Rohleder Nicolas, Joksimovic Ljiljana, Wolf Jutta M, Kirschbaum Clemens
Department of Psychology, Institute of Experimental Psychology II, University of Düsseldorf, Düsseldorf, Germany.
Biol Psychiatry. 2004 Apr 1;55(7):745-51. doi: 10.1016/j.biopsych.2003.11.018.
Posttraumatic stress disorder (PTSD) is associated with dysregulation of the hypothalamus pituitary adrenal (HPA) axis. Alterations include various responses to HPA axis stimulation, different basal hormone levels, and changes in glucocorticoid receptor (GR) numbers on lymphocytes. The functional significance of these latter changes remains elusive.
Twelve Bosnian war refugees with PTSD and 13 control subjects were studied. On 2 consecutive days, they collected saliva samples after awakening and at 11, 15, and 20 hours. Glucocorticoid (GC) sensitivity was measured by dexamethasone (DEX) inhibition of lipopolysaccharide (LPS)-induced interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) production in whole blood.
The PTSD patients showed no cortisol response after awakening and had lower daytime cortisol levels (F = 14.57, p <.001). Less DEX was required for cytokine suppression in PTSD patients (IL-6: t = -2.82, p =.01; TNF-alpha: t = 5.03, p <.001), reflecting higher GC sensitivity of pro-inflammatory cytokine production. The LPS-stimulated production of IL-6, but not TNF-alpha, was markedly increased in patients (IL-6: F = 10.01, p <.004; TNF-alpha: F =.89, p =.34).
In refugees with PTSD, hypocortisolism is associated with increased GC sensitivity of immunologic tissues. Whether this pattern reflects an adaptive mechanism and whether this is sufficient to protect from detrimental effects of low cortisol remains to be investigated.
创伤后应激障碍（PTSD）与下丘脑 - 垂体 - 肾上腺（HPA）轴功能失调有关。这些改变包括对HPA轴刺激的各种反应、不同的基础激素水平以及淋巴细胞上糖皮质激素受体（GR）数量的变化。后一种变化的功能意义仍不清楚。
对12名患有创伤后应激障碍的波斯尼亚战争难民和13名对照受试者进行了研究。在连续两天中，他们在醒来后以及11、15和20小时收集唾液样本。通过地塞米松（DEX）抑制全血中脂多糖（LPS）诱导的白细胞介素 - 6（IL - 6）和肿瘤坏死因子 - α（TNF - α）的产生来测量糖皮质激素（GC）敏感性。
创伤后应激障碍患者醒来后无皮质醇反应，且白天皮质醇水平较低（F = 14.57，p <.001）。创伤后应激障碍患者抑制细胞因子所需的地塞米松较少（IL - 6：t = -2.82，p =.01；TNF - α：t = 5.03，p <.001），这反映出促炎细胞因子产生对糖皮质激素的敏感性较高。患者中LPS刺激的IL - 6产生明显增加，但TNF - α未增加（IL - 6：F = 10.01，p <.004；TNF - α：F =.89，p =.34）。
在患有创伤后应激障碍的难民中，皮质醇过少与免疫组织对糖皮质激素的敏感性增加有关。这种模式是否反映了一种适应性机制，以及这是否足以保护免受低皮质醇的有害影响，仍有待研究。
