Kronfol Z, Starkman M, Schteingart D E, Singh V, Zhang Q, Hill E
Department of Psychiatry, University of Michigan Medical Center, Ann Arbor 48109-0722, USA.
Psychoneuroendocrinology. 1996 Oct;21(7):599-608. doi: 10.1016/s0306-4530(96)00021-2.
Hormones of the hypothalamic-pituitary-adrenal (HPA) axis are connected closely with immune measures. To investigate whether Cushing's syndrome (CS) is associated with immune dysregulation, we compared the percentage of specific lymphocyte subsets as well as natural cell activity (NKCA) in 48 patients with Cushing's syndrome and 48 age- and sex-matched normal controls. Lymphocyte subset analysis included the percentage of lymphocytes expressing CD3 (total T), CD4 (T helper/inducer), CD8 (T suppressor/cytotoxic) and CD56 (NK cell) antigens. Baseline plasma concentrations of cortisol, ACTH and beta-endorphin as well as 24 h urinary-free cortisol (UFC) levels also were determined. Results indicated a decrease in the percentage of CD4+ cells (p < 0.05), an increase in percentage of CD8+ cells (p < 0.05), a decrease in CD4/CD8 ratios (p < 0.01), and a reduction in NKCA (p < 0.05) in patients with CS compared to matched controls. We also found significant negative correlations between NKCA on the one hand and 24 h UFC (p < 0.05) and plasma beta-endorphin (p < 0.05) on the other. These results indicate there is immune dysregulation in CS patients which can be explained in part by an increase in HPA-axis hormones.
下丘脑 - 垂体 - 肾上腺（HPA）轴的激素与免疫指标密切相关。为了研究库欣综合征（CS）是否与免疫失调有关，我们比较了48例库欣综合征患者和48例年龄及性别匹配的正常对照者的特定淋巴细胞亚群百分比以及自然细胞活性（NKCA）。淋巴细胞亚群分析包括表达CD3（总T细胞）、CD4（辅助性/诱导性T细胞）、CD8（抑制性/细胞毒性T细胞）和CD56（NK细胞）抗原的淋巴细胞百分比。还测定了皮质醇、促肾上腺皮质激素（ACTH）和β-内啡肽的基线血浆浓度以及24小时尿游离皮质醇（UFC）水平。结果表明，与匹配的对照组相比，CS患者的CD4 +细胞百分比降低（p < 0.05），CD8 +细胞百分比增加（p < 0.05），CD4/CD8比值降低（p < 0.01），NKCA降低（p < 0.05）。我们还发现，一方面NKCA与另一方面的24小时UFC（p < 0.05）和血浆β-内啡肽（p < 0.05）之间存在显著负相关。这些结果表明，CS患者存在免疫失调，这部分可以由HPA轴激素的增加来解释。
