Karanikas Evangelos, Harsoulis Faidon, Giouzepas Ioannis, Griveas Ioannis, Chrisomallis Fotios
Department of Dermatology, Medical School of the Aristotelian University of Thessaloniki, Thessaloniki, Greece.
J Dermatol. 2009 Jan;36(1):35-44. doi: 10.1111/j.1346-8138.2008.00583.x.
Psoriasis constitutes one of the most representative examples of psychosomatic disorders. The published work investigating the psychological parameters and the way they interact during the course of the disease is extensive, whereas only a few studies have focused on the neuroendocrine framework of psoriasis. In the present study, the objective was to investigate the neuroendocrine parameters of psoriasis and the way they interact with psychopathological and immune variables. Patients with psoriasis (n=24) and the same number of matched healthy controls underwent psychiatric evaluation with interviews and psychometric questionnaires. Both of the groups underwent the corticotropin-releasing hormone (CRH) test and the dexamethasone suppression test (DST) to investigate functional parameters of the hypothalamus-pituitary-adrenal (HPA) axis. The evaluation of immune variables included the estimation of the distribution of T-cell and natural killer lymphocytes. Levels of depressive and anxiety features were increased within subjects with psoriasis and they were significantly correlated with stressful life events and the extent of the disease. The adrenocorticotrophic hormone and cortisol levels increased after CRH infusion without significant differences between the two groups and the psoriatic subjects' cortisol suppression after DST was within normal range, though relatively blunted. No significant correlations were identified among neuroendocrine, psychopathological and immune parameters. No particular neuroendocrine profile has been identified among psoriatic patients and the hypothesized interaction with psychopathological and immune parameters was not replicated. Nevertheless, it is still premature to exclude the possibility that a subtle latent alteration of the HPA axis function might exist, in psoriasis, either stemming from the psychopathology or from the disease per se.
银屑病是心身疾病最具代表性的例子之一。已发表的研究心理参数及其在疾病过程中相互作用方式的著作很多，而只有少数研究关注银屑病的神经内分泌框架。在本研究中，目的是调查银屑病的神经内分泌参数及其与精神病理学和免疫变量的相互作用方式。银屑病患者（n = 24）和相同数量的匹配健康对照者接受了访谈和心理测量问卷的精神科评估。两组均接受促肾上腺皮质激素释放激素（CRH）试验和地塞米松抑制试验（DST），以研究下丘脑 - 垂体 - 肾上腺（HPA）轴的功能参数。免疫变量的评估包括T细胞和自然杀伤淋巴细胞分布的估计。银屑病患者的抑郁和焦虑特征水平升高，且与应激性生活事件和疾病程度显著相关。CRH输注后促肾上腺皮质激素和皮质醇水平升高，两组之间无显著差异，银屑病患者DST后皮质醇抑制在正常范围内，尽管相对减弱。在神经内分泌、精神病理学和免疫参数之间未发现显著相关性。在银屑病患者中未发现特定的神经内分泌特征，且与精神病理学和免疫参数的假设相互作用未得到证实。然而，排除银屑病中可能存在HPA轴功能细微潜在改变的可能性仍为时过早，这种改变可能源于精神病理学或疾病本身。
