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Attenuated free cortisol response to psychosocial stress in children with atopic dermatitis.
Psychosom Med. 1997 Jul-Aug; 59(4):419-26.PM

Abstract

OBJECTIVE

Atopic dermatitis (AD) is an inflammatory skin disease characterized by a hyperactivity of the humoral immune system with an onset in infancy or early childhood. Although most of the research has focused on the pathophysiological role of the immune system in AD, the impact of endocrine signals in the pathology of AD has received only little attention. However, because the endocrine system may play a regulatory role in immune functioning, it might be of major interest to study endocrine reactivity in AD patients. The present two-part study investigated the relationship between adrenocortical stress response, heart rate response, and psychological parameters in children with AD.

METHOD AND RESULTS

In Study 1, a protocol for induction of psychosocial stress in children aged 8 to 14 years was evaluated. Healthy children (N = 16) were exposed to the Trier Social Stress Test for Children (TSST-C) that mainly consists of public speaking and mental arithmetic tasks in front of an audience. Salivary cortisol was measured 35, 15, and 1 minute before as well as 1, 10, 20, and 30 minutes after the stress; heart rate was monitored continuously. Results showed that the protocol induced a highly significant increase in free cortisol response (p < .001) and heart rate (p < .001). In Study 2, the TSST-C was applied to AD children (N = 15) and age- and sex-matched healthy controls (N = 15). All patients were in remission and medication-free for at least 3 weeks. Again, the stress test induced significant increases in cortisol and heart rate. However, the AD children showed a significantly blunted cortisol response to the stressor compared with the control group (p < .05). Heart rate responses were similar in both experimental groups. Neither subjective stress ratings nor personality traits were related to the blunted cortisol response.

CONCLUSIONS

These findings suggest that the adrenocortical response to stress is attenuated in atopic children. A hyporesponsive hypothalamus-pituitary-adrenal (HPA) axis might explain in part the stress-induced eruptions of AD symptoms.

Authors+Show Affiliations

Center for Psychobiological and Psychosomatic Research, University of Trier, Germany. buske@pcmail.uni-trier.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

9251162

Citation

Buske-Kirschbaum, A, et al. "Attenuated Free Cortisol Response to Psychosocial Stress in Children With Atopic Dermatitis." Psychosomatic Medicine, vol. 59, no. 4, 1997, pp. 419-26.
Buske-Kirschbaum A, Jobst S, Wustmans A, et al. Attenuated free cortisol response to psychosocial stress in children with atopic dermatitis. Psychosom Med. 1997;59(4):419-26.
Buske-Kirschbaum, A., Jobst, S., Wustmans, A., Kirschbaum, C., Rauh, W., & Hellhammer, D. (1997). Attenuated free cortisol response to psychosocial stress in children with atopic dermatitis. Psychosomatic Medicine, 59(4), 419-26.
Buske-Kirschbaum A, et al. Attenuated Free Cortisol Response to Psychosocial Stress in Children With Atopic Dermatitis. Psychosom Med. 1997 Jul-Aug;59(4):419-26. PubMed PMID: 9251162.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Attenuated free cortisol response to psychosocial stress in children with atopic dermatitis. AU - Buske-Kirschbaum,A, AU - Jobst,S, AU - Wustmans,A, AU - Kirschbaum,C, AU - Rauh,W, AU - Hellhammer,D, PY - 1997/7/1/pubmed PY - 1997/7/1/medline PY - 1997/7/1/entrez SP - 419 EP - 26 JF - Psychosomatic medicine JO - Psychosom Med VL - 59 IS - 4 N2 - OBJECTIVE: Atopic dermatitis (AD) is an inflammatory skin disease characterized by a hyperactivity of the humoral immune system with an onset in infancy or early childhood. Although most of the research has focused on the pathophysiological role of the immune system in AD, the impact of endocrine signals in the pathology of AD has received only little attention. However, because the endocrine system may play a regulatory role in immune functioning, it might be of major interest to study endocrine reactivity in AD patients. The present two-part study investigated the relationship between adrenocortical stress response, heart rate response, and psychological parameters in children with AD. METHOD AND RESULTS: In Study 1, a protocol for induction of psychosocial stress in children aged 8 to 14 years was evaluated. Healthy children (N = 16) were exposed to the Trier Social Stress Test for Children (TSST-C) that mainly consists of public speaking and mental arithmetic tasks in front of an audience. Salivary cortisol was measured 35, 15, and 1 minute before as well as 1, 10, 20, and 30 minutes after the stress; heart rate was monitored continuously. Results showed that the protocol induced a highly significant increase in free cortisol response (p < .001) and heart rate (p < .001). In Study 2, the TSST-C was applied to AD children (N = 15) and age- and sex-matched healthy controls (N = 15). All patients were in remission and medication-free for at least 3 weeks. Again, the stress test induced significant increases in cortisol and heart rate. However, the AD children showed a significantly blunted cortisol response to the stressor compared with the control group (p < .05). Heart rate responses were similar in both experimental groups. Neither subjective stress ratings nor personality traits were related to the blunted cortisol response. CONCLUSIONS: These findings suggest that the adrenocortical response to stress is attenuated in atopic children. A hyporesponsive hypothalamus-pituitary-adrenal (HPA) axis might explain in part the stress-induced eruptions of AD symptoms. SN - 0033-3174 UR - https://www.unboundmedicine.com/medline/citation/9251162/Attenuated_free_cortisol_response_to_psychosocial_stress_in_children_with_atopic_dermatitis_ L2 - https://doi.org/10.1097/00006842-199707000-00012 DB - PRIME DP - Unbound Medicine ER -