Enhanced cortisol increase upon awakening is associated with greater pain ratings but not salivary cortisol or soluble tumor necrosis factor-α receptor II responses to acute pain.
Enhanced cortisol increase upon awakening is associated with greater pain ratings but not salivary cortisol or soluble tumor necrosis factor-α receptor II responses to acute pain.
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DOI：
10.1097/ajp.0b013e31822cf542
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发表时间：
2012-05
期刊：
影响因子：
--
通讯作者：
McGuire L
中科院分区：
文献类型：
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作者：
Goodin BR;Quinn NB;King CD;Page GG;Haythornthwaite JA;Edwards RR;Stapleton LM;McGuire L
皮质醇觉醒反应（cortisol awakening response，CAR）与心理社会因素和健康状况密切相关，提示CAR可能是下丘脑-垂体-肾上腺（hypothalamic-pituitary-adrenal，HPA）轴功能和功能障碍的特异性标志。这试图扩展以前的工作，检查CAR和实验室诱发的急性疼痛刺激评级之间的关联。除了诱发疼痛评级外，本研究还检测了CAR是否与唾液皮质醇和可溶性肿瘤坏死因子-α受体II（sTNFαRII）对急性疼痛刺激的反应具有前瞻性相关性。这项研究包括36名通过张贴研究传单招募的健康、无痛的男女志愿者。在完成实验室疼痛测试之前，根据以下时间范围，在一个早晨的过程中在家中获得唾液皮质醇样品：在觉醒时，以及在觉醒后15、30和60分钟。在收集唾液后，研究参与者将他们的家庭唾液样本带到实验室进行分析，随后完成急性实验性疼痛测试程序。CAR的聚类分析揭示了两个不同的群体具有相似的唤醒皮质醇反应模式：增加和平坦。相对于平坦的CAR，增加的CAR与更大的疼痛强度和不愉快评分相关。疼痛测试后，唾液皮质醇显著增加，sTNFαRII显著降低，但这些反应均不因CAR增加与平坦而不同。CAR可能是压力敏感性和/或即将到来的压力的预测的标志物，这可以解释为什么增加CAR的队列报告了更大的急性疼痛评级。
The cortisol awakening response (CAR) is related with psychosocial factors and health in potentially significant ways, suggesting that it may be a distinctive marker of hypothalamic-pituitary-adrenal (HPA) axis function and dysfunction. This sought to expand upon previous work that examined the association between CAR and ratings of laboratory-evoked acute pain stimulation. In addition to evoked pain ratings, this study also tested whether CAR was prospectively related with salivary cortisol and soluble tumor necrosis factor-α receptor II (sTNFαRII) responses to acute pain stimulation. This study included 36 healthy, pain-free volunteers of both sexes recruited via posted study flyers. Prior to completion of laboratory pain testing, salivary cortisol samples were obtained at home over the course of a single morning according to the following time frame: upon awakening, and 15, 30, and 60 min after awakening. Following collection of saliva, study participants brought their home saliva samples to the laboratory for assay and subsequently completed acute experimental pain testing procedures. Cluster analysis of CAR revealed two distinct groups with similar patterns of cortisol response to awakening; increased and flattened. Relative to flattened CAR, increased CAR was associated with greater ratings of pain intensity and unpleasantness. Salivary cortisol was significantly increased and sTNFαRII significantly decreased following pain testing, but neither of these responses differed as a function of increased versus flattened CAR. CAR may be a marker for stress sensitivity and/or the anticipation of impending stress, which could explain why the increased CAR cohort reported greater acute pain ratings.