Infusion of epinephrine decreases serum levels of cortisol and 17-hydroxyprogesterone in patients with rheumatoid arthritis

被引:0
作者
Straub, RH [1 ]
Kittner, JM
Heijnen, C
Schedlowski, M
Schmidt, RE
Jacobs, R
机构
[1] Univ Regensburg, Ctr Med, Dept Internal Med 1, Lab Neuroendocrinoimmunol, D-93042 Regensburg, Germany
[2] Hannover Med Sch, Dept Clin Immunol, D-3000 Hannover, Germany
[3] Univ Essen Gesamthsch, Inst Med Psychol, Essen, Germany
[4] Univ Utrecht, Ctr Med, Wilhelmina Childrens Hosp, Dept Pediat Immunol, Utrecht, Netherlands
关键词
rheumatoid arthritis; cortisol; epinephrine infusion; adrenocorticotropic hormone; DHEAS; 17-hydroxyprogesterone;
D O I
暂无
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective. To investigate the pituitary and adrenal hormone response after an intravenous epinephrine challenge in patients with rheumatoid arthritis (RA) and controls. Methods. Fifteen untreated female patients with RA (age 51.5 +/- 3.2 yrs) and 7 healthy female controls (48.0 +/- 4.3 yrs) were infused with epinephrine (0.05 mug/kg/min) for about 20 min. Plasma levels of adrenocorticotropic hormone (ACTH), and serum levels of cortisol, 17-hydroxyprogesterone (17OHP), and dehydroepiandrosterone sulfate (DHEAS) were analyzed at baseline and shortly after cessation of epinephrine infusion (20 min). Results. At baseline and after epinephrine infusion, serum levels of cortisol (p = 0.045) and 170HP (p = 0.021) were higher in controls compared to patients with RA. In contrast, at baseline and after epinephrine infusion, plasma levels of ACTH and serum levels of DHEAS were similar in controls and patients. After epinephrine infusion, only the patients with RA had a significant decrease of serum cortisol (p = 0.026) and serum 17OHP (p = 0.026). Plasma levels of ACTH (p = 0.073) and serum levels of DHEAS (p = 0.055) tended to decrease. Conclusion. Serum cortisol and 17OHP (cortisol precursor) were lower in patients with RA compared to controls despite similar ACTH levels. Simulation of an adrenomedullary stress response by epinephrine infusion decreased serum cortisol and 17OHP in patients but not in controls. Such a response may play an unfavorable role during a typical stress reaction in patients with RA that may lead to a more proinflammatory situation.
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页码:1659 / 1664
页数:6
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