Neuroregulation of the Hypothalamus-Pituitary-Adrenal

A special issue of Endocrines (ISSN 2673-396X). This special issue belongs to the section "Neuroendocrinology and Pituitary Disorders".

Deadline for manuscript submissions: closed (20 May 2021) | Viewed by 26636

Special Issue Editor


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Guest Editor
1. Department of Clinical and Biological Sciences, University of Turin, 10043 Orbassano, Italy
2. Division of Endocrinology, Diabetes and Metabolism, AOU Città Salute e Scienza Torino, 10126 Turin, Italy
Interests: adrenal; neuroendocrinology; gynecological endocrinology

Special Issue Information

The hypothalamus-pituitary-adrenal (HPA) axis is a neuroendocrine system exerting a variety of effects at both the central and peripheral level, through the action of glucocorticoids.

The activity of the HPA axis is regulated mainly by the hypothalamic corticotrophin releasing hormone (CRH) and Arginine Vasopressin (AVP) neurohormones, which are, in turn, under the influence of several neurotransmitters and neuropeptides. Among them, GABAergic system exerts a clear inhibitory effect on corticotroph secretion. Alprazolam (ALP), a GABA-A receptor agonist, shows the most marked inhibitory effect on both spontaneous and stimulated HPA axis activity, in agreement with its peculiar efficacy in panic disorders and depression where an HPA axis hyperactivation is generally present.

Alterations in the balance of central activating and inhibiting neurotransmission on the HPA axis might be involved in the pathophysiology of some diseases such as psychiatric disorders, anorexia, and obesity, characterized by a functional hyperactivity of this axis. On the other hand, glucocorticoids influence most aspects of behavior and, in turn, many behaviors can influence HPA axis activity.

The glucocorticoid negative feedback action is mediated by both glucocorticoid (GR) and mineralocorticoid (MR) receptors activation at the central level, mainly in the hippocampus. In agreement with animal studies, MRs seem to play a crucial role in the maintenance of the circadian ACTH and cortisol rhythm, through the modulation of CRH and AVP release.

This special issue aims to review the present knowledge about some new aspects of the neuroendocrine control of the HPA axis in humans, in both physiological and some pathological conditions.

Prof. Dr. Roberta Giordano
Guest Editor

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Keywords

  • CRH 
  • AVP
  • GABAergic
  • Glucocorticoids
  • Stress
  • Behaviour
  • Cushing’s syndrome
  • Depression
  • Anorexia nervosa
  • Obesity

Published Papers (4 papers)

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Review

12 pages, 310 KiB  
Review
Stress Axis in the Cancer Patient: Clinical Aspects and Management
by Felicetti Francesco, Nervo Alice, Gatti Filippo, Rosso Daniela, Brignardello Enrico and Arvat Emanuela
Endocrines 2021, 2(4), 502-513; https://doi.org/10.3390/endocrines2040044 - 6 Dec 2021
Cited by 5 | Viewed by 3372
Abstract
Hypothalamus–pituitary–adrenal (HPA) axis alterations are common in cancer patients, mainly due to the different antitumoral therapies, which lead to several acute and late endocrine side effects. This review summarizes the most recent evidence regarding HPA derangement, both in patients with active neoplasms and [...] Read more.
Hypothalamus–pituitary–adrenal (HPA) axis alterations are common in cancer patients, mainly due to the different antitumoral therapies, which lead to several acute and late endocrine side effects. This review summarizes the most recent evidence regarding HPA derangement, both in patients with active neoplasms and in cancer survivors, with particular attention to the impact of the different antitumoral treatments, focusing on the major clinical aspects. While acute hormone failure usually results from injury caused directly by tumor burden or surgical interventions, short- and long-term effects are generally due to chemotherapy, radiotherapy and, as more recently shown, to different types of targeted- and immuno-therapy. Adrenal insufficiency (AI) is mostly caused by pituitary or hypothalamic injury rather than a direct damage of the adrenal gland. Moreover, other treatments commonly employed as supportive therapy or in the context of palliative care (i.e., glucocorticoids, opioids) can lead to HPA dysfunction. Epidemiology and pathophysiology of stress axis alterations in cancer patients still require clarification. Since AI may represent a life-threatening condition, monitoring adrenal function in cancer patients is mandatory, especially in subjects who experience fatigue or during stress conditions, in order to promptly start replacement treatment when needed. Full article
(This article belongs to the Special Issue Neuroregulation of the Hypothalamus-Pituitary-Adrenal)
21 pages, 2213 KiB  
Review
Copeptin and Stress
by Marianna Martino and Giorgio Arnaldi
Endocrines 2021, 2(4), 384-404; https://doi.org/10.3390/endocrines2040035 - 12 Oct 2021
Cited by 5 | Viewed by 5171
Abstract
Vasopressin (AVP) and copeptin are released in equimolar amounts from the same precursor. Due to its molecular stability and countless advantages as compared with AVP, copeptin perfectly mirrors AVP presence and has progressively emerged as a reliable marker of vasopressinergic activation in response [...] Read more.
Vasopressin (AVP) and copeptin are released in equimolar amounts from the same precursor. Due to its molecular stability and countless advantages as compared with AVP, copeptin perfectly mirrors AVP presence and has progressively emerged as a reliable marker of vasopressinergic activation in response to osmotic and hemodynamic stimuli in clinical practice. Moreover, evidence highlighting the prognostic potential of copeptin in several acute diseases, where the activation of the AVP system is primarily linked to stress, as well as in psychologically stressful conditions, has progressively emerged. Furthermore, organic stressors induce a rise in copeptin levels which, although non-specific, is unrelated to plasma osmolality but proportional to their magnitude: suggesting disease severity, copeptin proved to be a reliable prognostic biomarker in acute conditions, such as sepsis, early post-surgical period, cardiovascular, cerebrovascular or pulmonary diseases, and even in critical settings. Evidence on this topic will be briefly discussed in this article. Full article
(This article belongs to the Special Issue Neuroregulation of the Hypothalamus-Pituitary-Adrenal)
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15 pages, 831 KiB  
Review
The Stress Axis in Obesity and Diabetes Mellitus: An Update
by Laura Gianotti, Sara Belcastro, Salvatore D’Agnano and Francesco Tassone
Endocrines 2021, 2(3), 334-347; https://doi.org/10.3390/endocrines2030031 - 6 Sep 2021
Cited by 11 | Viewed by 9531
Abstract
The hypothalamic–pituitary–adrenal axis is a tightly regulated system that represents one of the body’s mechanisms for responding to acute and chronic stress. Prolonged stress and/or inadequate regulation of the stress system can lead to a condition of chronic hypercortisolism or, in some cases, [...] Read more.
The hypothalamic–pituitary–adrenal axis is a tightly regulated system that represents one of the body’s mechanisms for responding to acute and chronic stress. Prolonged stress and/or inadequate regulation of the stress system can lead to a condition of chronic hypercortisolism or, in some cases, a blunted cortisol response to stress, contributing to insulin resistance, increased adiposity and type 2 diabetes mellitus. Moreover, acute and chronic stress can exacerbate or worsen metabolic conditions by supporting an inflammatory state and a tight relationship between stress, inflammation and adipose tissue has been reported and has been a growing subject of interest in recent years. We reviewed and summarized the evidence supporting hypothalamic–pituitary–adrenal axis dysregulation as an important biological link between stress, obesity, inflammation and type 2 diabetes mellitus. Furthermore, we emphasized the possible role of infectious-related stress such as SarsCov2 infection in adrenal axis dysregulation, insulin resistance and diabetes in a bidirectional link. Understanding and better defining the links between stress and obesity or diabetes could contribute to further definition of the pathogenesis and the management of stress-related complications, in which the HPA axis dysregulation has a primary role. Full article
(This article belongs to the Special Issue Neuroregulation of the Hypothalamus-Pituitary-Adrenal)
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15 pages, 664 KiB  
Review
Nutrition, Exercise, and Stress Management for Treatment and Prevention of Psychiatric Disorders. A Narrative Review Psychoneuroendocrineimmunology-Based
by Francesco Bottaccioli, Anna Giulia Bottaccioli, Enrica Marzola, Paola Longo, Andrea Minelli and Giovanni Abbate-Daga
Endocrines 2021, 2(3), 226-240; https://doi.org/10.3390/endocrines2030022 - 29 Jul 2021
Cited by 3 | Viewed by 7916
Abstract
Psychoneuroendocrineimmunology (PNEI) brings together knowledge acquired since the 1930s from endocrinology, immunology, neuroscience, and psychology. With PNEI, a model of research and interpretation of health and disease is emerging, which sees the human body as a structured and interconnected unit, where the psychological [...] Read more.
Psychoneuroendocrineimmunology (PNEI) brings together knowledge acquired since the 1930s from endocrinology, immunology, neuroscience, and psychology. With PNEI, a model of research and interpretation of health and disease is emerging, which sees the human body as a structured and interconnected unit, where the psychological and biological systems are mutually coordinated. In the PNEI view, many factors could influence mental health, with the endocrine system involved in mediating the effects of environmental stress on mental health and inflammation in the onset and course of psychiatric disorders as a result of individual and collective conditions and behaviors. Among these, nutrition is one way by which the environment impacts physiology: indeed, many pieces of research showed that several elements (e.g., probiotics, fish oil, zinc) have a positive effect on mental disorders thus being potentially augmentation agents in treatment. Still, physical activity can moderate depressive symptoms, while prolonged stress increases the risk of psychopathology. Taken together, the PNEI-based approach may inform prevention and treatment strategies, also in the field of mental health care. Full article
(This article belongs to the Special Issue Neuroregulation of the Hypothalamus-Pituitary-Adrenal)
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