Department of Psychiatry, Referral Centre for Stress-Related Disorders, University Hospital Dubrava, Zagreb, Croatia.
Neuroimmunomodulation. 2011;18(4):199-211. doi: 10.1159/000322869. Epub 2011 Feb 19.
It is assumed that stress-related changes in the endocrine and immune systems are key mediators involved in the development of diseases associated with posttraumatic stress disorder (PTSD). Evidence suggests that those changes might be related to the duration of PTSD. The aim of our study was to investigate the differences in selected endocrine- and immune-related variables between PTSD patients and control subjects, and whether these differences persist over time.
We assessed 39 Croatian war veterans with PTSD and 25 healthy volunteers (civilians without traumatic experience), all men, at two time points separated by 5.6 years (median; interquartile range: 5.4-6.3). Cortisol and prolactin levels were measured by radioimmunoassays while interleukin-6 and tumor necrosis factor-α were determined by enzyme-linked immunosorbent assays. Immune function was assessed by in vitro natural killer cell cytotoxicity (NKCC). Lymphocyte counts, immunophenotype and intracellular glucocorticoid receptor expression in various lymphocyte subsets were determined by three-color flow cytometry.
At the first assessment, moderate to large effect size estimates of differences between patients and controls were observed for most of the measured variables. Only prolactin levels and lymphocyte counts remained significantly elevated in PTSD patients at the second assessment with low to moderate effect size estimates of differences between patients and controls in other variables.
Observed endocrine- and immune-related changes in PTSD over time may depend on the duration of the allostatic load posed by the disorder and its impact on interactions between the endocrine and immune systems involved in stress response.
据认为，与压力相关的内分泌和免疫系统的变化是涉及创伤后应激障碍（PTSD）相关疾病发展的关键介质。有证据表明，这些变化可能与 PTSD 的持续时间有关。我们的研究旨在调查 PTSD 患者和对照组之间在选定的与内分泌和免疫相关的变量方面的差异，以及这些差异是否会随着时间的推移而持续存在。
我们在两个时间点评估了 39 名患有 PTSD 的克罗地亚退伍军人和 25 名健康志愿者（没有创伤经历的平民），所有参与者均为男性，两次评估的时间间隔为 5.6 年（中位数；四分位距：5.4-6.3）。通过放射免疫测定法测量皮质醇和催乳素水平，通过酶联免疫吸附测定法测定白细胞介素-6 和肿瘤坏死因子-α。通过体外自然杀伤细胞细胞毒性（NKCC）评估免疫功能。通过三色流式细胞术测定淋巴细胞计数、免疫表型和各种淋巴细胞亚群中的细胞内糖皮质激素受体表达。
在第一次评估中，与对照组相比，患者组大多数测量变量的差异具有中到大的效应大小估计值。只有催乳素水平和淋巴细胞计数在 PTSD 患者的第二次评估中仍显著升高，而其他变量的患者与对照组之间的差异具有低到中到大的效应大小估计值。
随着时间的推移，在 PTSD 中观察到的与内分泌和免疫相关的变化可能取决于该疾病造成的压力反应中涉及的内分泌和免疫系统相互作用的全身性负荷的持续时间及其影响。
