AEGiS-GMHC: DHEA-Possible Immunomodulator

Important note: Information in this article was accurate in 1990. The state of the art may have changed since the publication date.

DHEA-Possible Immunomodulator

GMHC Treatment Issues; Volume 4 no. 2 April 6, 1990
Wayne Kawadler

Dehydroepiandrosterone (DHEA) is a hormone which originates in the adrenal gland and causes the release of both testosterone and cortisol. DHEA is found almost everywhere in the body incuding the testes, ovaries, lungs, and brain. Large amounts are concentrated in the urine. The amount of DHEA in the body peaks at 25 to 30 years of age and then decreases. Exercise does not change DHEA levels, but vegetarian diets result in lower levels.

DHEA has been shown to have immunoregulatory, anti-diabetic, anti-cancer and anti-stress activity. A test tube study has shown that DHEA inhibits Epstein-Barr virus. This same study provided hints that DHEA may play a role in the maturation process of T cells (17). In mice, DHEA has been shown to prevent obesity, prolong life, and fight cancer causing agents (18). Another study in mice showed that DHEA improved the immune response to viral infection (19).

In patients with AIDS, it has been noted that DHEA levels are dramatically lower than normal (20). A small double-blind, placebo-controlled study of DHEA, administered orally, has been done in Amsterdam. All 12 participants were p24 antigen positive, and received either a daily dose of powdered DHEA (750mg) or placebo. The results from this study, which were recently published, showed that DHEA may have no clear anti-HIV effect, but it may have had a positive effect on the immune system. Improvement in T cell performance and some evidence of immunomodulation were noted. In five of eight patients on drug, there was evidence of T cell activation and proliferation. No significant changes in p24 levels occurred in this group. This study suggests that the lower dose may be more effective. More trials of this sugbstance at differing doses may be useful (21).

Community Research Initiative (CRI) is continuing to enroll participants in a Phase I dose-escalating trial of DHEA to obtain initial information on toxicity and efficacy in PWAs. The 16- week trial will have two arms. One group will receive 1gm DHEA daily to be administered orally. The second group of 12 will receive 2gm daily if no significant toxicity is observed in the first group. For further information about this study, call CRI at 212-481-1050.

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