5Thermoregulation is crucial to homeostasis, but the mechanisms of its dysfunction are still largely mysterious, including fever, which is generally the most disconcerting sign of a serious infection or disease. Theories on body temperature dynamics that aim to explain a fever, such as changes in an internal setpoint, have been proposed, but none can identify the fundamental molecular pathways that produce a fever. Moreover, 10 causative substances, pyrogens such as prostaglandin E2 (PGE2), have not been associated with receptors at the hypothalamus, which is responsible for autonomic control of temperature, and therefore no molecular path has been previously identified that can elucidate the causative reason for fever. Here, molecular pathways resultant in fever are identified for the first time. Based on recent developments made by this lab, 15 which has shown that PGE2 possesses similar binding affinity as the hormone cortisol (CORT) at the critical ligand binding domain (LBD) of glucocorticoid receptors (GR); mathematical modeling and a case study for validation is used to present that competitive inhibition of CORT by PGE2 as the fundamental reason for dysfunctional dynamics of body temperature, including fever. The model characterizing temperature 20 is in the form of a multivariable feedback controller comprised of a superposition of proportional and derivative terms of temperature, CORT, and PGE2 concentration at the hypothalamus thereby linking the cardiovascular, immune, and neural systems. The model constitutes a framework of linear equations that describes a closed-loop system of body temperature effects in response to infectious agents, triggering events, 25 * cschaper@transferdevices.com
Graphical Abstract
65Here, the newly found association of CORT and PGE2 at the LBD is used to revisit the mathematical model of fever previously derived absent chemistry, although the model predicted its characteristics. Here, material and energy relations are added for CORT and PGE2, including the hypothalamic-pituitary-adrenal (HPA) axis, and the pathways are specified and integrated into the model to analyze temperature and fever. The model 85 is verified by comparing it to the case history of the temperature response including hypothermia and hyperthermia. Thus, a basic framework is developed for thermoregulation, which is vital to homeostasis and to understanding of basic physiology.Moreover, this study on fevers can be adapted to other signs and symptoms of disease, particularly infections. As the hypothalamus is the central controller of the autonomic 90 nervous system, disruption due to the processing of cortisol via prostaglandins, will cause misprocessing of other functions besides temperature. In a similar manner, other aspects such as fatigue and even emotional dysfunction, such as depression, may be impacted by disease through the molecular pathways described in this article. Some of these issues are described in the discussion section.
2 ResultsIt is the thesis of this article that through the competit...