Cortisol, role

Gilden, C., Sevanian, A., Tierney, D. F., Kaplan, S. A., and Barrett, C. T., 1977, Regulation of fetal lung phosphatidylcholine synthesis by cortisol Role of glycogen and glucose, Pediatr. Res. 11 845-848. 

V4. Vermes, I., Beishuizen, A., Hampsink, R. M and Haanen, C., Dissociation of plasma adreno-corticotropin and cortisol levels in critically ill patients Possible role of endothelin and atrial natriuretic hormone. J. Clin. Endocrinol. Metab. 80, 1238-1242 (1995). 

An account of the principles which help to understand how hormones achieve their roles in the body is given in Chapter 12. The understanding is based on separation of the effects of hormones into three components the action, the effects (biochemical and physiological) and the function. A steroid hormone binds to a cytosolic intracellular receptor, which then moves into the nucleus where it binds to DNA at a specific site (the steroid response element) and activates genes which result in the formation of proteins that elicit biochemical and physiological effects. This is discussed for cortisol in Chapter 12 and aldosterone in Chapter 22. Much of the interest in the reproductive steroid hormones is in the physiological effects and how these account for their functions. 

If the pituitary-adrenal axis plays such an important role in central neurotransmission, it may be speculated that glucocorticoid s)mthesis inhibitors (e.g. metyrapone) could reduce the abnormality in neurotransmitter function by decreasing the cortisol concentration. 

Hollander E, Liebowitz MR, Gorman JM, Cohen B, Fyer AJ, Klein DF (1989) Cortisol and sodium lactate-induced panic. Arch Gen Psychiatry 46 135-140 Holsboer F (2003) The role of peptides in treatment of psychiatric disorders. J Neiu-al Transm 64 17-34... 

Keck ME, Holsboer F (2001) Hyperactivity of CRH neiu-onal circuits as a target for therapeutic interventions in affective disorders. Peptides 22 835-844 Kellner M, Wiedemann K, Holsboer F (1992) ANF inhibits the CRH-stimulated secretion of ACTH and cortisol in man. Life Sci 50 1835-1842 Kellner M, Herzog L, Yassouridis A, Holsboer F, Wiedemann K (1995) A possible role of atrial natriuretic hormone in pituitary-adrenocortical imresponsiveness in lactate-induced panic disorder. Am J Psychiatry 152 1365-1367 Kennedy JL, Bradwein J, Koszycki D (1999) Investigation of cholecystokinin system genes in panic disorder. Mol Psychiatry 4 284-285... 

Interestingly, while peripheral neuroendocrine function appears normal in patients with panic disorder, decreased basal cortisol concentrations have been reported in most studies in PTSD patients. This relative hypocortisolism occurs in the context of increased feedback inhibition of the HPA axis (see Yehuda, 2000). However, a dissociation between central and adrenocortical (re)activity has been found in animal models of severe early-life stress as well as in abused children and women, suggesting that adrenal dysfunction may, at least in part, contribute to hypocortisolism in PTSD. In the face of hypocortisolism, it seems surprising that hippocampal atrophy is one of the most prominent findings in patients with PTSD, including adult survivors of childhood abuse with PTSD (see Newport and Nemeroff, 2000). While increased glucocorticoid sensitivity of hippocampal cells may play a role in the development of hippocampal atrophy, another potential mechanism may involve toxic effects of markedly increased cortisol responses to everyday stress in patients with PTSD. 

Cortisol and growth hormone These hormones are less important in the short-term maintenance of blood glucose concentrations. They do, however, play a role in the long-term management of glucose metabolism. 

Brown ES, Varghese FP, McEwen BS. Association of depression with medical illness does cortisol play a role Biol Psychiatry. 2004 55 1-9. 

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