HPA (hypothalamus pituitary-adrenal) axis

Sleep-immune interactions and mental disorders

Sleep-immune interactions and mental disorders

Prospective epidemiological studies suggest that sleep disturbance (ie, difficulties in sleep onset and sleep maintenance) is a robust predictor of major depression episodes and depression recurrence. In parallel, experimental endotoxin model support a role of innate immune activation (inflammation) in the aetiology of depression, yet the precise role played by sleep disturbance is poorly understood. Sleep disturbance may increase peripheral pro-inflammatory cytokines by upregulating NF-kB pathways, modulating gut-microbiota, autonomic and neuroendocrine (eg, HPA) activity.

Fixing the broken clock in adrenal disorders: focus on glucocorticoids and chronotherapy

The circadian rhythm derives from the integration of many signals that shape the expression of clock-related genes in a 24-hour cycle. Biological tasks, including cell proliferation, differentiation, energy storage and immune regulation, are preferentially confined to specific periods. A gating system, supervised by the central and peripheral clocks, coordinates the endogenous and exogenous signals and prepares for transition to activities confined to periods of light or darkness. The fluctuations of cortisol and its receptor are crucial in modulating these signals.

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