The role of the hypothalamic-pituitary-adrenal axis in rheumatoid arthritis.
It has become clear that there is a bidirectional communication between the neuroendocrine and the immune system and that both systems influence each other and interact under physiological conditions and in response to inflammatory stimuli. The hypothalamic-pituitary axis plays an important role in regulating and controlling immune responses and dysfunction of the axis has been implicated in the pathogenesis of rheumatoid arthritis (RA). Corticotrophin-releasing hormone (CRH), one of the main hormones of the axis, is also released extra-hypothalamically, peripherally at the site of inflammation and may modulate inflammatory responses locally. In this chapter we will discuss the role of the hypothalamic-pituitary-adrenal (HPA) axis and peripheral CRH, its influences on immune function and what is known about the possible pathogenetic role of the HPA axis and peripheral CRH in RA.
Eijsbouts
A M
AM
Department of Rheumatology, University Hospital Nijmegen, The Netherlands.
Murphy
E P
EP
D000328:Adult; D000818:Animals; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology*; D003346:Corticotropin-Releasing Hormone / Q000097:blood / Q000378:metabolism; D005260:Female; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000187:drug effects / Q000503:physiopathology*; D008297:Male; D010913:Pituitary-Adrenal System / Q000187:drug effects / Q000503:physiopathology*; D049590:Postpartum Period; D011247:Pregnancy
D018501:Antirheumatic Agents; D003346:Corticotropin-Releasing Hormone