title: Relationship between stress, inflammation and metabolism.
abstract: OBJECTIVE
  Various threatening stimuli, such as pain, low blood pressure, or infection, elicit a set of neuroendocrine responses that include an increased secretion of catecholamines and glucocorticoid from the adrenal gland and activation of the sympathetic nervous system. These hormonal secretions allow a "fight or flight" response by mobilizing endogenous substrate. They also exert anti-insulin actions, and may in the long term induce a state of insulin resistance. In addition, stress stimulates inflammatory mediators in mononuclear cells. Given the possible role of low-grade inflammation in chronic metabolic disorders, this suggests that stress may be a factor in the development of insulin resistance and the metabolic syndrome.
  
  
  RESULTS
  Studies reviewed in this article cover: (1) the metabolic and haemodynamic effects of stress in healthy and insulin-resistant individuals; (2) the relationship between stress and inflammation and the role of the autonomic nervous system; and (3) some factors known to modulate the neuroendocrine responses to stress. Future perspectives, together with some hints regarding the role of neurotrophins such as brain-derived neurotrophic factor, are delineated.
  
  
  CONCLUSIONS
  Recent work performed in the field has indicated that stress may be a significant factor in the pathogenesis of metabolic disorders. Nutritional intervention or pharmacological agents targeted at modulating stress should be investigated.
authors.affiliation: Service of Anesthesiology, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Gérald
authors.initials: G
authors.lastname: Seematter
authors.forename: Christophe
authors.initials: C
authors.lastname: Binnert
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Martin
authors.forename: Luc
authors.initials: L
authors.lastname: Tappy
mesh_terms: D016207:Cytokines / Q000502:physiology; D004734:Energy Metabolism / Q000502:physiology*; D006801:Humans; D007249:Inflammation / Q000276:immunology / Q000378:metabolism; D007333:Insulin Resistance; D008659:Metabolic Diseases / Q000503:physiopathology*; D018384:Oxidative Stress / Q000502:physiology; D013312:Stress, Physiological / Q000378:metabolism / Q000503:physiopathology*
chemical_list: D016207:Cytokines