Dose-response changes in plasma cortisol and lymphocyte glucocorticoid receptors following dexamethasone administration in combat veterans with and without posttraumatic stress disorder.
Dose-response changes in plasma cortisol and lymphocyte glucocorticoid receptors following dexamethasone administration in combat veterans with and without posttraumatic stress disorder.
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DOI：
10.1001/archpsyc.1995.03950190065010
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发表时间：
1995-07
影响因子：
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通讯作者：
R. Yehuda;David Boisoneau;M. Lowy;E. Giller
中科院分区：
文献类型：
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作者：
R. Yehuda;David Boisoneau;M. Lowy;E. Giller
背景：我们先前的研究表明，患有创伤后应激障碍(PTSD)的退伍军人存在下丘脑-垂体-肾上腺轴功能的改变，这不同于在严重抑郁障碍和应激暴露后观察到的已有文献记载的生物学变化。方法对14例患有创伤后应激障碍的老兵、12例无创伤后应激障碍的老兵和14例非精神科健康男性在服用0.50和0.25 mg地塞米松前后进行皮质醇和淋巴细胞糖皮质激素受体测定。所有受试者在测试时都没有服用药物，没有人符合严重抑郁症或物质依赖的诊断标准。结果在两种剂量的地塞米松作用下，患有创伤后应激障碍的退伍军人比没有创伤后应激障碍的退伍军人和正常对照组对皮质醇的抑制程度更大。皮质醇抑制的差异不能归因于物质依赖史或地塞米松生物利用度的差异。与正常男性相比，患有创伤后应激障碍的退伍军人表现出更多的基线糖皮质激素受体。与正常男性相比，没有创伤后应激障碍的退伍军人的基线糖皮质激素受体数量也更多，事实上，在这一指标上，与患有创伤后应激障碍的退伍军人相当。然而，只有患有创伤后应激障碍的退伍军人在服用地塞米松后淋巴细胞糖皮质激素受体数量减少。结论本研究结果支持创伤后应激障碍患者下丘脑-垂体-肾上腺轴负反馈敏感性增强的假说。
BACKGROUND Our previous studies have suggested that combat veterans with posttraumatic stress disorder (PTSD) have alterations in hypothalamic-pituitary-adrenal axis functioning that are different from the well-documented biological changes observed in major depressive disorder and following exposure to stress. METHODS In the present study, we examined cortisol and lymphocyte glucocorticoid receptor number before and after the administration of 0.50 and 0.25 mg of dexamethasone in 14 combat veterans with PTSD, 12 combat veterans without PTSD, and 14 nonpsychiatric healthy men. All subjects were medication free at the time of testing and none met diagnostic criteria for major depression or substance dependence. RESULTS Combat veterans with PTSD suppressed cortisol to a greater extent than did combat veterans without PTSD and normal controls in response to both doses of dexamethasone. Differences in cortisol suppression could not be attributed to substance dependence history or differences in dexamethasone bioavailability. Combat veterans with PTSD showed a larger number of baseline glucocorticoid receptors compared with normal men. Combat veterans without PTSD also had a larger number of baseline glucocorticoid receptors compared with normal men and in fact were comparable to combat veterans with PTSD on this measure. However, only veterans with PTSD showed a decrease in lymphocyte glucocorticoid receptor number following dexamethasone administration. CONCLUSION The data support the hypothesis of an enhanced negative feedback sensitivity of the hypothalamic-pituitary-adrenal axis in PTSD.