Circulating gonadal and adrenal steroids in amyotrophic lateral sclerosis: possible markers of susceptibility and outcome.

GISELLA GARGIULO-MONACHELLI; SIVORI M; MARIA MEYER; SICA RE; ALEJANDRO F. DE NICOLA; MARIA CLAUDIA GONZALEZ DENISELLE

HORMONE AND METABOLIC RESEARCH

GEORG THIEME VERLAG KG

Año: 2014 vol. 46 p. 433 - 439

0018-5043

Changes of some (delete) circulating steroids have been reported in patients with sporadic  amyotrophic lateral sclerosis (sALS), but a full comparison of the adrenal and gonadal steroid profile between sALS patients and controls has not be performed. Considering that respiratory failure is the most frequent cause of death in sALS, we also searched, as well, for the relationship between circulating steroids and some respiratory parameters. Serum levels of adrenal and gonadal steroids were measured in 52 age -and gender- matched subjects (28 sALS and 24 controls) using radioimmunoassay techniques. Respiratory parameters evaluated in sALS patients included:  % forced vital capacity (FVC), % maximal inspiratory pressure (MIP) and % maximal expiratory pressure (MEP) at the time of blood sample collection. Steroid levels and ratios were statistically correlated with respiratory parameters. Compared to controls, increased levels of testosterone were demonstrated in female ALS patients. With increasing age, testosterone declined in controls but not in ALS patients. Dehydroepiandrosterone sulfate/cortisol ratio showed a positive correlation with % FVC, MIP and MEP. Higher total testosterone and free testosterone, as well as lower progesterone/free testosterone ratio levels, were associated with a rapid worsening of the monthly % FVC. The present study shows that circulating gonadal and adrenal steroids are differentially expressed in sALS patients relative to controls and that they could influence respiratory outcome in patients. Thus, dehydroepiandrosterone sulfate or progesterone may provide a protective function, while others like testosterone or cortisol probably have a negative influence.