There is a substantial literature describing the interactions between the endocrine and immune systems. Although such interactions are less well known within the brain, one major brain function altered during inflammation and infection and by several endocrine hormones is sleep. Pathological disturbances, be they inflammation, infectious disease, and/or sleep deprivation, result in altered hypothalamus-pituitary function and cytokine metabolism. In respect to hormone secretion from the pituitary, cytokines are now recognized to play an important role in modulating the neuroendocrine system. Changes in sleep provide a useful illustration of the interactions between cytokines and the hypothalamus-pituitary axis. Evidence linking interleukin-I (IL-I ) to growth hormone releasing hormone and to corticotropin releasing hormone in regard to their effects on sleep is reviewed. c 1993 WiIey-Liss, Inc.Key words: cytokines, growth hormone releasing hormone, corticotropin releasing hormone, endocrine regulation, neuroendocrineThe host's initial response to infections is a nonspecific defense reaction called the acute phase response. The acute phase response promotes specific responses to the infectious agents mediated by cellular and humoral immune mechanisms. The acute phase response does this by several ways: the immune system is stimulated; an environment is provided which enhances the effectiveness of the specific immune response and at the same time is not optimal for the replication and spreading of the infectious agents; and the behavior and responsiveness to stimuli of the individual are modified in such a way that the exposure to further environmental challenges is reduced. These changes require substantial alterations in almost all functions of the body. The clinical manifestations of these alterations are the leading symptoms of sickness which are easily recognized by everybody: fever, somnolence, social withdrawal, reduced apetite, muscle pain, etc. Laboratory readings are also abnormal; changes are recorded in plasma proteins, in the number Received May 17, 1993; accepted July 16, 1993. Address reprint requests to James M. Krueger, University of Tennessee, Department of Physiology and Biophysics, 894 Union Avenue, Memphis, TN 38163. and percentage distribution of leukocytes, and in concentrations of various hormones: red blood cell sedimentation increases, and the basal metabolic rate is elevated [ll. An acute phase response, exaggerated in magnitude or prolonged, is detrimental to the individual. However, negative feedback mechanisms are also activated which attenuate various aspects of the functional changes and abolish the response when the infection is eliminated.Much information has accumulated within the past few years indicating that most, if not all, aspects of the acute phase response are driven by a complex array of cytokines in association with classical stress hormones [21. Most cytokines were first identified as immunocyte products involved in the amplification, coordination, and regulatio...