Vol 8, No 4
- Stress
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tress is commonly defined as a state of real or
perceived threat to homeostasis.Maintenance of home-
ostasis in the presence of aversive stimuli (stressors)
requires activation of a complex range of responses
involving the endocrine,nervous,and immune systems,
collectively known as the stress response.
1,2
Activation of
the stress response initiates a number of behavioral and
physiological changes that improve an individuals
chance of survival when faced with homeostatic chal-
lenges.Behavioral effects of the stress response include
increased awareness,improved cognition,euphoria,and
enhanced analgesia.
1,3
Physiological adaptations initiated
by activation of this system include increased cardio-
vascular tone,respiratory rate,and intermediate metab-
olism,along with inhibition of general vegetative func-
tions such as feeding,digestion,growth,reproduction,
and immunity.
4,5
Due to the wide array of physiologic
and potentially pathogenic effects of the stress response,
a number of neuronal and endocrine systems function to
tightly regulate this adaptive process.
Anatomy of the stress response
The anatomical structures that mediate the stress
response are found in both the central nervous system
and peripheral tissues.The principal effectors of the
stress response are localized in the paraventricular
B a s i c r e s e a r c h
S
Copyright © 2006 LLS SAS. All rights reserved
www.dialogues-cns.org
The role of the hypothalamic-pituitary-adrenal
axis in neuroendocrine responses to stress
Sean M.Smith,PhD;Wylie W.Vale,PhD
Keywords:
stress; corticotropin-releasing factor; adrenocorticotropic hormone;
glucocorticoid; hypothalamus; pituitary gland; adrenal gland
Author affiliations:
Clayton Foundation Laboratories for Peptide Biology, The
Salk Institute for Biological Studies, La Jolla, Calif, USA
Address for correspondence:
Wylie W. Vale, PhD, Clayton Foundation Laboratories
for Peptide Biology, The Salk Institute for Biological Studies, 10010 N. Torrey Pines
Road, La Jolla, CA 92037, USA
(e-mail: vale@salk.edu)
Animals respond to stress by activating a wide array of
behavioral and physiological responses that are collec-
tively referred to as the stress response. Corticotropin-
releasing factor (CRF) plays a central role in the stress
response by regulating the hypothalamic-pituitary-adrenal
(HPA) axis. In response to stress, CRF initiates a cascade of
events that culminate in the release of glucocorticoids
from the adrenal cortex. As a result of the great number
of physiological and behavioral effects exerted by gluco-
corticoids, several mechanisms have evolved to control
HPA axis activation and integrate the stress response.
Glucocorticoid feedback inhibition plays a prominent role
in regulating the magnitude and duration of glucocorti-
coid release. In addition to glucocorticoid feedback, the
HPA axis is regulated at the level of the hypothalamus by
a diverse group of afferent projections from limbic, mid-
brain, and brain stem nuclei. The stress response is also
mediated in part by brain stem noradrenergic neurons,
sympathetic andrenomedullary circuits, and parasympa-
thetic systems. In summary, the aim of this review is to dis-
cuss the role of the HPA axis in the integration of adap-
tive responses to stress. We also identify and briefly
describe the major neuronal and endocrine systems that
contribute to the regulation of the HPA axis and the main-
tenance of homeostasis in the face of aversive stimuli.
© 2006, LLS SAS
Dialogues Clin Neurosci
. 2006;8:383-395.