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 Orexins in the regulation of the hypothalamic-pituitary-adrenal axis Spinazzi R; Andreis PG; Rossi GP; Nussdorfer GGPharmacol Rev  2006[Mar]; 58 (1): 46-57Orexin-A and orexin-B are hypothalamic peptides that act via two G  protein-coupled receptors, named orexin type 1 and type 2 receptors (OX1-Rs and  OX2-Rs). The most studied biological functions of orexins are the central control  of feeding and sleep, but in the past few years findings that orexin system  modulates the hypothalamic-pituitary-adrenal (HPA) axis, acting on both its  central and peripheral branches, have accumulated. Orexins and their receptors  are expressed in the hypothalamic paraventricular nucleus and median eminence and  orexin receptors in pituitary corticotropes, adrenal cortex, and medulla. Whereas  the effects of orexins on adrenal aldosterone secretion are doubtful, compelling  evidence indicates that these peptides enhance glucocorticoid production in rats  and humans. This effect involves a 2-fold mechanism: 1) stimulation of the  adrenocorticotropin-releasing hormone-mediated pituitary release of  adrenocorticotropin, which in turn raises adrenal glucocorticoid secretion; and  2) direct stimulation of adrenocortical cells via OX1-Rs coupled to the adenylate  cyclase-dependent cascade. The effects of orexins on catecholamine release from  adrenal medulla are unclear and probably of minor relevance, but there are  indications that orexins can stimulate in vitro secretion of human  pheochromocytoma cells via OX2-Rs coupled to the phospholipase C-dependent  cascade. Evidence is also available that orexins enhance the growth in vitro of  adrenocortical cells, mainly acting via OX2-Rs. Moreover, findings suggest that  the orexin system may favor HPA axis responses to stresses and play a role in the  pathophysiology of cortisol-secreting adrenal adenomas.|Animals[MESH]|Humans[MESH]|Hypothalamo-Hypophyseal System/*physiology/physiopathology[MESH]|Intracellular Signaling Peptides and Proteins/*physiology[MESH]|Neuropeptides/*physiology[MESH]|Orexin Receptors[MESH]|Orexins[MESH]|Pituitary-Adrenal System/*physiology/physiopathology[MESH]|Receptors, G-Protein-Coupled[MESH]|Receptors, Neuropeptide/metabolism[MESH]
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