Response of ACTH and Cortisol to Corticotropin-Releasing Hormone in Anorexia Nervosa

Cavagnini, Francesco; Invitti, Cecilia; Passamonti, Marco; Ee, Polli

doi:10.1056/nejm198601163140318

Cited by 20 publications

(1 citation statement)

References 8 publications

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“…Due to negative feedback, the expression and activity of mineralocorticoid receptor (MR) increased instead (105). Moreover, it is worth noting that chronic heart failure patients based on NYHA classes III and IV have a higher proportion of hypothermia (106, 107), anorexia (108, 109), depression (110,111), and a poor prognosis, which is similar to the phenomenon of kidney-Yang deficiency of TCM (112) or a lower response of ACTH and cortisol (102,113). Many classic prescriptions for warming and nourishing kidney-Yang, such as Sini decoction reverses hypothermia and balances hypothalamic-pituitary-adrenal axis in vivo (114)(115)(116)(117) and improve chronic heart failure (38, 114, 118) (Figure 3).…”

Section: E Ect Of Prescriptions On Changes Of Sympathetic Excitabilit...mentioning

confidence: 99%

Mechanism of tonifying-kidney Chinese herbal medicine in the treatment of chronic heart failure

Chen

Ling

et al. 2022

Front. Cardiovasc. Med.

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According to traditional Chinese medicine (TCM), chronic heart failure has the basic pathological characteristics of “heart-kidney yang deficiency.” Chronic heart failure with heart- and kidney-Yang deficiency has good overlap with New York Heart Association (NYHA) classes III and IV. Traditional Chinese medicine classical prescriptions for the treatment of chronic heart failure often take “warming and tonifying kidney-Yang” as the core, supplemented by herbal compositions with functions of “promoting blood circulation and dispersing blood stasis.” Nowadays, there are still many classical and folk prescriptions for chronic heart failure treatment, such as Zhenwu decoction, Bushen Huoxue decoction, Shenfu decoction, Sini decoction, as well as Qili Qiangxin capsule. This review focuses on classical formulations and their active constituents that play a key role in preventing chronic heart failure by suppressing inflammation and modulating immune and neurohumoral factors. In addition, given that mitochondrial metabolic reprogramming has intimate relation with inflammation, cardiac hypertrophy, and fibrosis, the regulatory role of classical prescriptions and their active components in metabolic reprogramming, including glycolysis and lipid β-oxidation, is also presented. Although the exact mechanism is unknown, the classical TCM prescriptions still have good clinical effects in treating chronic heart failure. This review will provide a modern pharmacological explanation for its mechanism and offer evidence for clinical medication by combining TCM syndrome differentiation with chronic heart failure clinical stages.

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Section: E Ect Of Prescriptions On Changes Of Sympathetic Excitabilit...mentioning

confidence: 99%

Mechanism of tonifying-kidney Chinese herbal medicine in the treatment of chronic heart failure

Chen

Ling

et al. 2022

Front. Cardiovasc. Med.

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Could stress help understand the pathophysiology of anorexia nervosa?

et al. 1992

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The determinism and pathophysiology of anorexia nervosa (AN) remains to a large extent unknown. The nosographic debate is rather ideologically orientated, and neurobiological as well as psychodynamic or systemic hypotheses have been suggested and developed. Recent advances in neurobiology and the concept of ‘psychosocial stress’ could therefore provide an integrative approach which allows consideration of both neurobiological determinants of behavior and various psychological or interpersonal influences, as well as life events. Corticotropin releasing hormone (CRH), a hypothalamic neuropeptide, plays a major role both in the mechanisms underlying the stress response and in the regulation of eating behavior. The authors present an experimental study which was conducted in anorectic patients and age‐and sex‐matched healthy volunteers. They investigated the hypothalamo–pituitary–adrenal axis (HPA) reactivity to a neurotropic stimulation of the HPA axis at the hypothalamic and suprahypothalamic levels (NST). The HPA axis reactivity was assessed by repeated measures of salivary cortisol. There were significant differences in the responses of the anorectic group and the control group.

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The effect of neuroendocrine secretion on brain morphology and EEG sleep in patients with eating disorders

Lauer

Schreiber

Berger

et al. 1989

Eur Arch Psychiatr Neurol Sci

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Neuroendocrine disturbances [low plasma levels of triiodothyronine (T3), high plasma concentrations of cortisol], morphological brain alterations [enlarged external cerebrospinal fluid (CSF) spaces, dilatation of the ventricles] and altered sleep patterns [fragmented sleep continuity, a reduction of slow wave sleep (SWS) or REM sleep] have been described in patients with anorexia nervosa and bulimia nervosa. The present study investigates to what degree these disturbances interact with each other. In ten anorexic and five bulimic patients cranial computed tomography (CT) to estimate the size of the CSF spaces, blood sampling to measure cortisol and T3 plasma concentrations, and all-night polysomnography were performed. In comparison with patients with normal CT scans, the patients displaying enlarged CSF spaces spent more time in SWS, and the duration of REM sleep was reduced. In the whole sample, a negative correlation was found between the amount of REM sleep and cortisol, whereas a positive association was found between the amount of REM sleep and the T3 level. In addition, the degree of brain shrinkage correlated positively with cortisol and negatively with T3. On the basis of these results, it can be assumed that in patients with eating disorders the disease process with its neuroendocrine alterations affects brain morphology as well as EEG sleep.

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Response of ACTH and Cortisol to Corticotropin-Releasing Hormone in Anorexia Nervosa

Cited by 20 publications

References 8 publications

Mechanism of tonifying-kidney Chinese herbal medicine in the treatment of chronic heart failure

Mechanism of tonifying-kidney Chinese herbal medicine in the treatment of chronic heart failure

Could stress help understand the pathophysiology of anorexia nervosa?

The effect of neuroendocrine secretion on brain morphology and EEG sleep in patients with eating disorders

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