Multiple Sclerosis and Hypothalamic Pituitary Adrenal Axis Function

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Multiple Sclerosis and Hypothalamic Pituitary
Adrenal Axis Function

• By Nicole Clarke

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Overview

• Introduction
• What is Multiple Sclerosis
• Symptoms of the Disease
• Hypothalamic-Pituitary-Adrenal Axis Function
• Objective of this experiment
• Procedure
• Results
• Findings/Conclusion

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What is Multiple Sclerosis?

• 1. Relapsing remitting
• 2. Primary Progressive
• 3. Secondary Progressive
• 4. Progressive Relapsing

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Symptoms of Multiple Sclerosis
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Myelin

• Insulating material

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Hypothalamic-Pituitary-Adrenal Axis Function

• ultimately controls secretion of glucocorticoids
  from the adrenal gland
• cortisol in humans, and corticosterone in rats

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Objective

• Determine whether hypo-activity of the HPA axis
  could have contributed to the initial
  susceptibility to MS or Continuation of the
  ongoing process

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Urinary Free Cortisol

• Measures cortisol secretion
• Results
• Control 153.8 /- 10.9 nmol/day
• MS 212.0 /- nmol/day

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ACTH AVP Stimulation

• Plasma ACTH
• Lower in MS patients significantly
• MS 50.5 /-9.9 pmol /L.60min
• Control 134.3/-20.2 pmol /L.60min

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Cortisol AVP Stimulation

• Plasma Cortisol
• Higher in control but statistically insignificant
• MS 6,503 /-1,557.9 pmol /L.90min
• Control 10,608 /-2,044.2 pmol /L.90min

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Findings

• HPA axis activated in patients will clinically
  stable MS

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Accreditations

• Graphics courtesy of Schering AG (Berlin)
• Multiple sclerosis is associated with alterations
  in hypothalamic- pituitary-adrenal axis function
  J. Clin. Endocrinol. Metab. 1994 79 848-853.
• Noseworthy, John H.. Lucchinetti, Claudia.
  Rodriguez, Moses. Weinshenker, Brian G..Review
  ArticleMedical Progress Multiple Sclerosis.
  The New England Journal of Medicine. September
  2000. 746-750