Gonadal steroids in critical illness

Gonadal steroids are metabolized in target cells and then interact with specific receptors to exert genomic and nongenomic effects. Complex feedback loops that involve the immune-neuroendocrine axis, limbic system, and gonadal steroids play a vital role in the adaptation to critical illness. Preclin...

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Bibliographic Details
Published inCritical care clinics Vol. 22; no. 1; p. 87
Main Authors Mechanick, Jeffrey I, Nierman, David M
Format Journal Article
LanguageEnglish
Published United States 01.01.2006
Subjects
Androgens - physiology
Androgens - therapeutic use
Animals
Critical Illness
Estrogens - physiology
Estrogens - therapeutic use
Female
Gonadal Steroid Hormones - physiology
Gonadal Steroid Hormones - therapeutic use
Humans
Hypothalamo-Hypophyseal System - physiopathology
Male
Sex Factors
Stress, Physiological - drug therapy
Stress, Physiological - physiopathology
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Summary:Gonadal steroids are metabolized in target cells and then interact with specific receptors to exert genomic and nongenomic effects. Complex feedback loops that involve the immune-neuroendocrine axis, limbic system, and gonadal steroids play a vital role in the adaptation to critical illness. Preclinical studies demonstrate adverse physiological effects of androgens on the cardiovascular and immune systems despite its purported anabolic effects. Similar models also demonstrate salutary effects of estrogens on these systems. Thus, during the catabolic phases of acute and chronic critical illness, estrogen, and not androgen, therapy may prove to be a valuable intervention. However, during the post-critical illness recovery phase, when anabolism is critical, androgen therapy may still be useful and safe.
ISSN:0749-0704
DOI:10.1016/j.ccc.2005.08.005