Hypothalamic-Pituitary-Adrenal Axis Dysregulation in Women With Irritable Bowel Syndrome in Response to Acute Physical Stress
Hypothalamic-Pituitary-Adrenal Axis Dysregulation in Women With Irritable Bowel Syndrome in Response to Acute Physical Stress
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DOI：
10.1177/0193945909339320
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发表时间：
2009-11-01
影响因子：
1.8
通讯作者：
Sinha, Karabi
中科院分区：
文献类型：
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作者：
FitzGerald, Leah Z.;Kehoe, Priscilla;Sinha, Karabi
肠易激综合征（IBS）支持下丘脑-垂体-肾上腺（HPA）轴失调的概念。本研究通过评估中枢性和外周性HPA活动和情感测量，探讨了以腹泻为主的IBS女性腰穿刺（LP）急性生理应激对神经内分泌和心理的影响。从13名IBS女性和13名对照组中采集了基线、LP后立即和LP后1小时的血液样本。分析血浆促肾上腺皮质激素（ACTH）、皮质醇、肾上腺素和去甲肾上腺素水平。一个单一的测量脑脊液（CSF）浓度促肾上腺皮质激素释放因子（CRFCSF）和去甲肾上腺素CSF被注意。使用医院焦虑和抑郁量表（HADS）进行情感评估，对焦虑和抑郁进行评分；使用压力症状评分问卷（压力、焦虑、愤怒、觉醒）对急性情绪状态进行评分。IBS患者对LP表现出钝化的ACTH和皮质醇反应，以及提示慢性社会心理压力的情感反应，尽管两组之间没有观察到CRFCSF差异。
Irritable bowel syndrome (IBS) supports the concept of a dysregulated hypothalamic-pituitary-adrenal (HPA) axis. This study investigates the neuroendocrine and psychological responses to the acute physical stress of a lumbar puncture (LP) in women with diarrhea-predominant IBS by assessing central and peripheral HPA activity and affective measures. Blood samples have been collected at baseline and immediately post- and 1 hr following LP from 13 women with IBS and 13 controls. Plasma adrenocorticotropic hormone (ACTH), cortisol, epinephrine, and norepinephrine levels are analyzed. A single measure of cerebrospinal fluid (CSF) concentrations of corticotropin-releasing factor (CRFCSF) and norepinephrine CSF is noted. Affective assessments are used to rate anxiety and depression with the Hospital Anxiety and Depression Scale (HADS) and acute mood state is rated using the Stress Symptom Rating questionnaire (stress, anxiety, anger, arousal). The women with IBS display blunted ACTH and cortisol responses to the LP along with a profile of affective responsiveness suggestive of chronic psychosocial stress, although no CRFCSF differences between groups are observed.