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Changes of immune and endocrine parameters in PTSD over time

Distinct profile of hypothalamic-pituitary-adrenocortical (HPA) axis, manifested by low cortisol level and increased number of glucocorticoid receptors (GRs), is considered to be characteristic of posttraumatic stress disorder (PTSD). The findings rely on studies performed decades following exposure to trauma. Our previous study performed within 8 years from traumatic event revealed elevated plasma cortisol level and lower GRs expression in examined lymphocyte populations. We assumed that more time is needed for reversal of hormone and its receptor expression to take place due to hyperactivity of HPA-axis. Participants were Croatian war veterans with PTSD diagnosed according to DSM-IV criteria within 8 years after traumatic event. We re-assessed 18 of the same PTSD patients and 10 age matched civilian controls 5 years later. Proportions of total T, B and NK cells, Th and Tc cells, activated B, total and Th memory lymphocyte subpopulations, as well as GRs expression in these populations were determined by flow cytometry. NK cell activity was measured by 51Cr-release assays. Platelet activation status will be determined by flow cytometry according to proportion of leukocyte-platelet aggregates in circulation because platelet-mediated mechanisms might form one of the pathways through which psychological factors influence cardiovascular disease. We found decrease in percentages of Tc and total memory cells and did not reveal significant changes over time in GRs expression on total T, B and NK cells in this preliminary follow up study.

PTSD; glucocorticoid receptors; GR; cortisol; platelet; immunophenotype; flow cytometry

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