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
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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
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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
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Research works printed but not linked: 1
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Sapolsky, R. M., Romero, L. M., & Munck, A. U. (2000) · Endocrine Reviews · doi:10.1210/edrv.21.1.0389 · Cited by 7,541
Hypothalamic-pituitary-adrenal axis, neuroendocrine factors and stress
Tsigos, C., & Chrousos, G. P. (2002) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(02)00429-4 · Cited by 2,822
Self-citationThe Hypothalamic–Pituitary–Adrenal Axis and Immune-Mediated Inflammation
Chrousos, G. P. (1995) · New England Journal of Medicine · doi:10.1056/nejm199505183322008 · Cited by 2,579
Self-citationEndocrinology of the stress response
Charmandari, E., Tsigos, C., & Chrousos, G. (2005) · Annual Review of Physiology · doi:10.1146/annurev.physiol.67.040403.120816 · Cited by 1,799
Self-citationThe potential role of hypocortisolism in the pathophysiology of stress-related bodily disorders
Heim, C., Ehlert, U., & Hellhammer, D. H. (2000) · Psychoneuroendocrinology · doi:10.1016/s0306-4530(99)00035-9 · Cited by 1,688
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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