Hypothalamic-pituitary-adrenal axis function and the cellular immune response in former preterm children
Hypothalamic-pituitary-adrenal axis function and the cellular immune response in former preterm children
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DOI：
10.1210/jc.2006-2223
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发表时间：
2007-09-01
影响因子：
5.8
通讯作者：
Hellhammer, D. H.
中科院分区：
文献类型：
--
作者：
Buske-Kirschbaum, A.;Krieger, S.;Hellhammer, D. H.
目的：研究早产对下丘脑-垂体-肾上腺轴功能、心率反应和免疫功能的影响。研究对象：早产儿[8-14岁(n=18)]，性别和年龄匹配的足月儿对照组(n=18)，出生体重、胎龄、胎龄出生体重(SD单位)、实际体重、身高、设计和结果指标：受试者暴露在标准化的实验室应激源(“儿童社会压力测试”)中。在负荷试验前后每隔10分钟测定唾液中的皮质醇，并在负荷试验期间连续测量心率。另外还进行了唾液皮质醇的评估：1)在清醒后连续3天以及+10、+20和+30min(早晨皮质醇)；以及2)在0800、1400、1600和1900h(短日变化)。对7种召回抗原的迟发性超敏反应的测量[多重测试细胞介导的免疫(多重测试免疫，Biosyn，费尔巴赫，德国)]。结果：暴露于Trier社会应激测试的儿童皮质醇水平显著增加[F(8,232)=19.86；P<；0.001]和心率[F(38,988)=10.46；P<；0.001]，但未观察到早产和足月之间的差异。在短日变化的皮质醇分布中，组间没有发现差异。早产儿醒后皮质醇水平显著高于早产儿[F(3,102)=3.14；P<；0.05]。此外，早产儿的迟发型超敏反应明显受到抑制[阳性抗原数量减少(t=-2.64，P<；0.05)；硬化症(t=-2.4，P<；0.05)]。结论：这些数据提示早产可能与内分泌和免疫功能的改变有关，直到儿童后期。
Context: Animal data suggest that adverse early experiences may affect endocrine and immune functioning in later life.Objective: Our objective was to assess the impact of preterm delivery on hypothalamus-pituitary-adrenal axis functioning, heart rate responses, and immune function.Participants: Former preterm children [ aged 8-14 yr ( n = 18)], sex and age-matched full-term born control children ( n = 18), data on birth weight, gestational age, birth weight for gestational age ( in SD units), actual body weight, height, and body mass index were assessed.Design and Outcome Measures: Subjects were exposed to a standardized laboratory stressor (" Trier Social Stress Test for Children"). Cortisol in saliva was determined in 10-min intervals before and after the stress test; heart rates were obtained continuously during the stress test. Additional assessment of saliva cortisol was performed: 1) on 3 consecutive days after awakening and at + 10, + 20, and + 30 min ( morning cortisol); and 2) at 0800, 1400, 1600, and 1900 h ( short diurnal profile). Measurement of the delayed type hypersensitivity reaction to seven recall antigens [ Multitest cellular mediated immunity ( Multitest-Immignost, Biosyn, Fellbach, Germany)].Results: Exposure to the Trier Social Stress Test for Children yielded significantly increased cortisol levels [ F ( 8, 232) = 19.86; P < 0.001] and heart rates [ F ( 38, 988) = 10.46; P < 0.001], however, no difference between former preterms and full- terms could be observed. No between-group differences were found in the short diurnal cortisol profile. Former preterms showed significantly higher cortisol levels after awakening [ F ( 3, 102) = 3.14; P < 0.05]. In addition, a significantly suppressed delayed type hypersensitivity response [ reduced number of positive antigens ( t = - 2.64, P < 0.05); induration ( t = -2.4, P < 0.05)] was found in former preterms.Conclusion: The data suggest that preterm delivery may be associated with altered endocrine and immune functions well into late childhood.