Endocrine Abstracts

The role of the hypothalamic–pituitary adrenal axis in host response to an infection is crucial. The initial inflammatory response to sepsis activates the endogenous release of cortisol which in turn will modulate the synthesis and release of both pro- and anti-inflammatory mediators to restrict inflammation to the infected tissues. However, a number of factors including vascular or ischemic damage, inflammation and apoptosis within the hypothalamic–pituitary adrenal...

In severe sepsis circulating DHEA sulfate (DHEAS) has been shown to decrease whilst serum cortisol increases. This has led to the suggestion of an intraadrenal shift from adrenal androgen towards glucocorticoid synthesis in severe stress. Patients with sepsis are therefore assumed to be DHEA deficient and have been suggested to benefit from DHEA replacement. However, only desulfated DHEA is biologically active and DHEAS and DHEA may not freely interconvert as previously though...