrenal gland has not been explored yet. In this mini review, the authors discuss the role of dehydroepiandrosterone (DHEA) and DHEAS in the acute stress response and immunological modulation. Various effects of DHEAS have been demonstrated in different diseases. The specific inhibitory effect of DHEA on interleukin 6 (IL-6) could be of paramount importance in COVID-19. Further, DHEA supplementation has already been proposed in inflammatory conditions, like rheumatoid arthritis. DHEAS levels in COVID-19 may help to understand the HPA axis dysfunction as well as the possibility of repurposing DHEA as a drug for mitigating the pro-inflammatory COVID-19.
新冠病毒病的病理生理学包括过度的促炎反应。下丘脑 - 垂体 - 肾上腺（HPA）轴在各种炎症状态及调节免疫反应中起关键作用。关于HPA功能障碍在新冠病毒病中的发生率及影响，现有证据有限。尽管仅在少数研究中估计了皮质醇水平，但肾上腺硫酸脱氢表雄酮（DHEAS）的释放情况尚未得到研究。在这篇小型综述中，作者讨论了脱氢表雄酮（DHEA）和DHEAS在急性应激反应和免疫调节中的作用。DHEAS在不同疾病中已显示出多种作用。DHEA对白细胞介素6（IL - 6）的特异性抑制作用在新冠病毒病中可能至关重要。此外，在类风湿关节炎等炎症性疾病中已有人提出补充DHEA。新冠病毒病中的DHEAS水平可能有助于了解HPA轴功能障碍，以及将DHEA重新用作减轻新冠病毒病促炎作用药物的可能性。
