Biological Psychiatry
Volume 55, Issue 7, 2004, Pages 745-751

Hypocortisolism and increased glucocorticoid sensitivity of pro-Inflammatory cytokine production in Bosnian war refugees with posttraumatic stress disorder (Article)

Rohleder N. , Joksimovic L. , Wolf J.M. , Kirschbaum C.*
  • a Department of Psychology, Inst. of Experimental Psychology II, University of Düsseldorf, Düsseldorf, Germany
  • b Department of Psychology, Institute of Medical Sociology, University of Düsseldorf, Düsseldorf, Germany
  • c Department of Psychology, Inst. of Experimental Psychology II, University of Düsseldorf, Düsseldorf, Germany
  • d Department of Psychology, Inst. of Experimental Psychology II, University of Düsseldorf, Düsseldorf, Germany, Dept. of Experimental Psychology, University of Düsseldorf, Universitätsstrasse 1, D-40225 Düsseldorf, Germany

Abstract

Background Posttraumatic stress disorder (PTSD) is associated with dysregulation of the hypothalamus pituitary adrenal (HPA) axis. Alterations include various responses to HPA axis stimulation, different basal hormone levels, and changes in glucocorticoid receptor (GR) numbers on lymphocytes. The functional significance of these latter changes remains elusive. Methods Twelve Bosnian war refugees with PTSD and 13 control subjects were studied. On 2 consecutive days, they collected saliva samples after awakening and at 11, 15, and 20 hours. Glucocorticoid (GC) sensitivity was measured by dexamethasone (DEX) inhibition of lipopolysaccharide (LPS)-induced interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) production in whole blood. Results The PTSD patients showed no cortisol response after awakening and had lower daytime cortisol levels (F = 14.57, p < .001). Less DEX was required for cytokine suppression in PTSD patients (IL-6: t = -2.82, p = .01; TNF-α: t = 5.03, p < .001), reflecting higher GC sensitivity of pro-inflammatory cytokine production. The LPS-stimulated production of IL-6, but not TNF-alpha, was markedly increased in patients (IL-6: F = 10.01, p < .004; TNF-α: F = .89, p = .34). Conclusions In refugees with PTSD, hypocortisolism is associated with increased GC sensitivity of immunologic tissues. Whether this pattern reflects an adaptive mechanism and whether this is sufficient to protect from detrimental effects of low cortisol remains to be investigated.

Author Keywords

posttraumatic stress disorder inflammation Hypocortisolism HPA axis Glucocorticoid sensitivity Cytokines

Index Keywords

Germany refugee Hypothalamo-Hypophyseal System Escherichia coli human Refugees middle aged Pituitary-Adrenal System war controlled study Hydrocortisone priority journal Aged Bosnia-Herzegovina arousal Humans male glucocorticoid female Article adult posttraumatic stress disorder Stress Disorders, Post-Traumatic Anti-Inflammatory Agents dexamethasone Lipopolysaccharides Receptors, Glucocorticoid hydrocortisone urine level Tumor Necrosis Factor-alpha Interleukin-5 saliva analysis lipopolysaccharide Reference Values Lymphocytes Addison disease cytokine production
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-1642320206&doi=10.1016%2fj.biopsych.2003.11.018&partnerID=40&md5=2716d04e2d22d5b4f271f909c95aad40
DOI: 10.1016/j.biopsych.2003.11.018
ISSN: 00063223
Cited by: 277
Original Language: English