Osovina hipotalamus-hipofiza-nadbubrežna žlijezda u bolesnika s psorijazom

master's thesis

• Title (english): Hypothalamic-pituitary-adrenal axis in patients with psoriasis
• Author: Iva Buterin
• Mentor: Milan Vrkljan (mentor)
• Committee member: Mislav Vrsalović (predsjednik povjerenstva)
• Committee member: Jasenka Markeljević (član povjerenstva)
• Committee member: Milan Vrkljan (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2016-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Osovina hipotalamus-hipofiza-adrenalna žlijezda (HHA-os) je jedan od najvažnijih neuroendokrinih sustava koji posreduje reakciju na stres. Osnovna komponenta HHA-osi je hipotalamus, dio limbičkog sustava koji nadzire ljudsko ponašanje. Neadekvatna kompenzatorna reakcija na stres može dovesti do nastanka mnogih bolesti.
Sve kronične bolesti povezane sa stresom imaju promijenjenu HHA-os koja nije sposobna izvršavati svoju imunoregulatornu funkciju te je rezultat nastanak bolesti. Bez obzira na vrstu stresora, kompenzatorna reakcija na stres uvijek rezultira aktivacijom HHA-osi i pojačanom sekrecijom glukokortikoida. U uvjetima kroničnog stresa razine kortizola su niske što ukazuje na iscrpljenost HHA-osi u nastojanju da kompenzira odgovor na stresni podražaj.
Promjene HHA-osi nalazimo kod bolesti kao što su depresija, posttraumatski stresni poremećaj (PTSP), alkoholizam, anoreksija nervoza. Također je funkcija HHA-osi poremećena i u bolesnika s psorijazom. Psorijaza je kronična autoimuna bolest za koju je karakteristična pojava crvenih plakova prekrivenih bijelim ljuskama. Oboljeli imaju izrazito niske vrijednosti urinarnog kortizola, stroži cirkadijani ritam serumskog kortizola i pojačanu supresiju sekrecije kortizola u deksametazonskom testu. Dakle, u ovih pacijenata nalazimo promijenjenu HHA-os koja ne može osigurati svoju imunoregulatornu funkciju i posljedica je pojava kliničkih znakova bolesti.

Abstract (english)

Hypothalamic-pituitary-adrenal axis (HPA axis) is one of the most important neuroendocrine systems that mediate reaction to stress. The main component of this axis is hypothalamus, part of the limbic system which is in control of human behavior. Inappropriate compensatory response to stress can lead to numerous disorders.
Changes in HPA axis are present in diseases like depression, post-traumatic stress disorder (PTSD), alcoholism, anorexia nervosa.. Also function of HPA axis is abnormal in patients with psoriasis. Psoriasis is a chronic autoimmune disease characterised by red plaques covered with white scales. Patients suffering from psoriasis have significantly lower urine cortisol levels, more stringent circadian rhythm of serum cortisol secretion and enhanced suppression of cortisol secretion in dexamethasone test. In these patients exists altered HPA-axis function which is incompetent to realise its immunoregulatory function and consequence are clinical signs of psoriasis.
Altogether stress related chronic diseases have altered HPA axis function, which then, due to low levels of cortisol is unable to fulfill its immunoregulatory function, resulting in disease. Whatever the nature of stressor, compensatory central nervous system reaction to stress always leads to activation of HPA axis and increased glucocorticoid secretion in conditions of chronic stress level of stored cortisol is lower, suggesting that the HPA axis is exhausted, struggling with stressful stimuli.

• Keywords: os hipotalamus-hipofiza-adrenalna žlijezda; kortizol; kronični stres; psorijaza
• Keywords (english): Hypothalamic-pituitary-adrenal axis; cortisol; chronic stress; psoriasis
• Language: croatian
• URN:NBN: urn:nbn:hr:105:721466
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2017-06-28 12:24:20