Chronic hepatitis B and hormons of the pituitary adrenal system

Abstract

Introduction: Mechanisms of viral persistence and chronicity of the disease in chronic hepatitis B (CHB) are studied insufficiently and the role of hormones of the slow phase stress in chronic viral hepatitis is still unclear. Purpose: Evaluation the ACTH and cortisol levels during CHB in dependence on the activity and phase of the viral infection. Materials and Methods: We examined 83 patients. The control group consisted of 30 healthy individuals. The lot was divided into 3 groups: I group consisted of patients with anti- HBe + and minimal activity (ALT <2N), II with anti HBe + and moderate / maximum activity (ALT 2N), II with HBeAg + and moderate / maximum activity (ALT 2N). In this paper the author used original method of glucose and euphyllin load test (TGE) ( Iu. Lupasco), with determination of serum hormones both fasting and at 60 and 120 minute of the test. Results. Increased levels of cortisol were found In CHB, regardless of the disease form and activity, the most significant in CHB HBeAg + ( IIIgr ) in all intervals of the test (TGE) (354.0 ± 14.41 nmol / l, p <0.01; 369.60 ± 37.97 nmol / l, p < 0.01; 321.60 ± 36.20 nmol / l, p <0.01) in comparison with control data. In this group hormone values of ACTH were higher (29,0 ± 2,36 pg / ml) its levels in the case of anti HBe + (IIgr ) as fasting – 16.30 ± 2.46 pg / ml, as at 60, 120 minutes of the test ( 31.33 ± 4.39 pg / ml, p <0.01; 14.50 ± 2.33 pg / ml, p <0.01). In CHB were found not only changes in the ACTH and cortisol levels on empty stomach, but also the shape of their curves changes during loading test , that were different from control. This fact increases the importance of the TGE for evaluation of hormonal changes in CHB. Conclusions: Revealed changes of ACTH and cortisol levels may be probably caused by excessive reaction to a longacting form of stress in viral persistence on one hand, and with hormone metabolism violation in the liver itself on the other hand, presumably on the receptor and post receptor levels of their action.