Hypothalamic-Pituitary-Adrenal Axis Function and the Cellular Immune Response in Former Preterm Children

Buske‐Kirschbaum, Angelika; Krieger, Silke; Wilkes, Chloe; Rauh, W; Weiss, Sandra J.; Hellhammer, Dirk H.

doi:10.1210/jc.2006-2223

Cited by 73 publications

(78 citation statements)

References 40 publications

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“…We found GC-stimulated 11␤-HSD-1 activity to correlate inversely with birth weight (the degree of SGA) and GA (prematurity). Enhanced GC-stimulated 11␤-HSD-1 activity in children with shorter gestation and lower birth weight SDS is in agreement with previous reports of cortisol levels in SGA (21,22,56). However, this finding did not correlate with age, indicating that the process is not progressive, but rather programmed from birth.…”

Section: Discussionsupporting

confidence: 91%

11β–Hydroxysteroid Dehydrogenase Type 1 Activity in Short Small-For-GA Children and in Response to GH Therapy

et al. 2011

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Small for GA (SGA) children are at risk for developing the metabolic syndrome. Those who do not catch up, and remain short (SSGA), may benefit from GH therapy. 11␤ Hydroxysteroid dehydrogenase type 1 (11␤-HSD-1) is expressed in visceral fat and is implicated in metabolic morbidity. We hypothesized that SSGA children will have increased basal and glucocorticoid (GC)-stimulated 11␤-HSD-1 activity. Twenty SSGA children, aged 7.1 Ϯ 1 y (mean Ϯ SD), were studied before and while on GH therapy and compared with 12 normal age-matched controls. 11␤-HSD-1 activity was evaluated by gas chromatography mass spectrometry (GCMS) of urinary steroid product/substrate ratios. GC-stimulated 11␤-HSD-1 activity was assessed after overnight dexamethazone (DEX), by oral cortisone conversion to cortisol. In SSGA children, 11␤-HSD-1 activity was lower (p Ͻ 0.05) and GC-stimulated activity enhanced. SSGA children had maximal cortisol generation of 883 Ϯ 108 compared with 690 Ϯ 63 nmol/L in controls (p Ͻ 0.04). GH treatment suppressed 11␤-HSD-1 activity. GC-stimulated enzyme activity correlated negatively with GA (r ϭ Ϫ0.53, p Ͻ 0.01) and birth weight (r ϭ Ϫ0.55, p Ͻ 0.01). SSGA is associated with enhanced GC-stimulated 11␤-HSD-1 activity. This may be programmed in utero, as it is not a function of body composition or secondary metabolic derangement. GH therapy normalizes GCstimulated 11␤-HSD-1 activity. (Pediatr Res 70: 208-212, 2011) B y definition, 5-10% of all neonates are born small for GA (SGA). Some of these children do not catch up (1,2) and remain short. They may benefit from GH therapy (3-5). This subgroup is designated in this article as short SGA (SSGA). Regardless of their later growth pattern, SGA children are at risk for developing the metabolic syndrome later in life (6 -10). This increased risk for future morbidity has been documented more in SGA individuals who had catch up growth (11-13), than in those who did not (14 -16).Fetal programming might be coupled with several endocrine pathways (17), including the hypothalamic-pituitaryadrenal (HPA) axis (18 -20). Indeed, elevated cortisol levels have been reported for adults born SGA (21) and in SSGA children (22)(23)(24). Elevated cortisol levels may also be involved in pre-and postnatal growth, as demonstrated by the inverse correlation between cortisol levels in cord blood and embryo length gained during the first trimester in intrauterine growth retarded (IUGR) children (25) .Prereceptor modulation of cortisol by 11␤-hydroxysteroid dehydrogenase type 1 (11␤-HSD-1) converts cortisone to cortisol for intracrine action (26). Among other regulatory mechanisms of enzyme activity (27), GH inhibits 11␤-HSD-1 activity and gene expression, while GH deficiency is associated with enhanced enzyme activity (28 -31).The working hypotheses of this study were that SSGA children will have increased basal and GC-stimulated 11␤-HSD-1 activity and that these will be inhibited by GH treatment. Toward these hypotheses, we studied in vivo 11␤-HSD-1 activity, as measured by the ratio...

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Section: Discussionsupporting

confidence: 91%

11β–Hydroxysteroid Dehydrogenase Type 1 Activity in Short Small-For-GA Children and in Response to GH Therapy

et al. 2011

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“…School aged children born very preterm or with very-low-birth-weight (VLBW; < 1500 g) show lower diurnal cortisol profiles (Wadsby et al, 2014), faster decreasing cortisol levels in the evening , and decreased salivary cortisol responses to social stress (Buske-Kirschbaum et al, 2007), which is also consistent with findings in adults (Kaseva et al, 2014). Relatedly, boys born very preterm exposed to more distressing medical procedures had lower diurnal cortisol levels at age 7 (Brummelte et al, 2015).…”

Section: Maurersupporting

confidence: 63%

“…Two prior studies for instance found higher cortisol levels right at awakening in preterm compared to full-term children aged 8 to 12 years (Buske-Kirschbaum et al, 2007), particularly in girls (Quesada et al, 2014). There are three possibly relevant factors for these inconsistent findings.…”

Section: Differences In Salivary and Hair Glucocorticoids Between Vermentioning

confidence: 96%

“…However, there are also conflicting data. For example, preterm born children were found to exhibit no differences regarding morning (Brummelte et al, 2015;Perkinson-Gloor et al, 2015), evening (Quesada et al, 2014), and diurnal cortisol profiles (Buske-Kirschbaum et al, 2007;Kaseva et al, 2014) and salivary cortisol responses to social stress (Brummelte et al, 2015;Buske-Kirschbaum et al, 2007), or even higher salivary cortisol levels at awakening (Buske-Kirschbaum et al, 2007;Quesada et al, 2014).…”

Section: Maurermentioning

confidence: 98%

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Salivary and hair glucocorticoids and sleep in very preterm children during school age

Maurer

Perkinson-Gloor

Stalder

et al. 2016

Psychoneuroendocrinology

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Copyright and reuse:The Warwick Research Archive Portal (WRAP) makes this work by researchers of the University of Warwick available open access under the following conditions. Copyright © and all moral rights to the version of the paper presented here belong to the individual author(s) and/or other copyright owners. To the extent reasonable and practicable the material made available in WRAP has been checked for eligibility before being made available.Copies of full items can be used for personal research or study, educational, or not-for-profit purposes without prior permission or charge. Provided that the authors, title and full bibliographic details are credited, a hyperlink and/or URL is given for the original metadata page and the content is not changed in any way. A note on versions:The version presented here may differ from the published version or, version of record, if you wish to cite this item you are advised to consult the publisher's version. Please see the 'permanent WRAP url' above for details on accessing the published version and note that access may require a subscription. measures in very preterm children during school-age is rare. Eighty-five healthy children born very preterm (<32nd gestational week) and 91 full-term children aged 7-12 years were recruited for the present study. To assess HPA axis activity, salivary cortisol was measured at awakening, 10, 20, and 30 min later. In addition, hair cortisol and cortisone concentrations were quantified using liquid chromatography tandem mass spectrometry to assess cumulative endocrine activity over the preceding months. One night of in-home polysomnographic sleep assessment was conducted to assess sleep duration, sleep continuity, and sleep architecture. Children born very preterm showed significantly lower levels of cortisol at awakening and lower overall post-awakening cortisol secretion, lower cortisone in hair, and earlier sleep onset than full-term children. Across the whole sample, overall postawakening cortisol secretion was positively related to sleep onset time and negatively to sleep duration.The association between prematurity status and post-awakening cortisol secretion was partially mediated by earlier sleep onset time. In conclusion, this study provides evidence for a possible downregulation of the HPA axis activity and slightly earlier sleep phase in very preterm children during school age.

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“…There is emerging evidence that stressful prenatal and neonatal factors, such as preterm birth, may imprint a pattern of physiological activity in the developing brain, known as foetal programming [64]. The immune system and the hypothalamus-pituitary-adrenal stress-regulating system are found to be especially vulnerable to long-term alteration in children born preterm [65]. We therefore speculate that an altered stress-response might contribute Pegboard was associated with higher FA in CST (p<0.02), and poorer performance on…”

Section: Discussionmentioning

confidence: 99%

Motor skills at 23years of age in young adults born preterm with very low birth weight

Husby

Skranes

Olsen

et al. 2013

Early Human Development

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Printed by NTNU Grafisk senter LANGTIDSKONSEKVENSER AV FOR TIDLIG FØDSEL Motoriske ferdigheter, psykisk helse, livskvalitet og integritet av hjernens hvite substans hos unge voksne født for tidlig med veldig lav fødselsvektBarn som er født for tidlig har umodne organer som er mer utsatt for skade enn barn født til termin. Hjernen er spesielt sårbar, og diffus skade av hvit substans forekommer hyppig. Risikoen for død og sykelighet øker med lavere fødselsvekt og gestasjonsalder. Barn født med veldig lav fødselsvekt (VLBW; vansker med motorikk, kognisjon, atferd, oppmerksomhet og laering. Flere har sosiale utfordringer, og psykiske symptomer og plager blir mer fremtredende i tenårene. I voksen alder er det faerre som tar høyere utdanning, har fast partner og lever et selvstendig liv. Det er tidkrevende og kostbart å studere langtidseffektene av VLBW, og få studier har fulgt denne gruppen inn i voksen alder.Dette doktorgradsarbeidet er en del av et større hovedprosjekt, Lav fødselsvekt i et livstidsperspektiv, ved Senter for tidlig hjerneutvikling (CEBRA). I dette prosjektet har vi fulgt for tidlig fødte barn med VLBW og terminfødte barn med fødselsvekt -persentilen fra fødsel og inn i voksen alder. Disse gruppene har blitt undersøkt på flere tidspunkt med mange ulike tester, spørreskjema og MR av hjernen. I denne avhandlingen undersøkte vi motoriske ferdigheter, psykisk helse, livskvalitet og integritet av hjernens hvite substans ved 23 års alder. Vi undersøkte også utviklingen av motoriske ferdigheter fra 14 til 23 år og studerte potensielle endringer i psykisk helse og livskvalitet i overgangen til selvstendig voksenliv fra 20 til 23 års alder. Dessuten undersøkte vi om motoriske ferdigheter kunne vaere relatert til psykisk helse og livskvalitet, og om motoriske problemer kunne henge sammen med endringer i hvit substans.Vi fant at VLBW-gruppen hadde dårligere fin-og grovmotoriske ferdigheter ved 23 år sammenlignet med kontrollgruppen, saerlig på oppgaver som krevde motorisk hurtighet. Det var ingen forbedring av motoriske ferdigheter fra 14 til 23 år. Hovedforskjellene bestod da vi ekskluderte deltakere med cerebral parese. VLBW-gruppen rapporterte dårligere psykisk helse enn kontrollgruppen ved 23 år i form av mer oppmerksomhets-og internaliserende problemer, samt en tendens til flere symptomer på angst heller enn depresjon. Det var en økning i psykiske plager fra 20 til 23 år i VLBW-gruppen. Ved 23 år hadde de også en tendens til å rapportere faerre og svakere sosiale relasjoner, men et lavere alkoholforbruk enn kontrollgruppen. Videre rapporterte VLBW-gruppen lavere fysisk og psykisk livskvalitet enn kontrollgruppen, inkludert redusert fysisk og sosial fungering som påvirket deres hverdagsroller, samt mer kroppslig smerte. Både fysisk og psykisk livskvalitet ble svekket fra 20 til 23 år i VLBW-gruppen. Reduserte motoriske ferdigheter var relatert til dårligere psykisk helse, mer internaliserende problemer og lavere fysisk og psykisk livskvalitet. Gruppeforskjellene for psykisk helse og livskvalitet ble mindre...

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Hypothalamic-Pituitary-Adrenal Axis Function and the Cellular Immune Response in Former Preterm Children

Abstract: The data suggest that preterm delivery may be associated with altered endocrine and immune functions well into late childhood.

Cited by 73 publications

References 40 publications

11β–Hydroxysteroid Dehydrogenase Type 1 Activity in Short Small-For-GA Children and in Response to GH Therapy

11β–Hydroxysteroid Dehydrogenase Type 1 Activity in Short Small-For-GA Children and in Response to GH Therapy

Salivary and hair glucocorticoids and sleep in very preterm children during school age

Motor skills at 23years of age in young adults born preterm with very low birth weight

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