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Titolo:
Combined treatment with corticosteroids and moclobemide favors normalization of hypothalamo-pituitary-adrenal axis dysregulation in relapsing-remitting multiple sclerosis: A randomized, double blind trial
Autore:
Bergh, FT; Kumpfel, T; Grasser, A; Rupprecht, R; Holsboer, F; Trenkwalder, C;
Indirizzi:
Max Planck Inst Psychiat, Dept Neurol, D-80804 Munich, Germany Max Planck Inst Psychiat Munich Germany D-80804 D-80804 Munich, Germany
Titolo Testata:
JOURNAL OF CLINICAL ENDOCRINOLOGY AND METABOLISM
fascicolo: 4, volume: 86, anno: 2001,
pagine: 1610 - 1615
SICI:
0021-972X(200104)86:4<1610:CTWCAM>2.0.ZU;2-S
Fonte:
ISI
Lingua:
ENG
Soggetto:
EXPERIMENTAL ALLERGIC ENCEPHALOMYELITIS; CORTICOTROPIN-RELEASING HORMONE; DEXAMETHASONE-CRH TEST; ADRENOCORTICAL SYSTEM; DEPRESSED-PATIENTS; SHORT-TERM; THERAPY; RAT; DISORDERS; SUPPRESSION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
43
Recensione:
Indirizzi per estratti:
Indirizzo: Bergh, FT NINDS, Mol Biol Lab, NIH, 36 Convent Dr,Room 3C11, Bethesda, MD 20892 USA NINDS 36 Convent Dr,Room 3C11 Bethesda MD USA 20892 MD 20892 USA
Citazione:
F.T. Bergh et al., "Combined treatment with corticosteroids and moclobemide favors normalization of hypothalamo-pituitary-adrenal axis dysregulation in relapsing-remitting multiple sclerosis: A randomized, double blind trial", J CLIN END, 86(4), 2001, pp. 1610-1615

Abstract

Hyperresponsiveness of the hypothalamo-pituitary-adrenal (HPA) axis in multiple sclerosis (MS), an autoimmune inflammatory disease of the central nervous system, is presumably due to diminished corticosteroid receptor function. It probably influences the immune response, but its clinical significance is not clear. Similar HPA dysregulation occurs in depression and is reversible with successful antidepressant treatment. We conducted a double blind, placebo-controlled trial to evaluate the neuroendocrine effect of cotreatment with the antidepressant moclobemide as an adjunct to oral corticosteroids in MS. Twenty-one patients with definite relapsing-remitting MS (11 females, aged33.9 +/- 2.0 yr; Expanded Disability Status Scale score of neurological impairment. 2.0-6.5) in acute relapse were treated with placebo (n = 13) or 300 mg moclobemide (reversible monoamine oxidase A inhibitor; n = 8) for 75 days. All received oral fluocortolone from day 7 on, and the dose was tapered until day 29. Effects were evaluated using the combined dexamethasone-CRH test and clinically on days 1, 30, and 75. At baseline, theHPA axis was mildly activated, comparably for treatment groups [area underthe curve for cortisol (AUC-Cort), 213.8 +/- 76.8 arbitrary units in the moclobemide group us. 225.8 +/- 65.1 in the steroid alone group; mean +/- SEM]. In a group of healthy controls with comparable demographic characteristics, the AUC-Cort was 107.4 +/- 14.1. Moclobemide cotreatment resulted in normalization of the HPA axis response, whereas the HPA system hyperresponsewas maintained with steroids alone (AUC-Cort on day 30, 85.9 +/- 22.8 us. 177.1 +/- 68.5; on day 75, 111.0 +/- 46.0 us. 199.2 +/- 64.6). The change in Expanded Disability Status Scale was comparable for both groups. Although corticosteroids alone had no effect on the HPA response using thedexamethasone-CRH test, treatment with moclobemide combined with corticosteroids favors normalization of the HPA response in relapsing-remitting MS.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 23/01/20 alle ore 18:36:00