Neurohumoral dysregulation in vibration disease (response features of hormonal complexes to the introduction of tyroliberin)

Abstract

Introduction. The leading role in the body's adaptation to the external environment is the neuroendocrine system, although homeostatic mechanisms are highly diverse and at very different levels. Special functional hormonal tests can detect such disorders since obvious clinical manifestations do not accompany many neuroendocrine diseases. The use of tyroliberin with simultaneous determination of hormones of the peripheral endocrine gland and the corresponding tropic hormone of the pituitary gland in one portion of blood makes it possible to detect excessive or reduced hormonal secretion and diagnose the level of damage to the neuroendocrine system: hypothalamic, pituitary, peripheral. It seems relevant to characterize the features of the response of the pituitary-thyroid complex to the introduction of synthetic hypothalamic tyroliberin in vibration disease (VD). The study aims to develop objective criteria for detecting neurohormonal deregulation with varying degrees of severity of clinical manifestations of VD, to establish the pathogenetic, diagnostic, and prognostic significance of the detected changes. Materials and methods. Researchers examined three groups of patients: the first - persons with separate, early signs of vibration exposure (17 patients), the second - persons with grade 1 VD (26), the third - persons with grade 2 VD (27). The control group consisted of 37 practically healthy men, of similar age and profession, with no signs of vibration exposure. Results. In patients with VD, there is a qualitative and quantitative transition of the regulation of the pituitary-thyroid system, characterized by a different than average amount of thyroid hormones per unit of thyrotropin (TTH): less triiodothyronine (T3) and more thyroxine (T4). Since the primary source of T3 in the body is its conversion from T4 on the periphery in tissues, there is reason to believe that with the progression of clinical manifestations of vibration pathology, there is a decrease in the activity of this process. An increase in the T4/T3 ratios in parallel with the severity of the disease confirms this position. Conclusion. The features of the response of hormonal complexes to the introduction of synthetic hypothalamic tyroliberin were found, which made it possible to clarify the significance and role of neurohormonal dysregulation in the pathogenesis, diagnosis, and prediction of the risk of the occurrence and development of clinical manifestations of VD.