The hypothalamic-pituitary-adrenal axis controls reactions to stress and regulates various body processes such as digestion, the immune system, mood and sexuality, and energy usage. This volume focuses on the role it plays in the immune system and provides substantive experimental and clinical data to support current understanding in the field, and potential applications of this knowledge in the treatment of disease. - Evidence presented in this book suggests that the nervous, endocrine, and immune systems form the Neuroendoimmune Supersystem, which integrates all the biological functions of higher organisms both in health and disease for their entire life cycle - Contributors include both the scientists who initiated the work on the HPA axis and on the autonomic nervous system, and those who joined the field later
Recent years have seen spectacular advances in the field of circadian biology. These have attracted the interest of researchers in many fields, including endocrinology, neurosciences, cancer, and behavior. By integrating a circadian view within the fields of endocrinology and metabolism, researchers will be able to reveal many, yet-unsuspected aspects of how organisms cope with changes in the environment and subsequent control of homeostasis. This field is opening new avenues in our understanding of metabolism and endocrinology. A panel of the most distinguished investigators in the field gathered together to discuss the present state and the future of the field. The editors trust that this volume will be of use to those colleagues who will be picking up the challenge to unravel how the circadian clock can be targeted for the future development of specific pharmacological strategies toward a number of pathologies.
Anxiety affects millions, manifesting as generalized anxiety disorder (GAD), obsessive compulsive disorder, panic disorder, phobias, post-traumatic-stress disorder (PTSD), and social anxiety disorder. Not only are anxiety disorders common, but they are also crippling, frequently co-occurring and predict high risk for depressive disorders. Shared mechanisms may explain the overlapping features of many anxiety disorders and account for associations with other highly-impairing conditions, such as major depression and substance use. Beyond risk for specific disorders, anxiety also predicts a number of other adverse outcomes, including suicidal behavior, medical problems, social, and economic difficulties. Conversely, disorder-specific mechanisms may also exist and explain the unique features of each syndrome. Thus, it is important to understand both shared and specific aspects of anxiety. The Primer on Anxiety Disorders provides early-stage practitioners and trainees, as well as seasoned clinicians and researchers, with need-to-know knowledge on diagnosis and treatment. Clinical cases are used throughout the book to enhance understanding of and illustrate specific disorders, comorbid conditions and clinical issues. To facilitate an integrative approach, content allows clinicians to understand patient characteristics and tailor interventions. The integrated approach of each chapter includes recent research on genetics and neuroscience to understand the mechanisms of anxiety disorders, focusing on the forthcoming new nosology in DSM-5. Chapters further integrate innovative advances in clinical research providing research on a range of discoveries regarding biomarkers of illness, biological predictors of treatments and the effect of treatment on neurocircuitry.
This open access book sets out the stress-system model for functional somatic symptoms in children and adolescents. The book begins by exploring the initial encounter between the paediatrician, child, and family, moves through the assessment process, including the formulation and the treatment contract, and then describes the various forms of treatment that are designed to settle the child’s dysregulated stress system. This approach both provides a new understanding of how such symptoms emerge – typically, through a history of recurrent or chronic stress, either physical or psychological – and points the way to effective assessment, management, and treatment that put the child (and family) back on the road to health and well-being.
By stimulating adrenal gland and corticosteroid synthesis, the adrenocorticotropic hormone (ACTH) plays a central role in response to stress. In this Research Topic, a particular attention has been given to the recent developments on adrenocortical zonation; the growth-promoting activities of ACTH; the various steps involved in acute and chronic regulation of steroid secretion by ACTH, including the effect of ACTH on circadian rhythms of glucocorticoid secretion. The Research Topic also reviews progress and challenges surrounding the properties of ACTH binding to the MC2 receptor (MC2R), including the importance of melanocortin-2 receptor accessory protein (MRAP) in MC2R expression and function, the various intracellular signaling cascades, which involve not only protein kinase A, the key mediator of ACTH action, but also phosphatases, phosphodiesterases, ion channels and the cytoskeleton. The importance of the proteins involved in the cell detoxification is also considered, in particular the effect that ACTH has on protection against reactive oxygen species generated during steroidogenesis. The impact of the cellular microenvironment, including local production of ACTH is discussed, both as an important factor in the maintenance of homeostasis, but also in pathological situations, such as severe inflammation. Finally, the Research Topic reviews the role that the pituitary-adrenal axis may have in the development of metabolic disorders. In addition to mutations or alterations of expression of genes encoding components of the steroidogenesis and signaling pathways, chronic stress and sleep disturbance are both associated with hyperactivity of the adrenal gland. A resulting effect is increased glucocorticoid secretion inducing food intake and weight gain, which, in turn, leads to insulin and leptin resistance. These aspects are described in detail in this Research Topic by key investigators in the field. Many of the aspects addressed in this Research Topic still represent a stimulus for future studies, their outcome aimed at providing evidence of the central position occupied by the adrenal cortex in many metabolic functions when its homeostasis is disrupted. An in-depth investigation of the mechanisms underlying these pathways will be invaluable in developing new therapeutic tools and strategies.
Perinatal psychiatry is an emerging field that investigates the role of perinatal events – for example pregnancy complications and infections – in the development of neuropsychiatric conditions, such as schizophrenia and mood disorders. Among the implicated pathological mechanisms, perinatal-induced inflammation seems to play a major role and is being considered as a potential target for therapeutic intervention. Bringing together various approaches in the field (preclinical and clinical, epidemiological, immunological and genetic methods), the book discusses the available evidence, the putative mechanisms and the challenges ahead.
Understanding the influence and interaction between physical activity and the endocrine system are of paramount importance in dealing with a multitude of health problems. In Endocrinology of Physical Activity and Sport, renowned physicians and researchers provide a comprehensive and expanded update on the scientific, clinical and practical components of endocrinology as related to sport and exercise. The authors thoroughly review what is known about how such activity effects the endocrine system and how in turn these hormonal responses affect many other organs and systems of the body. In addition, aspects of endocrinology in non-glandular tissue which have endocrine actions are addressed; for example, adipocytes and the release of leptin and related adipocytokines. Further, a wide range of clinically related topics such as athletic amenorrhea, osteopenia, sarcopenia, and hypogonadism are included. This new edition critically integrates what is known about the complex interaction of the endocrine system in the sports context and will again prove immensely valuable to all physicians and clinical investigators treating those active in sports today.
