Title
Does hypothalamicpituitaryadrenal axis hypofunction in chronic fatigue syndrome reflect a crash in the stress system? Does hypothalamicpituitaryadrenal axis hypofunction in chronic fatigue syndrome reflect a crash in the stress system?
Author
Faculty/Department
Faculty of Medicine and Health Sciences
Publication type
article
Publication
Edinburgh ,
Subject
Human medicine
Source (journal)
Medical hypotheses. - Edinburgh
Volume/pages
72(2009) :6 , p. 701-705
ISSN
0306-9877
ISI
000265474100022
Carrier
E
Target language
English (eng)
Full text (Publishers DOI)
Affiliation
University of Antwerp
Abstract
The etiopathogenesis of chronic fatigue syndrome (CFS) remains poorly understood. Although neuroendocrine disturbances and hypothalamicpituitaryadrenal (HPA) axis hypofunction in particular have been found in a large proportion of CFS patients, it is not clear whether these disturbances are cause or consequence of the illness. After a review of the available evidence we hypothesize that that HPA axis hypofunction in CFS, conceptualized within a system-biological perspective, primarily reflects a fundamental and persistent dysregulation of the neurobiological stress system. As a result, a disturbed balance between glucocorticoid and inflammatory signaling pathways may give rise to a pathological cytokine-induced sickness response that may be the final common pathway underlying central CFS symptoms, i.e. effort/stress intolerance and pain hypersensitivity. This comprehensive hypothesis on HPA axis hypofunction in CFS may stimulate diagnostic refinement of the illness, inform treatment approaches and suggest directions for future research, particularly focusing on the neuroendocrineimmune interface and possible links between CFS, early and recent life stress, and depression.
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