Disorders of the hypothalamic-pituitary-adrenocortical system

Tomoshige Kino, Evangelia Charmandari, George P. Chrousos

Research output: Chapter in Book/Report/Conference proceedingChapter

5 Citations (Scopus)


This chapter discusses how the hypothalamic-pituitary-adrenocortical (HPA) system is essential for the maintenance of internal homeostasis and a major mediator component of the body's adaptive response to internal or external stressors. The HPA system consists of the paraventricular nucleus (PVN) located in the hypothalamus, the pituitary gland, and the adrenal cortices. Glucocorticoids regulate a variety of biologic processes and exert profound influences on many physiologic functions. They are essential for the maintenance of basal and stress-related homeostasis, while at pharmacologic doses they exert catabolic effects, mainly on the skeletal muscles and the bones, and potent, mostly suppressive effects on the immune system. Patients with major depression, particularly the melancholic type, demonstrate sustained hyperactivity of the HPA system and subsequent elevation of cerebrospinal fluid CRH, plasma ACTH and serum cortisol concentrations, possibly caused by mental stress. Destructive lesions in the pituitary gland can cause hypofunction of the HPA system and secondary adrenal insufficiency.

Original languageEnglish
Title of host publicationHandbook of Neuroendocrinology
PublisherElsevier Inc.
Number of pages19
ISBN (Print)9780123750976
Publication statusPublished - 2012
Externally publishedYes


ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Kino, T., Charmandari, E., & Chrousos, G. P. (2012). Disorders of the hypothalamic-pituitary-adrenocortical system. In Handbook of Neuroendocrinology (pp. 639-657). Elsevier Inc.. https://doi.org/10.1016/B978-0-12-375097-6.10029-0