Lymphocyte glucocorticoid receptor resistance and depressive symptoms severity: a preliminary report.

OBJECTIVE: Assessment of the temporal interrelationship of neuropsychiatric parameters requires technologies allowing frequent biological measurements. We propose glucocorticoid receptor (GR) function of lymphocytes to assess the temporal relationship between glucocorticoid resistance and the course of major depressive disorder. METHOD: Dexamethasone suppression of lymphocyte proliferation was in vitro assessed via 5-bromo-2' deoxyuridine (BrdU) incorporation in DNA. Optimal conditions were determined using blood of healthy volunteers. Thereafter the relation between depression severity (Hamilton Depression Rating Scale, HDRS, scores), lymphocyte proliferation and morning cortisol levels in blood was studied in thirteen depressed patients, mostly with a history of treatment resistance. RESULTS: Recovery from depression was not directly associated with changes in lymphocyte glucocorticoid resistance. However, a negative correlation was observed between HDRS and BrdU incorporation and a positive correlation between morning cortisol and BrdU incorporation. No significant correlation was found between cortisol and HDRS. Regression analyses showed that HDRS was related to both suppression of BrdU incorporation (beta -0.508, p<0.001) and cortisol levels (beta 0.364, p=0.001) in a highly significant model (F2,60=14,244, p<0.001) Except for one case, such relation could not be found within patients. CONCLUSION: Our preliminary results suggest a mutual relation between lymphocyte GR function, morning cortisol levels and MDD symptom severity. A direct relation between glucocorticoids resistance and recovery may not exist, but glucocorticoid resistance might attenuate or prevent recovery. It is clear that additional studies using larger and more homogenous groups of MDD patients are required to support our findings.

[The effect of dietotherapy and supplementary calcium intake on phosphorus-calcium homeostasis in hypertensive patients]. / Vliianie dietoterapii i dopolnitel'nogo priema kal'tsiia na fosforno-kal'tsievyi gomeostaz u bol'nykh gipertonicheskoi bolezn'iu.

A total of 25 patients with essential hypertension received a hyponatrium, hypocaloric antisclerotic diet providing 800 mg Ca and 1100 mg P/day, during 18-20 days. As a result of the dietotherapy, Ca concentration in the patients' blood serum rose from 9.9 +/- 0.2 to 10.4 +/- 0.1 mg/100 ml (p = 0.02), total cholesterol level was lowered from 6.58 +/- 0.43 to 5.42 +/- 0.3 mmol/l (p less than 0.05), Na+ and K+ distribution between the blood plasma and red blood cells was improved, and the arterial blood pressure was normalized in all the patients investigated. It dropped from 162 +/- 3.8/102 +/- 1.8 mm Hg before the treatment to 129 +/- 2.1/83.4 +/- 2.2 mm Hg after the treatment. Additional intake of 850 mg Ca/day, as CaCO3, decreased parathormone level in the blood serum from 0.40 +/- 0.03 to 0.23 ng/ml (p less than 0.01), intensified the hypolipidemic effect of the ration, and did not influence the degree of arterial blood pressure reduction under the action of this ration. Optimization of Ca consumption plays an important role in the combined dietotherapy of essential hypertension.