Article - Correcting HPA Axis - CFS

Discussion in 'Fibromyalgia Main Forum' started by LISALOO, Jan 29, 2009.


    LISALOO New Member

    The hypothalamic-pituitary-adrenal (HPA) axis is a major system maintaining body homeostasis by regulating the neuroendocrine and sympathetic nervous systems as well modulating immune function. Recent work has shown that the complex dynamics of this system accommodate several stable steady states, one of which corresponds to the hypocortisol state observed in patients with chronic fatigue syndrome (CFS). At present these dynamics are not formally considered in the development of treatment strategies. Here we use model-based predictive control (MPC) methodology to estimate robust treatment courses for displacing the HPA axis from an abnormal hypocortisol steady state back to a healthy cortisol level. This approach was applied to a recent model of HPA axis dynamics incorporating glucocorticoid receptor kinetics. A
    candidate treatment that displays robust properties in the face of significant biological variability and measurement uncertainty requires that cortisol be further suppressed for a short period until adrenocorticotropic hormone levels exceed 30% of baseline. Treatment may then be discontinued, and the HPA axis will naturally progress to a stable attractor defined
    by normal hormone levels. Suppression of biologically available cortisol may be achieved through the use of binding proteins such as CBG and certain metabolizing enzymes, thus offering possible avenues for deployment in a clinical setting.

    Treatment strategies can therefore be designed that maximally exploit system dynamics to provide a robust response to treatment and ensure a positive outcome over a wide range of conditions. Perhaps most importantly, a treatment courseinvolving further reduction in cortisol, even transient, is quite counterintuitive and challenges the conventional strategy of
    supplementing cortisol levels, an approach based on steady-state reasoning.

    The whole article is here

    LISALOO New Member

    Author Summary

    The hypothalamic-pituitary-adrenal (HPA) axis is one of the body’s major control systems helping to regulate functions ranging from digestion to immune response to metabolism.
    Dysregulation of the HPA axis is associated with a number of neuroimmune disorders including chronicfatigue syndrome (CFS), depression, Gulf War illness (GWI), and posttraumatic stress disorder (PTSD). Objective diagnosis and targeted treatments of these disorders have
    proven challenging because they present no obvious lesion. However, the body’s various components do not work in isolation, and it is important to consider exactly
    how their interactions might be altered by disease. Using a relatively simple mathematical description of the HPA axis, we show how the complex dynamical behavior of this
    system will readily accommodate multiple stable resting states, some of which may correspond to chronic loss of function. We propose that a well-directed push given at the right moment may encourage the axis to reset under its own volition. We use model-based predictive control
    theory to compute such a push. The result is counterintuitive and challenges the conventional time-invariant approach to disease and therapy. Indeed we demonstrate that in some cases it might be possible to exploit the natural dynamics of these physiological systems to stimulate recovery.

    I know this is a little too medical and not simple to read but I thought someone might be interested
  3. Jayna

    Jayna New Member

    Since many of us feel like a 'switch flipped' when we got sick, it would be great if it turned out there was a 'switch' to flip that would help reverse the body's illness-reactions.
  4. LindaJones

    LindaJones New Member

    thanks for posting
    the more we know the more people can get help

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