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Low levels of endogenous anabolic androgenic steroids in females with severe asthma taking corticosteroids
Clinical Lung and Allergy Research, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden; Department of Respiratory Medicine, Karolinska University Hospital, Stockholm, Sweden; The Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden.
Department of Respiratory Medicine, Karolinska University Hospital, Stockholm, Sweden; The Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden; Unit of Integrative Metabolomics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Department of Respiratory Medicine, Karolinska University Hospital, Stockholm, Sweden; The Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden; Unit of Integrative Metabolomics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden; Clinical Pharmacology, Karolinska University Hospital, Stockholm, Sweden; Laboratoire AntiDopage Français, Université Paris-Saclay, Châtenay-Malabry, France.
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2023 (English)In: ERJ Open Research, E-ISSN 2312-0541, Vol. 9, no 5, article id 00269-2023Article in journal (Refereed) Published
Abstract [en]

Rationale: Patients with severe asthma are dependent upon treatment with high doses of inhaled corticosteroids (ICS) and often also oral corticosteroids (OCS). The extent of endogenous androgenic anabolic steroid (EAAS) suppression in asthma has not previously been described in detail. The objective of the present study was to measure urinary concentrations of EAAS in relation to exogenous corticosteroid exposure.

Methods: Urine collected at baseline in the U-BIOPRED (Unbiased Biomarkers for the Prediction of Respiratory Disease outcomes) study of severe adult asthmatics (SA, n=408) was analysed by quantitative mass spectrometry. Data were compared to that of mild-to-moderate asthmatics (MMA, n=70) and healthy subjects (HC, n=98) from the same study.

Measurements and main results: The concentrations of urinary endogenous steroid metabolites were substantially lower in SA than in MMA or HC. These differences were more pronounced in SA patients with detectable urinary OCS metabolites. Their dehydroepiandrosterone sulfate (DHEA-S) concentrations were <5% of those in HC, and cortisol concentrations were below the detection limit in 75% of females and 82% of males. The concentrations of EAAS in OCS-positive patients, as well as patients on high-dose ICS only, were more suppressed in females than males (p<0.05). Low levels of DHEA were associated with features of more severe disease and were more prevalent in females (p<0.05). The association between low EAAS and corticosteroid treatment was replicated in 289 of the SA patients at follow-up after 12–18 months.

Conclusion: The pronounced suppression of endogenous anabolic androgens in females might contribute to sex differences regarding the prevalence of severe asthma.

Place, publisher, year, edition, pages
European Respiratory Society, 2023. Vol. 9, no 5, article id 00269-2023
National Category
Respiratory Medicine and Allergy
Identifiers
URN: urn:nbn:se:umu:diva-215705DOI: 10.1183/23120541.00269-2023ISI: 001075451800015PubMedID: 37868143Scopus ID: 2-s2.0-85173750900OAI: oai:DiVA.org:umu-215705DiVA, id: diva2:1811585
Funder
Swedish Heart Lung Foundation, HLF 20210519Swedish Research CouncilEU, FP7, Seventh Framework ProgrammeConsul Berghs FoundationKarolinska InstituteVårdal FoundationAvailable from: 2023-11-13 Created: 2023-11-13 Last updated: 2023-11-13Bibliographically approved

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Behndig, Annelie F.

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