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Hypoglycemia, an Old Tool for New Findings in the Adrenomedullary Hormonal System in Patients with Rheumatic Diseases
Author(s) -
IMRICH RICHARD
Publication year - 2006
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1196/annals.1351.008
Subject(s) - medicine , hypoglycemia , epinephrine , hormone , rheumatoid arthritis , immune system , stressor , endocrinology , insulin , immunology , clinical psychology
Over the past decades, research in patients with rheumatic disorders showed enormous progress in detecting various perturbations of the neuroendocrine system including those affecting autonomic nervous function. There is, however, a substantial lack of data on adrenomedullary hormonal system (AMHS) function in those patients. Insulin‐induced hypoglycemia (IIH) represents a metabolic stressor, which elicits a counterregulatory stress response not only of the hypothalamic‐pituitary axis but also of the AMHS. Therefore, in addition to traditional testing of hypothalamic‐pituitary function, IIH can be used as a well‐controlled functional test of the AMHS. Our recent studies showed, for the first time, attenuated epinephrine and norepinephrine responses to IIH in premenopausal females with rheumatoid arthritis (RA) and systemic sclerosis (SSc). These findings are suggestive of downregulation, or possibly defects, of the AMHS in those patients. This article reviews mechanism of the AMHS activation during IIH and demonstrates applications of the test in neuroendocrine‐immune research.