Cytokine inhibition after glucocorticoid exposure in healthy men with low versus high basal cortisol levels.

OBJECTIVE: The balance between glucocorticoid (GC) release and GC sensitivity in target cells is believed to be important to maintain homeostasis in the neuroendocrine control of inflammation. We investigated the impact of in vivo exposure to adrenocorticotropic hormone (ACTH) and dexamethasone (DEX) on GC sensitivity measured in vitro in healthy individuals with high versus low baseline cortisol levels. METHODS: 136 healthy male volunteers were screened twice and sorted according to their 24-hour urinary free cortisol (UFC) excretion. The 10 individuals with the highest UFC (290 +/- 87 nmol/24 h) and the 10 with the lowest UFC (168 +/- 34 nmol/24 h) were further tested. Measurements were performed at baseline, after a low dose (0.5 microg/1.73 m(2)) of ACTH challenge and after 2 weeks' exposure to DEX (0.1 mg twice daily). GC sensitivity was assessed in vitro as the ability of DEX to inhibit lipopolysaccharide-stimulated production of the cytokines interleukin 1-beta (IL-1beta), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha) in a whole-blood assay. RESULTS: After exposure to DEX in vivo, inhibition of IL-6 and TNF-alpha decreased. Also, after DEX in vivo, low-cortisol men showed lower inhibition of IL-1beta and IL-6, both compared to the high-cortisol group and their own baseline levels. CONCLUSION: A downregulation of GC sensitivity in leukocytes after exposure to an exogenous GC seems to occur most strongly in men with low cortisol levels.

Effects of examination stress on psychological responses, sleep and allergic symptoms in atopic and non-atopic students.

BACKGROUND: Recent findings indicate that atopics may be more vulnerable to stress than non-atopics. However, the roles of psychological well-being and sleep in this presumed increased sensitivity are not known. PURPOSE: To investigate the effects of a brief naturalistic stressor on psychological responses, sleep, and allergic symptoms and to compare those responses between atopic and non-atopic individuals. METHODS: We assessed atopic and non-atopic students during a period without and during a period with examinations. RESULTS: For both atopic and non-atopic students, tension, anxiety, and depression deteriorated in response to examination, as did sleep latency and sleep quality. Overall, atopics were more tense, had more anxiety, longer sleep latencies, and were less well rested than non-atopics. Non-atopic students rose from bed later during the examination period. In response to examination, atopic students reported increased frequency of stress behaviors (e.g., eating fast), while decreased stress behaviors were reported by non-atopic students. Allergic symptoms were not affected. CONCLUSION: Atopic students were worse off in aspects of psychological well-being and sleep, but displayed only partly stronger responses to a stressor compared to non-atopic students. In spite of a broad negative response to examination, allergic symptoms were not affected.