Rupprecht M, Salzer B, Raum B, Hornstein O P, Koch H U, Riederer P, Sofic E, Rupprecht R
Department of Dermatology, University of Erlangen-Nürnberg, Germany.
Exp Clin Endocrinol Diabetes. 1997;105(1):39-45. doi: 10.1055/s-0029-1211725.
Atopic eczema is a chronic inflammatory skin disease which shares some psychological and neuroendocrine disturbances with patients suffering from depression. In view of recent findings of an attenuated response of the hypothalamic-pituitary-adrenal (HPA) system in patients with atopic eczema during a human corticotropin-releasing hormone (hCRH) challenge paradigm fourteen consecutive non-specifically trained in-patients with atopic eczema (8 men, 6 women) and an age-matched control group (8 men, 6 women) performed exhausting incremental graded bicycle exercise to evaluate cortisol, adrenocorticotropin (ACTH), beta-endorphin, epinephrine and norepinephrine releases induced by physical stress. The exercise yielded significant increases in cortisol, ACTH, beta-endorphin, epinephrine and norepinephrine concentrations in both groups. Patients with severe eczema displayed a significantly lower increase in norepinephrine levels when compared with the less affected patient group. In contrast to the challenge with exogenous hCRH no substantial difference in the net responses of ACTH and cortisol could be detected between patients with atopic eczema and controls using the physical stress paradigm. These substantial differences in the net outcome between both challenges may be related to the potential synergizing effects of various neuropeptides, e.g. CRH and vasopressin, when activating the HPA system by challenges at a suprapituitary site which may override subtle disturbances in the responsivity of the HPA system as revealed by CRH challenge alone in patients with atopic eczema.
特应性皮炎是一种慢性炎症性皮肤病，与抑郁症患者存在一些心理和神经内分泌紊乱。鉴于最近的研究发现，在人类促肾上腺皮质激素释放激素（hCRH）激发试验中，特应性皮炎患者的下丘脑-垂体-肾上腺（HPA）系统反应减弱。对14名未经专门训练的特应性皮炎住院患者（8名男性，6名女性）和一个年龄匹配的对照组（8名男性，6名女性）进行了连续递增的分级自行车运动，以评估身体应激诱导的皮质醇、促肾上腺皮质激素（ACTH）、β-内啡肽、肾上腺素和去甲肾上腺素的释放。运动使两组的皮质醇、ACTH、β-内啡肽、肾上腺素和去甲肾上腺素浓度均显著升高。与病情较轻的患者组相比，重度湿疹患者的去甲肾上腺素水平升高明显较低。与外源性hCRH激发试验不同，在使用身体应激试验时，特应性皮炎患者和对照组在ACTH和皮质醇的净反应方面未检测到实质性差异。两种激发试验结果的这些实质性差异可能与各种神经肽（如CRH和加压素）在垂体上部位激发激活HPA系统时的潜在协同作用有关，这种协同作用可能会掩盖特应性皮炎患者单独通过CRH激发试验所揭示的HPA系统反应性的细微紊乱。
