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Immune and endocrine parameters in PTSD - follow up study

Our study performed on PTSD (post traumatic stress disorder) patients within 8 years from traumatic event revealed elevated plasma cortisol level and lower GRs (glucocorticoid receptors) expression in examined lymphocyte populations, opposite to studies performed decades following exposure to trauma. We assumed that longer time period is needed for reversal of hormone and its receptor expression to take place due to hyperactivity of HPA (hypothalamic-pituitary-adrenocortical) axis. This study also showed proportions of CD3 and CD4 cells, as well as NK activity to be significantly higher in PTSD patients than in healthy controls. Participants were 39 Croatian war veterans with PTSD re-tested 6 years later. Proportions of main lymphocyte populations and their activated subpopulations, as well as GRs expression in these populations were determined by flow cytometry. Cortisol levels were determined by radioimmunoassay. NK cell activity was measured by 51Cr-release assays. We found decrease in percentages of total memory cells while proportions of other tested populations did not significantly alter during 6 years. NK cell activity also remained unchanged over time but still higher in comparison to healthy control subjects 6 years previously. Interestingly, GRs levels were significantly higher and cortisol levels showed tendency to fall in this longitudinal study. This confirmed our hypothesis that changes in immune and endocrine systems in PTSD are not static but depend on duration of allostatic load. Distinct profile of HPA axis shown in the other studies (lower plasma cortisol level and higher GRs expression) is probably achieved later in the course of PTSD, more than 10 years following trauma. This is the first longitudinal study of its kind but longer follow up period is needed to better understand dynamics of changes in immune and endocrine systems and their interactions in people under prolonged stress.

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

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