肠易激综合征中下丘脑-垂体-肠腺轴调节失调:血浆细胞因子是否为潜在的生物标记

查看全文 作　　者：Dinan [1]T.G.;Quigley E.M.M.;Ahmed S.M.M.;赵天智 机构地区：[1]Department of Psychiatry, Cork University Hospital, Wilton, Cork, Ireland,Dr. 出　　处：《世界核心医学期刊文摘(胃肠病学分册)》索引2006年第2卷第8期,共1页 摘　　要：Background & Aims: Irritable bowel syndrome (IBS) is a functional disorder with an etiology that has been linked to both psychological stress and infection. The primary aim of this study was to examine the hypothalamic-pituitary-adrenal axis in patients with IBS and to relate such response to plasma cytokine profiles. Methods: A total of 151 subjects, 76 patients and 75 controls, were recruited. The patients with IBS were diagnosed according to Rome II criteria. Forty-nine patients and 48 matched controls had cytokine levels measured, and a subset of 21 patients and 21 controls also underwent a corticotropin-releasing hormone (CRH) stimulation test with plasma levels of adrenocorticotropic hormone (ACTH) and cortisol measured. The remaining 27 patients and 27 controls underwent a dexamethasone (1 mg) challenge. Results: Cortisol and the proinflammatory cytokines interleukin (IL)- 6 (together with its soluble receptor) and IL-8 were elevated in all IBS subgroups (diarrhea predominant, constipated, and alternators), although the elevation was most marked in the constipated subgroup. There was no alteration in the anti-inflammatory cytokine IL- 10. Following CRH infusion, an exaggerated release of both ACTH and cortisol was observed in patients with IBS. There was a significant correlation between the ACTH response (δ ACTH) and the IL- 6 levels. A similar relationship existed between the δ ACTH/δ cortisol ratio and the IL- 6 levels. Dexamethasone suppression of cortisol was similar in patients and controls. Conclusions: IBS is characterized by an overactivation of the hypothalamic-pituitary-adrenal axis and a proinflammat ory cytokine increase. 关 键 词：肠易激综合征(IBS) 血浆细胞因子 下丘脑-垂体 促肾上腺皮质激素释放激素(CRH) 生物标记 肠腺 IBS患者 细胞因子水平 潜在 失调