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Related Experiment Videos

Hypercortisolism after stroke--partly cytokine-mediated?

A Johansson1, T Olsson, B Carlberg

  • 1Department of Internal Medicine, Umeå University Hospital, Sweden.

Journal of the Neurological Sciences
|March 20, 1997
PubMed
Summary

Early stroke can disrupt the hypothalamic-pituitary-adrenal (HPA) axis, leading to abnormal cortisol levels. Interleukin-6 (IL-6) and other cytokines correlate with cortisol, suggesting a role in HPA axis dysregulation after stroke.

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Area of Science:

  • Neuroendocrinology
  • Stroke Pathophysiology
  • Inflammatory Response

Background:

  • Hypothalamic-pituitary-adrenal (HPA) axis hyperactivity and hypercortisolism are common early after stroke.
  • A dissociation between adrenocorticotrophic hormone (ACTH) and cortisol has been recently reported post-stroke.
  • Cytokines, such as Interleukin-6 (IL-6), are elevated after stroke and may influence HPA axis activity.

Purpose of the Study:

  • To investigate the correlations between cortisol, ACTH, and cytokines in the early phase after stroke.
  • To examine the relationship between blood pressure and blood hormone levels in stroke patients.
  • To explore potential mechanisms of HPA axis dysregulation in the acute stroke period.

Main Methods:

  • Analysis of serum cortisol, ACTH, IL-6, TNF alpha, norepinephrine, and epinephrine levels.

Related Experiment Videos

  • Four daily blood sample collections and 24-hour ambulatory blood pressure monitoring.
  • Correlation analysis between hormone levels, cytokines, and blood pressure in seven stroke patients with brain infarctions.

    • Main Results:

    • Plasma IL-6 levels showed a significant correlation with serum cortisol, whereas ACTH did not.
    • Catecholamine levels (norepinephrine and epinephrine) correlated with both cytokine and cortisol levels.
    • The study observed associations between inflammatory markers and hormonal changes in acute stroke.

    Conclusions:

    • Multiple pathways for HPA axis dysregulation exist early after stroke.
    • Cytokine release, particularly IL-6, appears to play a significant role in the neuroendocrine response to acute stroke.
    • These findings highlight the complex interplay between inflammation and the HPA axis in the post-stroke period.