The DOI matches its Crossref record; 35 of the 35 references it cites were found in a registry or an index.
Defective hypothalamic response to immune and inflammatory stimuli in patients with rheumatoid arthritis
Abstract
OBJECTIVE: To determine the integrity of the hypothalamic-pituitary-adrenal (HPA) axis responses to immune/inflammatory stimuli in patients with rheumatoid arthritis (RA). METHODS: Diurnal secretion of cortisol and the cytokine and cortisol responses to surgery were studied in subjects with active RA, in subjects with chronic osteomyelitis (OM), and in subjects with noninflammatory arthritis, who served as controls. RESULTS: Patients with RA had a defective HPA response, as evidenced by a diurnal cortisol rhythm of secretion which was at the lower limit of normal in contrast to those with OM, and a failure to increase cortisol secretion following surgery, despite high levels of interleukin-1 beta (IL-1 beta) and IL-6. The corticotropin-releasing hormone stimulation test in the RA patients showed normal results, thus suggesting a hypothalamic defect, but normal pituitary and adrenal function. CONCLUSION: These findings suggest that RA patients have an abnormality of the HPA axis response to immune/inflammatory stimuli which may reside in the hypothalamus. This hypothalamic abnormality may be an additional, and hitherto unrecognized, factor in the pathogenesis of RA.
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“Adrenocortical dysfunction, termed also as ‘relative’ or ‘functional’ adrenal insufficiency, has been described in patients with rheumatoid arthritis (RA) without any prior risk of, or evidence of, overt adrenal insufficiency.1–8”
From Diurnal production of cortisol and prediction of treatment response in rheumatoid arthritis: a 6-month, real-life prospective cohort study (2024) · cites this paper as [1]
Citations
Cites
1958 Revision of diagnostic criteria for rheumatoid arthritis
Ropes, M. W., Bennett, G. A., Cobb, S., Jacox, R. F., & Jessar, R. A. (1959) · Arthritis & Rheumatism · doi:10.1002/1529-0131(195902)2:1 · Cited by 1,999
Immunoregulatory Feedback Between Interleukin-1 and Glucocorticoid Hormones
Besedovsky, H., del Rey, A., Sorkin, E., & Dinarello, C. A. (1986) · Science · doi:10.1126/science.3014662 · Cited by 1,519
Cytokines and cytokine inhibitors or antagonists in rheumatoid arthritis
Arend, W. P., & Dayer, J. (1990) · Arthritis & Rheumatism · doi:10.1002/art.1780330302 · Cited by 957
Interleukin-1 Immunoreactive Innervation of the Human Hypothalamus
Breder, C. D., Dinarello, C. A., & Saper, C. B. (1988) · Science · doi:10.1126/science.3258444 · Cited by 755
Sternberg, E. M., Hill, J. M., Chrousos, G. P., Kamilaris, T., Listwak, S. J., Gold, P. W., & Wilder, R. L. (1989) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.86.7.2374 · Cited by 723
Self-citationSternberg, E. M., Young, W. S., Bernardini, R., Calogero, A. E., Chrousos, G. P., Gold, P. W., & Wilder, R. L. (1989) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.86.12.4771 · Cited by 568
Self-citationThe Corticotropin-Releasing Factor Stimulation Test
Chrousos, G. P., Schulte, H. M., Oldfield, E. H., Gold, P. W., Cutler, G. B., & Loriaux, D. L. (1984) · New England Journal of Medicine · doi:10.1056/nejm198403083101004 · Cited by 350
Self-citationRamadori, G., Van Damme, J., Rieder, H., & Zum Büschenfelde, K. M. (1988) · European Journal of Immunology · doi:10.1002/eji.1830180817 · Cited by 284
Mason, D. (1991) · Immunology Today · doi:10.1016/0167-5699(91)90158-p · Cited by 254
Black, R. L. (1984) · Military Medicine · doi:10.1093/milmed/149.3.161a · Cited by 248
Flagged first, then by citations
Research works printed but not linked: 1
- Dinarello CA, 1978, Radiolabelling and deposition in rabbits of purified human leucocyte pyrogen, Clin Res, 28, 522A
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Sorted by citations
Items 301–336 of 336
Behavioral and Social Dimensions of Pain in Rheumatic Disease
Bradley, L. A. (1999) · Springer eBooks · doi:10.1007/978-1-4615-4789-1_17
Chapter 9 Adrenal Involvement in Systemic Autoimmune Diseases
Ramos‐Casals, M., Brito‐Zerón, P., Espinosa, G., & Cervera, R. (2008) · Technical report · doi:10.1016/s1571-5078(07)00209-7
Systemic glucocorticoids in chronic arthritis
Kirwan, J. (2001) · Birkhäuser Basel eBooks · doi:10.1007/978-3-0348-8348-1_11
Hein, G. E., Oelzner, P., Sprott, H., & Manger, B. (1999) · Medizinische Klinik - Intensivmedizin und Notfallmedizin · doi:10.1007/bf03044940
Miedany, Y. M. E., Ahmed, I., Moustafa, H., & Baddini, M. E. (2003) · Revue du Rhumatisme · doi:10.1016/s1169-8330(03)00376-4
Hugh McGrath (2002) · Arthritis & Rheumatism · doi:10.1002/art.10490
Glucocorticoid Sensitivity in Rheumatoid Arthritis
Quax, R. A. M. (2013) · EUR Research Repository (Erasmus University Rotterdam)
Jokar, M. H., Mousavi, Z., & Azam Vaziri, F. A. R. D. (2007) · APLAR Journal of Rheumatology · doi:10.1111/j.1479-8077.2007.00271.x
Perspectives on the neuroendocrinological concomitants of chronic osteoarthritis pain
Khoromi, S., & Blackman, M. R. (2007) · Future Rheumatology · doi:10.2217/17460816.2.2.121
Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine 1248
Arvidson, N. G. (2003)
New Frontiers in the Pharmacotherapy of Inflammation
Flower, R. J. (1995) · Birkhäuser Basel eBooks · doi:10.1007/978-3-0348-7276-8_17
Aggressive Drug Therapy for Rheumatoid Arthritis
McGuire, J. L., & Ridgway, W. M. (1993) · Hospital Practice · doi:10.1080/21548331.1993.11442844
The Neuroendocrine System and Rheumatoid Arthritis: Focus on the Hypothalamic-Pituitary-Adrenal Axis
Gorby, H. E., & Sternberg, E. M. (2007) · Elsevier eBooks · doi:10.1016/b978-012088576-3/50012-5
Cytokines and Leptin as Mediators of the Hypothalamo-Pituitary-Adrenal Axis
Gaillard, R.-C. (2004) · Informa Healthcare eBooks · doi:10.1201/9780203021941.ch5
Wisneski, L., & Wisneski, L. (2017) · Routledge eBooks · doi:10.4324/9781315153889-4
Neuroendocrine Host Factors in Susceptibility and Resistance to Autoimmune/Inflammatory Disease
Webster, J. I., & Sternberg, E. M. (2004) · Informa Healthcare eBooks · doi:10.1201/9780203021941.ch20
Genomics in the Evaluation and Management of Rheumatoid Arthritis
Plenge, R. M., & Weinblatt, M. E. (2010) · Elsevier eBooks · doi:10.1016/b978-0-12-374934-5.00043-x
Рассказов, Д. А., Podkolodnyy, N. L., Podkolodnaya, O. A., Tverdokhleb, N. N., Suslov, V. V., Savinkova, L. K., Ponomarenko, P. M., & Ponomarenko, M. P. (2016) · Russian Journal of Genetics Applied Research · doi:10.1134/s207905971607011x
Could maternal stress increase the risk of developing psoriasis in the offspring?
Gisondi, P. (2017) · British Journal of Dermatology · doi:10.1111/bjd.15329
Molecular Basis of Rheumatoid Arthritis
Plenge, R. M., & Weinblatt, M. E. (2009) · Elsevier eBooks · doi:10.1016/b978-0-12-369420-1.00084-6
Subramanian, S., & Dhivya, S. (2009) · Biology and medicine
(2009) · CRC Press eBooks · doi:10.1201/b10166-4
Morand, E. F., & Hall, J. P. (1995) · Arthritis & Rheumatism · doi:10.1002/art.1780380531
Рассказов, Д. А., Podkolodnyy, N. L., Podkolodnaya, O. A., Podkolodnaya, N. N., Suslov, V. V., Savinkova, L. K., Ponomarenko, P. M., & Ponomarenko, M. P. (2016) · Vavilov Journal of Genetics and Breeding · doi:10.18699/vj15.083
How Do Skeletal Tissues Keep Time? Circadian Rhythms in Cartilage and Bone
Gonçalves, C. F., & Meng, Q. (2024) · Royal Society of Chemistry eBooks · doi:10.1039/bk9781839167553-00323
Emotional stress and cardiovascular health: Impacts on neurodegenerative disease progression
El‐Aziz, M. K. A., Wadan, A. S., Albahttiti, A. T. I., & Moradikor, N. (2025) · Progress in brain research · doi:10.1016/bs.pbr.2025.04.004 · Cited by 1
Schmidt, N. M. (2014) · University of Regensburg Publication Server (University of Regensburg) · doi:10.5283/epub.27673
Laoudi, E., Papalouka, D., Kokkotis, G., Gkizis, M., Mantzou, A., Lyrakos, G. N., Markopoulos, P. (., Prapa, P. M., Voulgaris, T. A., Vlachogiannakos, J., et al. (2026) · World Journal of Psychiatry · doi:10.5498/wjp.v16.i3.111523
Potential of CAR-T cell immunotherapy in rheumatoid arthritis
Chikanza, I. C., & Sakkas, L. I. (2026) · Clinical Rheumatology · doi:10.1007/s10067-026-08095-x
Self-citationWeisenseel, Z., & Glasper, E. R. (2026) · Brain Behavior & Immunity - Health · doi:10.1016/j.bbih.2026.101328
Straub, R. H., & Cutolo, M. (2001) · Arthritis & Rheumatism · doi:10.1002/1529-0131(200103)44:3
Metadata
- Authors
- Chikanza, I. C., Petrou, P., Kingsley, G., Chrousos, G., & Panayi, G. S.
- Affiliations
- Guy's Hospital (GB)
- Corresponding author
- Panayi, Gabriel S.
- Venue
- Arthritis & Rheumatism
- Publisher
- Wiley
- Published
- 1992-11
- Volume
- 35
- Issue
- 11
- Pages
- 1281-1288
- ISSN
- 0004-3591 (ISSN-L)
- 1529-0131
- OpenAlex
- W1718876362
- Cited by
- 337
- References
- 35
- Citations by year
- 2026: 5 · 2025: 1 · 2024: 5 · 2023: 3 · 2021: 4 · 2020: 4 · 2019: 2 · 2018: 1 · 2017: 8 · 2016: 9 · 2015: 4 · 2014: 6 · 2013: 7 · 2012: 9
- FWCI
- 8.08
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Arthritis & Rheumatism (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Health Sciences › Medicine › Rheumatology › Rheumatoid Arthritis Research and Therapies
- Keywords
- rheumatoid arthritis, hypothalamic-pituitary-adrenal axis, hypothalamic dysfunction, cortisol secretion, diurnal cortisol rhythm, corticotropin-releasing hormone stimulation test, IL-1β, interleukin-6, chronic osteomyelitis, inflammatory stimuli
- MeSH terms
- Adult, Aged, Arthritis, Rheumatoid, Circadian Rhythm, Corticotropin-Releasing Hormone, Female, Humans, Hydrocortisone, Hypothalamus, Immune System, Male, Middle Aged, Postoperative Period, Cytokines
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