Immune regulation in Cushing's syndrome: Relationship to hypothalamic-pituitary-adrenal axis hormones

Ziad Kronfol, Monica Starkman, David E. Schteingart, Vijendra Singh, Qun Zhang, Elizabeth Hill

Research output: Contribution to journalArticle

31 Citations (Scopus)


Hormones of the hypothalamic-pituitary-adrenal (HPA) axis are connected closely with immune measures. To investigate whether Cushing's syndrome (CS) is associated with immune dysregulation, we compared the percentage of specific lymphocyte subsets as well as natural killer cell activity (NKCA) in 48 patients with Cushing's syndrome and 48 age- and sex-matched normal controls. Lymphocyte subset analysis included the percentage of lymphocytes expressing CD3 (total T), CD4 (T helper/inducer), CD8 (T suppressor/cytotoxic) and CD56 (NK cell) antigens. Baseline plasma concentrations of cortisol, ACTH and β-endorphin as well as 24 h urinary-free cortisol (UFC) levels also were determined. Results indicated a decrease in the percentage of CD4+ cells (p < .05), an increase in the percentage of CD8+ cells (p < .05), a decrease in CD4/CD8 ratios (p < .01), and a reduction in NKCA (p < .05) in patients with CS compared to matched controls. We also found significant negative correlations between NKCA on the one hand and 24 h UFC (p < .05) and plasma β-endorphin (p < .05) on the other. These results indicate there is immune dysregulation in CS patients which can be explained in part by an increase in HPA-axis hormones.

Original languageEnglish
Pages (from-to)599-608
Number of pages10
Issue number7
Publication statusPublished - 1 Oct 1996



  • Cushing's syndrome
  • glucocorticoids
  • lymphocyte phenotype
  • natural killer cytotoxicity
  • neuroimmunomodulation
  • psychoneuroimmunology

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology
  • Endocrine and Autonomic Systems
  • Psychiatry and Mental health
  • Biological Psychiatry

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