DEHYDROEPIANDROSTERONE REDUCES PROGRESSIVE DERMAL ISCHEMIA CAUSED BY THERMAL-INJURY

Progressive ischemia and necrosis of the skin following thermal injury are reduced by postburn administration of the steroid hormone dehydro epiandrosterone (DHEA). Thermally injured animals were provided with a subcutaneous injection of DHEA, or a related species of steroid hormo ne, at various times after burning. During the 96 hr following adminis tration of the scald burn, tissue necrosis was closely monitored. Subc utaneous administration of DHEA at approximately 1 mg/kg/day achieved optimal protection against the development of progressive dermal ische mia. DHEA, 17 alpha-hydroxy-pregnenelone, 16 alpha-bromo-DHEA, and and rostenediol each demonstrated a similar level of protection. Other for ms of steroids, including DHEA sulfate, androstenedione, 17 beta-estra diol, or dihydrotestosterone, exhibited no protective effect under the conditions tested. Additionally, intervention therapy with DHEA could be initiated up to 4 hr, but not 6 hr, after burn without a marked re duction in therapeutic benefit. Examination of the microvasculature of thermally injured dorsal skin suggested that postburn intervention wi th DHEA, either directly or indirectly, maintained a normal architectu re in most of the dermal capillaries and venules within burn-exposed t issue. These findings suggest that systemic intervention therapy of bu rn patients with DHEA or a similar acting steroid hormone may be usefu l in preventing the progressive tissue destruction caused by progressi ve ischemia. (C) 1995 Academic Press, Inc.