Cytokines: regulation of the hypothalamo-pituitary-adrenocortical axis.

Many of the pro-inflammatory cytokines that are released in response to immune/inflammatory insults exert marked stimulatory influences on the hypothalamo-pituitary-adrenocortical axis. Thus, they provoke the release of glucocorticoids that, in turn, temper the ensuing immune/inflammatory response, and thereby complete a homeostatic neuroendocrine loop. The mechanisms by which cytokines cause glucocorticoid release are complex and can be affected by repeated or sustained cytokine exposure, gender and age, or counter-regulatory mechanisms.