University of Florida, Department of Psychology, United States; University of Florida, Department of Psychiatry, United States.
University of Florida, Department of Psychology, United States.
Psychoneuroendocrinology. 2019 Feb;100:180-189. doi: 10.1016/j.psyneuen.2018.10.004. Epub 2018 Oct 9.
Treatment-seeking men with alcohol use disorder (AUD) classically exhibit a blunted hypothalamic-pituitary-adrenal (HPA) axis response to pharmacologic and behavioral provocations during the early phases of abstinence from alcohol. Independent of alcohol, a significant muting of HPA axis reactivity is also observed among racial minority (e.g. Black) individuals. The effect of AUD upon the altered HPA axis response of racial minority individuals has not been explored. The current work represents a secondary analysis of race and AUD status among a sample of men.
Healthy male controls (17 White, 7 Black) and four-to six-week abstinent men with AUD (49 White, 13 Black) were administered a psychosocial stressor and two pharmacologic probes [ovine corticotropin releasing hormone (oCRH) and cosyntropin] to assess HPA axis reactivity. Plasma cortisol and adrenocorticotropin hormone (ACTH) were assessed at 10-20 min intervals prior to and following behavioral and pharmacological stimulation. Basal and net-integrated responses following provocations were analyzed to identify potential group differences. A measure of childhood adversity was also obtained to consider the implications of prior stressors upon HPA axis function.
A three-fold increase in oCRH-induced ACTH was seen in Black men relative to White men regardless of AUD status. Adversity exerted a dampening effect on this pituitary sensitivity within Black controls only. Adjusted for adversity, a significant blunting effect of AUD status on ACTH reactivity was identified within White participants following oCRH. No group differences were present following cosyntropin administration. In response to the psychosocial stressor, White, but not Black, men with AUD experienced the expected blunting of cortisol reactivity relative to White controls. Rather, Black men with AUD exhibited greater cortisol reactivity relative to White men with AUD.
Differences in HPA axis reactivity associated with race were present in men with and without AUD. Explanatory biological mechanisms of the relationship between alcohol use and/or stress, in both healthy and unhealthy populations, may require a reassessment in different racial populations.
在酒精戒断的早期阶段，寻求治疗的酒精使用障碍（AUD）男性在接受药物和行为刺激时，典型地表现出下丘脑-垂体-肾上腺（HPA）轴反应迟钝。独立于酒精，在少数族裔（例如黑人）个体中也观察到 HPA 轴反应明显减弱。AUD 对少数族裔个体改变的 HPA 轴反应的影响尚未得到探索。目前的工作是对男性样本中种族和 AUD 状态的二次分析。
健康男性对照（17 名白人，7 名黑人）和四至六周酒精戒断的 AUD 男性（49 名白人，13 名黑人）接受心理社会应激和两种药物探针[羊促皮质素释放激素（oCRH）和促皮质素]以评估 HPA 轴反应。在行为和药物刺激前后 10-20 分钟间隔评估血浆皮质醇和促肾上腺皮质激素（ACTH）。分析激发前后的基础和净积分反应，以确定潜在的组间差异。还获得了童年逆境的衡量标准，以考虑先前的压力源对 HPA 轴功能的影响。
无论 AUD 状态如何，黑人男性的 oCRH 诱导的 ACTH 增加了三倍。在黑人对照组中，逆境对这种垂体敏感性产生了抑制作用。在调整了逆境因素后，在接受 oCRH 后，白人参与者的 ACTH 反应明显减弱。在接受 cosyntropin 后，没有组间差异。在心理社会应激下，与白人对照组相比，患有 AUD 的白人男性预期会出现皮质醇反应迟钝，但实际上，患有 AUD 的黑人男性表现出比白人男性更高的皮质醇反应。
在患有和不患有 AUD 的男性中，与种族相关的 HPA 轴反应存在差异。在健康和不健康人群中，酒精使用和/或应激之间关系的生物学解释机制可能需要在不同的种族群体中重新评估。
