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Int. J. Mol. Sci. 2017, 18(10), 2131;

Association between Stress and the HPA Axis in the Atopic Dermatitis

Department of Dermatology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
Citrus Valley Medical Center, West Covina, CA 91790, USA
Dermatology Service & Translational Research Unit (UIT), Hospital General Universitario de Ciudad Real, Ciudad Real 13005, Spain
Authors to whom correspondence should be addressed.
Received: 1 September 2017 / Revised: 6 October 2017 / Accepted: 9 October 2017 / Published: 12 October 2017
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The hypothalamic–pituitary–adrenal (HPA) axis is one of the body’s neuroendocrine networks that responds to psychological stress (PS). In the skin, there exists a peripheral HPA axis similar to the central axis. Glucocorticoids (GCs) are key effector molecules of the HPA axis and are essential for cutaneous homeostasis. Atopic dermatitis (AD) is a condition typically characterized by a chronic relapsing course that often results in PS. HPA dysfunction is present in AD patients by the decreased response of GCs elevation to stress as compared to those unaffected by AD. Nevertheless, in skin, acute PS activates several metabolic responses that are of immediate benefit to the host. During the acute phase of PS, increased endogenous GCs have been shown to provide benefit rather than by aggravating cutaneous inflammatory dermatoses. However, a chronic T helper cell type 2 (Th2) predominant cytokine profile acts as a negative feedback loop to blunt the HPA axis response in AD. In this article, we reviewed the role of CRF, pro-opiomelanocortin (POMC)-derived peptides, GCs of the HPA, and 11β-hydroxysteroid dehydrogenase 1 (11β-HSD1) in AD, with a discussion of the pathogenetic mechanisms of inflammation and skin barrier functions, including antimicrobial defense, and their association with PS. View Full-Text
Keywords: atopic dermatitis; HPA axis; psychological stress; skin barrier; inflammation; glucocorticoid atopic dermatitis; HPA axis; psychological stress; skin barrier; inflammation; glucocorticoid

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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Lin, T.-K.; Zhong, L.; Santiago, J.L. Association between Stress and the HPA Axis in the Atopic Dermatitis. Int. J. Mol. Sci. 2017, 18, 2131.

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