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Intensive Care Medicine pp 861–872Cite as

Critical Role of Hormones in Traumatic Injury and Outcome

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Abstract

Besides the undesirable effects on cardiovascular function due to blood loss and hypoxia, a major consequence of traumatic injury is immunosuppression. Experimental studies demonstrate that depression of immune functions after trauma-hemorrhage is severe in young males, and ovariectomized (OVX) and aged females, as opposed to proestrus females in whom immune function is maintained. Moreover, the survival rate of proestrus females subjected to sepsis after trauma-hemorrhage is significantly higher than age-matched males or OVX females. In addition, administration of 17β-estradiol, dehydroepiandrosterone (DHEA), or prolactin to males, and 17β-estradiol to OVX females after trauma-hemorrhage restores immune functions similar to injured animals. Sex steroids, thus, play a critical role in trauma outcome and recent studies implicate increased synthesis and lowered catabolism of 5α-dihydrotestosterone for immunodepression in males, and continued synthesis of 17β-estradiol for the maintenance of immune functions in proestrus females following trauma-hemorrhage. Hormones are chemical messengers that coordinate the activities of different cells. Hormones are chemically diverse, synthesized by specific glands, and secreted directly into the blood that carries them to their sites of action where they specifically regulate the functions of tissues that respond. Nonetheless, many hormones or molecules possessing hormone-like activity are also synthesized in the peripheral tissues and they regulate tissue functions locally. Furthermore, T lymphocytes and macrophages express receptors for androgen and estrogen and T lymphocytes locally metabolize sex steroids. Since these cells are also the sites of cytokine production, local synthesis of active steroids in these cells is significant.

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Authors
  1. T. S. A. Samy
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  2. L. W. Rue III
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  3. I. H. Chaudry
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Editor information

Editors and Affiliations

  1. Department of Intensive Care, Erasme Hospital, Free University of Brussels, Route de Lennik 808, B-1070, Brussels, Belgium

    Jean-Louis Vincent MD, PhD, FCCM, FCCP (Head) (Head)

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© 2003 Springer-Verlag Berlin Heidelberg

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Samy, T.S.A., Rue, L.W., Chaudry, I.H. (2003). Critical Role of Hormones in Traumatic Injury and Outcome. In: Vincent, JL. (eds) Intensive Care Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4757-5548-0_79

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  • DOI: https://doi.org/10.1007/978-1-4757-5548-0_79

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4757-5550-3

  • Online ISBN: 978-1-4757-5548-0

  • eBook Packages: Springer Book Archive

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