Distress conditions during pregnancy may lead to pre-eclampsia by increasing cortisol levels and altering lymphocyte sensitivity to glucocorticoids
Distress conditions during pregnancy may lead to pre-eclampsia by increasing cortisol levels and altering lymphocyte sensitivity to glucocorticoids
复制标题
DOI：
10.1016/j.mehy.2011.04.007
复制
发表时间：
2011-08-01
影响因子：
4.7
通讯作者：
Bogo Chies, Jose Artur
中科院分区：
文献类型：
--
作者：
Vianna, Priscila;Bauer, Moises E.;Bogo Chies, Jose Artur
心理压力可能会影响多达18%的孕妇，改变神经内分泌和免疫系统的功能。窘迫状态可能会直接改变下丘脑-垂体-肾上腺(HPA)轴，导致皮质醇水平升高和相关的细胞免疫变化。心理事件，如高压力、焦虑或抑郁，可能直接或间接影响怀孕，从而可能导致先兆子痫(PE)。在这里，我们认为怀孕期间的窘迫状况可能通过提高体内皮质醇水平而导致PE的发生。高皮质醇水平与高血压和内皮功能障碍有关，这是PE患者经常观察到的特征。皮质醇水平高的患者的淋巴细胞对合成的糖皮质激素地塞米松(DEX)的敏感性可能会降低。应激相关的类固醇抵抗可能扰乱HPA轴，导致出生后的不利影响，如增加的变态负荷，增加的促炎细胞因子水平，甚至后代的抑郁。(C)2011爱思唯尔有限公司。保留所有权利。
Psychological stress may affect up to 18% of all pregnant women, altering the function of both neuroendocrine and immune systems. Distress conditions may directly change the hypothalamic-pituitary-adrenal (HPA) axis, leading to increased cortisol levels and associated changes in cellular immunity. Psychological events such as high stress levels, anxiety or depression may directly or indirectly affect pregnancy and may thus lead to pre-eclampsia (PE). Here, we suggest that distress conditions during pregnancy may lead the development of PE by enhancing in vivo cortisol levels. High cortisol levels are associated with hypertension and endothelial dysfunction, features often observed in patients with PE. Lymphocytes from patients with high cortisol levels may have a reduced sensitivity to the synthetic glucocorticoid dexamethasone (DEX). Stress-related steroid resistance may disrupt the HPA axis, leading to post-natal detrimental effects such as increased allostatic load, increased pro-inflammatory cytokine levels and even depression in the offspring. (C) 2011 Elsevier Ltd. All rights reserved.