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The response to stress—be it physical or psychological, acute or chronic—involves activation of the Hypothalamic-Pituitary-Adrenal (HPA) axis. The HPA axis is part of the neuroendocrine system because it involves both neuronal and hormonal communication. Its function is to regulate homeostatic systems—metabolic, cardiovascular, and immune—providing the necessary means to respond to a stressor.
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Stress triggers a coordinated physiological response involving the sympathetic nervous system (SNS) and the hypothalamic-pituitary-adrenal (HPA) axis. This dual activation ensures that the body is prepared for both immediate and prolonged stress management. The process begins with the perception of a stressor. This initial phase activates the SNS, leading to the rapid release of adrenaline (epinephrine) from the adrenal glands.
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The Trier Social Stress Test Protocol for Inducing Psychological Stress
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[Dynamic tests for assessing the hypothalamic-pituitary-adrenal axis].

Anne-Gaëlle Le Loupp1, François Schmitt2, François Desroys du Roure3

  • 1Laboratoire de Biochimie, Centre Hospitalier Bretagne Atlantique, Vannes, France.

Annales De Biologie Clinique
|January 17, 2026
PubMed
Summary
This summary is machine-generated.

Dynamic endocrine testing has evolved significantly, with a review of corticotropic axis tests based on current guidelines. This work aims to identify and summarize essential diagnostic tools for endocrine function assessment.

Keywords:
biochemistrycorticotropin axisdexamethasonedynamic testsexplorationlaboratoriessynacthen

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Area of Science:

  • Endocrinology
  • Biochemistry
  • Clinical Diagnostics

Background:

  • Dynamic endocrine tests have undergone significant evolution over the past decade.
  • Improvements in medical practice and imaging have rendered some traditional tests obsolete.

Purpose of the Study:

  • To review and summarize dynamic endocrine tests based on current clinical guidelines and updated literature.
  • To focus specifically on the corticotropic axis in this initial paper.

Main Methods:

  • A comprehensive review of dynamic endocrine tests was conducted by CNBH biologists.
  • Tests were evaluated against current clinical guidelines and the latest bibliography.
  • Tests were categorized into thematic axes: corticotropic, somatotropic, gonadotropic, lactotropic, and post-pituitary.

Main Results:

  • The review identified modifications and obsolescence of certain dynamic endocrine tests.
  • Summary sheets for each test were created.
  • The corticotropic axis tests were prioritized for this publication.

Conclusions:

  • Dynamic endocrine testing requires continuous reassessment due to medical advancements.
  • This review provides a concise summary of essential corticotropic axis tests.
  • Further papers will cover other endocrine axes.