Androstenediol Stimulates Myelopoiesis and Enhances Resistance to Infection in Gamma-Irradiated Mice Mark H
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International Journal of Immunopharmacology 22 (2000) 1±14 www.elsevier.com/locate/ijimmpharm Androstenediol stimulates myelopoiesis and enhances resistance to infection in gamma-irradiated mice Mark H. Whitnall a,*, Thomas B. Elliott a, Rita A. Harding a, Cynthia E. Inal a, Michael R. Landauer a, Catherine L. Wilhelmsen a, LuAnn McKinney a, Venita L. Miner a, William E. Jackson III a, Roger M. Loria b, G. David Ledney a, Thomas M. Seed a aRadiation Casualty Management Team, Armed Forces Radiobiology Research Institute, Bethesda, MD 20889, USA bVirginia Commonwealth University's Medical College of Virginia, Richmond, VA 23298, USA Abstract The ionizing radiation-induced hemopoietic syndrome is characterized by defects in immune function and increased mortality due to infections and hemorrhage. Since the steroid 5-androstene-3b,17b-diol (5-androstenediol, AED) modulates cytokine expression and increases resistance to bacterial and viral infections in rodents, we tested its ability to promote survival after whole-body ionizing radiation in mice. In unirradiated female B6D2F1 mice, sc AED elevated numbers of circulating neutrophils and platelets and induced proliferation of neutrophil progenitors in bone marrow. In mice exposed to whole-body 60Co gamma-radiation (3 Gy), AED injected 1 h later ameliorated radiation-induced decreases in circulating neutrophils and platelets and marrow granulocyte-macrophage colony- forming cells, but had no eect on total numbers of circulating lymphocytes or erythrocytes. In mice irradiated (0, 1 or 3 Gy) and inoculated four days later with Klebsiella pneumoniae, AED injected 2 h after irradiation enhanced 30- d survival. Injecting AED 24 h before irradiation or 2 h after irradiation increased survival to approximately the same extent. In K. pneumoniae-inoculated mice (irradiated at 3±7 Gy) and uninoculated mice (irradiated at 8±12 Gy), AED (160 mg/kg) injected 24 h before irradiation signi®cantly promoted survival with dose reduction factors (DRFs) of 1.18 and 1.26, respectively. 5-Androstene-3b-ol-17-one (dehydroepiandrosterone, DHEA) was markedly less ecacious than AED in augmenting survival, indicating speci®city. These results demonstrate for the ®rst time that a DHEA-related steroid stimulates myelopoiesis, and ameliorates neutropenia and thrombocytopenia and enhances resistance to infection after exposure of animals to ionizing radiation. # 2000 International Society for Immunopharmacology. Published by Elsevier Science Ltd. All rights reserved. * Corresponding author. Tel.: +1-301-295-9262; fax: +1- 707-922-0011. E-mail address: [email protected] (M.H. Whit- nall). 0192-0561/00/$20.00 # 2000 International Society for Immunopharmacology. Published by Elsevier Science Ltd. All rights reserved. PII: S0192-0561(99)00059-4 2 M.H. Whitnall et al. / International Journal of Immunopharmacology 22 (2000) 1±14 Keywords: Androst-5-ene-3 beta, 17 beta-diol; Prasterone; Hematopoiesis; Neutropenia; Experimental radiation injuries; Ionizing radiation; Gram-negative bacterial infections; Klebsiella pneumoniae 1. Introduction countermeasure to promote survival during the early phase of the hemopoietic syndrome are to Acute exposure to elevated doses of ionizing increase production of neutrophils and platelets radiation causes defects in hemopoiesis, resulting [32]. Very little is known about the eects of this in low numbers of circulating blood cells and pla- family of steroids on myelopoiesis and thrombo- telets and increased susceptibility to infection and cytopoiesis. One report indicated a slight inhibi- hemorrhage [1±3]. Past eorts to stimulate hemo- tory eect of 7±10 days of dietary DHEA poiesis in myelosuppressed animals have involved administration on granulopoiesis in irradiated administration of components of microbial cell mice [38]. AED increased formation of granulo- walls or their synthetic analogs [4±8], and natural mas during infection with Mycobacterium tuber- factors such as cytokines, prostaglandins, and culosis in mice [27]. In view of the ecacy of peptides or their synthetic analogs [9±12]. It AED and DHEA in promoting resistance to would be advantageous to develop a small-mol- infection in unirradiated animals, the limited in- ecule, nontoxic pharmacological agent that formation available on the eects of these ster- would ameliorate hemopoietic radiation injury. oids on myelopoiesis and thrombocytopoiesis, From the point of view of low toxicity, ease of and their modulation of expression of cytokines storage and administration, steroids would make known to be radioprotective, we tested their abil- attractive candidates. ity to enhance survival and reduce hemopoietic Administration of the adrenocortical steroid 5- injury after whole-body irradiation in mice. androstene-3b-ol-17-one (dehydroepiandroster- one, DHEA) or its metabolite 5-androstene- 3b,17b-diol (5-androstenediol, AED) to rodents 2. Experimental procedures results in increased immunocompetence and greater survival during infection [13±23]. AED is 2.1. Mice more potent than DHEA in promoting survival during bacterial or viral infection in rodents All studies were carried out in accordance with [14,15]. The DHEA-related steroids preserve the principles and procedures of the National immunocompetence after thermal injury [17] and Research Council Guide for the Care and Use of during aging [24]. They also modulate expression Laboratory Animals [71]. B6D2F1/J female mice of cytokines such as interleukin-1 (IL-1), IL-3, (Jackson Laboratory, Bar Harbor, ME), 18±24 IL-6, tumor necrosis factor (TNF) and inter- weeks of age, 22±30 g body weight, were held in feron-gamma (IFNg) [17,22,25±34]. These cyto- quarantine for two weeks. Mice were chosen for kines are known to aect recovery from these studies because of the similar responses of radiation-induced hemopoietic injury [32±34]. murine and human hemopoiesis to drugs and One report indicated small radioprotective or toxic insults [39]. Up to 10 mice were housed in radiosensitizing eects of ip DHEA pretreat- sanitized 46 24 15 cm polycarbonate boxes ments, depending on the interval between treat- with ®lter covers  (MicroIsolator; Lab Products, ment and irradiation [35]. Inc, Maywood, NJ) on autoclaved hardwood Although the DHEA-related steroids can chip bedding in a facility accredited by the As- stimulate proliferation or activation of lympho- sociation for Assessment and Accreditation of cytes, natural killer cells and macrophages Laboratory Animal Care International. Mice [16,20,22,24,31,36,37], the primary goals of a were given feed and acidi®ed (pH 2.5) water M.H. Whitnall et al. / International Journal of Immunopharmacology 22 (2000) 1±14 3 freely. The animal holding room was maintained 548 EtOH) and DHEA (melting point 149± À with conditioned fresh air that was changed at 1518C, rotation +138 EtOH) were purchased least 10 times per h at approximately 218C and from Steraloids (Wilton, NH). PEG-400 was 508 (210%) relative humidity and with a 12-h obtained from Sigma (St Louis, MO). PEG-400 light/dark full spectrum lighting cycle. All has been recommended as a nontoxic vehicle for research was approved by the Institutional Ani- administration of steroids, based on histopatho- mal Care and Use Committee of the Armed logical analysis of sc injection sites [42]. Forces Radiobiology Research Institute (AFRRI). 2.4. Peripheral blood element counts 2.2. Irradiation Blood (0.6±1.0 ml) was obtained from halothane-anesthetized mice by cardiac puncture Mice were placed in ventilated Plexiglas con- using a heparinized syringe attached to a 21- tainers and exposed bilaterally to gamma-radi- gauge needle. Blood was collected in EDTA-con- ation from the AFRRI 60Co source as described taining sample tubes. Mice were euthanized by previously [40]. Exposure time was adjusted so cervical dislocation after blood collection. White that each animal received a midline tissue- blood cell (WBC), red blood cell (RBC) and pla- absorbed dose of 1±12 Gy at a nominal dose rate telet (PLT) counts were performed using a of 0.4 Gy/min at ambient temperature. Using a Hematology System 9000 (Biochem Immunosys- standardized technique, the midline dose rate was tems). Wright-stained blood smears from the measured by placing a 0.5 cc tissue-equivalent same samples were made for dierential counts ionization chamber at the center of a 2.5-cm di- of neutrophils and lymphocytes by light mi- ameter cylindrical acrylic mouse phantom. The croscopy. calibration factor for the ionization chamber was calculated by means of a standard obtained from 2.5. Granulocyte-macrophage colony-forming cell an Accredited Dosimetry Calibration Laboratory (GM-CFC) assay (M.D. Anderson Cancer Center, Houston, TX) certi®ed by the National Institute of Standards Hemopoietic progenitor cells committed to and Technology. The tissue±air ratio, de®ned as granulocyte-macrophage dierentiation (GM- the ratio of the dose rate measured in the phan- CFC) were assayed by a single-layer modi®cation tom to the dose rate in free air, for this array of a double-layer semisolid agar technique was 0.96. Variation within the exposure ®eld was described by Patchen et al. [6]. Brie¯y, femoral less than 4% (unpublished results). Dosimetric marrow was extracted and cell suspensions were measurements were made in accordance with the prepared by ¯ushing with 3 ml of McCoy's 5A American Association of Physicists in Medicine medium containing 10% heat-inactivated fetal protocol for the determination of absorbed dose bovine serum (HIFBS; Hyclone, Logan,