Zusammenfassung
Während der Fetalzeit sind DHEA und DHEAS von essenzieller Bedeutung als lebenswichtige
Substrate für die Estrogenbiosynthese der fetoplazentaren Einheit und garantieren
damit das Wachstum des Uterus während der Schwangerschaft. Möglicherweise spielen
diese Steroide auch für die Initiierung der Pubertät eine wichtige Rolle. Ferner gibt
es klinische und experimentelle Hinweise darauf, dass DHEAS und DHEA in die Funktion
des zentralen Nervensystems im Sinne von Neurosteroiden modulierend eingreifen und
somit an kognitiven und emotionalen Leistungen des Gehirns beteiligt sind. Der altersabhängige
Abfall von Serumkonzentrationen von DHEA und DHEAS ist Ausdruck des Alterungsprozesses,
aber damit nicht zwingend seine Ursache. Die Substitution mit DHEA führt zu einem
entsprechenden Anstieg der peripheren Plasmakonzentrationen und gleichzeitig durch
Metabolisierung zu einer dosisabhängigen Erhöhung des zirkulierenden Estradiols und
Testosterons. Der gesunde ältere Mensch wird vermutlich von einer solchen Behandlung
nicht profitieren. Der physiologische Alterungsprozess lässt sich durch eine DHEA-Substitution
im Sinne eines Anti-Agings nicht aufhalten.
Abstract
Dehydroepiandrosterone (DHEA) and its sulfate DHEAS are essential for the regulation
of steroidogenesis in the feto-placental unit and thereby guarantee uterine growth
during pregnancy. Furthermore DHEA seems to play a role as modulator for the onset
of puberty. In vitro data support the function of DHEA in the central nervous system:
it acts as a neurosteroid - modulating cognitive and emotional brain functions. With
increasing age decreasing blood levels of DHEA and DHEAS can be detected. However,
this seems to be a physiological phenomenon of aging. DHEA-replacement therapy results
in an increase of DHEA blood levels and - due to metabolic processes - in an increase
of estradiol and testosterone levels.
For healthy elder people DHEA replacement therapy is not supposed to have beneficial
effects. Certainly the physiological processes of human aging can not be stopped or
even slowed down by DHEAS-replacement.
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Prof. Dr. M. Breckwoldt
Hugstetter Straße 55
79106 Freiburg
