The potential implication of decreased DHEA levels in the pathophysiology of chronic Chagas cardiomyopathy

Abstract

The use of decision-analytic methods in medicine is appealing since they are helpful when trying to get a more insightful assessment of the patient status aimed at better clinical management. Within this setting, the current issue of IJC publishes a study in which its authors analyzed the levels of dehydroepiandrosterone sulfate (DHEA-S) in patients with chronic Chagas cardiomyopathy -CCC- to ascertain whether values of this adrenal steroid were related to cardiac compromise, in terms of clinical, biochemical, and cardiological endpoints [1]. Beyond their proper effects, compounds released during an inflammatory process signal the brain to activate the stress system, particularly the hypothalamic-pituitary-adrenal axis [2] leading to the production of adrenal steroids glucocorticoids (GCs), and DHEA which mainly circulates in the blood as a conjugated ester in the form of DHEAS. Such immune-endocrine interaction serves to orchestrate a more effective defense strategy against the insult [3].