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Schematic of the HPA axis (CRH, corticotropin-releasing hormone; ACTH, adrenocorticotropic hormone) Hypothalamus, pituitary gland, and adrenal cortex The hypothalamic–pituitary–adrenal axis (HPA axis or HTPA axis) is a complex set of direct influences and feedback interactions among three components: the hypothalamus (a part of the brain located below the thalamus), the pituitary gland (a ...
The hypothalamic-pituitary-adrenal axis (HPA axis), in which the hypothalamus and pituitary gland control adrenal secretions, undergoes profound changes during critical illness. Both very high and very low levels of cortisol have been linked to a poor outcome in intensive care patients. [2]
Its main function is the stimulation of the pituitary synthesis of adrenocorticotropic hormone (ACTH), as part of the hypothalamic–pituitary–adrenal axis (HPA axis). Corticotropin-releasing hormone (CRH) is a 41-amino acid peptide derived from a 196-amino acid preprohormone.
Insulin tolerance testing is widely regarded as the gold standard for assessing the entire hypothalamic-pituitary-adrenal axis. [2] A high-dose ACTH stimulation test directly evaluates the adrenal secretory reserve, which can be compromised not only in primary adrenal insufficiency but also in long-term ACTH deficiency. [2]
The hypothalamic–pituitary–adrenal axis (HPA axis or HTPA axis) is a complex set of direct influences and feedback interactions among three components: the hypothalamus (a part of the brain located below the thalamus), the pituitary gland (a pea-shaped structure located below the hypothalamus), and the adrenal (also called "suprarenal ...
[128] [129] Dexamethasone has glucocorticoid activity, and potent ACTH-suppression properties within the hypothalamic–pituitary–adrenal axis. [130] [131] Lower ACTH leads to reduced production of all the steroids, including androgens.
The TSST increases levels of several substances known to indicate activation of the hypothalamic-pituitary-adrenal axis (HPAA), a core driver of physiological stress. These include prolactin, hGH, ACTH, and cortisol (both in saliva and blood). [1]
HPG regulation in males, with the inhibin/activin system playing a similar role on GnRH-producing cells. The hypothalamus is located in the brain and secretes GnRH. [1] GnRH travels down the anterior portion of the pituitary via the hypophyseal portal system and binds to receptors on the secretory cells of the adenohypophysis. [2]
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