Increase of sympathetic outflow measured by neuropeptide Y and decrease of the hypothalamic-pituitary-adrenal axis tone in patients with systemic lupus erythematosus and rheumatoid arthritis: another example of uncoupling of response systems

DOI to cite this document:

10.5283/epub.771 Copy

Härle, P. ; Straub, R. H. ; Wiest, R. ; Mayer, A. ; Schölmerich, J. ; Atzeni, F. ; Carrabba, M. ; Cutolo, M. ; Sarzi-Puttini, P.

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Date of publication of this fulltext: 05 Aug 2009 13:24

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Details

Item type:	Article
Journal or Publication Title:	Annals of the rheumatic diseases
Publisher:	BMJ PUBLISHING GROUP
Place of Publication:	LONDON
Volume:	65
Number of Issue or Book Chapter:	1
Page Range:	pp. 51-6
Date:	January 2006
Institutions:	Medicine > Lehrstuhl für Innere Medizin I
Identification Number:	Value Type 15941834 PubMed ID 10.1136/ard.2005.038059 DOI
Keywords:	TUMOR-NECROSIS-FACTOR; AUTONOMIC NERVOUS-SYSTEM; SEX-HORMONE STATUS; GLUCOCORTICOID-RECEPTOR; ADRENERGIC-RECEPTORS; ADRENOCORTICAL AXIS; SUBCELLULAR STORAGE; REVISED CRITERIA; AXONAL-TRANSPORT; ALTERED FUNCTION;
Dewey Decimal Classification:	600 Technology > 610 Medical sciences Medicine
Status:	Published
Refereed:	Yes, this version has been refereed
Created at the University of Regensburg:	Unknown
Item ID:	771

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Abstract

Objective: To study in parallel the outflow of the sympathetic nervous system (SNS) and the hypothalamic-pituitary adrenal (HPA) axis tone in systemic lupus erythematosus (SLE) and rheumatoid arthritis ( RA). Methods: 32 patients with SLE, 62 with RA, and 65 healthy subjects (HS) were included. To measure the tone of the HPA axis, plasma ACTH and serum cortisol were determined. Serum neuropeptide ...

Abstract

Objective: To study in parallel the outflow of the sympathetic nervous system (SNS) and the hypothalamic-pituitary adrenal (HPA) axis tone in systemic lupus erythematosus (SLE) and rheumatoid arthritis ( RA). Methods: 32 patients with SLE, 62 with RA, and 65 healthy subjects (HS) were included. To measure the tone of the HPA axis, plasma ACTH and serum cortisol were determined. Serum neuropeptide Y (NPY) was used to evaluate the sympathetic outflow. Results: Patients with SLE had increased NPY levels in comparison with HS, irrespective of prior prednisolone treatment (p < 0.001). For patients with RA, only those with prednisolone treatment had increased NPY levels in comparison with HS (p = 0.016). Daily prednisolone dose correlated positively with serum NPY in RA (R-Rank = 0.356, p = 0.039). In contrast, plasma ACTH levels were generally decreased significantly in comparison with HS in SLE with prednisolone, and in RA with/without prednisolone. Similarly, serum cortisol levels were also decreased in SLE with/without prednisolone, and in RA with prednisolone. The NPY/ACTH ratio was increased in SLE and RA, irrespective of prior prednisolone treatment. The NPY/cortisol ratio was increased in SLE with/without prednisolone, and in RA with prednisolone. Twelve weeks' anti-TNF antibody treatment with adalimumab did not decrease NPY levels in RA, irrespective of prednisolone treatment. Conclusions: An increased outflow of the SNS was shown and a decreased tone of the HPA axis in patients with SLE and RA. Low levels of cortisol in relation to SNS neurotransmitters may be proinflammatory because cooperative anti-inflammatory coupling of the two endogenous response axes is missing.

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