Salivary cortisol to assess the hypothalamic-pituitary-adrenal axis in healthy children under 3 years old - Authors' reply

The stress system co‐ordinates the adaptive responses of the organism to stressors of any kind. Inappropriate responsiveness may account for increased susceptibility to a variety of disorders, including asthma. Accumulated evidence from animal models suggests that exogenously applied stress enhances airway reactivity and increases allergen‐induced airway inflammation. This is in agreement with the clinical observation that stressful life events increase the risk of a new asthma attack. Activation of the hypothalamic–pituitary–adrenal (HPA) axis by specific cytokines increases the release of cortisol, which in turn feeds back and suppresses the immune reaction. Data from animal models suggest that inability to increase glucocorticoid production in response to stress is associated with increased airway inflammation with mechanical dysfunction of the lungs. Recently, a growing body of evidence shows that asthmatic subjects who are not treated with inhaled corticosteroids (ICS) are likely to have an attenuated activity and/or responsiveness of their HPA axis. In line with this concept, most asthmatic children demonstrate improved HPA axis responsiveness on conventional doses of ICS, as their airway inflammation subsides. Few patients may experience further deterioration of adrenal function, a phenomenon which may be genetically determined.

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Salivary cortisol to assess the hypothalamic-pituitary-adrenal axis in healthy children under 3 years old - Authors' reply

Abstract: Prezado Editor, O artigo de revisão em alergias alimentares (AA) de Ferreira et al. 1 trata, de forma adequada, de um tema de difícil

Cited by 2 publications

References 1 publication

Cortisol response to general anaesthesia for medical imaging in children

Cortisol response to general anaesthesia for medical imaging in children

Dysregulation of the stress response in asthmatic children

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