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a Institute of Experimental Endocrinology, Slovak Academy of Sciences, 83306 Bratislava, Slovakia
Key Words: insulin-induced hypoglycemia • epinephrine • norepinephrine • adrenomedullary hormonal system
Address for correspondence: Richard Imrich, Institute of Experimental Endocrinology, Slovak Academy of Sciences, Vlarska 3, 83306 Bratislava, Slovakia. Voice: +421 2 5477 4942; fax: +421 2 5477 4742. e-mail: richard.imrich{at}savba.sk
Over the past decades, research in patients with rheumatic disorders showed enormous progress in detecting various perturbations of the neuroendocrine system including those affecting autonomic nervous function. There is, however, a substantial lack of data on adrenomedullary hormonal system (AMHS) function in those patients. Insulin-induced hypoglycemia (IIH) represents a metabolic stressor, which elicits a counterregulatory stress response not only of the hypothalamic-pituitary axis but also of the AMHS. Therefore, in addition to traditional testing of hypothalamic-pituitary function, IIH can be used as a well-controlled functional test of the AMHS. Our recent studies showed, for the first time, attenuated epinephrine and norepinephrine responses to IIH in premenopausal females with rheumatoid arthritis (RA) and systemic sclerosis (SSc). These findings are suggestive of downregulation, or possibly defects, of the AMHS in those patients. This article reviews mechanism of the AMHS activation during IIH and demonstrates applications of the test in neuroendocrine-immune research.
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