Torpy D J, Chrousos G P
Developmental Endocrinology Branch, National Institute of Child Health and Human Development, Bethesda, MD 20892, USA.
Baillieres Clin Rheumatol. 1996 May;10(2):181-98. doi: 10.1016/s0950-3579(96)80014-8.
The stress system is controlled by brain nuclei at the hypothalamus and brainstem. These nuclei interact with each other and control the HPA axis and sympathetic nervous systems, respectively. Major inputs to the stress system arise from the cerebral cortex and subcortical systems, the sensory organs and nerves, and the endocrine and immune systems. The major peripheral effectors of the stress system are glucocorticoids and the catecholamines. Pathological hypoactivity of the stress system has been associated with atypical depression, the chronic fatigue/fibromyalgia syndromes and autoimmune inflammatory disease; hyperactivity with melancholic depression and anxiety disorders. The stress system responds in a quantitatively and qualitatively specific fashion to different stressors. A major role of the HPA axis is to restrain the immune system and prevent tissue damage. Reciprocal interactions between the HPA axis and immune system constitutes a new endocrine feedback loop that has given rise to the field of neuroendocrine immunology. Gonadal axis hormones directly, and indirectly via the HPA axis, alter the tone of the immune system and the quality and quantity of the inflammatory responses. Effects of the HPA axis on the gonadal axis are consistent with conservation and redirection of valuable resources towards homeostasis during times of stress. These complex interactions between the HPA axis, immune and the gonadal systems may prove to be fundamental in the genesis and perpetuation of autoimmune disease.
应激系统由下丘脑和脑干中的脑核控制。这些脑核相互作用，分别控制下丘脑-垂体-肾上腺（HPA）轴和交感神经系统。应激系统的主要输入来自大脑皮层和皮层下系统、感觉器官和神经，以及内分泌和免疫系统。应激系统的主要外周效应器是糖皮质激素和儿茶酚胺。应激系统的病理性活动减退与非典型抑郁症、慢性疲劳/纤维肌痛综合征和自身免疫性炎症性疾病有关；活动亢进与 melancholic 抑郁症和焦虑症有关。应激系统对不同的应激源以定量和定性的特定方式做出反应。HPA 轴的一个主要作用是抑制免疫系统并防止组织损伤。HPA 轴与免疫系统之间的相互作用构成了一个新的内分泌反馈回路，这催生了神经内分泌免疫学领域。性腺轴激素直接并通过 HPA 轴间接改变免疫系统的状态以及炎症反应的质量和数量。HPA 轴对性腺轴的影响与在应激期间将宝贵资源保存并重新导向内环境稳态一致。HPA 轴、免疫系统和性腺系统之间的这些复杂相互作用可能在自身免疫性疾病的发生和持续发展中起着根本性作用。
