Goldstein David S, Kopin Irwin J
Clinical Neurocardiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892-1620, USA.
Endocr Regul. 2008 Sep;42(4):111-9.
Exposure to stressors alters activities of the adrenomedullary hormonal system (AHS), hypothalamic-pituitary-adrenocortical (HPA) axis, and sympathetic nervous system (SNS). Here we report results of a meta-analysis of the literature, examining inter-relationships among AHS, HPA, and SNS responses to stressors, as measured by plasma epinephrine (EPI), corticotrophin (ACTH), and norepinephrine (NE) levels.
The medical scientific literature was culled by PubMed searches, to retrieve publications describing original data about plasma EPI, ACTH, and NE levels measured before and during or after exposure to stressors. Magnitudes of responses were graded from a score of 0 for no response to 4 for a massive increase to >or=10 times the baseline value.
A total of 15 stressors were identified for which at least 2 publications reported data for EPI, ACTH, and NE responses. A total of 60 reports were included. Mean EPI responses were strongly positively correlated with mean ACTH responses (r=0.93) and less strongly with NE responses (r=0.40). Plasma EPI responses were disproportionately larger than NE responses during hypoglycemia and smaller than NE responses during cold exposure without hypothermia, orthostasis, and active escape/avoidance. Plasma NE responses were disproportionately larger than ACTH responses during cold exposure without hypothermia and severe/exhausting exercise and smaller than ACTH responses during hypoglycemia.
The results of this meta-analysis indicate a close association between adrenomedullary and hypothalamic-pituitary-adrenocortical responses across a variety of stressors. This association seems to be if anything stronger than that between adrenomedullary and sympathetic noradrenergic responses.
暴露于应激源会改变肾上腺髓质激素系统（AHS）、下丘脑 - 垂体 - 肾上腺皮质（HPA）轴及交感神经系统（SNS）的活动。在此，我们报告一项文献荟萃分析的结果，该分析考察了通过血浆肾上腺素（EPI）、促肾上腺皮质激素（ACTH）和去甲肾上腺素（NE）水平所衡量的AHS、HPA和SNS对应激源反应之间的相互关系。
通过PubMed检索筛选医学科学文献，以获取描述在暴露于应激源之前、期间或之后所测量的血浆EPI、ACTH和NE水平原始数据的出版物。反应程度从无反应的0分至大幅增加至基线值≥10倍的4分进行分级。
共确定了15种应激源，针对这些应激源至少有2篇出版物报告了EPI、ACTH和NE反应的数据。总共纳入了60篇报告。平均EPI反应与平均ACTH反应呈强正相关（r = 0.93），与NE反应的相关性较弱（r = 0.40）。在低血糖期间，血浆EPI反应比NE反应大得不成比例，而在无体温过低、直立位及主动逃避/回避的冷暴露期间，血浆EPI反应比NE反应小。在无体温过低的冷暴露和剧烈/高强度运动期间，血浆NE反应比ACTH反应大得不成比例，而在低血糖期间则比ACTH反应小。
这项荟萃分析的结果表明，在各种应激源下，肾上腺髓质和下丘脑 - 垂体 - 肾上腺皮质反应之间存在密切关联。这种关联似乎比肾上腺髓质与交感去甲肾上腺素能反应之间的关联更强。
