EFFECT OF TASTE & TRIGEMINAL STIMULATION ON NEUROENDOCRINE VALUES

目前对慢性暴露于药物引起的不良味道和口腔刺激的急性或长期生理影响知之甚少。已经发现不愉快的味道会降低对药物治疗方案的依从性，但尚不清楚降低的依从性是否仅仅是由于味道的令人厌恶的方面或由感觉引起的生理副作用。本探索性研究旨在确定单次短暂暴露于苦味和/或口腔刺激是否对人体神经内分泌水平（特别是去甲肾上腺素、肾上腺素和皮质醇）产生生理学影响。 去甲肾上腺素、肾上腺素和皮质醇被研究，因为它们与压力和唤醒有关。 去甲肾上腺素和肾上腺素的分泌涉及肾上腺-髓质儿茶酚胺系统，而皮质醇的释放涉及垂体-肾上腺皮质系统。 受试者在杜克大学医学院的综合临床研究中心单独参加一个4 1/2小时的会议。 测试四种口腔刺激：水（对照组）、碳酸水、Invirase（一种用于治疗艾滋病毒感染的苦味药物）和辣椒素（辣椒中的成分）。 Invirase（0.09 mM）和辣椒素（100 ppm）具有较强的感知强度，但对受试者无害。 味觉刺激以固定的顺序呈现：水、碳酸水、苦味水（Invirase）和辣椒素。 在研究开始前60分钟将盐水锁置于外周臂静脉中。 然后进行基线抽血，随后递送10 ml第一口腔刺激物（水）喷入口中。 受试者将样品在整个口腔中漱口，然后吐出。 在刺激施用后5分钟、10分钟和25分钟采集另外的血液样品。 每个测试刺激之间有25分钟的休息时间。 然后以与对照刺激（水）类似的方式测试三种测试刺激，即在施用刺激之前即刻和施用刺激之后5、10和25分钟抽取血液。 受试者的脉搏和血压在刺激施用之前立即测量，并且在刺激施用之后25分钟测量。 受试者还对每种刺激的整体强度和愉悦感进行评分。 进行方差分析，以确定刺激对神经内分泌水平的影响是否存在差异。

Little is currently known about acute or long-term physiological impacts of chronic exposure to unpleasant tastes and oral irritation from medications. Unpleasant tastes have been found to lower compliance with drug regimens but it is not yet known if reduced compliance is due simply to the aversive aspects of the taste or to physiological side-effects caused by the sensation. This exploratory study is being performed to determine if a single brief exposure to bitter taste and/or oral irritation has a physiological effect on neuroendocrine levels (specifically norepinephrine, epinephrine, and cortisol) in humans. Norepinephrine, epinephrine, and cortisol were investigated because they are associated with stress and arousal. Secretion of norepinephrine and epinephrine involves the adrenal-medullary catecholamine system while the release of cortisol involves the pituitary-adrenal cortical system. Subjects participate individually in one 4 1/2 hour session on the General Clinical Research Center at Duke University Medical School. Four oral stimuli are tested: water (control), carbonated water, Invirase (a bitter drug used to treat HIV infection), and capsaicin (component in chili pepper). Invirase (0.09 mM) and capsaicin (100 ppm) had strong perceived intensities but were not be harmful to the subjects. The taste stimuli are presented in a fixed order: water, carbonated water, bitter water (Invirase), and capsaicin. A saline lock is placed in a peripheral arm vein sixty minutes prior beginning the study. Then a baseline blood draw is performed followed by delivery of 10 ml of the first oral stimulus (water) squirted into the mouth. Subjects swish the sample throughout the oral cavity and then expectorate. Additional blood samples are taken at 5 minutes, 10 minutes, and 25 minutes after stimulus administration. There is a twenty-five minute break between each test stimulus. Three test stimuli are then tested in a manner similar to the control stimulus (water), i.e. blood draws were taken immediately before, and 5, 10, and 25 minutes after administration of the stimulus. The subjects' pulse and blood pressure is taken immediately before stimulus administration, and 25 minutes after stimulus administration. Subjects also rate the perceived overall intensity and pleasantness of each stimulus. An analysis of variance is performed to determine is there are differences between stimuli in their effects on neuroendocrine levels.