Abstract
The pituitary-adrenocortical and adrenomedullary response to high altitude (HA) stress
was studied following daily single dose administration of prednisolone as a prophylaxis
against altitude-induced acute mountain sickness (AMS). Forty healthy men, randomly
divided into two groups of twenty, received placebo or prednisolone 20 mg once a day
at 08.00 h for two days prior to induction to HA and during an initial three days
stay at an altitude of 3450 m. The AMS score and circulatory levels of ACTH, cortisol,
epinephrine and norepinephrine were measured at sea level (SL) and during residency
at HA. The sensitivity of the hypothalamic-pituitary-adrenal axis in subjects receiving
prednisolone therapy was evaluated at SL and on day four of stay at HA. Administration
of prednisolone significantly (p < 0.01) decreased the severity of AMS in all the
subjects. The steroid dose used did not inhibit endogenous secretion of ACTH, cortisol,
epinephrine or norepinephrine, as HA response to adrenocortical and adrenomedullary
hormones was identical in placebo and prednisolone treated subjects. The integrity
of the hypothalamic-pituitary-adrenal axis was maintained well in subjects receiving
low dose prednisolone therapy. These observations suggest that short-term administration
of prednisolone is able to curtail AMS without causing suppression of the hypothalamic-pituitary-adrenal
axis.
Key words
High Altitude - Acute Mountain Sickness - HPA Axis - Glucocorticoids
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