Szczudlik A, Dziedzic T, Bartus S, Slowik A, Kieltyka A
Department of Neurology, Collegium Medicum, Jagiellonian University, Krakow, Poland.
J Endocrinol Invest. 2004 Jan;27(1):37-41. doi: 10.1007/BF03350908.
Altered hypothalamo-pituitary-adrenal axis was reported in stroke patients; however, mechanisms responsible for this phenomenon are barely understood. Acute cerebral ischemia triggers interleukin-6 (IL-6) release into blood. Circulating IL-6 can stimulate hypothalamo-pituitary-adrenal axis. The goal of our study was to assess a relationship between serum IL-6 and cortisol in acute ischemic stroke. Twenty two patients with ischemic stroke and 17 controls were included. Serum samples were collected on the 2nd day of stroke at 6:00, 10:00 18:00, 22:00 h and at the same time points in control group. Cytokines and cortisol levels were measured using ELISA method. Serum IL-6 and cortisol levels were higher in stroke patients than in controls. Cortisol displayed diurnal variations in both stroke patients and controls. In contrast with control subjects, serum IL-6 levels did not display diurnal variations in stroke patients. In stroke patients, but not in controls, IL-6 level correlated significantly with cortisol level and morning serum IL-6 level independently predicted evening/night cortisol level. In conclusion, brain ischemia could stimulate IL-6 release in blood and in this way modulate hypothalamo-pituitary-adrenal axis.
据报道，中风患者存在下丘脑 - 垂体 - 肾上腺轴改变的情况；然而，导致这种现象的机制却几乎不为人知。急性脑缺血会促使白细胞介素 - 6（IL - 6）释放到血液中。循环中的IL - 6能够刺激下丘脑 - 垂体 - 肾上腺轴。我们研究的目的是评估急性缺血性中风患者血清IL - 6与皮质醇之间的关系。研究纳入了22例缺血性中风患者和17名对照组人员。在中风第2天的6:00、10:00、18:00、22:00采集血清样本，对照组在相同时间点采集。采用酶联免疫吸附测定法（ELISA）检测细胞因子和皮质醇水平。中风患者血清IL - 6和皮质醇水平高于对照组。皮质醇在中风患者和对照组中均呈现昼夜变化。与对照组受试者不同，中风患者血清IL - 6水平未呈现昼夜变化。在中风患者中，而非对照组中，IL - 6水平与皮质醇水平显著相关，且早晨血清IL - 6水平可独立预测傍晚/夜间皮质醇水平。总之，脑缺血可刺激血液中IL - 6的释放，并以此方式调节下丘脑 - 垂体 - 肾上腺轴。
