Cited by 337Stress Responses and CortisolAdrenal Hormones and DisordersRheumatoid Arthritis Research and Therapies

Defective hypothalamic response to immune and inflammatory stimuli in patients with rheumatoid arthritis

Chikanza, Ian C., Petrou, Petros, Kingsley, Gabrielle, Chrousos, George, Panayi, Gabriel S.·1992·Arthritis & Rheumatism

Abstract

OBJECTIVE: To determine the integrity of the hypothalamic-pituitary-adrenal (HPA) axis responses to immune/inflammatory stimuli in patients with rheumatoid arthritis (RA). METHODS: Diurnal secretion of cortisol and the cytokine and cortisol responses to surgery were studied in subjects with active RA, in subjects with chronic osteomyelitis (OM), and in subjects with noninflammatory arthritis, who served as controls. RESULTS: Patients with RA had a defective HPA response, as evidenced by a diurnal cortisol rhythm of secretion which was at the lower limit of normal in contrast to those with OM, and a failure to increase cortisol secretion following surgery, despite high levels of interleukin-1 beta (IL-1 beta) and IL-6. The corticotropin-releasing hormone stimulation test in the RA patients showed normal results, thus suggesting a hypothalamic defect, but normal pituitary and adrenal function. CONCLUSION: These findings suggest that RA patients have an abnormality of the HPA axis response to immune/inflammatory stimuli which may reside in the hypothalamus. This hypothalamic abnormality may be an additional, and hitherto unrecognized, factor in the pathogenesis of RA.

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Crossref · 10.1002/art.1780351107

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Authors
Chikanza, I. C., Petrou, P., Kingsley, G., Chrousos, G., & Panayi, G. S.
Affiliations
Guy's Hospital (GB)
Corresponding author
Panayi, Gabriel S.
Venue
Arthritis & Rheumatism
Publisher
Wiley
Published
1992-11
Volume
35
Issue
11
Pages
1281-1288
ISSN
  • 0004-3591 (ISSN-L)
  • 1529-0131
OpenAlex
W1718876362
Cited by
337
References
35
Citations by year
2026: 5 · 2025: 1 · 2024: 5 · 2023: 3 · 2021: 4 · 2020: 4 · 2019: 2 · 2018: 1 · 2017: 8 · 2016: 9 · 2015: 4 · 2014: 6 · 2013: 7 · 2012: 9
FWCI
8.08
Type
journal article
Language
en
Open access
closed
Locations
  • Arthritis & Rheumatism (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
  • Health Sciences › Medicine › Rheumatology › Rheumatoid Arthritis Research and Therapies
Keywords
rheumatoid arthritis, hypothalamic-pituitary-adrenal axis, hypothalamic dysfunction, cortisol secretion, diurnal cortisol rhythm, corticotropin-releasing hormone stimulation test, IL-1β, interleukin-6, chronic osteomyelitis, inflammatory stimuli
MeSH terms
Adult, Aged, Arthritis, Rheumatoid, Circadian Rhythm, Corticotropin-Releasing Hormone, Female, Humans, Hydrocortisone, Hypothalamus, Immune System, Male, Middle Aged, Postoperative Period, Cytokines

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