title: Sex differences in glucocorticoid sensitivity of proinflammatory cytokine production after psychosocial stress.
abstract: OBJECTIVE
  Men and women show marked differences in susceptibility to disorders related to the immune system. These gender differences have been proposed to be mediated by functional interactions of the hypothalamus-pituitary-adrenal (HPA) and hypothalamus-pituitary-gonadal (HPG) axes. A potential mechanism involved in this interaction is the glucocorticoid (GC) sensitivity of relevant target tissues for GC. Therefore, the aim of the study reported here was to investigate the impact of psychosocial stress and HPA axis activation on the GC sensitivity of proinflammatory cytokine production in men and women.
  
  
  METHODS
  A total of 45 healthy subjects were investigated. Eighteen women in the luteal phase of their menstrual cycle and 27 men were exposed to a psychosocial stress test (Trier Social Stress Test). Salivary free cortisol levels were measured repeatedly after exposure to the stressor. GC sensitivity was assessed in vitro by dexamethasone inhibition of lipopolysaccharide-stimulated production of interleukin-6 and tumor necrosis factor-alpha.
  
  
  RESULTS
  The stress test induced significant increases in salivary free cortisol with no significant differences between men and women. In contrast, GC sensitivity and lipopolysaccharide-stimulated cytokine production showed large gender differences. In men GC sensitivity was markedly increased 1 hour after stress, whereas GC sensitivity decreased significantly in women. Similarly, lipopolysaccharide-induced cytokine production decreased in response to stress in men but increased in women.
  
  
  CONCLUSIONS
  These results demonstrate that despite similar free cortisol responses of men and women (studied in the luteal phase) to psychosocial stress, gender may exert differential effects on the immune system by modulating GC sensitivity of proinflammatory cytokine production.
authors.affiliation: Center for Psychobiological and Psychosomatic Research, University of Trier, Trier, Germany.
authors.forename: N
authors.initials: N
authors.lastname: Rohleder
authors.forename: N C
authors.initials: NC
authors.lastname: Schommer
authors.forename: D H
authors.initials: DH
authors.lastname: Hellhammer
authors.forename: R
authors.initials: R
authors.lastname: Engel
authors.forename: C
authors.initials: C
authors.lastname: Kirschbaum
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000493:pharmacokinetics*; D015992:Body Mass Index; D016207:Cytokines / Q000096:biosynthesis / Q000276:immunology*; D003907:Dexamethasone / Q000493:pharmacokinetics*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D007030:Hypothalamo-Hypophyseal System / Q000378:metabolism; D008297:Male; D010913:Pituitary-Adrenal System / Q000378:metabolism; D012737:Sex Factors; D013313:Stress Disorders, Post-Traumatic / Q000276:immunology* / Q000378:metabolism*
chemical_list: D000893:Anti-Inflammatory Agents; D016207:Cytokines; D003907:Dexamethasone; D006854:Hydrocortisone