压力与精神疾病中的内分泌因素:聚焦焦虑与唾液类固醇
Endocrine factors in stress and psychiatric disorders: focus on anxiety and salivary steroids.
作者信息
Jezova Daniela, Hlavacova Natasa
机构信息
Institute of Experimental Endocrinology, Laboratory of Pharmacological Neuroendocrinology, Slovak Academy of Sciences, Bratislava, Slovakia.
出版信息
Ann N Y Acad Sci. 2008 Dec;1148:495-503. doi: 10.1196/annals.1410.050.
Glucocorticoids and other steroids produced in the adrenal cortex are altered in chronic stress situations associated with enhanced anxiety. A useful tool to evaluate changes in adrenal steroids during stress and anxiety under both laboratory and real-life stress situations is determination of steroids in saliva. The main advantages of this technique are its noninvasiveness and its measurement of biologically active free hormone levels. Salivary cortisol is a valuable indicator of the activity of the hypothalamic-pituitary-adrenocortical axis, which is known to be altered in psychiatric disorders. Measurements of salivary cortisol helped to reveal changes that would otherwise remained undetected, such as increase in cortisol release in spontaneously occurring panic attacks. By selecting only the subjects with high and low trait anxiety, we have brought evidence confirmed by others that high trait anxiety may be associated with an inability to respond with adequate cortisol release during stress. Papers on the relationship between salivary dehydroepiandrosterone and trait anxiety or anxiety disorders are rare, and this stress hormone deserves more attention. Almost nothing is known on aldosterone and anxiety. We have modified the methodology of aldosterone radioimmunoassay by concentrating the saliva and validated it biologically by demonstrating daily variation and gender differences. We have provided the first data on the relationship between aldosterone and trait anxiety. Obtained results show a significant negative correlation between morning salivary aldosterone concentrations and trait anxiety scores in women (luteal phase), but not in men. A more proper elucidation of the association between aldosterone and anxiety seems to be an important target of further research.
在与焦虑加剧相关的慢性应激情况下,肾上腺皮质产生的糖皮质激素和其他类固醇会发生变化。在实验室和现实生活应激情况下,评估应激和焦虑期间肾上腺类固醇变化的一个有用工具是测定唾液中的类固醇。该技术的主要优点是其非侵入性以及对生物活性游离激素水平的测量。唾液皮质醇是下丘脑-垂体-肾上腺皮质轴活动的重要指标,已知该轴在精神疾病中会发生改变。唾液皮质醇的测量有助于揭示那些否则可能仍未被发现的变化,例如在自发性惊恐发作中皮质醇释放增加。通过仅选择特质焦虑高和低的受试者,我们提供了其他人也证实的证据,即高特质焦虑可能与应激期间无法以适当的皮质醇释放做出反应有关。关于唾液脱氢表雄酮与特质焦虑或焦虑症之间关系的论文很少,这种应激激素值得更多关注。关于醛固酮与焦虑的关系几乎一无所知。我们通过浓缩唾液改进了醛固酮放射免疫测定方法,并通过证明每日变化和性别差异对其进行了生物学验证。我们提供了关于醛固酮与特质焦虑之间关系的首批数据。获得的结果显示,女性(黄体期)早晨唾液醛固酮浓度与特质焦虑评分之间存在显著负相关,而男性则不存在。对醛固酮与焦虑之间关联的更恰当阐释似乎是进一步研究的一个重要目标。