The neuroendocrine axis in patients with multiple sclerosis

被引:124
作者
Wei, T
Lightman, SL
机构
[1] UNIV BRISTOL, BRISTOL ROYAL INFIRM, DEPT MED, BRISTOL BS2 8HW, AVON, ENGLAND
[2] INST NEUROL, DEPT CLIN NEUROL, LONDON WC1N 3BG, ENGLAND
关键词
hypothalamo-pituitary-adrenal axis; diurnal rhythm; multiple sclerosis;
D O I
10.1093/brain/120.6.1067
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
We investigated the basal and dynamic regulation of the hypothalamo-pituitary-adrenal (HPA), hypothalamo- pituitary-thyroid (HPT) and hypothalamo-pituitary-gonadal axes and prolactin secretion in 52 patients with clinically definite multiple sclerosis. These patients also had gadolinium enhanced brain MRI scans and were divided into relapsing-remitting, secondary progressive and primary progressive subgroups. These subgroups were compared with healthy controls and a group of patients with other neurological diseases. The cortisol diurnal rhythm was preserved in all groups of patients. The time-integrated cortisol response to human corticotropin-releasing hormone (CRH) stimulation was lower in the patients with secondary progressive multiple sclerosis, compared with patients with primary progressive multiple sclerosis and healthy subjects. The time-integrated beta-endorphin response to CRH was greater in the patients with relapsing-remitting multiple sclerosis compared with the others. Feedback regulation assessed by dexamethasone suppression was normal. Serum testosterone was low in 24% of male multiple sclerosis patients and oestradiol was low in 25% of pre-menopausal female multiple sclerosis patients, whereas prolactin and the HPT function were normal. Correlations with C-reactive protein (CRP) and MRI suggest that activation of the HPA axis in multiple sclerosis patients is secondary to an active inflammatory stimulus.
引用
收藏
页码:1067 / 1076
页数:10
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