title: Abnormal hypothalamic-pituitary-adrenal axis function in rheumatoid arthritis. Effects of nonsteroidal antiinflammatory drugs and water immersion.
abstract: OBJECTIVE
  To investigate the effects of nonsteroidal antiinflammatory drug (NSAID) therapy and water immersion on hypothalamic-pituitary-adrenal (HPA) axis function in rheumatoid arthritis (RA).
  
  
  METHODS
  Plasma levels of adrenocorticotropic hormone (ACTH) and serum and urine levels of cortisol were compared in untreated RA patients, NSAID-treated RA patients, and healthy control subjects.
  
  
  RESULTS
  ACTH levels were significantly higher in untreated RA patients (mean +/- SEM integrated area 11,377 +/- 5,246 hours ng/liter) than in NSAID-treated RA patients (2,285 +/- 388 hours ng/liter) or healthy controls (1,845 +/- 35.5 hours ng/liter) (P < 0.001). Serum and urine cortisol levels were not significantly different between groups. Two-hour head-out water immersion had no effect.
  
  
  CONCLUSIONS
  Elevated ACTH levels without hypercortisolemia occur in untreated RA. NSAID therapy alters HPA axis response, but immersion has no effect.
authors.affiliation: Royal National Hospital for Rheumatic Diseases, Bath, UK.
authors.forename: J
authors.initials: J
authors.lastname: Hall
authors.forename: E F
authors.initials: EF
authors.lastname: Morand
authors.forename: S
authors.initials: S
authors.lastname: Medbak
authors.forename: M
authors.initials: M
authors.lastname: Zaman
authors.forename: L
authors.initials: L
authors.lastname: Perry
authors.forename: N J
authors.initials: NJ
authors.lastname: Goulding
authors.forename: P J
authors.initials: PJ
authors.lastname: Maddison
authors.forename: J P
authors.initials: JP
authors.lastname: O'Hare
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000097:blood; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007030:Hypothalamo-Hypophyseal System / Q000187:drug effects / Q000502:physiology*; D007101:Immersion / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010913:Pituitary-Adrenal System / Q000187:drug effects / Q000502:physiology*; D014867:Water
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D014867:Water; D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone