Abstract
Stress is the adaptive response of the body to internal or external threats (or “stressors”) to its balance (homeostasis), whether
these events are real or perceived. Stressors activate diverse and intricate physiological, biological, and behavioural responses
(allostasis) aimed to restore the optimal balance of the body (eustasis). The adaptive response to stressors depends on a
complex and highly interconnected psycho-neuro-endocrine-immune-metabolic, cellular, and molecular network called “the
stress system” or “stress axis”. The key components are the hypothalamic-pituitary-adrenal (HPA) axis and the autonomic
nervous system (ANS). These interact with other relevant elements of the central nervous system (CNS) and with peripheral
organs and systems. Their activation generates a rapid, effective, multisystemic, and self-limiting response, allowing the
organism to achieve an optimal bodily and neuropsychic reaction. Catecholamines and cortisol are essential to mediate and activate the psychological and behavioural reactions in the stress response (the so-called “fight or flight” response). The
half-life of catecholamines is short, while the action of cortisol is more prolonged and mediated by the activation of cortisol
receptors (GR and MR, glucocorticoid and mineralocorticoid receptors, respectively), which are ubiquitously expressed.
Through non-genomic and genomic actions, glucocorticoids modulate various metabolic processes, exhibiting sex-specific
characteristics. Cortisol plays a key role in the pro/anti-inflammatory cytokine balance. In conditions of chronic stress. One
of the consequences associated with a persistent inadequately regulated stress is the development of chronic inflammation
characterised by a disruption in the pro/anti-inflammatory cytokine balance. The role of chronic inflammatory state is now
well-established in the pathophysiology of metabolic syndrome, obesity, diabetes as well as depression. In this review, we
will explore the psycho-neuroendocrine-metabolic mechanisms underlying stress regulation, and the potential metabolic and
psychological consequences associated with chronic stress and altered stress regulation.
these events are real or perceived. Stressors activate diverse and intricate physiological, biological, and behavioural responses
(allostasis) aimed to restore the optimal balance of the body (eustasis). The adaptive response to stressors depends on a
complex and highly interconnected psycho-neuro-endocrine-immune-metabolic, cellular, and molecular network called “the
stress system” or “stress axis”. The key components are the hypothalamic-pituitary-adrenal (HPA) axis and the autonomic
nervous system (ANS). These interact with other relevant elements of the central nervous system (CNS) and with peripheral
organs and systems. Their activation generates a rapid, effective, multisystemic, and self-limiting response, allowing the
organism to achieve an optimal bodily and neuropsychic reaction. Catecholamines and cortisol are essential to mediate and activate the psychological and behavioural reactions in the stress response (the so-called “fight or flight” response). The
half-life of catecholamines is short, while the action of cortisol is more prolonged and mediated by the activation of cortisol
receptors (GR and MR, glucocorticoid and mineralocorticoid receptors, respectively), which are ubiquitously expressed.
Through non-genomic and genomic actions, glucocorticoids modulate various metabolic processes, exhibiting sex-specific
characteristics. Cortisol plays a key role in the pro/anti-inflammatory cytokine balance. In conditions of chronic stress. One
of the consequences associated with a persistent inadequately regulated stress is the development of chronic inflammation
characterised by a disruption in the pro/anti-inflammatory cytokine balance. The role of chronic inflammatory state is now
well-established in the pathophysiology of metabolic syndrome, obesity, diabetes as well as depression. In this review, we
will explore the psycho-neuroendocrine-metabolic mechanisms underlying stress regulation, and the potential metabolic and
psychological consequences associated with chronic stress and altered stress regulation.
| Translated title of the contribution | The stress axis: neuroendocrine-immune-metabolic regulation and its role in the development of metabolic syndrome and depression |
|---|---|
| Original language | Italian |
| Journal | L'endocrinologo |
| Publication status | Published - 6 Nov 2023 |
Keywords
- Stress
- Cortisol
- Nervous system
- Metabolic syndrome
- Obesity
- Diabetes
- Depression
