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Neuroendocrine alterations in systemic disease.

M E Molitch, S H Hou

    Clinics in Endocrinology and Metabolism
    |November 1, 1983
    PubMed
    Summary

    Systemic disorders alter neuroendocrine function, impacting the hypothalamic-pituitary-adrenal (HPA) axis and hormone levels like cortisol and growth hormone (GH) to manage stress and energy. These adaptive changes, including thyroid and reproductive axis alterations, generally favor survival during illness.

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    Area of Science:

    • Endocrinology
    • Neuroendocrinology
    • Systemic Physiology

    Background:

    • Systemic disorders significantly influence neuroendocrine function, affecting the body's stress response and energy metabolism.
    • Physical or psychological stress can lead to an upward resetting of the hypothalamic-pituitary-adrenal (HPA) axis, increasing cortisol and growth hormone (GH) levels.

    Purpose of the Study:

    • To explore the adaptive neuroendocrine changes occurring during systemic illness.
    • To understand the role of these hormonal alterations in promoting organism survival.

    Main Methods:

    • Review of existing literature on neuroendocrine responses to systemic disorders.
    • Analysis of hormonal changes including cortisol, GH, somatomedin, prolactin (PRL), and thyroid hormones (T3).

    Main Results:

    • Stress-induced HPA axis activation increases cortisol and GH for energy substrate availability.
    • Decreased somatomedin activity in conditions like chronic renal failure may be primary, affecting feedback and increasing GH.
    • Illness often leads to 'euthyroid sick syndrome,' potentially a hypothyroid state conserving energy by lowering metabolic rate.
    • Reproductive axis impairment is common, possibly deactivating non-essential functions during stress.

    Conclusions:

    • Neuroendocrine adaptations during systemic illness, including HPA axis modulation and metabolic rate changes, appear to be survival mechanisms.
    • Further research is needed to fully elucidate the neurotransmitter and hypophyseotrophic hormone changes underlying these pituitary alterations.

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