COMPLEX RELATIONS BETWEEN CORTICOSTEROIDS AND THE ADHESIVE STATE OF THE WHITE BLOOD CELLS IN THE PERIPHERAL BLOOD: FURTHER ANALYSIS OF THE STATE OF LEUKOCYTE/ADHESIVENESS AGGREGATION IN THE PERIPHERAL BLOOD AS A MARKER OF STRESS

Stress is associated with an increment in the concentration of cortisol, a leukocytotic response and increased state of leukocyte adhesiveness/aggregation (LAA) in the peripheral blood. We investigated the interrelationship between these three parameters in individuals under various conditions of stress. These included 123 emergency room patients with chest pain who were also classified in regard to the presence or absence of heart failure; 15 men in the fertility clinic donating semen and 16 women in the operating room before induction of anaesthesia for dilatation and curettage. A low (r=0.35) but significant (p<0.001) correlation was noted between cortisol level, leukocyte count, and per cent of aggregated leukocytes in the peripheral blood in the first group (ischaemic heart disease) but not the fertility clinic or operating room patients. A complementary study in dogs which received an intravenous hydrocortisone injection revealed neither an increased leukocyte number in the peripheral blood nor an increment in the adhesive state. In vitro studies confirmed the depressant effect of high concentrations of hydrocortisone on cell adhesiveness despite an increment in the expression of various adhesive proteins on the surface of the peripheral blood leukocytes. We concluded that the increased state of leukocyte adhesiveness noted by us in the past in patients under stress is not necessarily related to the presence of an increased cortisol concentration, and that factors other than corticosteroid level should be explored as possible triggers of the LAA response during stress. © 1997 by John Wiley & Sons, Ltd.