GILZ: a new link between the hypothalamic pituitary adrenal axis and rheumatoid arthritis?

2014 ◽  
Vol 92 (9) ◽  
pp. 747-751 ◽  
Author(s):  
Laura E Eades ◽  
Angeline S Thiagarajah ◽  
James Harris ◽  
Sarah A Jones ◽  
Eric F Morand ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Hypothalamic Pituitary Adrenal Axis ◽  
Hypothalamic Pituitary Adrenal ◽  
Adrenal Axis ◽  
Pituitary Adrenal Axis

scholarly journals Use of the Dexamethasone-Corticotrophin Releasing Hormone Test to Assess Hypothalamic-Pituitary-Adrenal Axis Function in Rheumatoid Arthritis

2009 ◽  
Vol 2009 ◽  
pp. 1-6 ◽  
Author(s):  
Eman A. Hasan ◽  
David S. Jessop ◽  
Lynsey L. Power ◽  
Paul T. Monk ◽  
John R. Kirwan
Keyword(s):  
Rheumatoid Arthritis ◽  
Pilot Study ◽  
Plasma Cortisol ◽  
Hypothalamic Pituitary Adrenal Axis ◽  
Plasma Samples ◽  
Noninvasive Technique ◽  
Hypothalamic Pituitary Adrenal ◽  
Releasing Hormone ◽  
Adrenal Axis ◽  
Pituitary Adrenal Axis

Objectives. Hypothalamic-Pituitary-Adrenal axis function may be abnormal in rheumatoid arthritis (RA). A pilot study in 7 patients suggested impaired glucocorticoid feedback in some patients after the dexamethasone-corticotrophin releasing hormone (CRH) test. This study aimed to investigate the dexamethasone-corticotrophin releasing factor test in a larger group of patients and relate the results to characteristics of the disease.Methods. Outpatients with active RA (≥3 swollen and tender joints and C-reactive protein > 10 mg/L) took dexamethasone (1.5 mg) at 23:00 hour in the evening. Next day, baseline saliva and plasma samples were collected, CRH was infused at 11:00 hour, and 4 serial blood and saliva samples were collected. Plasma samples were stored at−80∘Cand a radioimmunoassay performed for saliva and plasma cortisol.Results. All 20 participants showed normal dexamethasone suppression and mounted no response to the CRH challenge. In samples with measurable cortisol, there was a strong correlation between saliva and plasma values (r= 0.876,n= 26,P<.01).Conclusion. No abnormalities were found in the Dexamethasone-CRH test in RA patients in contrast to a previous pilot study. Salivary cortisol measurement may offer an alternative noninvasive technique to plasma cortisol in RA patients in future studies.

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