ORAL DEHYDROEPIANDROSTERONE IN PHYSIOLOGICAL DOSES MODULATES IMMUNE FUNCTION IN POSTMENOPAUSAL WOMEN

OBJECTIVE: This study tests the hypothesis that dehydroepiandrosterone or its metabolic products are immunomodulatory in postmenopausal wome n with relative adrenal androgen deficiency. STUDY DESIGN: A prospecti ve, randomized, double-blind, crossover study of 11 subjects with 3-we ek treatment arms separated by a 2-week washout period was performed. Immunologic evaluation at the beginning and end of the treatment arms consisted of flow cytometry to delineate T-cell populations, in vitro T-cell mitogenic response and cytokine production, and natural killer cell cytotoxicity. Statistical analysis was based on a split-plot desi gn with analysis of variance with repeated measures. RESULTS: Dehydroe piandrosterone supplementation decreased CD4+ (helper) T cells and inc reased CD8+/CD56+ (natural killer) cells. Although T-cell mitogenic an d interleukin-6 responses were inhibited, natural killer cell cytotoxi city increased dramatically. CONCLUSIONS: These data provide the first in vivo evidence in human for an immunomodulatory effect of dehydroep iandrosterone. The salutary immune changes could account for clinical and experimental evidence of antioncogenic effects of this steroid. Th is study provides a strong rationale for further clinical studies on d ehydroepiandrosterone supplementation in adrenal androgen-deficient st ates.