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Increased serum levels of dehydroepiandrosterone (DHEA) and interleukin-6 (IL-6) in women with mild to moderate Alzheimer's disease

Published online by Cambridge University Press:  18 May 2011

Sigbritt Rasmuson*
Affiliation:
Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University Hospital, Umeå, Sweden
Birgitta Näsman
Affiliation:
Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University Hospital, Umeå, Sweden
Tommy Olsson
Affiliation:
Department of Public Health and Clinical Medicine, Medicine, Umeå University Hospital, Umeå, Sweden
*
Correspondence should be addressed to: Dr. Sigbritt Rasmuson, MD, PhD, Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University Hospital, SE-901 85 Umeå, Sweden. Phone: + 46–90-7858800; Fax: + 46- 90-130623. Email: [email protected].

Abstract

Background: It has been suggested that hypercortisolism contributes to the pathophysiology of Alzheimer's disease (AD), based on the fact that excess glucocorticoid exposure has potent adverse effects on the central nervous system. In contrast, dehydroepiandrosterone (DHEA) has been linked to a broad range of beneficial physiological effects including neuronal excitability and neuroprotection and even memory enhancing properties. Of note, proinflammatory cytokines are present in neuritic plaques (a hallmark of AD) and may regulate cortisol/DHEA release. In this exploratory study, we hypothesized that there is a flattened diurnal curve of cortisol and DHEA in mild to moderate AD, linked to increased cytokine levels.

Methods: Diurnal profiles of cortisol, adrenocorticotropic hormone (ACTH), and DHEA were studied in 15 patients with mild to moderate AD (7 men and 8 women, 75.6 ± 5.5 years) and 15 healthy elderly controls (7 men and 8 women, 73.3 ± 5.8 years, respectively). Interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), and soluble TNF receptors were analyzed.

Results: Women with AD had significantly increased morning levels of ACTH, DHEA, and IL-6 compared to healthy elderly women. Cortisol levels were significantly increased in men with AD at 0300 h versus healthy elderly men, in spite of slightly decreased ACTH levels.

Conclusions: Our data suggest important sex differences in hypothalamic–pituitary–adrenal (HPA) axis regulation and steroid hormone clearance in patients with AD. Increased secretion of IL-6 may have a contributory role in this difference.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2011

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