Am J Psychiatry 1991; 148:499-504
Copyright © 1991 by American Psychiatric Association
Lymphocyte glucocorticoid receptor number in posttraumatic stress disorder
R Yehuda, MT Lowy, SM Southwick, D Shaffer and EL Giller Jr
Psychiatry Department, University of Connecticut Health Center, Farmington 06032.
OBJECTIVE: The authors' objective was to investigate the possibility that
glucocorticoid receptor changes may be involved in the dysregulation of the
hypothalamic-pituitary-adrenal (HPA) axis in posttraumatic stress disorder
(PTSD). METHOD: They measured the number of lymphocyte cytosolic
glucocorticoid receptors and plasma cortisol concentrations in 15
consecutively admitted male combat Vietnam veterans with PTSD and in a
normal comparison group of 11 subjects. RESULTS: Both the patients and the
normal comparison subjects showed a morning-to-afternoon decline in
glucocorticoid receptor concentrations, paralleling the normal diurnal
decline in cortisol levels. The number of glucocorticoid receptors was 63%
greater in the morning and 26% greater in the afternoon in the patients
with PTSD than in the normal subjects. No group differences in cortisol
levels were observed, nor were glucocorticoid receptor number and cortisol
levels correlated. The number of morning glucocorticoid receptors was
positively correlated with symptoms of PTSD and anxiety. CONCLUSIONS: These
results provide further evidence for a dysregulation of the HPA axis in
PTSD. The finding that patients with PTSD had a substantially greater
number of lymphocyte glucocorticoid receptors than normal comparison
subjects is consistent with the authors' previous observations of low
24-hour urinary cortisol excretion in subjects with PTSD. Furthermore, the
receptor changes observed are opposite of those reported in major
depressive disorder. The present data, along with other findings of HPA
abnormalities in PTSD, support the possibility of a greater negative
feedback sensitivity at one or more levels of the HPA axis.
