Hypothalamic-pituitary-adrenal axis activation

In depressed patients, cortical-hypothalamic-pituitary-adrenal axis hyperactivity can be explained by the hypersecretion of CRF, and secondary pituitary and adrenal gland hypertrophy. Impaired negative feedback at various CNS sites, including the hippocampus and pituitary are also likely to contribute. Downregulation of hippocampal mineralocorticoid receptors and expression is reported in depressed suicides [50]. In bipolar disorder, hyperactivity of the cortical-hypothalamic-pituitary-adrenal axis has been observed [51]. This increase in cortical-hypothalamic-pituitary-adrenal axis activity has also been observed in mixed mood states, mania and in depression in rapidcycling patients. Partial reversal of HPA overactivity is associated with treatment and recovery from depression. 

Stogner KA, Holmes PV (2000) Neuropeptide-Y exerts antidepressant-like effects in the forced swim test in rats. Eur J Pharmacol 387 R9-R10 Stout SC, Owens MJ, Nemeroff CB (2002) Regulation of corticotropin-releasing factor neuronal systems and hypothalamic-pituitary-adrenal axis activity by stress and chronic antidepressant treatment. J Pharmacol Exp Ther 300 1085-1092 StrOhle A, Jahn H, Montkowski A, Liebsch G, Boll E, Landgraf R, Holsboer F, Wiedemann K (1997) Central and peripheral administration of atriopeptin is anxiolytic in rats. Neuroendocrinology 65 210-215... 

Zwanzger P, Eser D, Aicher S, Schule C, Baghai TC (2003) Effects of alprazolam on chole-cystokinin-tetrapeptide-induced panic and hypothalamic-pituitary-adrenal-axis activity a placebo-controlled study. Neuropsychopharmacology 28 979-984... 

Casale TB, Nelson HS, Strieker WE, Raff H, Newman KB. Suppression of hypothalamic-pituitary-adrenal axis activity with inhaled flunisolide and fluticasone propionate in adult asthma patients. Ann Allergy Asthma Immunol 2001 87(5) 379-85. 

Hypothalamic-pituitary-adrenal axis function in bipolar disorder has been reviewed, but lithium was mentioned only in passing (617). Two studies (n = 25, n = 24), possibly reporting many of the same patients, showed that lithium augmentation of antidepressant-resistant unipolar depression increased hypothalamic-pituitary-adrenal axis activity, measured by the dexamethasone suppression test, either alone or combined with the corticotropin releasing hormone test (618,619). However, the tests did not distinguish between lithium responders and nonresponders. 

Rosmond R, Bjorntorp P. The hypothalamic-pituitary-adrenal axis activity as a predictor of cardiovascular disease, type 2 diabetes and stroke. J Int Med 2000 247 188-197. 

Owens MJ, Edwards E, Nemeroff CB (1990) Effects of 5HT1A receptor agonists on hypothalamic-pituitary-adrenal axis activity and corticotropin-releasing factor containing neurons in the rat brain. Eur J Pharmacol 790 113-122. 

Rl 1. Rosmond, R., and Bjorntorp, R, The interactions between hypothalamic-pituitary-adrenal axis activity, testosterone, insulin-like growth factor I and abdominal obesity with metabolism and blood pressure. Int. J. Obes. Relat. Metab. Disord. 22, 1184—1196 (1998). 

The different methods of assessing hypothalamic-pituitary-adrenal axis activity in patients using inhaled glucocorticoids have been compared (35). The AUC of serum cortisol concentrations was the most reliable method. There were significant positive correlations between AUC and the 8 a.m. serum and salivary cortisol concentrations. The authors favored the non-invasive method of salivary concentration measurement. However, 24-hour urine collection is not recommended, as it correlated only moderately well. This finding is consistent with the results of other studies. Urinary free-cortisol estimation based on immunoassay after inhaled glucocorticoids may be an unreliable surrogate marker of... 

Sternberg, E. M., Hill, J. M., Chrousos, G. P., Kamilaris, T., Listnvak, S. J., Gold, P. W., and Wilder, R. L., Inflammatory mediator-induced hypothalamic-pituitary-adrenal axis activation in defective streptococcal cell wall arthritis-susceptible Lewis rats, Proc. Natl. Acad. Sci. USA, 86, 2374, 1989. 

Whittle, W.L., Patel, F.A., Alfaidy, N., Holloway, A.C., Fraser, M., Gyomorey, S., Lye, S.J., Gibb, W., and Challis, J.R. (2001) Glucocorticoid Regulation of Human and Ovine Parturition The Relationship Between Fetal Hypothalamic-Pituitary-Adrenal Axis Activation and Intrauterine Prostaglandin Production, Biol. Reprod. 64,1019-1032. 

Imura, H and Fukata, J., Endocrine-paracrine interaction in communication between the immune and endocrine systems. Activation of the hypothalamic-pituitary-adrenal axis in inflammation. Eur. J. Endocrinol. 130,32-37 (1994). 

RIO. Rivier, C., Chizzonite, R and Vale, W., In the mouse, the activation of the hypothalamic-pituitary-adrenal axis by a lipopolysaccharide (endotoxin) is mediated through interleukin-1. Endocrinology 125,2800-2805 (1989). 

However, nicotine also has been shown to stimulate the hypothalamic-pituitary-adrenal axis in rodents, leading to elevated plasma levels of adrenocorticotropic hormone and corticosterone (Andersson et al. 1983 Cam et al. 1979), which are known to exert a wake-promoting effect. However, studies in humans have shown that only intense smoking is able to activate the hypothalamic-pituitary-adrenal axis (Gilbert et al. 1992 Kirschbaum et al. 1992). Nicotine patches, in addition to their use in nicotine suppression and craving, have been used to explore the relationship between sleep and nicotine in human... 

Parsadaniantz, S. M. et al. Effects of the inhibition of cyclo-oxygenase 1 or 2 or 5-lipoxy-genase on the activation of the hypothalamic-pituitary-adrenal axis induced by interleukin-lbeta in the male Rat. J. Neuroendocrinol. 12, 766, 2000. 

Karrow, N. A., Activation of the hypothalamic-pituitary-adrenal axis and autonomic nervous system during inflammation and altered programming of the neuroendocrine-immune axis... 

NPY produces a variety of central nervous system effects, including increased feeding (it is one of the most potent orexigenic molecules in the brain), hypotension, hypothermia, respiratory depression, and activation of the hypothalamic-pituitary-adrenal axis. Other effects include vasoconstriction of cerebral blood vessels, positive chronotropic and inotropic actions on the heart, and hypertension. The peptide is a potent renal vasoconstrictor and suppresses renin secretion, but can cause diuresis and natriuresis. Prejunctional neuronal actions include inhibition of transmitter release from sympathetic and parasympathetic nerves. Vascular actions include direct vasoconstriction, potentiation of the action of vasoconstrictors, and inhibition of the action of vasodilators. 

Hypothalamic-pituitary-adrenal axis function provides one of the most sensitive markers of the systemic activity of inhaled glucocorticoids (35), and suppression can be used as a surrogate marker for adverse effects of inhaled glucocorticoids in other tissues. 

Vgontzas AN, Bixler EO, Lin H-M, Prolo P, Mastorakos G, Vela-Bueno A, Kales A, Chrousos GP. Chronic insomnia is associated with nyctohemeral activation of the hypothalamic-pituitary-adrenal axis clinical implications. J Clin Endocrinol Metab 2001 86 3787-3794. 

Patel, S., Roelke, C. T., Rademacher, D.J., Cullinan, W. E., and Hillard, C.J. (2004). Endocanna-binoid signaling negatively modulates stress-induced activation of the hypothalamic-pituitary-adrenal axis. Endocrinology 145, 5431-5438. 

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