The hypothalamic-pituitary-adrenal axis and genetic variants affecting its reactivity

The hypothalamic-pituitary-adrenal (HPA) axis plays a primary role in the body response to stresses. Activation of the HPA axis results in the production of corticosteroid hormones that influence a wide variety of body functions, including immunity, metabolism, ion exchange, and behavior. A well-balanced regulation of stress responses is pivotal for maintaining intrabody homeostasis. The HPA axis is regulated at several levels, including stimulatory or inhibitory signals from the brain mediated through neurotransmitter systems and the suppressive feedback influence of corticosteroids themselves. Corticosteroids affect the HPA axis through binding to the glucocorticoid and mineralocorticoid receptors located in the hippocampus. Genes encoding these receptors have several polymorphic regions in which the alleles are associated with different basal and stress-induced levels of hormones secreted in the course of HPS axis stimulation. Additionally, genetic variants of neurotransmitter systems involved in the activation or suppression of the HPA axis have been found. Thus, the given genetic variations are major contributors to the HPA axis-mediated individual resistance or susceptibility to stresses.