Dexamethasone is frequently administered to surgical patients for anti-emetic prophylaxis. We have examined the early in-vivo effects of dexamethasone (8 mg) to demonstrate the magnitude and temporal nature of immune-modulatory effects in circulating peripheral blood mononuclear cells in 10 healthy male volunteers. Blood samples were drawn at baseline, 2 h, 4 h and 24 h. Immune cell phenotypes were examined with flow cytometry, and we have already reported reductions in classical and intermediate monocytes and dendritic cells early after dexamethasone administration, followed by an increase in the level of these populations at 24 h. We also observed a profound reduction in the expression strength of the maturation marker, HLA-DR at 24 h in all monocyte subsets and dendritic cells. This study confirmed rapid transient effects of 8 mg dexamethasone on innate immune cells. We have now also evaluated the expression strength of additional markers involved in immune activation and immunosuppression as well as maturation, migration, cell death and responsiveness to signalling. Similar to the previously described surface markers, also these were profoundly affected by dexamethasone either at the early (2 h or 4 h) or later stage (24 h) after dexamethasone administration. Thereby these data improve our understanding of the immune-modulatory effects of the glucocorticoid dexamethasone in-vivo, which may be important for the optimisation of treatment regimens as well as the evaluation of new indications for glucocorticoid treatment.

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