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Selective increases in adrenal steroidogenic capacity during acute respiratory disease in infants
A Hanukoglu1, D Fried, I Nakash
1Department of Pediatrics, E. Wolfson Hospital, Holon, Israel.
Insights
During acute illness, infants show increased adrenal steroid production of cortisol and dehydroepiandrosterone (DHEAS), but not aldosterone. This enhanced steroidogenic capacity, particularly for DHEAS, may support immune responses in young infants.
Area of Science:
- Endocrinology
- Pediatrics
- Immunology
Background:
- Acute illness in infants can impact adrenal function.
- The adrenal cortex produces critical steroid hormones like cortisol, DHEAS, and aldosterone.
- Understanding these responses is vital for managing pediatric health during disease.
Purpose of the Study:
- To investigate adrenal steroidogenic responses to acute illness in infants.
- To compare basal and adrenocorticotropin (ACTH)-stimulated hormone levels during illness and recovery.
- To determine if age influences these steroidogenic capacities.
Main Methods:
- Measured basal and ACTH-stimulated cortisol, DHEAS, and aldosterone levels in 16 infants with acute bronchiolitis.
- Retested 14 infants after recovery.
- Analyzed correlations between hormone levels, ACTH stimulation, and infant age.
Main Results:
- Cortisol and DHEAS levels (basal and ACTH-stimulated) were significantly higher during illness than after recovery.
- Aldosterone secretion capacity remained unchanged despite acute illness.
- DHEAS levels correlated strongly with age, suggesting age-dependent responses.
Conclusions:
- Acute disease selectively enhances steroidogenic capacity for cortisol and DHEAS in infants, not aldosterone.
- The DHEAS response may play a role in bolstering immune function.
- Individual steroidogenic profiles for cortisol and DHEAS are consistent over time.
Abstract:
To examine steroidogenic responses of the different zones of the adrenal cortex to acute disease we determined the basal and adrenocorticotropin (ACTH)-stimulated levels of cortisol, dehydroepiandrosterone (DHEAS) and aldosterone in 16 infants aged 1-4 months with acute bronchiolitis. Fourteen of the infants were retested after recovery. During illness the mean basal levels of cortisol and DHEAS were twice as high as the levels after recovery (370 vs 180 nmol/l and 2.7 vs 1.3 mumol/l, respectively). The mean peak ACTH-stimulated levels of cortisol and DHEAS during illness were 1.5- and 2.5-fold higher, respectively, than the levels found after recovery. Although aldosterone secretion was stimulated > or = 3-fold by ACTH, illness was not associated with any change in aldosterone secretory capacity. The basal and stimulated levels of both cortisol and DHEAS during illness and after recovery were correlated significantly. Thus, the relative steroidogenic capacities for these two steroids were characteristic of the individual infant and showed constancy over a period of at least several weeks. While the levels of cortisol and aldosterone were not dependent on the age of the infants, both the basal and stimulated levels of DHEAS correlated strongly with age. We conclude that during acute disease the steroidogenic capacity selectively increases in the zones that secrete cortisol and DHEAS (only in infants < 3 months) but not in the zona glomerulosa that secretes aldosterone. The DHEAS response may be related to its putative effects to enhance immune responses.