Community violence exposure in a young adult sample: II. Psychophysiology and aggressive behavior

Research has shown a relationship between community violence exposure and heightened aggression in young adults (Scarpa, in press). This study tests the role of psychophysiological functioning in mediating this relationship. Fifty-four university students (mean age = 20.25) were selected from a screening sample (N= 476) based upon high- and low-violence exposure. Salivary cortisol, heart rate (HR), and heart rate variability (HRV) were obtained before and after two stressor tasks. Aggression was reported before the tasks. Aggression was significantly correlated with reduced baseline HR, increased baseline HRV, and increased poststressor cortisol. However, exposed groups did not differ psychophysiologically, suggesting that psychophysiological functioning does not serve as a mediator. Instead, violence exposure and psychophysiological functioning have independenteffects on aggressive behavior. © 2000 John Wiley & Sons, Inc.     

Association Between Cortisol to DHEA-s Ratio and Sickness Absence in Japanese Male Workers

Purpose

This study aimed to investigate the association between serum levels of cortisol and dehydroepiandrosterone sulfate (DHEA-s) and sickness absence over 2 years in Japanese male workers.

Method

A baseline survey including questions about health behavior, along with blood sampling for cortisol and DHEA-s, was conducted in 2009. In total, 429 men (mean ± SD age, 52.9?±?8.6 years) from whom blood samples were collected at baseline were followed until December 31, 2011. The hazard ratios (HR) and 95% confidence intervals (CI) for sickness absence were calculated using a Cox proportional hazard model, adjusted for potential confounders.

Results

Among 35 workers who took sickness absences, 31 had physical illness. A high cortisol to DHEA-s ratio increased the risk of sickness absence (crude HR?=?2.68, 95% CI 1.12–6.41; adjusted HR?=?3.33, 95% CI 1.35–8.20). The cortisol to DHEA-s ratio was linearly associated with an increased risk of sickness absence (p for trend <?.050). Single effects of cortisol and DHEA-s levels were not associated with sickness absences. This trend did not change when limited to absences resulting from physical illness.

Conclusion

Hormonal conditions related to the hypothalamus–pituitary–adrenocortical axis and adrenal function should be considered when predicting sickness absence. The cortisol to DHEA-s ratio may be more informative than single effects of cortisol and DHEA-s levels.

     

Role of shame and body esteem in cortisol stress responses

Studies assessing the role of shame in HPA axis reactivity report mixed findings. Discrepancies may be due to methodological difficulties and inter-individual differences in the propensity to experience shame in a stressful situation. Hence, the current study combined self-report of shame and facial coding of shame expressions and assessed the role of body esteem as a moderator of the shame–stress link. For this, 44 healthy students (24F, age 20.5 ± 2.1 years) were exposed to an acute psychosocial stress paradigm (Trier Social Stress Test: TSST). Salivary cortisol levels were measured throughout the protocol. Trait shame was measured before the stress test, and state shame immediately afterwards. Video recordings of the TSST were coded to determine emotion expressions. State shame was neither associated with cortisol stress responses nor with body esteem (self-report: all ps ≥ .24; expression: all ps ≥ .31). In contrast, higher trait shame was associated with both negative body esteem (p = .049) and stronger cortisol stress responses (p = .013). Lastly, having lower body esteem predicted stronger cortisol stress responses (p = .022); however, it did not significantly moderate the association between shame indices and cortisol stress responses (all ps ≥ .94). These findings suggest that body esteem and trait shame independently contribute to strength of cortisol stress responses. Thus, in addition to trait shame, body esteem emerged as an important predictor of cortisol stress responses and as such, a potential contributor to stress-related negative health outcomes.     

Stress responsivity in children with externalizing behavior disorders

Patterns of lower autonomic nervous system (ANS) and hypothalamic-pituitary-adrenal (HPA) axis activity have been found in children with oppositional defiant disorder (ODD). The aim of the present study was to investigate whether children with attention-deficit/hyperactivity disorder (ADHD) differ from ODD children with (OD/AD) or without comorbid ADHD in ANS and HPA axis activity under baseline and stressful conditions. The effects of stress on cortisol, heart rate (HR), and skin conductance level (SCL) were studied in 95 children (26 normal control [NC] children and 69 child psychiatric patients referred for externalizing behavior problems [15 ODD, 31 OD/AD, and 23 ADHD]). No baseline differences were found in cortisol between the four groups. However, the ODD and OD/AD groups showed a significantly weaker cortisol response to stress compared to the ADHD and NC groups; the ADHD group had a similar cortisol response as the NC group. Within the ODD group this pattern of low cortisol responsivity was most clearly present in the more severely affected inpatients. With respect to HR, the ODD group had a significantly lower HR during baseline and stressful conditions. The higher HR levels in the OD/AD and ADHD groups were likely to be caused by methylphenidate. The externalizing groups had significantly lower SCL levels, and no differences were found between these groups. It was concluded that differences in cortisol responsivity during stress exposure are important in distinguishing within a group of children with externalizing behavior between those with ODD and ADHD.     

Physiological indicators of salinity stress in the grey mullet,Mugil cephalus,Linnaeus, 1758 juveniles

Grey mullet (Mugil cephalus) juveniles were subjected to salinity stress in order to determine physiological response and recovery. Variations in the most important blood physiological indicators of stress (i.e., cortisol and glucose) were analyzed after application of stress. According to the results, the concentration of cortisol increased significantly 30 min after delivery of fish to water with 15 and 25 ppt salinities. The elevated levels of cortisol returned to basal levels 60 min after application of stress (P?>?0.05). Plasma cortisol and glucose did not show significant changes after delivery of fish to water with 35 ppt salinity (P?>?0.05). The elevation of plasma glucose occurred 30 and 60 min after delivery of fish to water with 15 and 25 ppt salinities (P?>?0.05). Our study demonstrated that low salinities are stressful for grey mullet juveniles.     

Self-compassion,chronic age-related stressors,and diurnal cortisol secretion in older adulthood

Many older adults experience chronic age-related stressors (e.g., life regrets or health problems) that are difficult to control and can disturb cortisol regulation. Self-compassion may buffer adverse effects of these stressful experiences on diurnal cortisol secretion in older adulthood. To examine whether self-compassion could benefit older adults’ cortisol secretion in the context of chronic and largely uncontrollable age-related stressors, 233 community-dwelling older adults reported their levels of self-compassion, age-related stressors (regret intensity, physical health problems, and functional disability), and relevant covariates. Diurnal cortisol was measured over 3 days and the average area-under-the-curve and slope were calculated. Higher levels of self-compassion were associated with lower daily cortisol levels among older adults who reported higher levels of regret intensity, physical health problems, or functional disability (βs?<???.53, ps?<?.01), but not among their counterparts who reported lower levels of these age-related stressors (βs?<?.24, ps?>?.28). These results suggest that self-compassion may represent an important personal resource that could protect older adults from stress-related biological disturbances resulting from chronic and uncontrollable stressors.     

Sympathetic arousal during the processing of dysphoric affect by youths at high and low familial risk for depression

Youths at high risk for depression have been shown to have problems in repairing their own sad mood. Given that sympathetic arousal has been implicated both in the experience and regulation of affect, an atypical pattern of arousal may be one of the factors that contribute to mood repair problems. In the current study, we measured sympathetic arousal of never-depressed youths at high (n = 56) and low (n = 67) familial risk for depression during sad mood induction and instructed mood repair. Sympathetic arousal was indexed by skin conductance level (SCL) and cardiac pre-ejection period (PEP); mood repair outcome was indexed by self-rated affect. High-risk youths demonstrated increased SCL during sadness induction, which persisted during mood repair; low-risk youths evidenced increased SCL only during mood repair. Shortened PEP was evident only among high-risk youths and only during mood repair. Furthermore, shortened PEP during mood induction predicted less successful mood repair in the low-risk but not in the high-risk group. The findings suggest that: (a) depression-prone youths differ from control peers in patterns of sympathetic responses to emotional stimuli, which may impair their ability to relieve sadness, and (b) activation patterns differ across subsystems (SCL vs. PEP) of sympathetic activity, in conjunction with depression risk status.     

Examining the mediating roles of binge eating and emotional eating in the relationships between stress and metabolic abnormalities

To test whether binge eating and emotional eating mediate the relationships between self-reported stress, morning cortisol and the homeostatic model of insulin resistance and waist circumference. We also explored the moderators of gender and age. Data were from 249 adults (mean BMI = 26.9 ± 5.1 kg/m²; mean age = 28.3 ± 8.3 years; 54.2 % male; 69.5 % white) recruited from the community who were enrolled in a cross-sectional study. Participants completed a comprehensive assessment panel of psychological and physiological assessments including a morning blood draw for plasma cortisol. We found negative relationships between stress and morning cortisol (r = ?0.15 to ?0.21; p < 0.05), and cortisol and the homeostatic model of insulin resistance and waist circumference (r = ?0.16, ?0.25, respectively; p < 0.05). There was not statistical support for binge eating or emotional eating as mediators and no support for moderated mediation for either gender or age; however, gender moderated several paths in the model. These include the paths between perceived stress and emotional eating (B = 0.009, p < 0.001), perceived stress and binge eating (B = 0.01, p = 0.003), and binge eating and increased HOMA-IR (B = 0.149, p = 0.018), which were higher among females. Among women, perceived stress may be an important target to decrease binge and emotional eating. It remains to be determined what physiological and psychological mechanisms underlie the relationships between stress and metabolic abnormalities.     

Intense physical exercise increases systemic 11β-hydroxysteroid dehydrogenase type 1 activity in healthy adult subjects

Intense physical exercise activates the hypothalamic–pituitary–adrenocortical axis but little is known about changes in glucocorticoid sensitivity at the target cell level. No data are available on the acute effects of exercise on 11β-hydroxysteroid dehydrogenase (11β-HSD) type 1 activity, which generates biologically active cortisol from inactive cortisone and is expressed also in skeletal muscle. Fifteen healthy, trained males (age mean ± SE 28 ± 1) were assessed on three non-consecutive days: at rest, during an endurance and strength sessions. During each session, between 1000 and 1600 hours, 6-h urine and four salivary samples were collected. Urinary total tetrahydrocortisol (THF) + alloTHF, tetrahydrocortisone (THE), cortisol (F) and cortisone (E) were measured with HPLC-tandem mass spectrometry; urinary-unconjugated F and E were measured by HPLC-UV. Salivary cortisol and interleukin (IL)-6 were measured by RIA and ELISA, respectively. Both endurance and strength exercises caused an increase in (THF + alloTHF)/THE ratio (mean ± SE 1.90 ± 0.07 and 1.82 ± 0.05 vs. 1.63 ± 0.06, P < 0.01 and P = 0.03, respectively), consistent with increased systemic 11β-HSD type 1 activity. No relationship was found with age, BMI, $ V{{{\text{O}}_{2\max } }} , $ maximal power load or perceived exertion. No significant change was apparent in F/E ratio, an index of 11β-HSD type 2 activity. No effect of exercise on salivary cortisol and IL-6 was observed, whereas a significant effect of sampling time was found. Intense physical exercise acutely increases systemic 11β-HSD type 1 activity in humans. Such an increase may lead to higher cortisol concentration in target tissues, notably in skeletal muscle where it could contribute to limit exercise-induced muscle inflammatory response.     

Changes in blood biochemistry of common carp Cyprinus carpio (Linnaeus), following exposure to different concentrations of clove solution

The effect of different concentrations of clove solution on blood biochemistry of common carp Cyprinus carpio was investigated. Fish were exposed to 700, 1,000, 2,000, 3,000, 4,000, and 5,000 ppm clove solution over a period of 300, 200, 150, 100, 75, and 70 s, respectively, to reach stage 4 anesthesia. Immediately after induction, blood samples were collected to determine biochemical characteristics. Results showed significant (P?<?0.0001) changes in serum cortisol and glucose levels; however, no significant changes were found in serum levels of triglyceride, total protein, cholesterol, albumin, calcium, chloride, or sodium. Serum levels of cortisol and glucose were similar (P?>?0.05) in fish exposed to concentrations 4,000 and 5,000 ppm of clove solution, which significantly increased while anesthetic concentration decreased, reaching maximum levels at 700 ppm. The results suggest that anesthesia using higher concentrations of clove solution (and over short period) is preferred compared to lower concentrations (and long period), in the case of stress response. However, the other tested parameters are not sensitive to the anesthesia protocol, at least under the conditions of the present study.     

Psychophysiological and neuroendocrine responses to laboratory stressors in women: Implications of menstrual cycle phase and stressor type

This study assessed stressor and menstrual phase effects on psychophysiological and neuroendocrine responses to laboratory stressors in freely cycling women (N = 78, ages 18-45). Participants performed counterbalanced stressors [Paced Auditory Serial Addition Test (PASAT) or cold pressor test (CP)] during their follicular and luteal menstrual cycle phases between 1:00 and 3:00 p.m. to control for cortisol rhythm. Participants rested 30-min, performed the stressor, and then recovered 30-min while electrocardiography continuously monitored heart rate (HR). Systolic (SBP) and diastolic blood pressure (DBP), salivary cortisol, and state anxiety were assessed at timed intervals. HR, SBP, and cortisol varied more over the course of luteal than follicular phase testing. A three-way interaction revealed state anxiety reactivity was greater with the PASAT during the follicular phase. DBP showed equal and persistent reactivity with both stressors during both cycle phases. Results extend the stressor-specific HPAA hypothesis and have important methodological implications for women's biopsychology research.     

Metadherin expression and lung relapse in patients with colorectal carcinoma

Colorectal cancer (CRC) is the third most common malignant disease in men and the second in women worldwide. CRC relapse occurs mostly in liver and lungs, decreasing the 5-year survival to 6 %. Metadherin (MTDH) is overexpressed in several types of cancer, has been implicated in proliferation, invasion, metastasis, angiogenesis, and chemoresistance, and is a factor of poor prognosis in CRC. In this work we addressed the prognostic significance of MTDH expression in CRC progression to the lungs. We found that MTDH gene was more frequently amplified (copy number >1.8) in patients with CRC and relapse to the lung, when compared to patients without lung metastases (17.4 vs 100 %; p < 0.001). We observed a correlation between MTDH gene copy number and MTDH expression by IHC (p = 0.0001). Next we also analyzed MTDH expression by IHC in samples from 85 patients diagnosed with CRC, stage II or III, M0, with at least 3 years of follow-up. Kaplan–Meier survival analysis showed that lung relapse-free survival (HR 5.29, 95 % CI 1.90–14.77, p = 0.0004), liver relapse-free survival (HR 8.59, 95 % CI 0.99–74.18, p = 0.003), relapse-free survival (HR 4.85, 95 % CI 1.88–12.45, p = 0.0003) and overall survival (HR 3.75, 95 % CI 1.15–12.18, p = 0.018) were significantly lower in the group with high MTDH expression. Multivariate analysis showed that high MTDH expression was an independent factor for all outcomes. This study demonstrates that high MTDH expression is a biomarker of relapse in CRC, including lung-specific relapse. Determination of MTDH expression in primary CRC may be useful in the earlier detection of lung metastases in patients with high expression and increased risk.     

Optimism moderates psychophysiological responses to stress in older people with Type 2 diabetes

Optimism is thought to be beneficial for health, and these effects may be mediated through modifications in psychophysiological stress reactivity. Type 2 diabetes (T2D) is associated with reduced cardiovascular responses to stress and heightened cortisol over the day. This study assessed the relationships between optimism, stress responsivity, and daily cortisol output in people with T2D. A total of 140 participants with T2D were exposed to laboratory stress. Heart rate (HR), systolic (SBP), diastolic blood pressure (DBP), and cortisol were measured throughout the session. Cortisol output over the day was also assessed. Optimism and self‐reported health were measured using the revised Life Orientation Test and the Short Form Health Survey. Optimism was associated with heightened SBP and DBP stress reactivity (ps < .047) and lower daily cortisol output (p = .04). Optimism was not related to HR, cortisol stress responses, or the cortisol awakening response (ps > .180). Low optimism was related to poorer self‐reported physical and mental health (ps < .01). Optimism could have a protective role in modulating stress‐related autonomic and neuroendocrine dysregulation in people with T2D.     

Time-course response in serum markers of bone turnover to a single-bout of electrical stimulation in patients with recent spinal cord injury

The objective of the present repeat-measures study was to determine whether plasma serum levels of testosterone, cortisol, osteocalcin or type I collagen C-telopeptide (CT) are acutely affected following an electro-myostimulation (EMS) bout, and their relation to bone mineral density and muscle mass. Ten men with recent (8 weeks) thoracic spinal cord injury (SCI) (ASIA A) and 10 age-matched able-bodied (AB) men performed one EMS bout on the quadriceps femoris muscle. Blood samples were drawn at basal condition, immediately after EMS, and 15 min, 30 min, 24 h and 48 h post-EMS. Muscle cross-sectional area was measured by magnetic resonance imaging. Bone mineral density (BMD) was determined by dual-energy X-ray absorptiometry. In the SCI group, a significant decrease in testosterone, cortisol and CT together with a significant increase in testosterone/cortisol ratio and osteocalcin/CT ratio was observed after EMS. For the AB subjects, only testosterone and CT decreased significantly following EMS. Muscle size was only related to testosterone/cortisol ratio in the SCI sample (R = 0.659, p < 0.05), whereas BMD did not show any relation to any biomarker. Acute EMS in recent spinal cord injured men seems to induce positive effects on bone turnover biomarkers, and anabolic and catabolic hormones.     

Altered stress patterns and increased risk for postpartum depression among low-income pregnant women

Postpartum depression (PPD) has been associated with a number of negative maternal and infant health outcomes. Despite these adverse health effects, few studies have prospectively examined patterns of pre- and postnatal stress that may increase a woman’s risk for PPD. The current study examined whether the timing of altered salivary cortisol patterns and perceived stress levels during pregnancy and at 3 months postpartum was associated with PPD symptoms among 100 low-income mothers. Higher levels of PPD were found among women with a lower cortisol awakening response (first and second trimester), lower average daily cortisol (second trimester), a flatter diurnal cortisol pattern (second and third trimester and at 3 months postpartum), and a less abrupt drop in both cortisol and perceived stress from the third trimester to 3 months postpartum. These results support the need for early screening and regulation of stress levels to promote depression prevention efforts in at-risk populations.     

Circulating hormone and cytokine response to low-load resistance training with blood flow restriction in older men

It has been suggested that circulating hormones and cytokines are important in the adaptive response to low-load resistance training (LLRT) with blood flow restriction (BFR); however, their response following this type of training in older men is unclear. Seven healthy older men (age 71.0 ± 6.5 year, height 1.77 ± 0.05 m, body mass 80.0 ± 7.5 kg; mean ± SD) performed five sets of unilateral LLRT knee extensions (20 % 1-RM) of both limbs, with or without BFR in a counterbalanced order. For the BFR condition, a pressure cuff was applied on the upper thigh and inflated to ~110 mmHg. Venous blood samples were taken at rest and 30-, 60- and 120-min post-exercise and measured for plasma concentrations of growth hormone (GH), insulin-like growth factor 1 (IGF-1), vascular endothelial growth factor (VEGF), cortisol and interleukin-6 (IL-6). GH increased (P < 0.05) from rest to 30-min post-exercise and was greater (P < 0.05) during LLRT with BFR than without. VEGF was significantly (P < 0.05) elevated from resting levels at 30-, 60- and 120-min post-exercise following LLRT with BFR with no change seen following LLRT without BFR. IL-6 increased (P < 0.05) from 30- to 60-min post-exercise and remained elevated at 120-min post-exercise in both conditions. Cortisol and IGF-1 were unaffected following exercise. In conclusion, a single bout of LLRT with BFR increases the circulating concentrations of GH and VEGF in older men and may explain the skeletal muscle and peripheral vascular adaptations observed following training with BFR.     

Comparing apples and oranges or different types of citrus fruits? Using wearable versus stationary devices to analyze psychophysiological data

Wearable devices capable of capturing psychophysiological signals are popular. However, such devices have, yet, to be established in experimental and clinical research. This study, therefore, compared psychophysiological data (skin conductance level (SCL), heart rate (HR), and heart rate variability (HRV)) captured with a wearable device (Microsoft band 2) to those of a stationary device (Biopac MP150), in an experimental pain induction paradigm. Additionally, the present study aimed to compare two analytical techniques of HRV psychophysiological data: traditional (i.e., peaks are detected and manually checked) versus automated analysis using Python programs. Forty-three university students (86% female; Mage = 21.37 years) participated in the cold pressor pain induction task. Results showed that the majority of the correlations between the two devices for the mean HR were significant and strong (rs > .80) both during baseline and experimental phases. For the time-domain measure of mean RR (function of autonomic influences) of HRV, the correlations between the two devices at baseline were almost perfect (rs = .99), whereas at the experimental phase were significantly strong (rs > .74). However, no significant correlations were found for mean SCL (p> .05). Additionally, automated analysis led to similar features for HRV stationary data as the traditional analysis. Implications for data collection include the establishment of a methodology to compare stationary to mobile devices and a new, more cost efficient way of collecting psychophysiological data. Implications for data analysis include analyzing the data faster, with less effort and allowing for large amounts of data to be recorded.     

Chronic pain and cardiovascular stress responses in a general population: the Tromsø Study

We tested whether cardiovascular stress responsiveness is elevated in individuals experiencing chronic pain in a large general population sample. Blood pressure (BP) and heart rate (HR) were assessed at rest, during the cold pressor test, and during subsequent recovery in 554 individuals reporting daily chronic pain and 3,082 individuals free of chronic pain. After correcting for potential confounds, differences as a function of chronic pain status were noted for only 5 of 23 cardiovascular outcomes despite very high statistical power. Compared to the pain-free group, the chronic pain group displayed higher baseline HR/mean arterial pressure (MAP) ratio (p = .03), greater systolic BP (SBP) reactivity during the cold pressor test (p = .04), and higher HR/MAP ratio (p = .047) and significantly less SBP (p = .017) and MAP (p = .041) return to baseline during recovery. Findings suggest that changes in cardiovascular stress responsiveness associated with chronic pain are of limited clinical significance and unlikely to contribute to increased cardiovascular risk in the chronic pain population.     

Prognosis of hepatocellular carcinoma patients with extrahepatic metastasis and the controllability of intrahepatic lesions

Although advanced hepatocellular carcinoma (HCC) with extrahepatic metastasis is recommended to be treated by a systemic chemotherapeutic agent without local treatment targeting the liver, studies reported that causes of death in these patients were mostly from progression of intrahepatic lesions. Thus, this study investigated prognosis and factors predicting survival in these patients so as to evaluate the role of local treatments against intrahepatic lesions when the patients already had extrahepatic metastasis. This retrospective study evaluated medical records of 277 patients with HCC and extrahepatic metastasis. The median survival was 5.9 months, and 257 patients died during the follow up. Factors affecting survival of HCC patients with extrahepatic metastasis were poor response to treatment of hepatic lesions (HR 2.207; 95 % CI; p < 0.001), applying local treatment specifically targeting intrahepatic lesions (HR 0.591; 95 % CI 0.436–0.803; p = 0.001), intrahepatic tumor size larger than 3 cm (HR 2.065; 95 % CI 1.444–2.954; p < 0.001), and ECOG performance status 2 or higher (HR 1.543; 95 % CI 1.057–2.253; p = 0.025). The patients with either complete or partial response to the therapy had 1- and 2-year survival rate of 48.8 and 12.1 % whereas patient with either stable or progressive disease had 1-year survival rate of 11.4 %. These results suggest that even in the HCC patients with extrahepatic metastasis, effective local treatment may still be beneficial for the survival especially in patients with acceptable performance status.     

Changes in serum cytokine and cortisol levels in normothermic and hypothermic term neonates after perinatal asphyxia

Objective

Perinatal asphyxia is characterized by an inflammatory response that contributes to cerebral injury. Therapeutic hypothermia improves neurological outcome in asphyxiated term neonates, but its clear effect on the inflammatory response is unknown.

Subjects and methods

A range of cytokines and cortisol levels were measured at the 6th, 12th and 24th postnatal hours in neonates with hypoxic-ischemic encephalopathy treated with standard intensive care on hypothermia (n = 10) or normothermia (n = 8). The influence of postnatal age and hypothermia on serum cytokine and cortisol levels was evaluated.

Results

Interleukin (IL)-6 levels (at 6 h of age) and IL-4 levels (at all time points) were significantly lower in asphyxiated neonates treated with hypothermia compared to normothermic neonates. Vascular endothelial growth factor levels were higher in the hypothermia than in the normothermia group at the 6th and 12th postnatal hours. IL-10 levels decreased significantly between 6 and 24 h of age in both groups. However, no difference of IL-10 levels was observed between the study groups. The duration of hypothermia before 6 hours of age correlated with lower levels of IL-6, interferon-γ and tumor necrosis factor-α measured at 6 h of age and IL-10 levels at 12 h of age. Cortisol levels did not differ between the study groups, but did gradually decrease in both groups during the study period. At 6 and 24 h of age, a positive correlation was observed between cortisol and IL-10 levels.

Conclusions

Therapeutic hypothermia may rapidly suppress and modify the immediate cytokine response to asphyxia. The correlation between cytokine levels and duration of hypothermia suggests that the earlier hypothermia is introduced, the more pronounced its beneficial immunomodulatory effect.