Talk:Hypothalamic–pituitary–adrenal axis

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I
I rounded out this article with a start on anatomy and function, but am stalled for the moment on specific methods of action for ANS-induced adrenal releases from the adrenal medulla and how they relate to corticosteroid releases from the adrenal cortex mediated by CRF/ACTH.

This is the sort of writing where a well-informed editor might do a lot of good by just reading, correcting, commenting and suggesting direction. Of course there is a lot of detail to be added as well, about the anatomy, function and study of the HPA Axis, and about its role in physical and psychiatric diseases.

I've seen a couple notes of writers intending to work on this, but it's a tough subject to get exactly right in every detail, and can take a bit of meticulous checking. But it is an important topic for many reasons, and it gets front-page listing from Google searches, so this is an open call for any contribution to this topic anyone might have to offer. SoCal 20:29, 15 Feb 2004 (UTC)

____

I don't beleive this is accurate. The language seems scientific enough, but it seems like vague stabs with no real explanation of how this thing operates. And the 5HT research is only one of thousands of studies - this isn't a news service its an encyclopedia and I haven't seen anybody here qualified to say that research warrants mention in an encyclopedia, and there is certainly no evidence that it is anything but a study somebody published and it deals with interesting subjects that can be related to interesting world events. The entire Wikipedia approach to the subject of stress is laced with generalizations and vague snippets of anatomy that tend to suggest ideas familiarized by the popular press. There is no specific pathway described here to explain the activation of the HPA axis, or how one part of it gives way to another, or if it even really does correlate with any part of that general adaptation responses. I wrote it and I would rather see it reduced to the stub it was before I started using it as a note page. User:172.196.16.3 (contribs) (Apparently User:Bird)

User:SoCal wrote much of the text you removed. I've no reason to believe that user did anything wrong. Jamesday 21:13, 9 Mar 2004 (UTC)

The role of 5-HT in HPA regulation is indeed contraversial, and there are many other systems that impinge on the PVN. 5-HT IS an input to the PVN, but the data is not clear as to its role as of yet. Any discussion of HPA activation is nearing the limits of knowledge and as such may not belong in this article. Its not just wikipedia that is confused when it comes to stress, its the whole world! The mainstream media often publish stuff about stress which is utter balderdash, and the whole field is prone to quackery. One thing that should be mentioned about HPA activation in response to stress is that it's mechanisms seem to vary with respect to the type of stress being experienced. Stresses have been catagorised as interoceptive (psychological) and exteroceptive (physical) but this is flawed, as often a physical stress will have psychological aspects and vice-versa. Povmcdov 21:15, 25 February 2007 (UTC) --

from the article:
 * (Svante Winberg, Olof Tottmar, Per-Ove Thörnqvist, Olivier Lepage, Joachim Schjolden for Department of Comparative Physiology - Uppsala University, Norbyvägen, Uppsala, Sweden)

credits moved here as part of the policy of no in-article credits for editors

-- I believe that the two should be merged. The issue would be to include all the information in both articles in the merged article. Mention to the PVN and specifying the anterior pituitary gland is pivotal. User:Wesley1610

Hi guys.

I'm a post-doct who studies this sort of thing. I'm trained in anthropology, but now I'm doing my post-doc in Consumer Psych at McGill University. I've published in Human Nature, Hormones and Behavior, Brain and Behavior Sciences, etc. I am currently writing a review article for Yearbook of Physical Anthropology that addreses some of the ambiguities and differences in viewpoint that have emerged between the different commenters in this discussion.

I have not had a chance to read this entire Wiki article yet, so I just wanted to give a quick response.

My view, is that the HPA is not a "stress axis," but is a general regulatory axis. It regulates immunity, reproduction, growth, metabolism, growth and breakdown of tissue. It regulates these each and every day, irrespective of any exceptional events that one might feel compelled to regard as "stressful" or even "challenging." The article I am currently writing, which I believe is both timely and controversial, is primarily focused on making this central point, which is in fact contrary to the prevailing wisdom among nearly everyone who formally studies the topic.

So, I guess the short answer to any discussion about a Wiki article on the HPA is that, even the experts are not yet in full agreement about what it is, how it influences the ANS, and other key questions like, whether it is always elevated under situations of distress, whether "stress" is always operationalized as relatively increased levels of activity, etc.

The histology, pathology, molecular biology part of the puzzle are I think fairly better understood, but because the HPA is so QUINTESSENTIALLY pscyho-biological, i.e., it lies right at the intersection between our minds as perceiving, appraising, and feeling machines and our bodies as devices used by our minds to get its purposes achieved, the HPA as a physiological topic remains still highly controversial. I believe that the next 10 years will show tremendous advances in our understanding of what it really is for, how it really does work, and what it really does do under X, Y, and Z psychosocial and psychosomatic contexts. But at present, there is a whole lot of anedotal evidence, which is not surprising because up till now, people have been largely occupied just answering the basic questions.


 * Yes, I agree that it is more accurate to say that the HPA axis is the body's energy regulation system rather than simply the "stress axis". In the article it does say that the HPA axis is involved in regulating digestion, the immune system and energy usage, so I think this is covered. But please feel free to contribute your knowledge by adding to the article or tidying it up. --Sciencewatcher 23:10, 7 March 2007 (UTC)

Cleanup
This page was merged. If it looks okay to the doctors around, please feel free to remove the cleanup tag. Ste4k 05:40, 14 July 2006 (UTC)

HPA
AS the article stood before I made a few explanatory additions it was short on basics and long on bald statements that are only half-correct. It still needs more work. Essentially the basic nature of the HPA axis needs explaining and some of the finer details need leaving out: this is not after all a medical textbook. Nervous and hormonal inputs to the hypothalamus cause release or not of the releasing hormones that control the pituitary; this is the crucial point and it is not properly made. The pituitary hormones GH, Prolactin (Acidophils) and basophils: FSH, ACTH, LH and TSH are then released and do their thing. The adrenals also need a bit more explaining: basic cortex versus medulla differences and how the secretions (into the bloodstream) then feedback onto the H and the P of the axis. Maybe a few practical considerations also: for example to get proper GH secretion (vital for anti-ageing, healing, body maintenance, etc) you need Phase IV sleep before midnight, etc. Lgh 02:39, 24 July 2006 (UTC)

Pituitary Adrenal
The "pituitary adrenal axis" section of the article (which I assume was added during the merge) seems to be a duplicate of the main article, and is very badly written. As far as I can see it doesn't really have any information that isn't included in the main section, so I have removed the section. If anyone has any objections, feel free to discuss it here (or make changes). --Sciencewatcher 23:10, 7 March 2007 (UTC)

The HPA Axis is considered by researchers working on cutting edge hormonal studies as perhaps the key to how hormones interact with the body, and is also considered by most to remain an elusive mystery to current medical knowledge. As a person who suffers from multiple hormonal diseases due to a Cushing's tumor on my pituitary gland, my research eventually ended up at the HPA Axis, a fascinating look into the future of medicine, but a dead end. I have discussed the HPA axis with some of the leading researchers in the world, and their collective opinion is that understanding how the HPA Axis works, and how the Hormonal Cascade works, will someday lead to our understanding a great variety of endocrine disorders. But as of today, those facts are in bitter dispute between various research teams, and thus I feel this article does as good of a job as any in trying to explain the complex functions of a key part of the endocrine system that the greatest researchers in the field today cannot claim to fully understand. Or indeed, the order of events in the hormonal cascade, and where to begin working with the complex "domino effect" of hormones when looking for a cure for any given endocrine disorder. Naturally, this is anecdotal, so I can't produce footnotes of studies where researchers boldly claim they don't truly understand the workings of the HPA Axis, but I admire anyone taking a stab at putting together what IS known today and thus advance the lay person's, or the medical professional's, understanding of this complex and mysterious subject which warrants intense study as it could be the key to understanding and curing a plethora of diseases.Panhypopit (talk) 23:34, 24 April 2010 (UTC)


 * Well, speaking as a neuroscience professional I can tell you that we really don't understand any aspect of the brain very well at the system level. The HPA axis is not unusual in that respect. Looie496 (talk) 01:36, 25 April 2010 (UTC)

Lack of references and Citations
As a lay person reading this article it does provide some useful background. However, I also observe that it essentially lacks citations to reference sources, so it could also be summarising original research or worse a piece of fiction. The overview and anatomy sections have no citations. The function section cites three references for specific points, but in non-standard format '(MacHale, 1998)', '(Backhaus, 2004)', '(Pruessner, 1999)'. It is also unclear as to the general source of the function section. Is this reference 2? However, even if it is, this is a briefing on the British Society for Neuroendocrinology website, rather than a properly peer reviewed paper in a primary medical reference publication.

This article falls short of a B quality criterion. &mdash; TerryE (talk) 11:17, 18 February 2009 (UTC)


 * I agree that this is better described (according to the mid-2008 standards revisions) as a C class article. However, the refs that you complain about are a standard format:  please read WP:Parenthetical referencing.  WhatamIdoing (talk) 00:41, 22 February 2009 (UTC)


 * I just noticed that there are still a lot of citations missing, especially in the lede. Also there is stuff in the lede that isn't mentioned anywhere in the main article. --sciencewatcher (talk) 19:03, 29 April 2014 (UTC)

Disputed
Vasopressin is not transported to the anterior pituitary. It is transported to and released from the posterior pituitary. Hundreds of medical texts substantiate this, but here is one respected source (http://www.uptodate.com/patients/content/topic.do?topicKey=~sAx8p4UzDeKUx). There are a number of other factual inaccuracies and half-truths in the article, and as I have time, I'll try to add more to this discussion. On2flight (talk) 04:17, 9 December 2009 (UTC)
 * This may be a stupid question, but why would vasopressin need transporting to the posterior pituitary if it originates there? Spiral5800 (talk) 18:36, 28 December 2009 (UTC)
 * When a substance is released by the axon terminals of neurons, it can be synthesized at the cell body, and then transported along the axon to the point where it is released. That's what On2flight says happens here, and the source substantiates it. Looie496 (talk) 19:12, 28 December 2009 (UTC)
 * Ah, as an individual working in the neurosciences I am of course familiar with the process whereby substances are made in the cell bodies of neurons and then transported along the axon to the axon terminals. Perhaps I didn't read closely enough, as I was thinking on a more macrocellular level; that is, I had in mind active transport between distinct brain areas and between groups of neurons rather than within individual neurons.  Next time I'll check out the source a user is citing; I just thought it couldn't hurt to pose such a succinct simple question ;)  Thanks.  Spiral5800 (talk) 20:19, 29 December 2009 (UTC)
 * On2flight is wrong: Try reading the source he gives. —Preceding unsigned comment added by 88.104.230.205 (talk) 07:10, 22 December 2010 (UTC)

I've now fixed this. On2flight was correct. Only CRH is transported to the anterior pituitary through the portal blood vessel system. Vasopressin is transported using axonal transport to the posterior pituitary. --sciencewatcher (talk) 19:19, 22 February 2011 (UTC)

Review of HPA axis, stress and disease
This review has 194 citations and should probably be added. See here and full-text here. --sciencewatcher (talk) 04:18, 19 February 2011 (UTC)

The last sentence that claims that cortisol levels are low in PTSD and that a blunted hormonal response is a predisposing factor to PTSD is *WAY* too controversial to be presented the way it is. The first part of the sentence alone has all but been refuted (see pubmed 17978317), the HPA-Axis / PTSD story is much more complicated than that. The sentence should be removed or major disclaimers should be added. --MBVECO — Preceding unsigned comment added by 209.6.34.240 (talk) 21:15, 4 September 2011 (UTC)
 * You are welcome to edit this article to make it more correct. Looie496 (talk) 23:23, 4 September 2011 (UTC)

Presence of an HPA axis in animals
In the intro you write "A wide variety of species, from single cellular to multi-cellular organisms including humans, share components of the HPA axis." Somebody has correctly put the "citation needed" because they doubt that this is correct. I also think that the APH-Axis and corticosteroids are common to vertebrates only. While it is correct to say that insects and other invertebrates have similar systems with similar functions in stress response,they do not have this axis and do not synthesise steroids. See: I suggest therefore:

While steroids are produced only by vertebrates, the physiological role of the HPA axis and corticosteroids in stress response is so fundamental that analogous systems can be found in invertebrates and monocellular organisms as well. — Preceding unsigned comment added by Alpengruebler (talk • contribs) 16:48, 5 January 2013 (UTC)


 * Thanks for your edits. This article has been rather neglected, and you should feel free to make any edits that seem right to you.  Regards, Looie496 (talk) 18:10, 5 January 2013 (UTC)

CAR
Perhaps some mention of cortisol awakening response should be added (other than just a link to the article). --sciencewatcher (talk) 04:55, 29 April 2014 (UTC)

Expanding on Immune system section
Hello All! I am a student at Carleton College and I would like to expand on the Immune System section of this article for my Immunology course. Here are six sources that I am looking at: Let me know what you think about these references and whether or not they will be appropriate to use to add to this section. All of these articles are reviews and not primary literature. Immcarle24 (talk) 04:33, 21 February 2016 (UTC)Immcarle24

Proposed Expansion to Immune System Section
Hello there again!

Here are some information that I would like to add to this section:

1. Discuss how inflammatory cytokines activate the HPA axis 2. Discuss how the HPA negatively regulates inflammatory cytokines released by immune cells (regulate homeostatic state) 3. What happens when a person is a chronically stress- how does HPA affect immune response? 4. Paradoxical responses of sustained HPA activation- in some studies, HPA activation leads to supression of immune response, while other studies show that chronic HPA activation leads to inflammatory diseases 5. discuss different models that explain these paradoxical results

I won't be adding these 5 points separately in the body of this section. I will be addressing them all together, but I am not sure how I will do that yet. I might end up writing 3 paragraphs in total.

Immcarle24 (talk) 04:47, 21 February 2016 (UTC)Immcarle24

HPA axis suppression and corticosteroids
So: a side effect of chronic (and maybe acute?) use of fluocinonide -- a corticosteroid, is HPA axis suppression. A short review of what "HPA axis suppression" actually means, in practical terms, would be nice. I'm also wondering if topical corticosteroids are best applied in the morning, not the evening, to avoid flattening the diurnal cycle.. !? 67.198.37.16 (talk) 03:27, 17 June 2018 (UTC)