IMMUNE REGULATION IN CUSHINGS-SYNDROME - RELATIONSHIP TO HYPOTHALAMIC-PITUITARY-ADRENAL AXIS HORMONES

Hormones of the hypothalamic-pituitary-adrenal (HPA) axis are connecte d closely with immune measures. To investigate whether Cushing's syndr ome (CS) is associated with immune dysregulation, we compared the perc entage of specific lymphocyte subsets as well as natural killer cell a ctivity (NKCA) in 48 patients with Cushing's syndrome and 48 age- and sex-matched normal controls. Lymphocyte subset analysis included the p ercentage of lymphocytes expressing CD3 (total T), CD4 (T helper/induc er), CD8 (T suppressor/cytotoxic) and CD56 (NK cell) antigens. Baselin e plasma concentrations of cortisol, ACTH and beta-endorphin as well a s 24 h urinary-free cortisol (UFC) levels also were determined. Result s indicated a decrease in the percentage of CD4+ cells (P < .05), an i ncrease in the percentage of CD8+ cells (p < .05), a decrease in CD4/C D8 ratios (p < .01), and a reduction in NKCA (p < .05) in patients wit h CS compared to matched controls. We also found significant negative correlations between NKCA on the one hand and 24 h UFC (p < 0.5) and p lasma beta-endorphin (p < .05) on the other. These results indicate th ere is immune dysregulation in CS patients which can be explained in p art by an increase in HPA-axis hormones. (C) 1997 Elsevier Science Ltd .