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CRH-ACTH-POMC-ADRENAL |
Laboratory of Molecular Endocrinology and Department of Anatomy and Physiology Centre Hospitalier de lUniversité Laval (CHUL) Research Center and Laval University Québec G1V 4G2, Canada
Address all correspondence and requests for reprints to: Serge Rivest, Ph.D., Laboratory of Molecular Endocrinology, CHUL Research Center and Laval University, 2705 Boulevard Laurier, Québec G1V 4G2, Canada. E-mail: . Serge.Rivest{at}crchul.ulaval.ca
| Introduction |
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One major question is whether GCs during fetal development play a role in programming the events that will be occurring later in life, especially in the perception and integration of a stressful situation. It has indeed been proposed that exposing the fetal brain to exogenous corticosteroids can produce irreversible effects on specific population of neurons and neuroendocrine functions, especially the HPA axis (5). In the present issue of Endocrinology, Moritz et al. (6) have revised this question in exposing ovine fetuses to a low dose of dexamethasone from d 25 to 45 gestation. They performed a series of analyses from the tissues of fetuses killed at 45 or 130 d or lambs at 2 months and found that twin fetuses had a retard in growth and altered gene expression in the hippocampus but no change in the adrenal steroidogenic gene expression. Of great interest, however, is the lack of persistent, long-term effects of prolonged treatment with dexamethasone in normal ovine fetuses. All the parameters analyzed in this study were essentially normal by 2 months after birth. Although subtle changes may take place, and these remain quite difficult to identify, the study by Moritz et al. (6) challenged the concept that fetal exposure to GCs may cause permanent changes in the central nervous and neuroendocrine systems.
The animal model, the time at which the fetal brain is exposed to steroids, and the methods selected to investigate permanent changes in the brain are obvious critical elements that most likely explain discrepancies between studies. By using chronically catheterized sheep fetuses close to term, as well as neonatal and adult sheep, Forhead et al. (7) looked at the effects of GCs on plasma leptin secretion. They found that plasma leptin increases in association with the postpartum cortisol surge, which was abolished by fetal adrenalectomy and restored by infusion of the steroid or dexamethasone. Once again, though, the effects were not permanent, but were transient; by the fifth day of infusion, plasma leptin was restored to baseline range.
These two papers published in this issue of Endocrinology provided evidence that fetal exposure to GCs may not be associated with permanent changes in the brain and with endocrine functions. More studies are clearly needed to firmly establish the direct link between fetal stress environment, brain plasticity, and permanent consequences. One must therefore be careful before reaching the conclusion that exposing fetuses to GCs will, no doubt, be associated with potential problems during postpartum life. The causes involved in the increased susceptibility to specific stressful situations (such as social stress) and uncontrolled activity of the HPA axis are numerous, but whether fetal exposure to the hormone is involved in this phenomenon still remains an open question. Are then GCs good or bad for the cerebral tissue? As mentioned at the beginning of this editorial, increased activity of the HPA axis is believed to be intimately associated with brain disorders and neurodegeneration. However, the direct evidence and exact mechanisms explaining these effects are still lacking at this point. GCs are the most powerful endogenous immunosuppressors, especially for the innate immune response and the subsequent inflammatory reaction (8). Such a system also exists in the central nervous system (9), and there is accumulating evidence that, once chronically activated, it may lead to neurodegenerative disorders (10, 11). By inhibiting the cerebral innate immune system, GCs would therefore be neuroprotective and prevent overproduction of inflammatory molecules that can be harmful for the neuronal elements. On the other hand, they may have opposite effects in changing the immune status of the organism and may make neurons more susceptible to insults. The time and duration at which the activity of the HPA axis is triggered by stressful stimuli are therefore likely to be the critical factors determining the good or bad roles of GCs in brain development, plasticity, and homeostasis.
| Footnotes |
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Received January 15, 2002.
Accepted for publication January 29, 2002.
| References |
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B activity through induction of I
B synthesis. Science 270:286290This article has been cited by other articles:
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H. Scholz The adrenal response of neonates to hypoxia Am J Physiol Regulatory Integrative Comp Physiol, January 1, 2003; 284(1): R76 - R77. [Full Text] [PDF] |
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H. Raff, J. J. Hong, M. K. Oaks, and E. P. Widmaier Adrenocortical responses to ACTH in neonatal rats: effect of hypoxia from birth on corticosterone, StAR, and PBR Am J Physiol Regulatory Integrative Comp Physiol, January 1, 2003; 284(1): R78 - R85. [Abstract] [Full Text] [PDF] |
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