Androstenetriol improves survival in a rodent model of traumatic shock.
Trauma results in activation of the hypothalamic-pituitary-adrenal axis to mediate a cascade of neurohormonal changes as a defensive mechanism. Its prolongation, however, leads to a hypermetabolic, hypoperfused, and immunosuppressed state, setting the stage for subsequent sepsis and organ failure. Androstenetriol (5-androstene-3beta, 7beta, 17betatriol - AET), a metabolite of dehydroepiandrosterone, up-regulates the host immune response markedly, prevents immune suppression and controls inflammation, leading to improved survival after lethal infections by several diverse pathogens and lethal radiation. Such actions may be useful in improving survival from traumatic shock.


OBJECTIVE
The neurosteroid AET will increase survival following traumatic shock.


METHODS
A combat relevant model of traumatic shock was used. Male Sprague-Dawley rats were anesthetized, catheterized and subjected to soft tissue injury (laparotomy). Animals were allowed to regain consciousness over the next 0.5 h and then bled 40% of their blood volume over 15 min. Forty-five minutes after the onset of hemorrhage animals were randomized to receive either a single subcutaneous dose of AET (40 mg/kg, sc) or vehicle (methylcellulose). Volume resuscitation consisted of l-lactated Ringer's (three times the shed blood volume), followed by packed red blood cells (one-third shed red cell volume). Animals were observed for three days.


RESULTS
A total of 24 animals were studied. Of the 12 animals randomized to receive AET, all (100%) survived compared to 9 of 12 animals (75%) randomized to receive the vehicle (p < 0.05).


CONCLUSIONS
AET significantly improved survival when administered subcutaneously in a single dose in this rodent model of traumatic shock. Further survival and mechanism studies are warranted.
Marcu
Andreea C
AC
Virginia Commonwealth University Reanimation Engineering Shock Center (VCURES), Richmond, VA 23298, USA.
Kielar
Nicole D
ND
Paccione
Kristin E
KE
Barbee
R Wayne
RW
Carter
Hans
H
Ivatury
Rao R
RR
Diegelmann
Robert F
RF
Ward
Kevin R
KR
Loria
Roger M
RM
D000737:Androstenols / Q000494:pharmacology* / Q000627:therapeutic use; D000818:Animals; D018932:Chemokine CCL2 / Q000097:blood; D004195:Disease Models, Animal; D007155:Immunologic Factors / Q000494:pharmacology* / Q000627:therapeutic use; D053582:Interleukin-1alpha / Q000097:blood; D008297:Male; D010865:Pilot Projects; D011897:Random Allocation; D051381:Rats; D017207:Rats, Sprague-Dawley; D012107:Research Design; D012151:Resuscitation; D012774:Shock, Traumatic / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology / Q000628:therapy
C108492:5-androstene-3,7,17-triol; D000737:Androstenols; C491766:Ccl2 protein, rat; D018932:Chemokine CCL2; D007155:Immunologic Factors; D053582:Interleukin-1alpha