Sapolsky R M, Romero L M, Munck A U
Department of Biological Sciences, Stanford University, California 94305, USA.
Endocr Rev. 2000 Feb;21(1):55-89. doi: 10.1210/edrv.21.1.0389.
The secretion of glucocorticoids (GCs) is a classic endocrine response to stress. Despite that, it remains controversial as to what purpose GCs serve at such times. One view, stretching back to the time of Hans Selye, posits that GCs help mediate the ongoing or pending stress response, either via basal levels of GCs permitting other facets of the stress response to emerge efficaciously, and/or by stress levels of GCs actively stimulating the stress response. In contrast, a revisionist viewpoint posits that GCs suppress the stress response, preventing it from being pathologically overactivated. In this review, we consider recent findings regarding GC action and, based on them, generate criteria for determining whether a particular GC action permits, stimulates, or suppresses an ongoing stress-response or, as an additional category, is preparative for a subsequent stressor. We apply these GC actions to the realms of cardiovascular function, fluid volume and hemorrhage, immunity and inflammation, metabolism, neurobiology, and reproductive physiology. We find that GC actions fall into markedly different categories, depending on the physiological endpoint in question, with evidence for mediating effects in some cases, and suppressive or preparative in others. We then attempt to assimilate these heterogeneous GC actions into a physiological whole.
糖皮质激素（GCs）的分泌是对应激的一种经典内分泌反应。尽管如此，关于GCs在这些时候发挥何种作用仍存在争议。一种观点可追溯到汉斯·塞尔耶时代，认为GCs有助于介导正在进行的或即将发生的应激反应，要么通过GCs的基础水平使应激反应的其他方面有效出现，和/或通过GCs的应激水平积极刺激应激反应。相比之下，一种修正主义观点认为GCs会抑制应激反应，防止其发生病理性过度激活。在本综述中，我们考虑了关于GC作用的最新研究结果，并在此基础上制定标准，以确定特定的GC作用是允许、刺激还是抑制正在进行的应激反应，或者作为另一类别，为后续应激源做准备。我们将这些GC作用应用于心血管功能、液体容量与出血、免疫与炎症、代谢、神经生物学和生殖生理学领域。我们发现，根据所讨论的生理终点，GC作用可分为明显不同的类别，在某些情况下有介导作用的证据，而在其他情况下则有抑制或准备作用的证据。然后，我们试图将这些不同的GC作用整合为一个生理整体。
