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Hypothalamic-Pituitary-End-Organ Axes: Hormone Function in Female Patients with Major Depressive Disorder

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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.

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Acknowledgements

We thank Yueyin Pan for image processing. This review was supported by the National Key Research and Development Program of China (2016YFC1307100, 2016YFC1307105), the National Natural Science Foundation of China (81771465, 81930033), the National Key Technologies R&D Program of China (2012BAI01B04), Shanghai Key Project of Science and Technology (2018SHZDZX05), the Sanming Project of Medicine in Shenzheng (SZSM201612006), Shanghai Key Medicine Specialties Program (ZK2019A06), Shanghai Clinical Research Center for Mental Health (SCRC-MH, 19MC1911100), the Special Project for Clinical Research in Health Industry of Shanghai Municipal Health Commission (20204Y0025), the Innovative Research Team of High-level Local Universities in Shanghai, and the National Health System “Good Doctor” Construction Project of Yangpu District of Shanghai Municipality (2020–2023).

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  1. Yuncheng Zhu and Xiaohui Wu contributed equally to this work.

Authors and Affiliations

  1. Division of Mood Disorders, Shanghai Hongkou Mental Health Center, Shanghai, 200083, China

    Yuncheng Zhu

  2. Clinical Research Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China

    Yuncheng Zhu, Xiaohui Wu, Rubai Zhou, Zhiang Niu & Yiru Fang

  3. Shanghai Medical College, Fudan University, Shanghai, 200032, China

    Oliver Sie

  4. Shanghai Yangpu Mental Health Center, Shanghai, 200093, China

    Fang Wang

  5. CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai, 200031, China

    Yiru Fang

  6. Shanghai Key Laboratory of Psychotic Disorders, Shanghai, 201108, China

    Yiru Fang

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Zhu, Y., Wu, X., Zhou, R. et al. Hypothalamic-Pituitary-End-Organ Axes: Hormone Function in Female Patients with Major Depressive Disorder. Neurosci. Bull. 37, 1176–1187 (2021). https://doi.org/10.1007/s12264-021-00689-6

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