FIGURE 1 | Stress-associated modulation of the hormone response by the central nervous system.

From the following article:

Stress-induced immune dysfunction: implications for health

Ronald Glaser and Janice K. Kiecolt-Glaser

Nature Reviews Immunology 5, 243-251 (March 2005)

doi:10.1038/nri1571

Stress-induced immune dysfunction: implications for health

Experiencing a stressful situation, as perceived by the brain, results in the stimulation of the hypothalamic–pituitary–adrenal (HPA) axis and the sympathetic–adrenal–medullary (SAM) axis. The production of adrenocorticotropic hormone by the pituitary gland results in the production of glucocorticoid hormones. The SAM axis can be activated by stimulation of the adrenal medulla to produce the catecholamines adrenaline and noradrenaline, as well as by 'hard-wiring', through sympathetic-nervous-system innervation of lymphoid organs. Leukocytes have receptors for stress hormones that are produced by the pituitary and adrenal glands and can be modulated by the binding of these hormones to their respective receptors. In addition, noradrenaline produced at nerve endings can also modulate immune-cell function by binding its receptor at the surface of cells within lymphoid organs. These interactions are bidirectional in that cytokines produced by immune cells can modulate the activity of the hypothalamus. APC, antigen-presenting cell; IL-1, interleukin-1; NK, natural killer.

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