Sleep deprivation and hypothalamic-pituitary-adrenal (HPA) axis activity in depressed patients

SYNOPSISIn order to investigate the relationship between the immune apparatus and the hypothalamic–pituitary–adrenal (HPA)-axis activity in depressed patients, we measured in vitro lymphocyte responses to the mitogens Phytohaemagglutinin (PHA), Pokeweed (PWM) and Concanavalin A (Con A) and 8 a.m. baseline cortisol values in plasma, free cortisol excretion in 24 h urine (UFC), basal and post-dexamethasone βendorphin values. Major depressed patients with melancholia/psychotic features exhibited a significantly lower mitogen-induced blast transformation as compared to minor and simple major depressed patients. The lymphocyte responses to the three mitogens were significantly inversely related to baseline cortisol values and postdexamethasone β-endorphin values. The proliferative capacity of lymphocytes to stimulation with PHA and PWM was significantly and positively related to UFC excretion. Up to 45% of the variance in the immune responses to the mitogens was explained by the baseline cortisol, post-dexamethasone β-endorphin and UFC values.

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Vitamin A regulates hypothalamic–pituitary–adrenal axis status in LOU/C rats

Journal of Endocrinology ◽

10.1530/joe-13-0062 ◽

2013 ◽

Vol 219 (1) ◽

pp. 21-27 ◽

Cited By ~ 13

Author(s):

Nathalie Marissal-Arvy ◽

Rachel Hamiani ◽

Emmanuel Richard ◽

Marie-Pierre Moisan ◽

Véronique Pallet

Keyword(s):

Vitamin A ◽

Hpa Axis ◽

Restraint Stress ◽

Vitamin A Deficiency ◽

Plasma Corticosterone ◽

Hypothalamic Pituitary Adrenal ◽

Corticosteroid Receptors ◽

Vitamin A Status ◽

Corticosterone Response ◽

Hpa Axis Activity

The aim of this study was to explore the involvement of retinoids in the hypoactivity and hyporeactivity to stress of the hypothalamic–pituitary–adrenal (HPA) axis in LOU/C rats. We measured the effects of vitamin A deficiency administered or not with retinoic acid (RA) on plasma corticosterone in standard conditions and in response to restraint stress and on hypothalamic and hippocampal expression of corticosteroid receptors, corticotropin-releasing hormone and 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) in LOU/C rats. Interestingly, under control conditions, we measured a higher plasma concentration of retinol in LOU/C than in Wistar rats, which could contribute to the lower basal activity of the HPA axis in LOU/C rats. Vitamin A deficiency induced an increased HPA axis activity in LOU/C rats, normalized by RA administration. Compared with LOU/C control rats, vitamin A-deficient rats showed a delayed and heightened corticosterone response to restraint stress. The expression of corticosteroid receptors was strongly decreased by vitamin A deficiency in the hippocampus, which could contribute to a less efficient feedback by corticosterone on HPA axis tone. The expression of 11β-HSD1 was increased by vitamin A deficiency in the hypothalamus (+62.5%) as in the hippocampus (+104.7%), which could lead to a higher production of corticosterone locally and contribute to alteration of the hippocampus. RA supplementation treatment restored corticosterone concentrations and 11β-HSD1 expression to control levels. The high vitamin A status of LOU/C rats could contribute to their low HPA axis activity/reactivity and to a protective effect against 11β-HSD1-mediated deleterious action on cognitive performances during ageing.

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Lithium ameliorates sleep deprivation-induced mania-like behavior, hypothalamic-pituitary-adrenal (HPA) axis alterations, oxidative stress and elevations of cytokine concentrations in the brain and serum of mice

Bipolar Disorders ◽

10.1111/bdi.12503 ◽

2017 ◽

Vol 19 (4) ◽

pp. 246-258 ◽

Cited By ~ 31

Author(s):

Samira S. Valvassori ◽

Wilson R. Resende ◽

Gustavo Dal-Pont ◽

Heron Sangaletti-Pereira ◽

Fernanda F. Gava ◽

...

Keyword(s):

Oxidative Stress ◽

Sleep Deprivation ◽

Hpa Axis ◽

Hypothalamic Pituitary Adrenal ◽

The Brain

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Effects of lithium on the HPA axis in patients with unipolar major depression

European Psychiatry ◽

10.1016/s0924-9338(11)72319-7 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 612-612

Author(s):

T. Bschor ◽

D. Ritter ◽

U. Lewitzka ◽

M. Bauer ◽

M. Uhr ◽

...

Keyword(s):

Hpa Axis ◽

Antidepressant Treatment ◽

Challenge Test ◽

Tricyclic Antidepressant ◽

List Type ◽

Depressed Patients ◽

Design And Methods ◽

Hpa Axis Activity ◽

Drug Free ◽

Lithium Augmentation

Background(I)Profound alterations of the hypothalamic-pituitary-adrenocortical (HPA) axis regulation were repeatedly shown in depressed patients. The most sensitive challenge test of the HPA axis, the combined dexamethasone/CRH test (DEX/CRH test), shows an overstimulation of ACTH and cortisol in depressed patients. Under tricyclic antidepressant treatment, a normalization of the HPA axis overdrive was found to precede the clinical improvement.(II)Lithium is a well established drug for the treatment of affective disorders. Yet, its exact mode of action and its effects on the HPA axis are still unknown.Design and methodsThree 4-week studies with each 30 acutely depressed patients (unipolar, SCID I confirmed) were conducted. In study 1, patients refractory to a treatment trial with an antidepressant of at least four weeks were treated with lithium augmentation. In study 2 and 3, drug free patients were treated with lithium monotherapy or citalopram monotherapy respectively. Weekly HAM-D ratings were performed. In each study, the DEX/CRH test was conducted right before and four weeks after initiation of the pharmacotherapy.ResultsAll three pharmacological strategies showed good antidepressive efficacy. Both lithium monotherapy and lithium augmentation led to a (for most parameters significant) increase in the HPA axis activity. In contrast, citalopram monotherapy resulted in a decrease of the hormone response to the DEX/CRH test.

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Effects of prolonged exendin-4 administration on hypothalamic-pituitary-adrenal axis activity and water balance

AJP Endocrinology and Metabolism ◽

10.1152/ajpendo.00529.2012 ◽

2013 ◽

Vol 304 (10) ◽

pp. E1105-E1117 ◽

Cited By ~ 14

Author(s):

Manuel Gil-Lozano ◽

Marina Romaní-Pérez ◽

Verónica Outeiriño-Iglesias ◽

Eva Vigo ◽

Patricia L. Brubaker ◽

...

Keyword(s):

Adrenal Gland ◽

Hpa Axis ◽

Stress Responses ◽

Fold Increase ◽

Acute Administration ◽

Sprague Dawley ◽

Hypothalamic Pituitary Adrenal ◽

Sprague Dawley Rats ◽

Glucagon Like Peptide 1 ◽

Hpa Axis Activity

Exendin-4 (Ex-4) is a natural agonist of the glucagon-like peptide-1 (GLP-1) receptor, currently being used as a treatment for type 2 diabetes mellitus due to its insulinotropic properties. Previous studies have revealed that acute administration of both GLP-1 and, in particular, Ex-4 potently stimulates hypothalamic-pituitary-adrenal (HPA) axis activity. In this work, the effects of prolonged Ex-4 exposure on HPA function were explored. To this end, Sprague-Dawley rats were subjected to a daily regimen of two Ex-4 injections (5 μg/kg sc) for a minimum of 7 days. We found that subchronic Ex-4 administration produced a number of effects that resemble chronic stress situations, including hyperactivation of the HPA axis during the trough hours, disruption of glucocorticoid circadian secretion, hypertrophy of the adrenal gland, decreased adrenal gland sensitivity, impaired pituitary-adrenal stress responses, and reductions in both food intake and body weight. In addition, a threefold increase in diuresis was observed followed by a 1.5-fold increase in water intake; these latter effects were abolished by adrenalectomy. Together, these findings indicate that Ex-4 induces a profound dysregulation of HPA axis activity that may also affect renal function.

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Assessment of the hypothalamic–pituitary–adrenal axis activity: glucocorticoid receptor and mineralocorticoid receptor function in depression with early life stress – a systematic review

Acta Neuropsychiatrica ◽

10.1111/j.1601-5215.2011.00610.x ◽

2012 ◽

Vol 24 (1) ◽

pp. 4-15 ◽

Cited By ~ 26

Author(s):

Cristiane Von Werne Baes ◽

Sandra M. de Carvalho Tofoli ◽

Camila Maria S. Martins ◽

Mario F. Juruena

Keyword(s):

Systematic Review ◽

Glucocorticoid Receptor ◽

Hpa Axis ◽

Life Stress ◽

Early Life ◽

Mineralocorticoid Receptor ◽

Early Life Stress ◽

Hypothalamic Pituitary Adrenal ◽

Depressed Patients ◽

Suppression Test

Objective:The mechanisms involved in the dysregulation of the hypothalamic–pituitary–adrenal (HPA) axis, especially in the functioning of glucocorticoid receptor (GR) and mineralocorticoid receptor (MR) in depressed patients, are not well elucidated. The objective of this study was to conduct a systematic review of articles that assess the HPA axis activity from GR and MR in depressed patients and healthy controls with or without early life stress.Methods:We conducted a systematic review of articles in PubMed, SCOPUS and SciELO published between 2000 and 2011, using the following search terms:child abuse,depression,HPA axis,dexamethasone,prednisolone,fludrocortisoneandspironolactone. Thirty-four papers were selected for this review.Results:Most studies identified in this review used the dexamethasone/corticotropin-releasing hormone test and dexamethasone suppression test. In these studies, hypercortisolaemia was associated with depression. We identified three studies with the Prednisolone suppression test, only one study with the use of fludrocortisone and one with spironolactone. This review found nine studies that evaluated the HPA axis in individuals with early life stress.Conclusions:The majority of the studies assessed in this review show that early life stress leads to permanent changes in the HPA axis and may lead to development of depression in adults. The most consistent findings in the literature show increased activity of the HPA axis in depression associated with hypercortisolaemia and reduced inhibitory feedback. These findings suggest that this dysregulation of the HPA axis is partially attributable to an imbalance between GR and MR. Evidences have consistently showed that GR function is impaired in major depression, but few studies have assessed the activity of MR in depression and early life stress.

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Sleep deprivation and stress: a reciprocal relationship

Interface Focus ◽

10.1098/rsfs.2019.0092 ◽

2020 ◽

Vol 10 (3) ◽

pp. 20190092 ◽

Cited By ~ 6

Author(s):

Mathieu Nollet ◽

William Wisden ◽

Nicholas P. Franks

Keyword(s):

Sleep Deprivation ◽

Hpa Axis ◽

Confounding Factor ◽

Stress Hormones ◽

Sleep Loss ◽

Reciprocal Relationship ◽

Sleep Homeostasis ◽

Scoring Algorithms ◽

Hpa Axis Activity ◽

Circulating Levels

Sleep is highly conserved across evolution, suggesting vital biological functions that are yet to be fully understood. Animals and humans experiencing partial sleep restriction usually exhibit detrimental physiological responses, while total and prolonged sleep loss could lead to death. The perturbation of sleep homeostasis is usually accompanied by an increase in hypothalamic–pituitary–adrenal (HPA) axis activity, leading to a rise in circulating levels of stress hormones (e.g. cortisol in humans, corticosterone in rodents). Such hormones follow a circadian release pattern under undisturbed conditions and participate in the regulation of sleep. The investigation of the consequences of sleep deprivation, from molecular changes to behavioural alterations, has been used to study the fundamental functions of sleep. However, the reciprocal relationship between sleep and the activity of the HPA axis is problematic when investigating sleep using traditional sleep-deprivation protocols that can induce stress per se . This is especially true in studies using rodents in which sleep deprivation is achieved by exogenous, and potentially stressful, sensory–motor stimulations that can undoubtedly confuse their conclusions. While more research is needed to explore the mechanisms underlying sleep loss and health, avoiding stress as a confounding factor in sleep-deprivation studies is therefore crucial. This review examines the evidence of the intricate links between sleep and stress in the context of experimental sleep deprivation, and proposes a more sophisticated research framework for sleep-deprivation procedures that could benefit from recent progress in biotechnological tools for precise neuromodulation, such as chemogenetics and optogenetics, as well as improved automated real-time sleep-scoring algorithms.

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Regulation of the hypothalamic-pituitary-adrenal axis by neuropeptides

Hormone Molecular Biology and Clinical Investigation ◽

10.1515/hmbci.2011.123 ◽

2011 ◽

Vol 7 (2) ◽

Cited By ~ 5

Author(s):

Greti Aguilera

Keyword(s):

Hpa Axis ◽

Fine Tuning ◽

Metabolic Adaptation ◽

Pituitary Hormone ◽

Hypothalamic Pituitary Adrenal ◽

External Zone ◽

Adrenal Steroidogenesis ◽

Pituitary Adenylate Cyclase ◽

Response To Stress ◽

Hpa Axis Activity

AbstractThe major endocrine response to stress occurs via activation of the hypothalamic-pituitary-adrenal (HPA) axis, leading ultimately to increases in circulating glucocorticoids, which are essential for the metabolic adaptation to stress. The major players in the HPA axis are the hypothalamic neuropeptide, corticotropin releasing hormone (CRH), the pituitary hormone adrenocorticotropic hormone, and the negative feedback effects of adrenal glucocorticoids. In addition, a number of other neuropeptides, including vasopressin (VP), angiotensin II, oxytocin, pituitary adenylate cyclase activating peptide, orexin and cholecystokinin, and nesfatin can affect HPA axis activity by influencing the expression and secretion of CRH, and also by modulating pituitary corticotroph function or adrenal steroidogenesis. Of these peptides, VP co-secreted with CRH from axonal terminals in the external zone of the median eminence plays a prominent role by potentiating the stimulatory effect of CRH and by increasing the number of pituitary corticotrophs during chronic challenge. Although the precise role and significance of many of these neuropeptides in regulating HPA axis activity requires further investigation, it is likely that they are part of a multifactorial system mediating the fine tuning of HPA axis activity during adaptation to a variety of physiological and stressful conditions.

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