Sapolsky R M
Department of Biological Sciences, Stanford University, CA 94305.
Arch Gen Psychiatry. 1989 Nov;46(11):1047-51. doi: 10.1001/archpsyc.1989.01810110089012.
Recent studies suggest that the hypercortisolism and dexamathasone resistance of depression arise, at least in part, at the level of the brain, ie, cortisol-releasing factor (CRF) and/or other corticotropin-secretagogues are hypersecreted. This article suggests a similar cause of the hypercortisolism of social subordinance. Two troops of wild olive baboons, living freely in the Serengeti Ecosystem of East Africa, have been under long-term study. Consistently, in stable dominance hierachies, subordinate males are hypercortisolemic relative to dominant animals. Furthermore, hypercortisolemic males are dexamethasone resistant. There are no rank-related difference in cortisol clearance or adrenal sensitivity to corticotropin, suggesting a pituitary and/or neural locus of the hypercortisolism. Subordinate males were shown to secrete less corticotropin in response to a CRF-challenge than did dominant males. Following the logic used in similar studies with depressives, if subordinate males were hypercortisolemic despite decreased pituitary sensitivity to CRF, then this implies that the hyperactivity of the adrenocortical axis is driven at the level of the brain. Furthermore, subordinate males were hyporesponsive to CRF after administration of metyrapone, which blocks cortisol secretion and disinhibits the pituitary from feedback inhibition. Thus, the pituitary appears to have lost sensitivity to CRF itself in these low-ranking males. These observations are interpreted in light of behavioral data suggesting that these subordinate males are under sustained social stress.
近期研究表明,抑郁症患者的皮质醇增多症和地塞米松抵抗至少部分源于大脑层面,即促肾上腺皮质激素释放因子(CRF)和/或其他促肾上腺皮质激素分泌因子分泌过多。本文提出社会从属地位导致的皮质醇增多症也有类似原因。对生活在东非塞伦盖蒂生态系统中自由活动的两群野生橄榄狒狒进行了长期研究。在稳定的优势等级制度中,从属雄性相对于优势动物而言,皮质醇水平一直较高。此外,皮质醇水平高的雄性对地塞米松有抵抗性。在皮质醇清除率或肾上腺对促肾上腺皮质激素的敏感性方面,不存在与等级相关的差异,这表明皮质醇增多症的发病部位在垂体和/或神经。研究表明,与优势雄性相比,从属雄性在CRF刺激下分泌的促肾上腺皮质激素较少。按照对抑郁症患者进行的类似研究中所使用的逻辑,如果从属雄性尽管垂体对CRF的敏感性降低但皮质醇水平仍较高,那么这意味着肾上腺皮质轴的亢进是由大脑层面驱动的。此外,给予美替拉酮(一种阻断皮质醇分泌并解除垂体反馈抑制的药物)后,从属雄性对CRF的反应减弱。因此,在这些地位较低的雄性中,垂体似乎对CRF本身失去了敏感性。这些观察结果结合行为数据进行了解释,这些数据表明这些从属雄性处于持续的社会压力之下。