A Comorbid Major Depression in Patients with Panic Disorder Affects the HPA Axis Response in the DEX-CRH Test

2014 ◽  
Vol 28 (4) ◽  
pp. 257-264
Author(s):  
Katja Petrowski ◽  
Gloria-Beatrice Wintermann ◽  
Clemens Kirschbaum ◽  
Stefan R. Bornstein

Panic disorder (PD) has been associated with an altered reactivity of the hypothalamic-pituitary-adrenocortical (HPA) system in the dexamethasone-corticotropin-releasing-hormone (DEX-CRH) test. Recent findings showed that the duration of the PD and the severity of psychopathology are prominent moderators of the HPA-axis reactivity under hormonal stress induction. As major depression (MD) often occurs as comorbidity in patients with PD, a secondary MD might influence the reactivity of HPA-axis in the DEX-CRH test. For this study, the DEX-CRH test was implemented to observe the adreno-corticotropin-hormone (ACTH) and the cortisol release. The sample included 20 patients diagnosed with PD (mean age = 32.20 years, SD = 9.98), 20 patients with PD and comorbid MD (mean age = 37.63 years, SD = 11.31) in a Structured Clinical Interview (SCID), and 20 healthy controls (mean age = 31.97 years, SD = 10.53) matched by age and gender. The ACTH and the cortisol release increased significantly in all three groups due to the CRH injection (p < .001). The two anxiety patient groups differed in the cortisol response pattern, however, not in the ACTH. Patients with pure PD showed a lower CRH-induced cortisol release than healthy controls (p < .038) and patients with a comorbid major depression (p = .001); the latter showed the highest cortisol release in DEX-CRH test. Duration (AUCg: r = .353, p = .030; AUCi: r = .339, p = .037) and severity of psychopathology (AUCg: r = .496, p = .026; AUCi: r = .463, p = .040) significantly correlated with the cortisol release. Patients with/without comorbid MD showed some dissociation between the central and the peripheral HPA-axis functionality under the DEX-CRH test. Furthermore, it seems that a secondary depressive disorder is the decisive factor in explaining an increased reactivity of HPA-axis in patients with PD.

NeuroImage ◽  
2008 ◽  
Vol 41 ◽  
pp. T146 ◽  
Author(s):  
Paul J. Carlson ◽  
E. Bain ◽  
R. Tinsley ◽  
A. Nugent ◽  
R. Carson ◽  
...  

Author(s):  
Johannes J. Kovarik ◽  
Anna K. Kämpf ◽  
Fabian Gasser ◽  
Anna N. Herdina ◽  
Monika Breuer ◽  
...  

This study aimed to determine the specific cytokine profile in peripheral blood during the early onset of COVID-19 infection. This was a cross-sectional exploratory, single center study. A total of 55 plasma samples were studied. Serum samples of adults showing symptoms of COVID-19 infection who were tested positive for SARS-CoV-2 infection (CoV+, n=18) at the COVID-19 outpatient clinic of the Medical University of Vienna were screened for immune activation markers by Luminex technology. Additionally, age and gender-matched serum samples of patients displaying COVID-19 associated symptoms, but tested negative for SARS-CoV-2 (CoV-, n=16) as well as healthy controls (HC, n=21) were analyzed. COVID-19 positive (CoV+) patients showed a specific upregulation of BLC (141; 74-189 pg/mL), SCD30 (273; 207-576 pg/mL), MCP-2 (18; 12-30 pg/mL) and IP-10 (37; 23-96 pg/mL), compared to patients with COVID19-like symptoms but negative PCR test (CoV-), BLC (61; 22-100 pg/mL), sCD30L (161; 120-210 pg/mL), MCP-2 (8; 5-12 pg/mL) and IP-10 (9; 6-12 pg/mL) and healthy controls (HC) (BLC 22; 11-36 pg/mL, sCD30 74; 39-108 pg/mL, MCP-2 6; 3-9. pg/mL, IP-10 = 8; 5-13). The markers APRIL, sIL-2R, IL7, MIF, MIP-1b, SCF, SDF-1a, sTNF-RII were elevated in both CoV+ and CoV- patient groups compared to healthy controls. HGF, MDC and VEGF-A were elevated in CoV- but not CoV+ compared to healthy controls. BLC, sCD30, MCP-2 and IP-10 are specifically induced during early stages of COVID-19 infection and might constitute attractive targets for early diagnosis and treatment of this disease.


2000 ◽  
Vol 58 (2B) ◽  
pp. 408-411 ◽  
Author(s):  
ACIOLY L.T. LACERDA ◽  
DORGIVAL CAETANO ◽  
SHEILA C. CAETANO

Serum plasma total cholesterol levels were measured in 85 male or female outpatients with panic disorder (PD; N=41), generalized anxiety disorder (GAD; N=23) and major depression (MD; N=21) according to DSM-IV criteria. All the patients had a mean cholesterol level within the normal range; males (N=22) and females (N=63) had approximately the same serum cholesterol levels (p > .05). No significant differences in cholesterol levels emerged between PD, GAD and MD patient groups. Both female PD and female GAD subjects had a mean cholesterol level similar to their male counterparts (p>.05). It is concluded that both Hayward and colleagues and Bajwa et al. findings could not be replicated by our study.


2020 ◽  
Vol 39 (04) ◽  
pp. 222-237
Author(s):  
Lena Schneider ◽  
Andreas Walther

ZusammenfassungHintergrund: Frauen erkranken fast doppelt so häufig wie Männer an einer Major Depression. Eine Hyperaktivität der Hypothalamus-Hypophysen-Nebennierenrinden-Achse (HHNA) und eine chronisch niedrig-gradige Inflammation sind 2 der konsistentesten biologischen Befunde bei schweren Depressionen. Inwiefern diese Parameter für die Existenz von Geschlechtsunterschieden bei Depression eine Rolle spielen, ist noch unzureichend untersucht worden. Methoden: Es wurde eine systematische Literaturrecherche mittels der elektronischen Fachdatenbanken (PubMed, Web of Science, PsycARTICLES) durchgeführt. Die Suche umfasste alle englischsprachigen Artikel, die bis zum 29. Juni 2019 aufgenommen wurden. Als MeSH terms wurden depression, sex differences, inflammation, hpa axis, mit Zusätzen wie cortisol, crp, IL-6, TNF-alpha, dex/crh oder tsst verwendet. Ergebnisse: Insgesamt konnten 62 Primärstudien mit einem Total von 91318 Probanden (52 % Frauen) eingeschlossen werden. Basale Glucocorticoidkonzentrationen scheinen für beide Geschlechter tendenziell positiv mit dem Vorliegen oder der Schwere einer Depressionssymptomatik assoziiert zu sein. Konsistente Geschlechtsunterschiede konnten für die Cortisolreaktion auf einen Stressor sowie für Entzündungsmarker identifiziert werden. Fazit: Geschlechtsunterschiede in der Neurobiologie der Depression sind identifizierbar und geben Anlass für geschlechtsspezifische Untersuchungen der Pathophysiologie von Depressionen und deren geschlechtsspezifischer Behandlungen.


2013 ◽  
Vol 46 (06) ◽  
Author(s):  
A Menke ◽  
S Kloiber ◽  
J Best ◽  
M Rex-Haffner ◽  
M Uhr ◽  
...  

2005 ◽  
Vol 38 (05) ◽  
Author(s):  
TS Frodl ◽  
T Zetzsche ◽  
G Schmitt ◽  
T Schlossbauer ◽  
MW Jäger ◽  
...  

2021 ◽  
Vol 22 (11) ◽  
pp. 5495
Author(s):  
Felipe Borges Almeida ◽  
Graziano Pinna ◽  
Helena Maria Tannhauser Barros

Under stressful conditions, the hypothalamic-pituitary-adrenal (HPA) axis acts to promote transitory physiological adaptations that are often resolved after the stressful stimulus is no longer present. In addition to corticosteroids (e.g., cortisol), the neurosteroid allopregnanolone (3α,5α-tetrahydroprogesterone, 3α-hydroxy-5α-pregnan-20-one) participates in negative feedback mechanisms that restore homeostasis. Chronic, repeated exposure to stress impairs the responsivity of the HPA axis and dampens allopregnanolone levels, participating in the etiopathology of psychiatric disorders, such as major depressive disorder (MDD) and post-traumatic stress disorder (PTSD). MDD and PTSD patients present abnormalities in the HPA axis regulation, such as altered cortisol levels or failure to suppress cortisol release in the dexamethasone suppression test. Herein, we review the neurophysiological role of allopregnanolone both as a potent and positive GABAergic neuromodulator but also in its capacity of inhibiting the HPA axis. The allopregnanolone function in the mechanisms that recapitulate stress-induced pathophysiology, including MDD and PTSD, and its potential as both a treatment target and as a biomarker for these disorders is discussed.


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