EFFECT OF TASTE & TRIGEMINAL STIMULATION ON NEUROENDOCRINE VALUES

目前，人们对慢性暴露于不愉快的味道和药物引起的口腔刺激的急性或长期生理影响知之甚少。人们已经发现，令人不快的味道会降低人们对药物治疗方案的依从性，但目前还不清楚，顺应性降低是由于味道的厌恶方面，还是由于感觉引起的生理副作用。这项探索性研究是为了确定单一的短暂接触苦味和/或口腔刺激是否对人类的神经内分泌水平(特别是去甲肾上腺素、肾上腺素和皮质醇)有生理影响。对去甲肾上腺素、肾上腺素和皮质醇进行了研究，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个半小时的会议。测试了四种口服刺激物：水(对照组)、碳酸水、英韦酶(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(100ppm)对受试者有强烈的感知强度，但对受试者无害。味觉刺激以固定的顺序呈现：水、碳酸水、苦水(Inviase)和辣椒素。在研究开始前60分钟，将生理盐水锁放置在外周手臂静脉中。然后进行基线抽血，然后将10毫升的第一口刺激(水)喷入口腔。受试者将样本从口腔中呼啸而出，然后吐出。在刺激后5分钟、10分钟和25分钟采集额外的血样。每个测试刺激之间有25分钟的休息时间。然后以类似于对照刺激(水)的方式测试三个测试刺激，即在给药前立即、以及在给药后5、10和25分钟抽血。受试者在刺激前立即测量脉搏和血压，并在刺激后25分钟测量。受试者还会对每个刺激的总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.