Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, "Aghia Sophia" Children's Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece.
Endocrine Unit, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
Horm Res Paediatr. 2023;96(1):8-16. doi: 10.1159/000523975. Epub 2022 Mar 10.
Human organisms have to cope with a large number of external or internal stressful stimuli that threaten - or are perceived as threatening - their internal dynamic balance or homeostasis. To face these disturbing forces, or stressors, organisms have developed a complex neuroendocrine system, the stress system, which consists of the hypothalamic-pituitary-adrenal axis and the locus caeruleus/norepinephrine-autonomic nervous system.
Upon exposure to stressors beyond a certain threshold, the activation of the stress system leads to a series of physiological and behavioral adaptations that help achieve homeostasis and increase the chances of survival. When, however, the stress response to stressors is inadequate, excessive, or prolonged, the resultant maladaptation may lead to the development of several stress-related pathologic conditions. Adverse environmental events, especially during critical periods of life, such as prenatal life, childhood, and puberty/adolescence, in combination with the underlying genetic background, may leave deep, long-term epigenetic imprints in the human expressed genome.
In this review, we describe the components of the stress system and its functional interactions with other homeostatic systems of the organism; we present the hormonal regulators of the stress response, and we discuss the development of stress-related pathologies.
人类机体必须应对大量的外部或内部应激刺激，这些刺激要么威胁到、要么被感知为威胁到其内部动态平衡或内稳态。为了应对这些干扰力量或应激源，机体已经发展出了一个复杂的神经内分泌系统，即应激系统，它由下丘脑-垂体-肾上腺轴和蓝斑/去甲肾上腺素自主神经系统组成。
当机体暴露于超过一定阈值的应激源时，应激系统的激活会导致一系列生理和行为上的适应，从而有助于实现内稳态并增加生存机会。然而，当机体对应激源的应激反应不足、过度或持久时，由此产生的适应不良可能导致多种与应激相关的病理状况的发展。不利的环境事件，特别是在生命的关键时期，如产前、儿童期和青春期/青少年期，加上潜在的遗传背景，可能会在人类表达基因组中留下深刻而持久的表观遗传印记。
在这篇综述中，我们描述了应激系统的组成部分及其与机体其他稳态系统的功能相互作用；我们介绍了应激反应的激素调节剂，并讨论了与应激相关的病理疾病的发展。
