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Hypothalamic pituitary adrenal axis and prolactin abnormalities in suicidal behavior.
Maurizio Pompili1, Gianluca Serafini, Mario Palermo
1Department of Neurosciences, Mental Health and Sensory Organs - Sant'Andrea Hospital, "Sapienza" University of Rome, 1035-1039, Via di Grottarossa, 00189, Rome, Italy. maurizio.pompili@uniroma1.it.
CNS & Neurological Disorders Drug Targets
|September 18, 2013
Summary
Hypothalamic-Pituitary-Adrenal (HPA) axis hyperactivity and elevated prolactin (PRL) levels may predict suicidal behavior in mood disorder patients. These neuroendocrine changes, alongside lipid and immune dysregulations, are linked to depression and suicidality.
Area of Science:
- Neuroendocrinology
- Psychiatry
- Behavioral Science
Background:
- Hypothalamic-Pituitary-Adrenal (HPA) axis hyperactivity, assessed via dexamethasone suppression and dexamethasone/CRH tests, shows potential predictive value for suicidal behavior in mood disorders.
- Elevated prolactin (PRL) levels are associated with both physiological and pathological states, and may coexist with HPA-axis abnormalities.
- Neuroendocrine changes may simultaneously influence HPA axis activity and PRL release, suggesting a common underlying mechanism in certain patient populations.
Purpose of the Study:
- To explore the predictive power of HPA axis hyperactivity and elevated prolactin levels for suicidal behavior in patients with mood disorders.
- To investigate the potential link between HPA axis abnormalities, PRL levels, and suicidal behavior.
- To examine the role of lipid/immune dysregulations and pro-inflammatory cytokines in major depression and suicidal behavior.
Main Methods:
- Utilized dexamethasone suppression tests and dexamethasone/CRH tests to measure HPA axis activity.
- Assessed prolactin (PRL) levels in patients with mood disorders.
- Reviewed existing literature on HPA axis function, PRL levels, androgen/testosterone levels, lipid/immune dysregulations, and pro-inflammatory cytokines in relation to depression and suicidal behavior.
Main Results:
- HPA axis hyperactivity is presumed to be present in a significant subpopulation of depressed individuals.
- While high androgen levels are linked to aggression, lower plasma total testosterone has been reported in depressed subjects with higher suicidality.
- Increased PRL levels, lipid/immune dysregulations, and an elevated blood fatty acid ratio may correlate with increased pro-inflammatory cytokine production, observed in major depression and suicidal behavior.
Conclusions:
- HPA axis hyperactivity and elevated PRL levels may serve as potential biomarkers for suicidal behavior in mood disorders.
- The interplay between neuroendocrine factors, immune function, and hormonal imbalances warrants further investigation in the context of suicidality.
- Future research could explore the utility of post-mortem PRL levels as an indicator of ante-mortem physical stress.
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