@article{24dc70eb91da484fad0933731a11b331,
title = "Low levels of endogenous anabolic androgenic steroids in females with severe asthma taking corticosteroids",
abstract = "Rationale Patients with severe asthma are dependent upon treatment with high doses of inhaled corticosteroids (ICS) and often also oral corticosteroids (OCS). The extent of endogenous androgenic anabolic steroid (EAAS) suppression in asthma has not previously been described in detail. The objective of the present study was to measure urinary concentrations of EAAS in relation to exogenous corticosteroid exposure. Methods Urine collected at baseline in the U-BIOPRED (Unbiased Biomarkers for the Prediction of Respiratory Disease outcomes) study of severe adult asthmatics (SA, n=408) was analysed by quantitative mass spectrometry. Data were compared to that of mild-to-moderate asthmatics (MMA, n=70) and healthy subjects (HC, n=98) from the same study. Measurements and main results The concentrations of urinary endogenous steroid metabolites were substantially lower in SA than in MMA or HC. These differences were more pronounced in SA patients with detectable urinary OCS metabolites. Their dehydroepiandrosterone sulfate (DHEA-S) concentrations were <5% of those in HC, and cortisol concentrations were below the detection limit in 75% of females and 82% of males. The concentrations of EAAS in OCS-positive patients, as well as patients on high-dose ICS only, were more suppressed in females than males (p<0.05). Low levels of DHEA were associated with features of more severe disease and were more prevalent in females (p<0.05). The association between low EAAS and corticosteroid treatment was replicated in 289 of the SA patients at follow-up after 12–18 months. Conclusion The pronounced suppression of endogenous anabolic androgens in females might contribute to sex differences regarding the prevalence of severe asthma.",
author = "Valentyna Yasinska and Cristina G{\'o}mez and Johan Kolmert and Magnus Ericsson and Anton Pohanka and Anna James and Andersson, {Lars I.} and Maria Sparreman-Mikus and Sousa, {Ana R.} and Riley, {John H.} and Stewart Bates and Bakke, {Per S.} and Kermani, {Nazanin Zounemat} and Massimo Caruso and Pascal Chanez and Fowler, {Stephen J.} and Thomas Geiser and Howarth, {Peter H.} and Ildik{\'o} Horv{\'a}th and Norbert Krug and Paolo Montuschi and Marek Sanak and Annelie Behndig and Shaw, {Dominick E.} and Knowles, {Richard G.} and Barbro Dahl{\'e}n and {van der Zee}, {Anke-Hilse Maitland} and Sterk, {Peter J.} and Ratko Djukanovic and Adcock, {Ian M.} and Chung, {Kian Fan} and Wheelock, {Craig E.} and Sven-Erik Dahl{\'e}n and Jonsson, {Eva Wikstr{\"o}m}",
note = "Funding Information: Support statement: The U-BIOPRED study has received infrastructure and operational funding from the Innovative Medicines Initiative (www.imi.europa.eu) joint undertaking under grant agreement 115010, resources which are composed of financial contributions from the European Union{\textquoteright}s Seventh Framework Programme (FP7/2007–2013) and the European Federation of Pharmaceutical Industries and Associations. The partners have provided matching funding to enable studies utilising the data and bioresources collected in the study. For this report, funding to Karolinska Institutet from the following sources have been instrumental: the Swedish Heart–Lung Foundation; the Swedish Research Council; the Stockholm Region County Council funds (ALF); CIMED; the Konsul Th.C. Bergh Research Foundation; the ChAMP (Centre for Allergy Research Highlights Asthma Markers of Phenotype) consortium, which is funded by the Swedish Foundation for Strategic Research; the Karolinska Institutet; the AstraZeneca & Science for Life Laboratory Joint Research Collaboration; and the V{\aa}rdal Foundation. A. James was supported by the Osher Initiative for Severe Asthma Research. C.E. Wheelock was supported by the Swedish Heart–Lung Foundation (HLF 20210519). Funding information for this article has been deposited with the Crossref Funder Registry. Publisher Copyright: {\textcopyright} The authors 2023.",
year = "2023",
month = sep,
day = "1",
doi = "https://doi.org/10.1183/23120541.00269-2023",
language = "English",
volume = "9",
journal = "ERJ open research",
issn = "2312-0541",
publisher = "BMJ Publishing Group",
number = "5",
}