Steroid effect on the release of the lysosomal enzyme acid phosphatase in shock.

The effect of corticosteroids on cellular resistance in shock was studied by serial measurement of the serum concentration of the lysosomal enzyme acid phosphatase in untreated and steroid dogs subjected to hemorrhagic, endotoxin and cardiogenic shock. In each shock category, elevation in serum acid phosphatase was significantly less in steroid treated dogs as compared to untreated animals at corresponding time intervals. This difference was most apparent in endotoxin shock, next in hemorrhagic shock and least in cardiogenic shock. Steroid treatment also reduced the serum lactate increment in hemorrhagic and cardiogenic shock and delayed or reduced the onset and severity of the occurring acidosis, an apparent reflection of the ability of steroids to promote increased tissue perfusion. In addition, steroid treatment increased or prolonged survival in all three shock groups. By showing that glucocorticoids affect a reduction in the release of the lysosomal enzyme acid phosphatase during shock, the study offers direct evidence that steroids enhance cellular resistance to shock stress in the dog. Whether this salutary effect is due solely to the ability of steroids to stabilize cellular membranes or is in part secondary to promoting improved tissue hemodynamics could not be established. The interpretation and clinical application of these results must take into account the possibility of a species specific response.