Dissociation of ACTH and glucocorticoids

被引:269
作者
Bornstein, Stefan R. [1 ]
Engeland, William C. [2 ]
Ehrhart-Bornstein, Monika [1 ]
Herman, James P. [3 ,4 ]
机构
[1] Tech Univ Dresden, Med Fac Carl Gustav Carus, D-01307 Dresden, Germany
[2] Univ Minnesota, Grad Program Neurosci, Dept Neurosci, Minneapolis, MN 55455 USA
[3] Univ Cincinnati, Dept Psychiat & Cell Biol, Reading, OH 45237 USA
[4] Univ Cincinnati, Dept Neurobiol & Anat, Reading, OH 45237 USA
关键词
D O I
10.1016/j.tem.2008.01.009
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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.
引用
收藏
页码:175 / 180
页数:6
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