Gonadal hormones modulate the HPA‐axis and the SNS in response to psychosocial stress

Barel, Efrat; Abu-Shkara, Randa; Colodner, Raul; Masalha, Refaat; Mahagna, Lila; Zemel, Or Chen; Cohen, A.

doi:10.1002/jnr.24259

Cited by 32 publications

(24 citation statements)

References 72 publications

(106 reference statements)

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“…A formal assessment in those with postoperative basal cortisol between 80 and 325 nmol/L or symptoms suggestive of AI is advised at least 6 weeks after surgery. Reliability of testing can be optimized when testing is postponed in case of concomitant factors that can potentially affect ACTH and cortisol secretion and/or its bioavailability, i.e diabetes insipidus, SIADH, CSF-leakage, fever, and oral contraceptive use in the 6 weeks before testing [26].…”

Section: Discussionmentioning

confidence: 99%

Early postoperative HPA-axis testing after pituitary tumor surgery: reliability and safety of basal cortisol and CRH test

et al. 2019

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Purpose To assess the reliability and safety of a postsurgical evaluation strategy of adrenal function using CRH stimulation and basal cortisol concentrations after transsphenoidal pituitary surgery. Methods Retrospective cohort study of all patients undergoing endoscopic transsphenoidal surgery from 2010 to 2017, in whom early postoperative basal cortisol and/or CRH-stimulated cortisol secretion were available, including confirmation of adrenal function during follow-up. Patients with Cushing's disease were excluded. Optimal test performances were assessed using ROC analysis. Results A total of 156 patients were included. Sensitivity and specificity of the CRH test were 78% and 90%, respectively, and 86% and 92% for basal cortisol, respectively, using an optimal cutoff of 220 nmol/L. Eight patients had false-negative test results with the CRH test (normal test but adrenal insufficient at follow-up), and six patients with basal cortisol, the majority of which had multiple pituitary hormone deficiencies and fluid imbalances. No clinical adverse events occurred in patients with false-negative test results. The diagnostic performance of a single basal cortisol measurement was superior to the CRH test. Conclusions The early postoperative basal cortisol is a safe and simple measurement to guide (dis)continuation of hydrocortisone replacement. However, disturbing factors, e.g., sodium balance disorders, contraceptives, untreated hypopituitarism, and illness impact the interpretation and in those cases this measure is unreliable. We propose an algorithm in which hydrocortisone replacement at discharge is based on basal cortisol <220 nmol/L on postoperative day 2 or 3 in a stable condition.

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Section: Discussionmentioning

confidence: 99%

Early postoperative HPA-axis testing after pituitary tumor surgery: reliability and safety of basal cortisol and CRH test

et al. 2019

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“…Although sex hormones may influence intrusive memories, the inconsistent finding highlight the need for future research to further delineate the relationship between specific hormones and intrusive memories. Given that both intrusive memories and estradiol are associated with limbic network activation [52, 53], and that estradiol modulates noradrenergic activity which is associated with intrusive memories [15, 54, 55], it is important to examine the potential interaction of sex and stress hormones on intrusive memories following trauma exposure.…”

Section: Discussionmentioning

confidence: 99%

Sex differences in intrusive memories following trauma

et al. 2018

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BackgroundA key mechanism thought to underlie Posttraumatic Stress Disorder (PTSD) is enhanced emotional memory consolidation. Recent evidence in healthy controls revealed that women have greater negative memory consolidation following stress relative to men. This study examined emotional memory consolidation in women and men with PTSD, and in trauma-exposed and non-trauma controls to test the hypothesis that emotionally negative memory consolidation would be greater in women with PTSD.MethodOne hundred and forty-seven men and women (47 with PTSD, 49 trauma-exposed controls, and 51 non-trauma controls) completed an emotional memory task where they looked at negative, neutral and positive images from the International Affective Picture System (IAPS). Delayed recall and an intrusive memory diary were completed two days later.ResultsWomen displayed greater recall, and reported more negative intrusive memories than men. A gender x group interaction effect showed that both women with PTSD and trauma-exposed women reported more intrusive memories than women without trauma exposure or men.ConclusionThis study provided preliminary evidence of sex differences in intrusive memories in those with PTSD as well as those with a history of trauma exposure. Future research should include measures of sex hormones to further examine sex differences on memory consolidation in the context of trauma exposure and PTSD.

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“…Pandemic restriction and isolation by quarantine during COVID-19 are acting as sources of stress [ 120 ]. Cumulating evidence suggest that gender based response to stress probably results from differential modulation of HPA axis by sex hormones [ 121 ]. Both clinical as well as experimental models reported that exposure to stress in initial life enhance the risk of development of psychosocial disorders in males [ 122 ].…”

Section: Probable Factors Responsible For Higher Mortality Rate Amongmentioning

confidence: 99%

An Assessment on Impact of COVID-19 Infection in a Gender Specific Manner

Agrawal

Das

Nathani

et al. 2020

Stem Cell Rev and Rep

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Coronavirus disease 2019 (COVID-19) is caused by novel coronavirus Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It was first time reported in December 2019 in Wuhan, China and thereafter quickly spread across the globe. Till September 19, 2020, COVID-19 has spread to 216 countries and territories. Severe infection of SARS-CoV-2 cause extreme increase in inflammatory chemokines and cytokines that may lead to multi-organ damage and respiratory failure. Currently, no specific treatment and authorized vaccines are available for its treatment. Renin angiotensin system holds a promising role in human physiological system specifically in regulation of blood pressure and electrolyte and fluid balance. SARS-CoV-2 interacts with Renin angiotensin system by utilizing angiotensin-converting enzyme 2 (ACE2) as a receptor for its cellular entry. This interaction hampers the protective action of ACE2 in the cells and causes injuries to organs due to persistent angiotensin II (Ang-II) level. Patients with certain comorbidities like hypertension, diabetes, and cardiovascular disease are under the high risk of COVID-19 infection and mortality. Moreover, evidence obtained from several reports also suggests higher susceptibility of male patients for COVID-19 mortality and other acute viral infections compared to females. Analysis of severe acute respiratory syndrome coronavirus (SARS) and Middle East respiratory syndrome coronavirus (MERS) epidemiological data also indicate a gender-based preference in disease consequences. The current review addresses the possible mechanisms responsible for higher COVID-19 mortality among male patients. The major underlying aspects that was looked into includes smoking, genetic factors, and the impact of reproductive hormones on immune systems and inflammatory responses. Detailed investigations of this gender disparity could provide insight into the development of patient tailored therapeutic approach which would be helpful in improving the poor outcomes of COVID-19.

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Gonadal hormones modulate the HPA‐axis and the SNS in response to psychosocial stress

Cited by 32 publications

References 72 publications

Early postoperative HPA-axis testing after pituitary tumor surgery: reliability and safety of basal cortisol and CRH test

Early postoperative HPA-axis testing after pituitary tumor surgery: reliability and safety of basal cortisol and CRH test

Sex differences in intrusive memories following trauma

An Assessment on Impact of COVID-19 Infection in a Gender Specific Manner

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