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In this thesis, three studies investigating the impact of stress on the protective startle eye blink reflex are reported. In the first study a decrease in prepulse inhibition of the startle reflex was observed after intravenous low dose cortisol application. In the second study a decrease in reflex magnitude of the startle reflex was observed after pharmacological suppression of endogenous cortisol production. In the third study, a higher reflex magnitude of the startle reflex was observed at reduced arterial and central venous blood pressure. These results can be interpreted in terms of an adaption to hostile environments.
Fast and Slow Effects of Cortisol on Several Functions of the Central Nervous System in Humans
(2014)
Cortisol is one of the key substances released during stress to restore homeostasis. Our knowledge of the impact of this glucocorticoid on cognition and behavior in humans is, however, still limited. Two modes of action of cortisol are known, a rapid, nongenomic and a slow, genomic mode. Both mechanisms appear to be involved in mediating the various effects of stress on cognition. Here, three experiments are presented that investigated fast and slow effects of cortisol on several functions of the human brain. The first experiment investigated the interaction between insulin and slow, genomic cortisol effects on resting regional cerebral blood flow (rCBF) in 48 young men. A bilateral, locally distinct increase in rCBF in the insular cortex was observed 37 to 58 minutes after intranasal insulin admission. Cortisol did not influence rCBF, neither alone nor in interaction with insulin. This finding suggests that cortisol does not influence resting cerebral blood flow within a genomic timeframe. The second experiment examined fast cortisol effects on memory retrieval. 40 participants (20 of them female) learned associations between neutral male faces and social descriptions and were tested for recall one week later. Cortisol administered intravenously 8 minutes before retrieval influenced recall performance in an inverted U-shaped dose-response relationship. This study demonstrates a rapid, presumably nongenomic cortisol effect on memory retrieval in humans. The third experiment studied rapid cortisol effects on early multisensory integration. 24 male participants were tested twice in a focused cross-modal choice reaction time paradigm, once after cortisol and once after placebo infusion. Cortisol acutely enhanced the integration of visual targets and startling auditory distractors, when both stimuli appeared in the same sensory hemi-field. The rapidity of effect onset strongly suggests that cortisol changes multisensory integration by a nongenomic mechanism. The work presented in this thesis highlights the essential role of cortisol as a fast acting agent during the stress response. Both the second and the third experiment provide new evidence of nongenomic cortisol effects on human cognition and behavior. Future studies should continue to investigate the impact of rapid cortisol effects on the functioning of the human brain.
In jüngerer Zeit wurde in der neuroendokrinologischen Forschung das Phänomen eines Hypocortisolismus bei verschiedenen Störungen, die mit Stress assoziiert sind, beschrieben. Insbesondere bei der Posttraumatischen Belastungsstörung (PTSD) wurde eine verringerte adrenale Aktivität berichtet. Aber auch bei Patienten mit verschiedenen körperlichen Beschwerden wurden ähnliche neuroendokrine Veränderungen gefunden. Dazu zählen unter anderem das Fibromyalgiesyndrom (FMS) und chronische Unterbauchbeschwerden (CUBB). Die Mechanismen, welche dem Hypocortisolismus zugrunde liegen, sind bislang sowohl für die PTSD als auch für stressabhängige körperliche Beschwerden nicht abschließend geklärt. Weiterhin besteht Unklarheit darüber, inwieweit eine Vergleichbarkeit dieser Mechanismen zwischen den verschiedenen Störungsbildern besteht. Die Entstehung und Aufrechterhaltung dieser Erkrankungen scheinen somit ein sehr komplexes Zusammenspiel verschiedener Faktoren darzustellen. Andererseits weisen die Überlappungen hinsichtlich symptomatologischer, psychologischer und endokrinologischer Variablen zwischen PTSD, FMS und CUBB auf die Existenz störungsübergreifender Subgruppen hin. In der vorliegenden Studie wurden psychologische und endokrinologische Auffälligkeiten bei PTSD, FMS und CUBB weiter untersucht. Vorrangiges Ziel war, zu überprüfen, inwieweit störungsübergreifende Subgruppen mit vergleichbaren psychoendokrinologischen Auffälligkeiten bestehen. Insgesamt wurden 59 Patientinnen mittels verschiedener endokrinologischer Tests untersucht und mit 30 gesunden Kontrollfrauen verglichen. Mit einer Clusteranalyse konnten drei unabhängige störungsübergreifende Subgruppen identifiziert werden, die sich hinsichtlich ihrer Reaktionen in den endokrinologischen Tests unterschieden. Es konnte somit gezeigt werden, dass es sich bei den untersuchten Störungsgruppen weder um eine Störungsfamilie mit identischen endokrinen Auffälligkeiten noch um isolierte, d.h. distinkte, von einander unabhängige Erkrankungen handelt. Vielmehr scheinen störungsübergreifende Subgruppen zu bestehen. Weitere Studien sollten die gefunden Muster replizieren und gegebenenfalls erweitern.
Das Stresshormon Cortisol zeigt einen starken zirkadianen Rhythmus mit hohen Cortisolwerten nach dem morgendlichen Erwachen und niedrigen Werten am Abend. Die vorliegende Arbeit legt die Grundlagen dafür, dass der Cortisolspiegel nach dem Erwachen (Cortisol Awakening Response) zukünftig Bestandteil einer multimodalen Diagnostik stressbezogener Erkrankungen werden kann. Zu diesem Zweck werden besonders messmethodische Aspekte des Cortisol Awakening Response (CAR) dargestellt und eingehend diskutiert. Der Einfluss verschiedener konfundierender Variablen wurde in einer quantitativen Metaanalyse untersucht. Ein gesonderter Abschnitt beschreibt verschiedene Möglichkeiten der statistischen Analyse des CAR. Zu diesem Zweck wurden verschiedene statistische Kennwerte generiert und deren Reliabilitäten und Interkorrelationen an einem empirischen Datensatz untersucht. In dieser Arbeit werden auch Normwerte für die einzelnen statistischen Kennwerte des CAR angegeben.
The glucocorticoid (GC) cortisol, main mediator of the hypothalamic-pituitary-adrenal axis, has many implications in metabolism, stress response and the immune system. GC function is mediated mainly via the glucocorticoid receptor (GR) which binds as a transcription factor to glucocorticoid response elements (GREs). GCs are strong immunosuppressants and used to treat inflammatory and autoimmune diseases. Long-term usage can lead to several irreversible side effects which make improved understanding indispensable and warrant the adaptation of current drugs. Several large scale gene expression studies have been performed to gain insight into GC signalling. Nevertheless, studies at the proteomic level have not yet been made. The effects of cortisol on monocytes and macrophages were studied in the THP-1 cell line using 2D fluorescence difference gel electrophoresis (2D DIGE) combined with MALDI-TOF mass spectrometry. More than 50 cortisol-modulated proteins were identified which belonged to five functional groups: cytoskeleton, chaperones, immune response, metabolism, and transcription/translation. Multiple GREs were found in the promoters of their corresponding genes (+10 kb/-0.2 kb promoter regions including all alternative promoters available within the Database for Transcription Start Sites (DBTSS)). High quality GREs were observed mainly in cortisol modulated genes, corroborating the proteomics results. Differential regulation of selected immune response related proteins were confirmed by qPCR and immuno-blotting. All immune response related proteins (MX1, IFIT3, SYWC, STAT3, PMSE2, PRS7) which were induced by LPS were suppressed by cortisol and belong mainly to classical interferon target genes. Mx1 has been selected for detailed expression analysis since new isoforms have been identified by proteomics. FKBP51, known to be induced by cortisol, was identified as the strongest differentially expressed protein and contained the highest number of strict GREs. Genomic analysis of five alternative FKBP5 promoter regions suggested GC inducibility of all transcripts. 2D DIGE combined with 2D immunoblotting revealed the existence of several previously unknown FKBP51 isoforms, possibly resulting from these transcripts. Additionally multiple post-translational modifications were found, which could lead to different subcellular localization in monocytes and macrophages as seen by confocal microscopy. Similar results were obtained for the different cellular subsets of human peripheral blood mononuclear cells (PBMCs). FKBP51 was found to be constitutively phosphorylated with up to 8 phosphosites in CD19+ B lymphocytes. Differential Co-immunoprecipitation for cytoplasm and nucleus allowed us to identify new potential interaction partners. Nuclear FKBP51 was found to interact with myosin 9, whereas cytosolic FKBP51 with TRIM21 (synonym: Ro52, Sjögren`s syndrome antigen). The GR has been found to interact with THOC4 and YB1, two proteins implicated in mRNA processing and transcriptional regulation. We also applied proteomics to study rapid non-genomic effects of acute stress in a rat model. The nuclear proteome of the thymus was investigated after 15 min restraint stress and compared to the non-stressed control. Most of the identified proteins were transcriptional regulators found to be enriched in the nucleus probably to assist gene expression in an appropriate manner. The proteomic approach allowed us to further understand the cortisol mediated response in monocytes/macrophages. We identified several new target proteins, but we also found new protein variants and post-translational modifications which need further investigation. Detailed study of FKBP51 and GR indicated a complex regulation network which opened a new field of research. We identified new variants of the anti-viral response protein MX1, displaying differential expression and phosphorylation in the cellular compartments. Further, proteomics allowed us to follow the very early effects of acute stress, which happen prior to gene expression. The nuclear thymocyte proteome of restraint stressed rats revealed an active preparation for subsequent gene expression. Proteomics was successfully applied to study differential protein expression, to identify new protein variants and phosphorylation events as well as to follow translocation. New aspects for future research in the field of cortisol-mediated immune modulation have been added.
There is considerable evidence for an association between chronic dysregulation of the hypothalamus-pituitary adrenal (HPA) axis, atrophy of the hippocampus (HC) and cognitive and mood changes in clinical populations and in aging. The present thesis investigated this relationship in young healthy male subjects. Special emphasis was put on measures of HC volume and function derived from structural and functional magnetic resonance imaging (MRI). Higher cortisol levels after awakening were observed in subjects with higher levels of depressive symptomatology. Larger HC volume was associated with higher cortisol levels after awakening and in response to acute stress, whereas cognitive performance was impaired in subjects with larger HC volumes. Hippocampal activation during picture encoding was reduced after stress induction, and positive associations between activation and cognitive performance before stress were not present anymore afterwards. The present findings underscore the importance of structural and functional brain imaging for psychoneuroendocrinological research. The investigation of the association between cortisol levels and hippocampal integrity in young healthy subjects elicited unexpected results and adds to the understanding of HPA dysfunction and HC atrophy in clinical and aged populations.