Re: Epinephrine Infusion Lowers Serum Cortisol in Patients With Rheumatoid Arthritis

[Guest guest]

Hi !

As usual, I'm never quite sure what these researchers are trying to say...

Am I to understand that " psychological stress " can increase the pain of RA?

Well, DUH...

Suzanne

[ ] Epinephrine Infusion Lowers Serum Cortisol in Patients

With Rheumatoid Arthritis

> Epinephrine Infusion Lowers Serum Cortisol in Patients With Rheumatoid

> Arthritis

>

>

>

>

> NEW YORK (Reuters Health) Aug 28 - Patients with rheumatoid arthritis

> show a dip in serum cortisol and in 17-hydroxyprogesterone (17OHP) after

> an infusion of intravenous epinephrine, whereas healthy controls show no

> such change, European researchers report in the August issue of The

> Journal of Rheumatology.

> To further elucidate the effect of stress on rheumatoid arthritis, Dr.

> Rainer H. Straub of University Medical Center Regensburg, Germany, and

> colleagues infused 15 untreated female patients with rheumatoid

> arthritis (mean age 51) and 7 healthy female controls (mean age 48) with

> epinephrine 0.05 micrograms/kg per minute for 20 minutes.

>

> The investigators found that baseline serum cortisol and 17OHP levels

> were higher in controls both before and after epinephrine infusion.

> After epinephrine infusion, patients with RA showed a statistically

> significant decrease in serum cortisol levels and serum 17OHP.

> Adrenocorticotropic hormone levels (ACTH) and dehydroepiandrosterone

> sulfate (DHEAS) levels tended to drop in RA patients, though not to a

> statistically significant degree, but remained constant in controls.

>

> Since patients with RA or juvenile chronic arthritis may have elevated

> levels of catecholamines or an increased sympathetic tone, " adrenoceptor

> expression may be changed in tissue, " the researchers explain. " Indeed,

> it has been demonstrated that beta-adrenoceptor expression on peripheral

> blood mononuclear cells was decreased, " they write. " This could lead to

> subsequent impairment of epinephrine effects due to receptor

> desensitization. "

>

> While the mechanisms for such changes in the sympathetic nervous system

> of RA patients remains unknown, " some situations may arise in which

> psychological stress with similar conditions comparable to epinephrine

> infusion may lead to an unfavorable response of the

> hypothalamic-pituitary-adrenal axis, " the investigators point out.

> " Downregulation of serum cortisol in such a situation may be a relevant

> factor for exacerbation of RA. "

>

> J Rheumatol 2002;29:1659-1664.

[Guest guest]

Hello, Suzanne! Glad to see that you are still trying to decipher these

studies along with me. I don't feel so alone.

Yes, the researchers are saying that " downregulation of serum cortisol "

might be one of the reasons for RA flares after stress (simulated by the

epinephrine infusion). More than that, however, they are saying that RA

patients have a different response to stress than normals. The reasons

for this, although there are many theories, are unclear.

Hope you are doing well,

[ ] Epinephrine Infusion Lowers Serum Cortisol in

Patients

> With Rheumatoid Arthritis

>

>

> > Epinephrine Infusion Lowers Serum Cortisol in Patients With

Rheumatoid

> > Arthritis

> >

> >

> >

> >

> > NEW YORK (Reuters Health) Aug 28 - Patients with rheumatoid

arthritis

> > show a dip in serum cortisol and in 17-hydroxyprogesterone (17OHP)

after

> > an infusion of intravenous epinephrine, whereas healthy controls

show no

> > such change, European researchers report in the August issue of The

> > Journal of Rheumatology.

> > To further elucidate the effect of stress on rheumatoid arthritis,

Dr.

> > Rainer H. Straub of University Medical Center Regensburg, Germany,

and

> > colleagues infused 15 untreated female patients with rheumatoid

> > arthritis (mean age 51) and 7 healthy female controls (mean age 48)

with

> > epinephrine 0.05 micrograms/kg per minute for 20 minutes.

> >

> > The investigators found that baseline serum cortisol and 17OHP

levels

> > were higher in controls both before and after epinephrine infusion.

> > After epinephrine infusion, patients with RA showed a statistically

> > significant decrease in serum cortisol levels and serum 17OHP.

> > Adrenocorticotropic hormone levels (ACTH) and dehydroepiandrosterone

> > sulfate (DHEAS) levels tended to drop in RA patients, though not to

a

> > statistically significant degree, but remained constant in controls.

> >

> > Since patients with RA or juvenile chronic arthritis may have

elevated

> > levels of catecholamines or an increased sympathetic tone,

" adrenoceptor

> > expression may be changed in tissue, " the researchers explain.

" Indeed,

> > it has been demonstrated that beta-adrenoceptor expression on

peripheral

> > blood mononuclear cells was decreased, " they write. " This could lead

to

> > subsequent impairment of epinephrine effects due to receptor

> > desensitization. "

> >

> > While the mechanisms for such changes in the sympathetic nervous

system

> > of RA patients remains unknown, " some situations may arise in which

> > psychological stress with similar conditions comparable to

epinephrine

> > infusion may lead to an unfavorable response of the

> > hypothalamic-pituitary-adrenal axis, " the investigators point out.

> > " Downregulation of serum cortisol in such a situation may be a

relevant

> > factor for exacerbation of RA. "

> >

> > J Rheumatol 2002;29:1659-1664.