title: Repeated assessments of endocrine- and immune-related changes in posttraumatic stress disorder.
abstract: OBJECTIVE
  It is assumed that stress-related changes in the endocrine and immune systems are key mediators involved in the development of diseases associated with posttraumatic stress disorder (PTSD). Evidence suggests that those changes might be related to the duration of PTSD. The aim of our study was to investigate the differences in selected endocrine- and immune-related variables between PTSD patients and control subjects, and whether these differences persist over time.
  
  
  METHODS
  We assessed 39 Croatian war veterans with PTSD and 25 healthy volunteers (civilians without traumatic experience), all men, at two time points separated by 5.6 years (median; interquartile range: 5.4-6.3). Cortisol and prolactin levels were measured by radioimmunoassays while interleukin-6 and tumor necrosis factor-α were determined by enzyme-linked immunosorbent assays. Immune function was assessed by in vitro natural killer cell cytotoxicity (NKCC). Lymphocyte counts, immunophenotype and intracellular glucocorticoid receptor expression in various lymphocyte subsets were determined by three-color flow cytometry.
  
  
  RESULTS
  At the first assessment, moderate to large effect size estimates of differences between patients and controls were observed for most of the measured variables. Only prolactin levels and lymphocyte counts remained significantly elevated in PTSD patients at the second assessment with low to moderate effect size estimates of differences between patients and controls in other variables.
  
  
  CONCLUSIONS
  Observed endocrine- and immune-related changes in PTSD over time may depend on the duration of the allostatic load posed by the disorder and its impact on interactions between the endocrine and immune systems involved in stress response.
authors.affiliation: Department of Psychiatry, Referral Centre for Stress-Related Disorders, University Hospital Dubrava, Zagreb, Croatia. avidovic@gmail.com
authors.forename: Anđelko
authors.initials: A
authors.lastname: Vidović
authors.forename: Katja
authors.initials: K
authors.lastname: Gotovac
authors.forename: Maja
authors.initials: M
authors.lastname: Vilibić
authors.forename: Ante
authors.initials: A
authors.lastname: Sabioncello
authors.forename: Tanja
authors.initials: T
authors.lastname: Jovanović
authors.forename: Sabina
authors.initials: S
authors.lastname: Rabatić
authors.forename: Vera
authors.initials: V
authors.lastname: Folnegović-Šmalć
authors.forename: Dragan
authors.initials: D
authors.lastname: Dekaris
mesh_terms: D000328:Adult; D002469:Cell Separation; D003130:Combat Disorders / Q000276:immunology* / Q000378:metabolism*; D003602:Cytotoxicity, Immunologic / Q000276:immunology; D004797:Enzyme-Linked Immunosorbent Assay; D005434:Flow Cytometry; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D016130:Immunophenotyping; D015850:Interleukin-6 / Q000097:blood; D007694:Killer Cells, Natural / Q000276:immunology; D018655:Lymphocyte Count; D008214:Lymphocytes / Q000378:metabolism; D008297:Male; D011388:Prolactin / Q000097:blood; D011863:Radioimmunoassay; D011965:Receptors, Glucocorticoid / Q000096:biosynthesis; D013313:Stress Disorders, Post-Traumatic / Q000276:immunology* / Q000378:metabolism*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D014728:Veterans; D014857:Warfare
chemical_list: D015850:Interleukin-6; D011965:Receptors, Glucocorticoid; D014409:Tumor Necrosis Factor-alpha; D011388:Prolactin; D006854:Hydrocortisone