Lawrence Stephanie, Scofield R Hal
Department of Veterans Affairs Medical Center, Oklahoma City, OK, 73104, USA.
University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA.
Brain Behav Immun Health. 2024 Aug 20;41:100849. doi: 10.1016/j.bbih.2024.100849. eCollection 2024 Nov.
Conventional human stress responses are mediated by the sympathetic adrenal medullar (SAM) axis and the hypothalamic pituitary adrenal (HPA) axis. The SAM axis mediates the immediate response to stress through norepinephrine and epinephrine while the HPA axis mediates the slow response through corticosteroids, primarily cortisol, to effect systemic changes. Post Traumatic Stress Disorder (PTSD), a psychiatric disorder that develops in a small subset of people exposed to a traumatic event, may dysregulate these systems and result in increased risk of various clinical conditions. These conditions include but are not limited to cardiovascular disease, metabolic conditions, autoimmune diseases, neurocognitive disorders, and women's health complications such as preterm birth, polycystic ovarian syndrome, and endometriosis to name a few. This review focuses on how PTSD dysregulates the HPA axis, and further, how these alterations affect the immune system and physical health outcomes.
传统的人类应激反应由交感肾上腺髓质（SAM）轴和下丘脑-垂体-肾上腺（HPA）轴介导。SAM轴通过去甲肾上腺素和肾上腺素介导对应激的即时反应，而HPA轴则通过皮质类固醇（主要是皮质醇）介导缓慢反应，以实现全身变化。创伤后应激障碍（PTSD）是一种在一小部分经历创伤事件的人群中发生的精神障碍，可能会使这些系统失调，并导致各种临床疾病的风险增加。这些疾病包括但不限于心血管疾病、代谢性疾病、自身免疫性疾病、神经认知障碍以及女性健康并发症，如早产、多囊卵巢综合征和子宫内膜异位症等。本综述重点关注PTSD如何使HPA轴失调，以及这些改变如何影响免疫系统和身体健康结果。
