Young Allan H
School of Neurology, Neurobiology and Psychiatry, University of Newcastle upon Tyne, Royal Victoria Infirmary, UK.
Stress. 2004 Dec;7(4):205-8. doi: 10.1080/10253890500069189.
Dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis has been well-described in mood disorders. Hypercortisolaemia, which has been attributed to a breakdown in glucocorticoid-receptor-mediated negative feedback mechanisms within the HPA axis, may be central to the pathogenesis of both the depressive symptoms and the cognitive deficits, which characterise severe mood disorders. Strategies to normalise glucocorticoid receptor (GR) function, and thus restore HPA functional integrity, have been the focus of recent research. Preliminary preclinical and clinical studies report encouraging results which suggest that lowering circulating cortisol levels, by up-regulating GRs, may have therapeutic efficacy in terms of improvements in depressive symptoms and cognitive functioning.
下丘脑-垂体-肾上腺（HPA）轴功能障碍在情绪障碍中已有充分描述。高皮质醇血症被认为是由于HPA轴内糖皮质激素受体介导的负反馈机制崩溃所致，可能是严重情绪障碍所特有的抑郁症状和认知缺陷发病机制的核心。使糖皮质激素受体（GR）功能正常化从而恢复HPA功能完整性的策略一直是近期研究的重点。初步的临床前和临床研究报告了令人鼓舞的结果，表明通过上调GR来降低循环皮质醇水平，可能在改善抑郁症状和认知功能方面具有治疗效果。
