Uncoupling of the sympathetic nervous system and the hypothalamic–pituitary–adrenal axis in inflammatory bowel disease?
Abstract
In inflammatory diseases such as Crohn's disease (CD) and ulcerative colitis (UC), one would expect that TNF or IL-6 stimulates the hypothalamus, which activates the hypothalamus-autonomic nervous system (HANS) axis and the hypothalamic-pituitary-adrenal (HPA) axis in a parallel fashion. The study was initiated in order to investigate the parallelism of the HANS and HPA axes. We measured a typical marker of the HANS axis (neuropeptide Y, NPY) and of the HPA axis (serum cortisol). Plasma NPY was positively correlated with serum cortisol in control subjects (R(Rank)=0.259, p=0.026), which is a sign for the parallel activation of the two axes in healthy subjects. However, serum cortisol was not correlated with plasma NPY in CD or UC patients. In the active CD or UC, inclusion of patients with and without prior prednisolone therapy revealed a negative correlation between the serum cortisol and plasma NPY (CD: R(Rank)=-0.285, p<0.05; UC: R(Rank)=-0.510, p<0.01). This study demonstrates that the two stress axes seem to act in a parallel fashion in control subjects but are uncoupled in IBD patients. Uncoupling of these two axes may be partly due to prior corticosteroid therapy, whereas inverse coupling is a result of simultaneous corticosteroid therapy. It is discussed how the uncoupling of the two anti-inflammatory stress axes can appear.
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There is a dissociation between high activity of the sympathetic nervous system and relatively normal activity of the HPA axis in chronic inflammatory diseases.
“There seems to be a dissociation between high activity of the SNS and relatively normal activity of the HPA axis in CIDs [114,115].”
From Interaction of the endocrine system with inflammation: a function of energy and volume regulation (2014) · cites this paper as [114]
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Heart rate variability and inflammatory bowel disease in humans
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Autonomic Dysfunction in Rheumatic Diseases
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Self-citationPang, X. H., Li, T. K., Xie, Q., He, F. Q., Cui, D. J., Chen, Y. Q., Huang, X. L., & Gan, H. T. (2010) · International Journal of Colorectal Disease · doi:10.1007/s00384-010-0964-z · Cited by 25 · see citing works
Psychoneuroimmunologic factors in inflammatory bowel disease
Mackner, L. M., Clough-Paabo, E., PAJER, K. A., Lourie, A., & Crandall, W. (2010) · Inflammatory Bowel Diseases · doi:10.1002/ibd.21430 · Cited by 25 · see citing works
Effects of intestinal inflammation on specific subgroups of guinea-pig celiac ganglion neurons
Dong, X.-X., Thacker, M., Pontell, L. J., Furness, J. B., & Nurgali, K. (2008) · Neuroscience Letters · doi:10.1016/j.neulet.2008.08.045 · Cited by 24 · see citing works
Toward a better understanding of the central consequences of intestinal inflammation
Nyuyki, K. D., & Pittman, Q. J. (2015) · Annals of the New York Academy of Sciences · doi:10.1111/nyas.12935 · Cited by 23 · see citing works
Wang, H., Li, J., Wu, G., Lin, X., Chen, J., Liang, J., Zhang, J., Luo, X., Mao, H., Xie, J., et al. (2024) · Cell Reports Medicine · doi:10.1016/j.xcrm.2024.101754 · Cited by 22 · see citing works
Lucas, A., Cobelens, P. M., Kavelaars, A., Heijnen, C. J., Holtmann, G., Haag, S., Gerken, G., Langhorst, J., Dobos, G., Schedlowski, M., et al. (2006) · Journal of Neuroimmunology · doi:10.1016/j.jneuroim.2006.09.011 · Cited by 22 · see citing works
Brenner, L., Zerlin, L., & Tan, L. L. (2021) · Scientific Reports · doi:10.1038/s41598-021-81256-x · Cited by 21 · see citing works
Schwemmer, S., Beer, P., Schölmerich, J., Fleck, M., & Straub, R. H. (2006) · PubMed · Cited by 21 · see citing works
Self-citationDepression has a Strong Relationship to Alterations in the Immune, Endocrine and Neural System
Hestad, K. A., Aukrust, P., Tønseth, S., & Reitan, S. K. (2009) · Current Psychiatry Reviews · doi:10.2174/157340009789542105 · Cited by 20 · see citing works
Contoreggi, C. S., Rice, K. C., & Chrousos, G. P. (2004) · Neuroendocrinology · doi:10.1159/000081785 · Cited by 20 · see citing works
Predictive and potentially predictive factors in early arthritis: a multidisciplinary approach
Härle, P. (2005) · British journal of rheumatology · doi:10.1093/rheumatology/keh530 · Cited by 19 · see citing works
A method for describing and evaluating naturopathic whole practice.
Herman, P. M., Sherman, K. J., Erro, J. H., Cherkin, D. C., Milliman, B., & Adams, L. A. (2006) · PubMed · Cited by 16 · see citing works
Hill, E., Nguyen, N. H., Qian, A. S., Patel, S., Chen, P. L., Tse, C.-S., & Singh, S. (2022) · Digestive Diseases and Sciences · doi:10.1007/s10620-022-07505-9 · Cited by 15 · see citing works
STRAUB, R. H., DEL REY, A., & BESEDOVSKY, H. O. (2007) · Psychoneuroimmunology · doi:10.1016/b978-012088576-3/50014-9 · Cited by 14 · see citing works
Self-citationStraub, R. H. (2014) · Annals of the New York Academy of Sciences · doi:10.1111/nyas.12409 · Cited by 14 · see citing works
Self-citationEffects of Some Kampo Medicines on Plasma Levels of Neuropeptide Y under Venipuncture Stress
Sato, Y., Katagiri, F., Itoh, H., & Takeyama, M. (2005) · Biological and Pharmaceutical Bulletin · doi:10.1248/bpb.28.1757 · Cited by 14 · see citing works
Shibolet, O., Alper, R., Ilan, Y., & Weidenfeld, J. (2005) · Inflammatory Bowel Diseases · doi:10.1097/01.mib.0000191610.97842.51 · Cited by 14 · see citing works
Electroacupuncture ameliorates experimental colitis induced by acetic acid in rat
Kang, J. W., Kim, T. W., La, J., Sung, T. S., Kim, H. J., Kwon, Y., Kim, J. Y., & Yang, I. S. (2004) · Journal of Veterinary Science · doi:10.4142/jvs.2004.5.3.189 · Cited by 14 · see citing works
A bio-behavioral study of chronic idiopathic colitis in the rhesus macaque (Macaca mulatta)
Howell, S., White, D., Ingram, S., Jackson, R., Larin, J., Morales, P. R., García, A. P., Hicks, C., Hopper, K., & Wagner, J. (2012) · Applied Animal Behaviour Science · doi:10.1016/j.applanim.2012.01.003 · Cited by 13 · see citing works
Lanters, L. R., Öhlmann, H., Langhorst, J., Theysohn, N., Engler, H., Icenhour, A., & Elsenbruch, S. (2024) · Molecular Psychiatry · doi:10.1038/s41380-024-02612-7 · Cited by 13 · see citing works
Cardiac and autonomic function in patients with Crohn’s disease during remission
Zawadka‐Kunikowska, M., Słomko, J., Kłopocka, M., Liebert, A., Tafil‐Klawe, M., Klawe, J. J., Newton, J. L., & Zalewski, P. (2018) · Advances in Medical Sciences · doi:10.1016/j.advms.2018.04.009 · Cited by 11 · see citing works
Öhlmann, H., Lanters, L. R., Theysohn, N., Langhorst, J., Engler, H., Icenhour, A., & Elsenbruch, S. (2023) · Journal of Crohn s and Colitis · doi:10.1093/ecco-jcc/jjad080 · Cited by 10 · see citing works
Bottom-up and top-down signaling of IL-6 with and without habituation?
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Self-citationRuiz-Pablos, M., Paiva, B., & Zabaleta, A. (2025) · Frontiers in Immunology · doi:10.3389/fimmu.2025.1710571 · Cited by 11 · see citing works
A History of Psycho-Neuro-Endocrine Immune Interactions in Rheumatic Diseases
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Self-citationLi, X., Li, C., Ni, W., Wang, D., Hou, X., Liu, Z., Cao, Y., Yao, Y., Zhang, X., & Hu, S. (2018) · Journal of Genetics · doi:10.1007/s12041-018-0991-z · Cited by 7 · see citing works
Lechner, J., & von Baehr, V. (2015) · International Journal of General Medicine · doi:10.2147/ijgm.s77693 · Cited by 7 · see citing works
Kamogashira, T., Nakada, T., & Kanaya, K. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14020341 · Cited by 6 · see citing works
Myocardial IL-6 regulation by neurohormones—an in vitro superfusion study
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Bonaz, B. (2016) · Springer eBooks · doi:10.1007/978-3-319-28609-9_7 · Cited by 6 · see citing works
Neuroendocrine-immune aspects of accelerated aging in rheumatoid arthritis
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Self-citationPsychological Stress in Chronic Intestinal Diseases
Byun, Y. J., & Eun, C. S. (2014) · Hanyang Medical Reviews · doi:10.7599/hmr.2014.34.2.66 · Cited by 4 · see citing works
Wolff, C., Straub, R. H., Hahnel, A., Randolf, A., Wildmann, J., Besedovsky, H. O., & del Rey, A. (2015) · Molecular and Cellular Endocrinology · doi:10.1016/j.mce.2015.08.005 · Cited by 3 · see citing works
Self-citationFilip, P., Vojtíšek, Ľ., Jičínská, A. M., Valenta, Z., Horák, O., Hrunka, M., Mangia, S., Michaeli, S., & Jabandžiev, P. (2024) · Frontiers in Neuroscience · doi:10.3389/fnins.2024.1491770 · Cited by 4 · see citing works
NPY and Immune Functions: Implications for Health and Disease
Bedoui, S., Pabst, R., & von Hörsten, S. (2004) · Handbook of experimental pharmacology · doi:10.1007/978-3-642-18764-3_14 · Cited by 3 · see citing works
Chapter 27 Modulation of Hormone Axes by Anti-TNF Therapy
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Self-citationMon cerveau et mon intestin communiquent, parfois mal !
Bonaz, B. L., & Sonia Pellissier, A. (2013) · Pratique Neurologique - FMC · doi:10.1016/j.praneu.2013.10.004 · Cited by 2 · see citing works
Neuroendocrinology of Inflammatory Disorders
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Warum gibt es analoge Krankheitsmechanismen bei chronisch entzündlichen Krankheiten?
Straub, R. H., Besedovsky, H. O., & del Rey, A. (2007) · Wiener klinische Wochenschrift · doi:10.1007/s00508-007-0834-z · Cited by 2 · see citing works
Self-citationAn unusual finding in a patient with iron deficiency anaemia
Leyden, J. E., O’Shea, C., Hegarty, S., & MacMathúna, P. (2005) · Gut · doi:10.1136/gut.2005.067082 · Cited by 1 · see citing works
Factors associated with the development of dynapenia in patients with ulcerative colitis
Равильевна, Б. Г., Livzan, M. A., Сергеевна, Л. Н., Евгеньевна, Р. А., & Бондаренко, А. А. (2025) · Bulletin of Siberian Medicine · doi:10.20538/1682-0363-2025-1-6-13 · Cited by 1 · see citing works
Han, Y., Sun, L., Liu, Y., Zhang, X., Liu, H., Zhang, H., Ren, X., Wang, F. F., Fan, H., Chen, J., et al. (2026) · JCI Insight · doi:10.1172/jci.insight.190894 · Cited by 1 · see citing works
Inflammatory Mediators Affect the Autonomic Nervous System
Straub, R. H., Kees, M. G., Janele, D., Pongratz, G., Schölmerich, J., & Härle, P. (2007) · Neuroimmune biology · doi:10.1016/s1567-7443(07)00215-3 · Cited by 1 · see citing works
Self-citation„Old Friends“, Immunregulation und Stressresilienz
Langgartner, D., Lowry, C. A., & Reber, S. O. (2020) · Nervenheilkunde · doi:10.1055/a-1037-0710 · Cited by 1 · see citing works
Wasserbauer, M., Malá, Š., Štechová, K., Hlava, Š., Cernikova, P., Šťovíček, J., Drabek, J., Brož, J., Pichlerová, D., Kučerová, B., et al. (2023) · PLoS ONE · doi:10.1371/journal.pone.0294441 · Cited by 1 · see citing works
Pathogenesis and Neuroendocrine Immunology
Straub, R. H. (2015) · Elsevier eBooks · doi:10.1016/b978-0-12-803321-0.00002-1 · Cited by 1 · see citing works
Self-citationTungland, B. C. (2018) · Elsevier eBooks · doi:10.1016/b978-0-12-814649-1.00012-0 · Cited by 1 · see citing works
Straub, R. H., Schölmerich, J., & Cutolo, M. (2004) · Neuroimmune biology · doi:10.1016/s1567-7443(04)80024-3 · Cited by 1 · see citing works
Self-citationNPY, NPY receptors and DPPIV in innate immunity and autoimmune disorders
Bedoui, S., & von Hörsten, S. (2005) · Birkhäuser Basel eBooks · doi:10.1007/3-7643-7427-6_5
Psychological Stress: Something to Worry About?
Mawdsley, J. E. D., & Rampton, D. S. (2006) · Wiley eBooks · doi:10.1002/9780470750827.ch35
- Authors
- Straub, R. H., Herfarth, H., Falk, W., Andus, T., & Schölmerich, J.
- Affiliations
- University Hospital Regensburg (DE)
- Venue
- Journal of Neuroimmunology
- Publisher
- Elsevier BV
- Published
- 2002-05
- Volume
- 126
- Issue
- 1-2
- Pages
- 116-125
- ISSN
- 0165-5728 (ISSN-L)
- OpenAlex
- W2082901516
- Semantic Scholar
- d6ff2f63c6820d719fdf42dcd5f9a8dcb63589cb
- Cited by
- 115
- References
- 59
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 5 · 2023: 4 · 2022: 3 · 2021: 2 · 2020: 2 · 2019: 3 · 2018: 4 · 2017: 3 · 2016: 4 · 2015: 8 · 2014: 10 · 2013: 4 · 2012: 6
- FWCI
- 3.58
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Neuroimmunology (publishedVersion)
- PubMed (publishedVersion)
- University of Regensburg Publication Server (University of Regensburg) (acceptedVersion)
- Funders
- Deutsche Forschungsgemeinschaft
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Keywords
- inflammatory bowel disease, Crohn's disease, ulcerative colitis, hypothalamic-pituitary-adrenal axis, neuropeptide Y, cortisol, corticosteroid therapy, prednisolone, cytokines, TNF-α, interleukin-6
- MeSH terms
- Adult, Anti-Inflammatory Agents, Female, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Male, Middle Aged, Neuropeptide Y, Pituitary-Adrenal System, Prednisolone, Sex Factors, Sympathetic Nervous System, Tumor Necrosis Factor-alpha, Inflammatory Bowel Diseases, Neuroimmunomodulation, Interleukin-6
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