HIGH PLASMA-CONCENTRATIONS OF CORTISOL AND THROMBOXANE B-2 IN PATIENTS WITH DEPRESSION

Modulation of the hypothalamic-pituitary-adrenal axis in major depress ion is thought to depend on the hypothalamus and other areas of the ce ntral nervous system, or both. Hypothalamic over-activity may be respo nsible for the hypercortisolism observed in 50% of depressed subjects. To investigate the relation between psychosocial factors and cardiova scular disease, morning (8 AM) plasma concentrations of cortisol and t hromboxane B-2 (the stable metabolite of thromboxane A(2), an eicosano id closely linked to thrombotic disorders) were measured by radioimmun oassay in 32 patients with major depression (DSM III) triggered by psy chosocial events and in 9 nondepressed volunteers. The depressed patie nts were studied in two groups, 16 with cortisol levels under 90 ng/mL and 16 with levels over 90 ng/mL. All the healthy nondepressed subjec ts had cortisol values over 100 ng/mL. The depressed patients with hig h cortisol had significantly higher plasma TxB(2) concentrations than the other two groups. In addition, plasma cortisol and TxB(2) concentr ations correlated significantly over the whole group of depressed pati ents and in the high cortisol subgroup but not in the low-cortisol sub -group or in the nondepressed subjects. These findings appear to suppo rt the recently proposed role of the hypothalamic dysfunction associat ed with affective disorders in the pathogenesis of cardiovascular dise ase.