Role of the hypothalamic-pituitary-adrenal axis, glucocorticoids and glucocorticoid receptors in toxic sequelae of exposure to bacterial and viral products.
The hypothalamic-pituitary-adrenal (HPA) axis is activated during many bacterial and viral infections, resulting in an increase in circulating glucocorticoid levels. This HPA axis activation and glucocorticoid response are critical for the survival of the host, as demonstrated by the fact that removal of the HPA axis (by adrenalectomy or hypophysectomy) or glucocorticoid receptor (GR) blockade enhances the severity of the infection and in some cases enhances the mortality rate. Replacement with a synthetic glucocorticoid reverses these effects by reducing the severity of the infection and provides protection against lethal effects. In addition, some bacteria and viral infections have been shown to affect the GR directly. These have been described and the implications of such an effect discussed.
Webster
Jeanette I
JI
Section on Neuroendocrine Immunology and Behavior, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland 20892, USA.
Sternberg
Esther M
EM
D000818:Animals; D001424:Bacterial Infections / Q000276:immunology* / Q000503:physiopathology; D001426:Bacterial Proteins / Q000378:metabolism; D016207:Cytokines / Q000276:immunology; D005938:Glucocorticoids / Q000378:metabolism*; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000502:physiology*; D010913:Pituitary-Adrenal System / Q000502:physiology*; D011965:Receptors, Glucocorticoid / Q000378:metabolism*; D012772:Shock, Septic / Q000378:metabolism / Q000503:physiopathology; D014764:Viral Proteins / Q000378:metabolism; D014777:Virus Diseases / Q000276:immunology* / Q000503:physiopathology
D001426:Bacterial Proteins; D016207:Cytokines; D005938:Glucocorticoids; D011965:Receptors, Glucocorticoid; D014764:Viral Proteins