Low cerebrospinal fluid corticotropin-releasing hormone concentrations in eucortisolemic depression
Low cerebrospinal fluid corticotropin-releasing hormone concentrations in eucortisolemic depression
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DOI：
10.1016/s0006-3223(96)00312-5
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发表时间：
1997-08-01
影响因子：
10.6
通讯作者：
Orth, DN
中科院分区：
文献类型：
--
作者：
Geracioti, TD;Loosen, PT;Orth, DN
促肾上腺皮质激素释放激素（CRH）的高分泌和由此导致的高皮质醇血症与重度抑郁症的发病机制有关。为了验证CRH高分泌假说，从上午11点到下午5点，通过蛛网膜下腔留置导管（上午8点放置）连续抽取脑脊液（CSF），并每隔10分钟测定10例抑郁症患者的免疫反应性CRH浓度，其中大多数患者表现出至少一种“非典型”症状。在15个正常志愿者中。抑郁症患者脑脊液CRH低，血浆促肾上腺皮质激素（ACTH）趋于低，血浆皮质醇正常。此外，吸烟的人脑脊液CRH低于不吸烟的人。CRH在腰椎穿刺后急剧升高，半衰期短，随时间浓度变化迅速，在禁食个体和大多数抑郁症患者中表现出昼夜浓度节律，CSF CRH与血浆ACTH或皮质醇无关；这及其快速波动的水平提示腰椎脑脊液CRH主要起源于下丘脑外。(C) 1997年生物精神病学学会。
Hypersecretion of corticotropin-releasing hormone (CRH) and resulting hypercortisolism have been implicated in the pathogenesis of major depression, To test this CRH hypersecretion hypothesis, cerebrospinal fluid (CSF) was continuously withdrawn from 11:00 AM to 5:00 PM via an indwelling subarachnoid catheter (placed at 8:00 AM), and immunoreactive CRH concentrations were determined at 10-min intervals in 10 depressed patients, the majority of whom exhibited at least one ''atypical'' symptom, and in 15 normal volunteers. CSF CRH was low, plasma adrenocorticotropin (ACTH) fended to be low, and plasma cortisol was normal in the depressed patients. Also, tobacco smokers had lower CSF CRH than nonsmokers. CRH increased acutely in response to lumbar puncture, had a brief half-life, showed rapid variability in concentration over time, and displayed a diurnal concentration rhythm that was preserved in fasting individuals and in most depressed patients, CSF CRH did not correlate with plasma ACTH or cortisol; this and its rapidly fluctuating levels suggest a primarily extrahypothalamic origin of lumbar CSF CRH. (C) 1997 Society of Biological Psychiatry.