Hypothalamic-pituitary-adrenal axis and interleukin-6 activity in children with head trauma and syndrome of inappropriate secretion of antidiuretic hormone

Gionis, D; Ilias, L; Moustaki, M; Mantzos, E; Papadatos, L; Koutras, DA; Mastorakos, G

dc.contributor.author	Gionis, D	en
dc.contributor.author	Ilias, L	en
dc.contributor.author	Moustaki, M	en
dc.contributor.author	Mantzos, E	en
dc.contributor.author	Papadatos, L	en
dc.contributor.author	Koutras, DA	en
dc.contributor.author	Mastorakos, G	en
dc.date.accessioned	2014-03-01T01:53:07Z
dc.date.available	2014-03-01T01:53:07Z
dc.date.issued	2003	en
dc.identifier.issn	0334-018X	en
dc.identifier.uri	https://dspace.lib.ntua.gr/xmlui/handle/123456789/26862
dc.subject	syndrome of inappropriate antidiuretic hormone	en
dc.subject	secretion (SIADH)	en
dc.subject	interleukin-6	en
dc.subject	vasopressins	en
dc.subject.classification	Endocrinology & Metabolism	en
dc.subject.classification	Pediatrics	en
dc.subject.other	NECROSIS-FACTOR-ALPHA	en
dc.subject.other	RECOMBINANT INTERLEUKIN-6	en
dc.subject.other	VASOPRESSIN	en
dc.subject.other	INJURY	en
dc.subject.other	ADRENOCORTICOTROPIN	en
dc.subject.other	CYTOKINES	en
dc.subject.other	HUMANS	en
dc.subject.other	SERUM	en
dc.subject.other	FLUID	en
dc.title	Hypothalamic-pituitary-adrenal axis and interleukin-6 activity in children with head trauma and syndrome of inappropriate secretion of antidiuretic hormone	en
heal.type	journalArticle	en
heal.language	English	en
heal.publicationDate	2003	en
heal.abstract	Objective: Arginine vasopressin (AVP; antidiuretic hormone) and corticotropin-releasing hormone are the two major secretagogues of hypophyseal adrenocorticotropin (ACTH). Interleukin-6 (IL-6) is a potent stimulator of the human hypothalamic-pituitary-adrenal axis (HPA) and a secretagogue of both parvocellular and magnocelullar AVP. We have previously suggested that IL-6-stimulated AVP secretion may be the origin of the syndrome of inappropriate antidiuretic hormone secretion (SIADH) in inflammatory conditions. Study design: To further elucidate the relationship between IL-6 and SIADH as well as IL-6 and HPA axis activity, we studied eight previously healthy children (age 6.3 +/- 4.8 [mean +/- SD] years, weight 23.8 +/- 10.5 kg) who - after sustaining head trauma - presented SIADH during hospitalization (for 7.1 +/- 3.8 days) in the pediatric intensive care unit (P-ICU). Routine blood samples were taken twice daily at 08:00 and 20:00 hours. All children but one survived. Measurements included blood and urine osmolality (BIOsm and UrOsm, respectively), serum cortisol (F) and IL-6, plasma ACTH and AVP. Correlations were assessed with linear regression among the areas under the curve (AUC) of BIOsm, UrOsm, ACTH, F, IL-6 and AVP, separately for BIOsm values <280 mOsm (SIADH phase) and greater than or equal to280 mOsm (non-SIADH phase). Results: During the SIADH phase AVP-AUC correlated positively with IL-6-AUC (r = +0.96, p <0.05), BIOsm-AUC correlated positively with AVP-AUC and F-AUC (r = +0.95 and +0.98, p <0.05, respectively) and F-AUC correlated positively with ACTH-AUC (r = +0.99, p &LT;0.05). During the non-SIADH phase ACTH-AUC correlated positively with BIOsm-AUC (r +0.96, p &LT;0.05). Conclusion: IL-6 secreted during an aseptic inflammatory state, such as sustaining head trauma with SIADH, is quantitatively correlated to AVP, indicating that this cytokine is directly and/or indirectly involved in the pathogenesis of SIADH.	en
heal.publisher	FREUND PUBLISHING HOUSE LTD	en
heal.journalName	JOURNAL OF PEDIATRIC ENDOCRINOLOGY & METABOLISM	en
dc.identifier.isi	ISI:000180894000007	en
dc.identifier.volume	16	en
dc.identifier.issue	1	en
dc.identifier.spage	49	en
dc.identifier.epage	54	en