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Athanasiou N, Bogdanis GC, Mastorakos G. Endocrine responses of the stress system to different types of exercise. Rev Endocr Metab Disord 2023; 24:251-266. [PMID: 36242699 PMCID: PMC10023776 DOI: 10.1007/s11154-022-09758-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/28/2022] [Indexed: 10/17/2022]
Abstract
Physical activity is an important part of human lifestyle although a large percentage of the population remains sedentary. Exercise represents a stress paradigm in which many regulatory endocrine systems are involved to achieve homeostasis. These endocrine adaptive responses may be either beneficial or harmful in case they exceed a certain threshold. The aim of this review is to examine the adaptive endocrine responses of hypothalamic-pituitary-adrenal axis (HPA), catecholamines, cytokines, growth hormone (GH) and prolactin (PRL) to a single bout or regular exercise of three distinct types of exercise, namely endurance, high-intensity interval (HIIE) and resistance exercise. In summary, a single bout of endurance exercise induces cortisol increase, while regular endurance exercise-induced activation of the HPA axis results to relatively increased basal cortisolemia; single bout or regular exercise induce similar GH peak responses; regular HIIE training lowers basal cortisol concentrations, while catecholamine response is reduced in regular HIIE compared with a single bout of HIIE. HPA axis response to resistance exercise depends on the intensity and volume of the exercise. A single bout of resistance exercise is characterized by mild HPA axis stimulation while regular resistance training in elderly results in attenuated inflammatory response and decreased resting cytokine concentrations. In conclusion, it is important to consider which type of exercise and what threshold is suitable for different target groups of exercising people. This approach intends to suggest types of exercise appropriate for different target groups in health and disease and subsequently to introduce them as medical prescription models.
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Affiliation(s)
- Nikolaos Athanasiou
- grid.5216.00000 0001 2155 0800Unit of Endocrinology, Diabetes mellitus and Metabolism, School of medicine, ARETAIEION hospital, National and Kapodistrian University of Athens, Neofytou Vamva str 10674, Athens, Greece
- grid.414655.70000 0004 4670 4329Dermatology Department, Evangelismos General hospital, Athens, Greece Ipsilantou 45-47, 10676
| | - Gregory C. Bogdanis
- grid.5216.00000 0001 2155 0800School of Physical Education and Sports Science, National and Kapodistrian University of Athens, 17237 Dafne, Greece
| | - George Mastorakos
- grid.5216.00000 0001 2155 0800Unit of Endocrinology, Diabetes mellitus and Metabolism, School of medicine, ARETAIEION hospital, National and Kapodistrian University of Athens, Neofytou Vamva str 10674, Athens, Greece
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Harbeck B, Kropp P, Kreitschmann-Andermahr I. Glucocorticoid replacement therapy for primary and secondary adrenal insufficiency and their impact on cognition. Front Endocrinol (Lausanne) 2023; 14:1153595. [PMID: 37008924 PMCID: PMC10064134 DOI: 10.3389/fendo.2023.1153595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 03/07/2023] [Indexed: 03/19/2023] Open
Abstract
Patients with adrenal insufficiency (AI) are treated with conventional or modified-release glucocorticoid (GC) replacement therapy (GRT). Although current GRT regimens aim to mimic the physiological circadian pattern of cortisol secretion, temporary phases of hypo- and hypercortisolism are common. There is good evidence that prolonged phases of hypo- or hypercortisolism are associated with impaired cognitive functioning. However, little is known about cognitive functioning in patients with AI regarding the effects of dosage and duration of glucocorticoid replacement therapy. There is also little data available comparing the effects of GC therapy on patients with primary and secondary forms of AI as well as with respect to different formulas. This Mini-Review gives an overview of the current studies on GRT for primary and secondary AI and their impact on cognition. Strengths and weaknesses of the studies and their Implications for clinical daily routine are discussed with a special emphasis on practical considerations for the treating endocrinologist.
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Affiliation(s)
- Birgit Harbeck
- III. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Medizinisches Versorgungszentrum (MVZ) Amedes Experts, Endocrinology, Hamburg, Germany
| | - Peter Kropp
- Institute of Medical Psychology and Medical Sociology, University of Rostock, Rostock, Germany
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Zhao R, Luo S, Wang S, Wen Y, Xiong F. Coronary artery disease in a patient with Addison's disease: a case report and literature review. BMC Cardiovasc Disord 2023; 23:54. [PMID: 36709280 PMCID: PMC9884407 DOI: 10.1186/s12872-023-03079-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 01/18/2023] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Addison's disease which is due to dysfunction of the adrenal gland, with abnormal secretion of glucocorticoids and mineralocorticoids, is rare. By inducing inflammation and disorders of water and electrolyte metabolism, Addison's disease may accelerate progression of co-existed cardiovascular diseases. Addison's disease combined with cardiovascular disease is infrequent, only 10 cases in the literature. CASE PRESENTATION We reported a 51-year-old male patient with unstable angina pectoris and hypotension. Changes on coronary angiography within 2 years suggested rapid progression of coronary artery disease in a patient with low cardiovascular risk. An additional clue of skin hyperpigmentation, fatigue and further examination confirmed the diagnosis of Addison's disease caused by adrenal tuberculosis. After hormone replacement treatment, the frequency and severity of the angina pectoris were alleviated significantly, as were hypotension, hyperpigmentation and fatigue. CONCLUSIONS The combination of Addison's disease and coronary artery disease in one patient is rare. Addison's disease can induce inflammation and disorders of water and electrolyte metabolism, which may further accelerate the course of coronary artery disease. Meanwhile, the hypotension in Addison's disease may affect the coronary blood flow, which may result in an increased susceptibility to unstable angina in the presence of coronary stenosis. So, we should analyze comprehensively if the coronary artery disease progress rapidly.
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Affiliation(s)
- Ruohan Zhao
- grid.263901.f0000 0004 1791 7667Department of Cardiology, Cardiovascular Institute of Chengdu Third People’s Hospital/The Affiliated Hospital of Southwest Jiaotong University, Chengdu, 610031 China
| | - Suxin Luo
- grid.452206.70000 0004 1758 417XDepartment of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016 China
| | - Shuzhen Wang
- grid.263901.f0000 0004 1791 7667Department of Cardiology, Cardiovascular Institute of Chengdu Third People’s Hospital/The Affiliated Hospital of Southwest Jiaotong University, Chengdu, 610031 China
| | - Yi Wen
- grid.203458.80000 0000 8653 0555Health Management Centre, University-Town Hospital of Chongqing Medical University, Chongqing, 401331 China
| | - Feng Xiong
- grid.263901.f0000 0004 1791 7667Department of Cardiology, Cardiovascular Institute of Chengdu Third People’s Hospital/The Affiliated Hospital of Southwest Jiaotong University, Chengdu, 610031 China
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Mendes BC, Copetti CLK, Panza VSP, Orssatto LBR, da Rosa JS, Diefenthaeler F, Dalmarco EM, Pietro PFD, Rieger DK. Effects of Euterpe edulis Martius on inflammatory responses to high-intensity intermittent exercise: Crossover randomized trial. Nutrition 2021; 91-92:111344. [PMID: 34273682 DOI: 10.1016/j.nut.2021.111344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 04/21/2021] [Accepted: 05/06/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVE High-intensity intermittent exercise (HIIE) may enhance the antiinflammatory status. The juçara fruit juice (JFJ) has well-established antioxidant and antiinflammatory properties. This study investigated the effect of JFJ consumption on the inflammatory response to HIIE in physically active subjects. METHODS In a randomized crossover design, 15 men were assigned to drink 250 mL of either JFJ or water (control) 1 h before a cycling HIIE session (seven sets of 60 s at 100% peak power output; 75 s recovery between sets). Blood samples were obtained before and at 0, 30, and 60 min post-HIIE, and the serum was analyzed for interleukin (IL)-6, IL-1β, IL-8, IL-10, tumor necrosis factor-α, and cortisol. RESULTS After HIIE, the IL-6 levels were higher than baseline (percent change) at 30 min (P = 0.041) and 60 min (P = 0.038) for the control, but were unaffected by JFJ. IL-10 was higher in the JFJ group than in the control at 30 min (d = ‒0.63). Tumor necrosis factor-α was lower than baseline at 30 min for the control (d = ‒0.71) and at 60 min for the JFJ group (d = ‒0.60). For control, cortisol increased to higher than the baseline at 30 and 60 min (d = 0.54 and d = 0.76, respectively). For the JFJ group, the cortisol levels were significantly higher than the baseline at 30 min (P = 0.022). Performance during sprints was higher in the JFJ group than in the control (P = 0.002). In the control group, performance was with both IL-6 (semipartial correlation; sr = -0.59, large effect size) and cortisol at 0 h (sr = -0.52, large effect size). CONCLUSIONS JFJ intake attenuated the antiinflammatory response to HIIE, possibly resulting from a lower degree of muscle stress.
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Affiliation(s)
- Bruna Cunha Mendes
- Nutrition Postgraduate Program, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil.
| | | | - Vilma Simões Pereira Panza
- Nutrition Postgraduate Program, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | - Lucas B R Orssatto
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Julia Salvan da Rosa
- Pharmacy Postgraduate Program, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | - Fernando Diefenthaeler
- Physical Education Postgraduate Program, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | | | - Patricia Faria Di Pietro
- Nutrition Postgraduate Program, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | - Débora Kurrle Rieger
- Nutrition Postgraduate Program, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
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Su M, Zhang R, Liu N, Zhang J. Modulation of inflammatory response by cortisol in the kidney of spotted scat (Scatophagus argus) in vitro under different osmotic stresses. FISH & SHELLFISH IMMUNOLOGY 2020; 104:46-54. [PMID: 32474084 DOI: 10.1016/j.fsi.2020.05.060] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Revised: 05/20/2020] [Accepted: 05/23/2020] [Indexed: 06/11/2023]
Abstract
Salinity changes on renal osmoregulation have often been investigated while the immune response of the kidney under osmotic stress is poorly understood in teleosts. Acute stress is generally associated with enhancement of circulating cortisol. The effects of osmotic stress on renal immune response and its regulation by cortisol deserve more attention. In the present study, the effects of exogenous cortisol treatment on the lipopolysaccharide (LPS)-induced immune response were analyzed in renal masses of Scatophagus argus under different osmotic stresses in vitro. mRNA expression of pro-inflammatory cytokines (TNF-α, IL1-β and IL-6) and immune-regulatory related genes (GR and SOCS1) was measured over a short course (15 h). Comprehensive analysis reveals that transcript abundances of pro-inflammatory cytokine genes such as TNF-α, IL-1β, and IL-6 induced by LPS, alone or in the combination of cortisol, are tightly associated with osmoregulation under acute osmotic stress. Our results showed that osmotic challenge could significantly enhance mRNA expression levels of pro-inflammatory cytokines in renal masses in vitro. Based on our analysis, it can be inferred that cortisol suppresses the magnitude of renal inflammatory response and attenuates LPS-induced immune response through GR signaling in the face of challenging environmental conditions.
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Affiliation(s)
- Maoliang Su
- Shenzhen Key Laboratory of Marine Bioresource & Eco-Environmental Science, College of Life Sciences and Oceanography, Shenzhen University, Shenzhen, 518060, China; Key Laboratory of Optoelectronic Devices and Systems of Ministry of Education and Guangdong Province, College of Optoelectronic Engineering, Shenzhen University, Shenzhen, 518060, China
| | - Ran Zhang
- Shenzhen Key Laboratory of Marine Bioresource & Eco-Environmental Science, College of Life Sciences and Oceanography, Shenzhen University, Shenzhen, 518060, China; Department of Physical and Environmental Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Nanxi Liu
- Shenzhen Key Laboratory of Marine Bioresource & Eco-Environmental Science, College of Life Sciences and Oceanography, Shenzhen University, Shenzhen, 518060, China
| | - Junbin Zhang
- Shenzhen Key Laboratory of Marine Bioresource & Eco-Environmental Science, College of Life Sciences and Oceanography, Shenzhen University, Shenzhen, 518060, China.
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Abstract
Adrenal insufficiency patients are treated with glucocorticoid replacement therapy. However, mimicking the in vivo circadian rhythm of cortisol levels is challenging, and suboptimal replacement increases the risk of mortality from cardiovascular disease. We herein report a case of coronary spastic angina (CSA) with simultaneous low early-morning serum cortisol levels in a patient undergoing corticosteroid replacement therapy for primary adrenal insufficiency. Steroid therapy is reportedly effective for refractory angina, but underlying adrenal deficiency has never been revealed. Our case intimates the probable risk of CSA as a complication of relative adrenal insufficiency and highlights the effectiveness of dexamethasone in these patients.
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Affiliation(s)
- Yuki Otsuka
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
| | - Ko Harada
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
| | - Miho Yasuda
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
| | - Yasuhiro Nakano
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
| | - Kou Hasegawa
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
| | - Fumio Otsuka
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
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Rahvar AH, Riesel M, Graf T, Harbeck B. Adrenal insufficiency treated with conventional hydrocortisone leads to elevated levels of Interleukin-6: a pilot study. Endocrine 2019; 64:727-729. [PMID: 31102070 DOI: 10.1007/s12020-019-01956-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 05/09/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Amir-Hossein Rahvar
- Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | | | - Tobias Graf
- Department of Cardiology, University Hospital Luebeck, Luebeck, Germany
| | - Birgit Harbeck
- University of Luebeck, Luebeck, Germany
- MVZ Amedes Experts, Endocrinology, Hamburg, Germany
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Increased Cardiovascular Risk in Patients with Adrenal Insufficiency: A Short Review. BIOMED RESEARCH INTERNATIONAL 2017; 2017:3691913. [PMID: 29376070 PMCID: PMC5742446 DOI: 10.1155/2017/3691913] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 11/06/2017] [Accepted: 11/15/2017] [Indexed: 11/18/2022]
Abstract
Cardiovascular disease (CVD) is the most common cause of death in the world. Recent studies have shown an association between adrenal insufficiency (AI) and increased cardiovascular risk (CVR). Patients with AI receive glucocorticoid (GC) replacement therapy which can lead to varying levels of blood cortisol. It was shown that these imbalances in blood cortisol may lead to a higher prevalence of coronary heart disease, major adverse coronary events, and increased mortality. GC substitution is essential in the treatment of AI without which the disease has been shown to be fatal. The most frequently used GC formula for replacement therapy is hydrocortisone (HC). There is no uniform opinion on hydrocortisone replacement therapy. Alternative GC such as prednisolone is also in use. Overreplacement of GC may lead to adverse effects including obesity, high blood pressure, and hyperglycaemia. Outcome may vary between primary and secondary AI mainly due to differences in the renin-angiotensin-aldosterone system (RAAS). Furthermore, decreased blood levels of cortisol may lead to a compensatory secretion of inflammatory mediators such as Interleukin-1 (IL-1), Interleukin-6 (IL-6), and/or tumor-necrosis factor (TNF). Physicians and patients should be properly educated about the increased risk of CVD in patients with AI.
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Montero-López E, Santos-Ruiz A, González R, Navarrete-Navarrete N, Ortego-Centeno N, Martínez-Augustín O, Rodríguez-Blázquez M, Peralta-Ramírez MI. Analyses of hair and salivary cortisol for evaluating hypothalamic-pituitary-adrenal axis activation in patients with autoimmune disease. Stress 2017; 20:541-548. [PMID: 28853298 DOI: 10.1080/10253890.2017.1369524] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Although many studies have shown that patients with autoimmune disease present a hypoactive hypothalamic-pituitary-adrenal axis (HPA), controversial results have been described. Our objective was to study HPA axis activity in women with autoimmune disease compared to healthy women. Therefore, we analyzed salivary cortisol over the course of a day, and hair cortisol concentrations from the three preceding months, from 65 women divided into two groups: healthy women (n = 30), with a mean age of 44.70 ± 11.65 years; and women with autoimmune disease (n = 35), with a mean age of 48.26 ± 9.04 years. The latter group comprises women with systemic lupus erythematosus (SLE), Sjögren's syndrome (SS), and systemic sclerosis (SSc). Perceived stress and psychopathological symptomatology were also evaluated. Autoimmune disease group scored higher on the somatization subscale SCL-90-R and lower on the anxiety subscale than the control group. Regarding HPA axis activation, the area under curve for cortisol levels during the day was higher for the autoimmune disease group. In addition, higher cortisol levels in hair were found in the group with autoimmune disease. Our findings show greater short and long-term HPA axis activity in women with autoimmune disease than in healthy women.
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Affiliation(s)
- Eva Montero-López
- a Department of Clinical Psychology , University of Granada , Granada , Spain
| | - Ana Santos-Ruiz
- b Department of Health Psychology, School of Health Sciences , University of Alicante , Alicante , Spain
| | - Raquel González
- c Department of Pharmacology, CIBERehd, School of Pharmacy , University of Granada , Granada , Spain
| | - Nuria Navarrete-Navarrete
- d Systemic Autoimmune Disease Unit, Internal Medicine Service , Virgen de las Nieves University Hospital , Granada , Spain
| | - Norberto Ortego-Centeno
- e Systemic Autoimmune Disease Unit, Internal Medicine Service , San Cecilio Clinical Hospital , Granada , Spain
| | - Olga Martínez-Augustín
- f Department of Biochemistry and Molecular Biology II, CIBERehd, School of Pharmacy , University of Granada , Granada , Spain
| | | | - María Isabel Peralta-Ramírez
- a Department of Clinical Psychology , University of Granada , Granada , Spain
- h Mind , Brain and Behavior Research Center (CIMCYC) , Granada , Spain
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Coronel-Restrepo N, Posso-Osorio I, Naranjo-Escobar J, Tobón GJ. Autoimmune diseases and their relation with immunological, neurological and endocrinological axes. Autoimmun Rev 2017; 16:684-692. [DOI: 10.1016/j.autrev.2017.05.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 03/23/2017] [Indexed: 10/19/2022]
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Wolff C, Straub RH, Hahnel A, Randolf A, Wildmann J, Besedovsky HO, del Rey A. Mimicking disruption of brain-immune system-joint communication results in collagen type II-induced arthritis in non-susceptible PVG rats. Mol Cell Endocrinol 2015; 415:56-63. [PMID: 26265448 DOI: 10.1016/j.mce.2015.08.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 07/27/2015] [Accepted: 08/04/2015] [Indexed: 11/29/2022]
Abstract
The brain-immune system-joint communication is disrupted during collagen type II (CII) arthritis in DA rats. Since PVG rats are not susceptible to arthritis induction, comparison of hypothalamic and peripheral neuro-endocrine and immune responses between immunized DA and PVG rats might help to explain their different susceptibility to develop the disease. PVG and DA rats were immunized with CII. Corticosterone, neurotransmitters, anti-CII antibodies, and cytokine concentrations in plasma, and hypothalamic neurotransmitters and cytokines were determined by ELISA, Luminex, HPLC and RT-qPCR. Adrenalectomy or sham-operation was performed in PVG and DA rats 14 days before immunization. Basal plasma corticosterone and adrenaline concentrations were significantly higher, and plasma cytokines and hypothalamic noradrenaline were lower in PVG rats than in DA rats. While DA rats developed severe arthritis upon immunization (maximum score 16), only 12 out of 28 PVG rats showed minimal symptoms (score 1-2). The density of sympathetic nerve fibers in arthritic joints of DA rats markedly decreased, but it remained stable in immunized PVG rats. The ratio corticosterone to IL-1β levels in plasma was markedly higher in immunized PVG rats than in arthritic DA rats. Adrenalectomy resulted in severe arthritis in PVG rats upon immunization with CII. While DA rats show an altered immune-brain communication that favors the development of arthritis, PVG rats express a protective neuro-endocrine milieu, particularly linked to the basal tone of the HPA axis. Mimicking disruption of this axis elicits arthritis in non-susceptible PVG rats.
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Affiliation(s)
- Christine Wolff
- Laboratory of Experimental Rheumatology and Neuroendocrine Immunology, Division of Rheumatology, Department of Internal Medicine I, University Hospital Regensburg, Germany
| | - Rainer H Straub
- Laboratory of Experimental Rheumatology and Neuroendocrine Immunology, Division of Rheumatology, Department of Internal Medicine I, University Hospital Regensburg, Germany.
| | - Anja Hahnel
- Laboratory of Experimental Rheumatology and Neuroendocrine Immunology, Division of Rheumatology, Department of Internal Medicine I, University Hospital Regensburg, Germany
| | - Anke Randolf
- Department of Immunophysiology, Institute of Physiology and Pathophysiology, University of Marburg, Germany
| | - Johannes Wildmann
- Department of Immunophysiology, Institute of Physiology and Pathophysiology, University of Marburg, Germany
| | - Hugo O Besedovsky
- Department of Immunophysiology, Institute of Physiology and Pathophysiology, University of Marburg, Germany
| | - Adriana del Rey
- Department of Immunophysiology, Institute of Physiology and Pathophysiology, University of Marburg, Germany
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Christophi GP, Caza T, Curtiss C, Gumber D, Massa PT, Landas SK. Gene expression profiles in granuloma tissue reveal novel diagnostic markers in sarcoidosis. Exp Mol Pathol 2014; 96:393-9. [PMID: 24768588 DOI: 10.1016/j.yexmp.2014.04.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Accepted: 04/10/2014] [Indexed: 01/16/2023]
Abstract
Sarcoidosis is an immune-mediated multisystem disease characterized by the formation of non-caseating granulomas. The pathogenesis of sarcoidosis is unclear, with proposed infectious or environmental antigens triggering an aberrant immune response in susceptible hosts. Multiple pro-inflammatory signaling pathways have been implicated in mediating macrophage activation and granuloma formation in sarcoidosis, including IFN-γ/STAT-1, IL-6/STAT-3, and NF-κB. It is difficult to distinguish sarcoidosis from other granulomatous diseases or assess disease severity and treatment response with histopathology alone. Therefore, development of improved diagnostic tools is imperative. Herein, we describe an efficient and reliable technique to classify granulomatous disease through selected gene expression and identify novel genes and cytokine pathways contributing to the pathogenesis of sarcoidosis. We quantified the expression of twenty selected mRNAs extracted from formalin-fixed paraffin embedded (FFPE) tissue (n = 38) of normal lung, suture granulomas, sarcoid granulomas, and fungal granulomas. Utilizing quantitative real-time RT-PCR we analyzed the expression of several genes, including IL-6, COX-2, MCP-1, IFN-γ, T-bet, IRF-1, Nox2, IL-33, and eotaxin-1 and revealed differential regulation between suture, sarcoidosis, and fungal granulomas. This is the first study demonstrating that quantification of target gene expression in FFPE tissue biopsies is a potentially effective diagnostic and research tool in sarcoidosis.
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Affiliation(s)
- George P Christophi
- Department of Gastroenterology, Washington University School of Medicine, St. Louis, MO, United States.
| | - Tiffany Caza
- Department of Pathology, SUNY Upstate Medical University, Syracuse, NY, United States
| | - Christopher Curtiss
- Department of Pathology, SUNY Upstate Medical University, Syracuse, NY, United States
| | - Divya Gumber
- Department of Internal Medicine, Cleveland Clinic, Cleveland, OH, United States
| | - Paul T Massa
- Department of Microbiology & Immunology, SUNY Upstate Medical University, Syracuse, NY, United States
| | - Steve K Landas
- Department of Pathology, SUNY Upstate Medical University, Syracuse, NY, United States
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13
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Braam AWE, de Haan SN, Vorselaars ADM, Rijkers GT, Grutters JC, van den Elshout FJJ, Korenromp IHE. Influence of repeated maximal exercise testing on biomarkers and fatigue in sarcoidosis. Brain Behav Immun 2013; 33:57-64. [PMID: 23727274 DOI: 10.1016/j.bbi.2013.05.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Revised: 05/14/2013] [Accepted: 05/21/2013] [Indexed: 01/08/2023] Open
Abstract
Fatigue in the immune mediated inflammatory disease sarcoidosis is thought to be associated with impaired exercise tolerance. This prospective study assessed fatigue and recuperative capacity after repeated exercise, and examined whether changing concentrations in biomarkers upon exercise are associated with fatigue. Twenty sarcoidosis patients and 10 healthy volunteers performed maximal cardiopulmonary exercise tests on two successive days. Concentrations of cytokines, stress hormones, ACE and CK were assessed before and after the two exercise tests, and 3 days thereafter. All participants completed a sleep diary. Severely fatigued patients showed significant lower VO2 max (p=0.038, p=0.022) and maximal workload (p=0.034, p=0.028) on both exercise tests compared to healthy controls. No impairment of maximal exercise testing was demonstrated during the second cycling test in any group. Fatigue was not correlated with changes in concentrations of biomarkers upon exercise. Severely fatigued patients rated both tests as significantly more fatiguing, and reported significant lower mean subjective night sleeping time during the testing period. Fatigue in sarcoidosis patients cannot be objectified by reduction of exercise capacity after repeated maximal exercise testing, and is not correlated with significant changes in biomarkers. Severe fatigue is only and consistently featured by patient reported outcomes.
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Affiliation(s)
- A W E Braam
- Rijnstate Hospital, Arnhem, The Netherlands; Beatrix Hospital, Gorinchem, The Netherlands
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