Altemus M, Dale J K, Michelson D, Demitrack M A, Gold P W, Straus S E
Weill Medical College, Cornell University, Box 244, 1300 York Avenue, New York, NY 10021, USA.
Psychoneuroendocrinology. 2001 Feb;26(2):175-88. doi: 10.1016/s0306-4530(00)00044-5.
Several neuroendocrine studies have suggested hypoactivation of the hypothalamic-pituitary-adrenal axis in chronic fatigue syndrome. One possible determinant of this neuroendocrine abnormality, as well as the primary symptom of fatigue, is reduced hypothalamic secretion of corticotropin-releasing hormone (CRH). Because CRH and vasopressin secreted from the hypothalamus act synergistically at the pituitary to activate ACTH secretion, the ACTH response to peripheral infusion of vasopressin can provide an indirect measure of hypothalamic CRH secretion. We measured the ACTH and cortisol response to a one hour infusion of arginine vasopressin in 19 patients with chronic fatigue syndrome and 19 age and sex matched healthy volunteers. Patients with chronic fatigue syndrome had a reduced ACTH response to the vasopressin infusion and a more rapid cortisol response to the infusion. These results provide further evidence of reduced hypothalamic CRH secretion in patients with chronic fatigue syndrome.
多项神经内分泌研究表明，慢性疲劳综合征患者存在下丘脑 - 垂体 - 肾上腺轴功能减退。这种神经内分泌异常以及疲劳这一主要症状的一个可能决定因素是下丘脑促肾上腺皮质激素释放激素（CRH）分泌减少。由于下丘脑分泌的CRH和血管加压素在垂体协同作用以激活促肾上腺皮质激素（ACTH）分泌，ACTH对血管加压素外周输注的反应可间接衡量下丘脑CRH的分泌。我们测量了19例慢性疲劳综合征患者以及19名年龄和性别匹配的健康志愿者对1小时精氨酸血管加压素输注的ACTH和皮质醇反应。慢性疲劳综合征患者对血管加压素输注的ACTH反应降低，对输注的皮质醇反应更快。这些结果为慢性疲劳综合征患者下丘脑CRH分泌减少提供了进一步证据。
