[Endocrine-metabolic disturbances in chronic stress]

This review focuses on the neuroendocrine infrastructure of the adaptive response to chronic stress and on its concerted effects on behavior, the major endocrine axes and immune systems. Cytokines such as TNF-alpha, IL-1, and IL-6 and other humoral mediators of inflammation are potent activators of central stress-responsive neurotransmitter systems, constituting the afferent limb of a feedback loop from the immune/inflammatory system to the central nervous system. Steroid hormones influence a variety of neuroendocrine events, including brain development, sexual differentiation and reproduction. Hormones elicit many of these effects by binding to neuronal steroid receptors, which are members of a nuclear receptor superfamily of transcriptional activators. Nuclear receptor coactivators enhance the transcriptional activity of steroid receptors.