Hypothalamic-Pituitary-End-Organ Axes: Hormone Function in Female Patients with Major Depressive Disorder
Yuncheng Zhu1,2 • Xiaohui Wu2 • Rubai Zhou2 • Oliver Sie3 • Zhiang Niu2 • Fang Wang4 • Yiru Fang2,5,6
1 Division of Mood Disorders, Shanghai Hongkou Mental Health Center, Shanghai 200083, China
2 Clinical Research Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
3 Shanghai Medical College, Fudan University, Shanghai 200032, China
4 Shanghai Yangpu Mental Health Center, Shanghai 200093, China
5 CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai 200031, China
6 Shanghai Key Laboratory of Psychotic Disorders, Shanghai 201108, China
Abstract
Classic hypothalamic-pituitary-end-organ feedback loops – the hypothalamic-pituitary-adrenal axis (HPAA), hypothalamic-pituitary-thyroidal axis (HPTA), and hypothalamic-pituitary-gonadal axis (HPGA) – are associated with the neuroendocrine and immune systems in major depressive disorder (MDD). Female patients with MDD present with evident neuroendocrine and immunological changes. Glucocorticoid, thyroid hormone, and reproductive steroid levels fluctuate with menstrual cycles, which might lead to glucocorticoid receptor resistance, impairment of triiodothyronine conversion, and sex hormone secretion disorders. In this review, we summarize the independent and interactive functions of these three axes in female MDD patients. The similar molecular structure of steroids implies an interrelationship between the hypothalamic-pituitary-end-organ axes and the competitive inhibitory effects at the receptor level, especially when considering the HPAA and HPGA.
Keywords
Major depressive disorder; Neurosecretory systems; Sex steroid hormones
