Abstract
It is increasingly clear that significant differential regulation of pituitary and adrenal gland activation exists, leading to a dissociation of plasma adrenocorticotropic hormone and corticosteroid secretion during fetal, postnatal and adult life. An increasing number of preclinical and clinical studies report dissociation of adrenocorticotropic hormone and cortisol levels in critical illness, inflammation and mental disorders. Mechanisms involve an altered adrenal sensitivity, aberrant receptor expression or modulation of adrenal function by cytokines, vasoactive factors or neuropeptides. The degree of dissociation has been associated with the level of complications of sepsis, surgery, malignant disease and depression. The separation of adrenocorticotropic hormone and corticosteroid secretion is of clinical relevance and should be incorporated into our view on endocrine stress regulation.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 175-180 |
| Number of pages | 6 |
| Journal | Trends in Endocrinology and Metabolism |
| Volume | 19 |
| Issue number | 5 |
| DOIs | |
| State | Published - Jul 2008 |
Bibliographical note
Funding Information:Supported by grants NSF IOB-0548584 (W.C.E.), MH049698 (J.P.H.), MH069725 (J.P.H.), MH069680 (J.P.H.), AG12962 (J.P.H.), DFG Collaborative Research Centre Dresden (SFB 655-A6; M.E.B. and S.R.B.). Figure 1 was produced using SERVIER Medical Art.