Hypothalamic-Pituitary-Adrenal Axis Reactivity in Chronic Fatigue Syndrome and Health Under Psychological, Physiological, and Pharmacological Stimulation

Gaab, Jens; Hüster, Dominik; Peisen, Renate; Engert, Veronika; Heitz, Vera; Schad, Tanja; Schürmeyer, T. H.; Ehlert, Ulrike

doi:10.1097/00006842-200211000-00012

Cited by 26 publications

(33 citation statements)

References 63 publications

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“…One explanation for the low ACTH but normal cortisol levels in CFS, hypothesized by Demitrack and colleagues (35), is that blunted ACTH is in part the result of an impaired central nervous system drive inducing a reduction of hypothalamic output of corticotrophin-releasing hormone (CRH) and/or other secretagogues. This consequently leads to reduced ACTH levels and a compensatory upregulation of the adrenal cortex responsivity to ACTH, something previously found by some (36) but not others (37)(38)(39).…”

Section: Hypothalamo-pituitary-adrenal Axismentioning

confidence: 72%

24-Hour Pituitary and Adrenal Hormone Profiles in Chronic Fatigue Syndrome

Giorgio

Hudson

Jerjes

et al. 2005

Psychosomatic Medicine

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Patients with CFS demonstrated subtle alterations in HPA axis activity characterized by reduced ACTH over a full circadian cycle and reduced levels during the usual morning physiological peak ACTH secretion. This provides further evidence of subtle dysregulation of the HPA axis in CFS. Whether this dysregulation is a primary feature of the illness or instead represents a biologic effect secondary to having the illness itself remains unclear.

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Section: Hypothalamo-pituitary-adrenal Axismentioning

confidence: 72%

24-Hour Pituitary and Adrenal Hormone Profiles in Chronic Fatigue Syndrome

Giorgio

Hudson

Jerjes

et al. 2005

Psychosomatic Medicine

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“…Low VP levels have been found in subjects with postviral fatigue syndrome. Gaab et al (2002b) found that patients with CFS had reduced baseline ACTH levels and also found significantly lower ACTH response levels to several stress tests. However, Gaab et al (2003) later found no CFS versus healthy control cortisol differences after administration of low-dose or high-dose ACTH, indicating that primary adrenal insufficiency is unlikely to play a significant role in the etiology of CFS.…”

Section: Neuroendocrinologymentioning

confidence: 93%

Chronic Fatigue Syndrome: The Need for Subtypes

et al. 2005

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Chronic fatigue syndrome (CFS) is an important condition confronting patients, clinicians, and researchers. This article provides information concerning the need for appropriate diagnosis of CFS subtypes. We first review findings suggesting that CFS is best conceptualized as a separate diagnostic entity rather than as part of a unitary model of functional somatic distress. Next, research involving the case definitions of CFS is reviewed. Findings suggest that whether a broad or more conservative case definition is employed, and whether clinic or community samples are recruited, these decisions will have a major influence in the types of patients selected. Review of further findings suggests that subtyping individuals with CFS on sociodemographic, functional disability, viral, immune, neuroendocrine, neurology, autonomic, and genetic biomarkers can provide clarification for researchers and clinicians who encounter CFS' characteristically confusing heterogeneous symptom profiles. Treatment studies that incorporate subtypes might be particularly helpful in better understanding the pathophysiology of CFS. This review suggests that there is a need for greater diagnostic clarity, and this might be accomplished by subgroups that integrate multiple variables including those in cognitive, emotional, and biological domains.

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“…There are some illnesses which are characterized by hypocortisolaemia, such as chronic fatigue syndrome and post traumatic stress disorder (Gaab et al 2002;Cleare 2003). It is an interesting possibility that an isatin-dependent intervention to increase the activity of the HPA axis may be of benefit in such conditions.…”

Section: Future Possibilities In Stress-related Isatin Researchmentioning

confidence: 99%

Isatin: Role in stress and anxiety

Медведев

Igosheva

Crumeyrolle-Arias

et al. 2005

Stress

109

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(Indoledione 2,3) isatin is an endogenous indole found both in mammalian brain and peripheral tissues. Isatin concentration in blood can exceed 1 microM and tissue concentrations vary from < 0.1 to 10 microM. Its level in the brain and periphery is increased by stress. Isatin has a wide spectrum of behavioural and metabolic effects. It is anxiogenic at lower doses and sedative at higher doses. Its most potent known in vitro actions are as an antagonist of atrial natriuretic peptide (ANP) function and NO signaling. In this review, we discuss isatin and stress in animal models, the few human studies, and also what it is known to date about the molecular mechanisms of its action. We suggest the possibility that isatin and its analogues may be interesting new pharmacological agents; Isatin antagonists may be anxiolytic, and isatin agonists may activate the HPA axis.

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Hypothalamic-Pituitary-Adrenal Axis Reactivity in Chronic Fatigue Syndrome and Health Under Psychological, Physiological, and Pharmacological Stimulation

Cited by 26 publications

References 63 publications

24-Hour Pituitary and Adrenal Hormone Profiles in Chronic Fatigue Syndrome

24-Hour Pituitary and Adrenal Hormone Profiles in Chronic Fatigue Syndrome

Chronic Fatigue Syndrome: The Need for Subtypes

Isatin: Role in stress and anxiety

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