[Immune outcomes of sleep disorders: the hypothalamic-pituitary-adrenal axis as a modulatory factor].
OBJECTIVE
To review the literature on the interaction between sleep and the immune system.


METHODS
A search on Web of Science and Pubmed database including the keywords sleep, sleep deprivation, stress, hypothalamic-pituitary-adrenal axis, immune system, and autoimmune diseases.


RESULTS
On Web of Science, 588 publications were retrieved; 61 references, more significant and closer to our objective, were used, including original articles and review papers.


CONCLUSIONS
Sleep deprivation and immune system exert a bidirectional influence on each other. Since sleep deprivation is considered a stressor, inasmuch as it induces elevation of cortisol or corticosterone levels in humans and rodents, respectively, and given the well-known immunosuppressive effect of glucocorticoids, we propose that increased activation of the hypothalamic-pituitary-adrenal axis is a major mediator of the immune alterations observed in patients with insomnia or in sleep deprived subjects.
Palma
Beatriz Duarte
BD
Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Tiba
Paula Ayako
PA
Machado
Ricardo Borges
RB
Tufik
Sergio
S
Suchecki
Deborah
D
D000324:Adrenocorticotropic Hormone / Q000378:metabolism; D000818:Animals; D002940:Circadian Rhythm / Q000502:physiology; D005938:Glucocorticoids / Q000378:metabolism; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D007030:Hypothalamo-Hypophyseal System / Q000502:physiology*; D007107:Immune System / Q000502:physiology*; D010913:Pituitary-Adrenal System / Q000502:physiology*; D012890:Sleep / Q000276:immunology / Q000502:physiology*; D012892:Sleep Deprivation / Q000276:immunology / Q000503:physiopathology*; D020178:Sleep Disorders, Circadian Rhythm / Q000503:physiopathology; D012895:Sleep, REM; D013312:Stress, Physiological / Q000503:physiopathology*
D005938:Glucocorticoids; D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone