Chatterton R T, Green D, Harris S, Grossman A, Hechter O
Department of Obstetrics and Gynecology, Northwestern University Medical School, Chicago, IL 60611, USA.
J Lab Clin Med. 1996 Jun;127(6):545-52. doi: 10.1016/s0022-2143(96)90145-6.
The objective of the study was to relate plasma dehydroepiandrosterone sulfate (DHEA-S) concentrations to the progression of HIV infection in individual HIV-infected men with hemophilia and to obtain information on the cause of DH EA-S alterations. Blood samples were obtained from 16 men with hemophilia; in 9 men serial samples were available for up to 11 years after HIV-1 infection. Control samples were obtained from men of comparable ages without hemophilia or HIV infection. Measurements were made of CD4+ cell counts, plasma adrenocorticotropic hormone (ACTH), cortisol, DHEA, DHEA-S, and prolactin. Before HIV infection, men with hemophilia had significantly lower plasma levels of DHEA-S than control men. After infection, 3 of 9 subjects studied serially had little or no change in plasma DHEA-S levels or in CD4+ cell counts over 11 years. Four of the 9 i n whom AIDS developed had progressive decreases in plasma DHEA-S concentrations that, in some cases, preceded a precipitous fall in CD4+ cell counts. Major decreases in plasma DHEA-S levels before falls in CD4+ counts were observed in 2 ot her subjects who had other severe illnesses. None of the decreases in DHEA-S levels were associated with decreased concentrations of plasma cortisol, ACTH, or prolactin. We conclude that plasma DHEA-S is an indicator of general health rather than a specific indicator for progression of HIV. The decrease in plasma DHEA-S is not related to ACTH stimulation of the adrenal gland or to cortisol secretion, but it may be related to cytokines that can inhibit 17-hydroxylation of DH EA-S precursors.
该研究的目的是探讨感染人类免疫缺陷病毒（HIV）的血友病男性个体中血浆硫酸脱氢表雄酮（DHEA-S）浓度与HIV感染进展之间的关系，并获取有关DHEA-S改变原因的信息。从16名血友病男性中采集血样；其中9名男性在感染HIV-1后的11年内可获得系列样本。对照样本取自年龄相仿、无血友病或HIV感染的男性。检测了CD4+细胞计数、血浆促肾上腺皮质激素（ACTH）、皮质醇、DHEA、DHEA-S和催乳素。在HIV感染前，血友病男性的血浆DHEA-S水平显著低于对照男性。感染后，9名接受系列研究的受试者中有3名在11年内血浆DHEA-S水平和CD4+细胞计数几乎没有变化。9名患艾滋病的受试者中有4名血浆DHEA-S浓度逐渐下降，在某些情况下，这先于CD4+细胞计数的急剧下降。在另外2名患有其他严重疾病的受试者中，观察到在CD4+计数下降之前血浆DHEA-S水平大幅下降。DHEA-S水平的下降均与血浆皮质醇、ACTH或催乳素浓度的降低无关。我们得出结论，血浆DHEA-S是总体健康状况的指标，而非HIV进展的特异性指标。血浆DHEA-S的降低与ACTH对肾上腺的刺激或皮质醇分泌无关，但可能与可抑制DHEA-S前体17-羟化的细胞因子有关。
