Does abuse of anabolic steroids imply decreased immunity, ie increased susceptibility (sensitivity)

Fråga: Does abuse of anabolic steroids imply decreased immunity, ie increased susceptibility (sensitivity) to infections?

Sammanfattning: At present, it is not clear to what degree anabolic steroid abuse may contribute to increased susceptibility to infections. However, there is both clinical and experimental evidence suggesting that gonadal steroid hormones influence immune functions. Thus, it cannot be excluded that the use of high, superphysiological doses of anabolic steroid abuse might alter immunological responses but positive evidence is lacking.

Svar: Though it is well established that sex hormones have potent influences on immune reactivity, relatively little is known regarding the direct effect of testosterone and its derivatives on the human immune response (1-4). In a comparative study in 13 competitive bodybuilders self-administrating anabolic-androgenic steroids and 10 bodybuilders not administrating these drugs (5), it was found that anabolic steroid users had lower levels of IgG, IgM and IgA than controls. The IgA levels in 4 of 13 anabolic steroid users fell below the lower limit of the normal range. No significant differences were seen for lymphocyte subpopulations and lymphocyte proliferative ability to the mitogens PHA, PWM except that responses to Con-A were higher in non-steroid users than in steroid users and responses to SAC were higher in steroid users than in non-steroid users. There was also a significant higher natural killer activity in steroid users than controls. The authors did not find any dose-response relationships between the immunological abnormalities and the total anabolic-androgenic steroids dose utilized.

They suggested that, though there was no sign of any form of infection from the history and physical examinations, reduced serum immunoglobulins could lead to reduced resistance to infection.

Only two brief clinical reports and a letter related to anabolic steroid abuse and possible predisposition to infections have been found in the literature. In the brief clinical reports (6,7), three cases of mycobacterial skin infections caused by anabolic steroid injection were reported. The pathogen has been frequently reported to produce skin infections in immunocompetent hosts or systemic disease in the immunocompromised, so it may infer that these two patients might have been in the immunosuppressive condition caused by anabolic steroids abuse. In the letter (8), a case of candida albicans endophthalmitis after anabolic steroid abuse was reported. Usually, in patients with candida endophthalmitis predisposing factors include immunocompromised states, immunosuppressive drugs, and intravenous drug abuse. It was suggested that anabolic steroid abuse might predispose to fungal infections by inducing immunological abnormalities in the host.