Stalder Tobias, Oster Henrik, Abelson James L, Huthsteiner Katharina, Klucken Tim, Clow Angela
Department of Psychology, University of Siegen, 57076 Siegen, Germany.
Institute of Neurobiology, University of Lübeck, 23562 Lübeck, Germany.
Endocr Rev. 2025 Jan 10;46(1):43-59. doi: 10.1210/endrev/bnae024.
In healthy individuals, the majority of cortisol secretion occurs within several hours surrounding morning awakening. A highly studied component of this secretory period is the cortisol awakening response (CAR), the rapid increase in cortisol levels across the first 30 to 45 minutes after morning awakening. This strong cortisol burst at the start of the active phase has been proposed to be functional in preparing the organism for the challenges of the upcoming day. Here, we review evidence on key regulatory and functional processes of the CAR and develop an integrative model of its functional role. Specifically, we propose that, in healthy individuals, the CAR is closely regulated by an intricate dual-control system, which draws upon key circadian, environmental, and neurocognitive processes to best predict the daily need for cortisol-related action. Fine-tuned CAR expression, in turn, is then assumed to induce potent glucocorticoid action via rapid nongenomic and slower genomic pathways (eg, affecting circadian clock gene expression) to support and modulate daily activity through relevant metabolic, immunological, and neurocognitive systems. We propose that this concerted action is adaptive in mediating two main functions: a primary process to mobilize resources to meet activity-related demands and a secondary process to help the organism counterregulate adverse prior-day emotional experiences.
在健康个体中，大多数皮质醇分泌发生在早晨醒来后的几个小时内。这一分泌期经过深入研究的一个组成部分是皮质醇觉醒反应（CAR），即早晨醒来后的最初30至45分钟内皮质醇水平的快速升高。有人提出，在活跃期开始时这种强烈的皮质醇激增有助于机体为迎接即将到来的一天的挑战做好准备。在此，我们回顾关于CAR关键调节和功能过程的证据，并建立其功能作用的综合模型。具体而言，我们提出，在健康个体中，CAR受到一个复杂的双重控制系统的密切调节，该系统利用关键的昼夜节律、环境和神经认知过程来最佳预测每日对皮质醇相关作用的需求。反过来，经过微调的CAR表达被认为通过快速的非基因组和较慢的基因组途径（如影响昼夜节律时钟基因表达）诱导有效的糖皮质激素作用，以通过相关的代谢、免疫和神经认知系统支持和调节日常活动。我们提出，这种协同作用在介导两个主要功能方面具有适应性：一个主要过程是调动资源以满足与活动相关的需求，另一个次要过程是帮助机体对抗前一天的不良情绪体验。
