Alterations of the hypothalamic-pituitary-adrenal axis in systemic immune diseases - a role for misguided energy regulation.
Clin Exp Rheumatol
; 29(5 Suppl 68): S23-31, 2011.
Article
de En
| MEDLINE
| ID: mdl-22018180
ABSTRACT
The investigation of the hypothalamicpituitary-adrenal (HPA) axis in chronic inflammation has demonstrated 1) an anti-inflammatory influence of the HPA axis; 2) low serum levels of adrenal androgen; 3) equivocal results with respect to levels of adrenocorticotropic hormone and cortisol; 4) inadequately low secretion of adrenal hormones in relation to inflammation (the disproportion principle); 5) modulating role of TNF and IL-6 on the HPA axis; 6) disturbed cooperativity of HPA axis and sympathetic nervous system (uncoupling); 7) observable glucocorticoid resistance; 8) the circadian rhythmicity explains morning symptoms; 9) new medications based on malfunction of the HPA axis (e.g. adapted to the circadian rhythm of hormones and cytokines); and 10) the newly described role of the HPA axis in the context of misguided energy regulation in chronic inflammatory diseases. This review discusses items 1-6 and 10, while the other items are presented elsewhere in this Supplement. Evidence is presented that the basis for many alterations is in an adaptive program positively selected for short-lived inflammatory responses (energy appeal reaction), which becomes a disease-inherent pathogenetic factor, if it continues too long, that can drive systemic disease sequelae of chronic inflammatory diseases such as the metabolic syndrome.
Recherche sur Google
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Axe hypophyso-surrénalien
/
Rhumatismes
/
Métabolisme énergétique
/
Axe hypothalamohypophysaire
/
Maladies du système immunitaire
Limites:
Animals
/
Humans
Langue:
En
Journal:
Clin Exp Rheumatol
Année:
2011
Type de document:
Article
Pays d'affiliation:
Allemagne