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Clinical Studies |
(TNF
) Production in Humans: High Sensitivity of TNF
and Resistance of IL-6
Clinical Neuroendocrinology Branch, National Institute of Mental Health, National Institutes of Health (R.D., D.M., B.K., E.S., P.G.), Bethesda, Maryland 20892; the Departments of Physiology and Military and Emergency Medicine, Uniformed Services of the University of the Health Sciences,(J.P., E.G., P.D.), Bethesda, Maryland 20814; and CytImmune Sciences Inc. (G.P.), College Park, Maryland 20740
Address all correspondence and requests for reprints to: Dr. R. H. DeRijk, Leiden/Amsterdam Center for Drug Research, Center for Bio-Pharmaceutical Sciences, Sylvius Laboratories, Wassenaarseweg 72, 2300 RA Leiden, The Netherlands. E-mail: r.rijk{at}lacdr.leidenuniv.nl
Although we have previously shown that the integrity of inflammatory
mediator-induced activation of the hypothalamic-pituitary-adrenal axis
is essential for conferring resistance to inflammatory disease in
susceptible Lewis rats, the role of endogenous glucocorticoid secretion
in human immune function in either health or disease is less clear. To
further understand the relevance of physiological variations in plasma
cortisol on immune function in humans, we evaluated ex
vivo lipopolysaccharide-induced interleukin-1ß (IL-1ß),
IL-6, and tumor necrosis factor-
(TNF
) production in the whole
blood of healthy volunteers studied under conditions chosen to
approximate either physiological or pharmacological glucocorticoid
levels.
Administration of a pharmacological dose of hydrocortisone suppressed
the production of all three cytokines, whereas administration of a
physiological dose of hydrocortisone suppressed only TNF
production.
Stress-induced levels of glucocorticoids, achieved during exercise at
100% maximal oxygen utilization, suppressed IL-1ß and TNF
production, but were without effect on IL-6 production. In addition,
circadian variations of cortisol were associated with decreased TNF
production, but were without effect on IL-1ß or IL-6 production.
These studies challenge the generally accepted idea that
glucocorticoids consistently suppress cytokine production and indicate
a hierarchy of sensitivity, with TNF
having the greatest
sensitivity, IL-1ß having intermediate sensitivity, and IL-6 being
resistant. The resistance of IL-6 production to glucocorticoid
suppression is compatible with data suggesting an antiinflammatory as
well as a proinflammatory action for this cytokine.
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