CRF mRNA in normal and stress conditions

■ REVIEW : Corticotropin-releasing Factor, Stress, and Depression

Corticotropin-releasing factor (CRF), a 41 amino acid-containing neuropeptide, acts both as a hypothalamic releasing factor, controlling ACTH and corticosteroid secretion, and at extrahypothalamic CNS sites to mod ulate mammalian organisms' responses to stress. In this article, the evidence that CRF-containing neurons within the CNS are hyperactive in patients with depression is reviewed. The evidence, taken together, suggests that during depressive episodes, CRF is hypersecreted, resulting in both pituitary-adrenal axis hyperactivity and certain of the signs and symptoms of depression, including decreased appetite, decreased libido and disturbed sleep. There is also evidence that treatments for depression, including antidepressant medications and electroconvulsive therapy, reduce CRF hypersecretion within the CNS. Finally, evidence suggests that alterations in CRF-containing neurons and receptors are responsible for the widely held ob servation that early untoward life events increase an individual's vulnerability for affective disorders. These findings have a number of implications for treatment of the mood disorders, including the suggestion that the pharmacological manipulation of CRF receptors may provide a novel avenue for the treatment of de pression. NEUROSCIENTIST 3:186-194, 1997

The interface of oxytocin-labeled cells and serotonin transporter-containing fibers in the primate hypothalamus: a substrate for SSRIs therapeutic effects?

Oxytocin (OT) is a neuropeptide synthesized in the paraventricular (PVN) and supraoptic nuclei (SON) in the hypothalamus. Although OT is more commonly known for its role in the milk-ejection reflex, in recent years research has indicated that OT participates in the expression of social behavior, memory processing, modulation of fear, and stress responses. The demonstration that OT influences affiliative behaviors, such as parental care and reproduction, and decreases anxiety has lead to speculations that it may have a role in mood disorders. Evidence from pharmacologic studies, pointing out the modulation of the OT system by serotonin, has argued in favor of OT as a mediator of serotonin reuptake inhibitors (SSRIs) antidepressant properties. In the present study, we investigated the distribution and overlap of OT-labeled cells and serotonin transporter (5-HTT) immunoreactive (IR) fibers in the Macaque hypothalamus, utilizing immunocytochemical and double-immunofluorescent techniques. Consistent with previous reports, the distribution of OT-labeled cells in the hypothalamus is confined to the PVN and SON. In these nuclei, we demonstrate that the distribution of 5-HTT-labeled fibers follows the distribution of OT-labeled cells. Overlap of OT-labeled neurons and 5-HTT-IR fibers occurs in the parvicellular, magnocellular, dorsal, and posterior subdivisions of the PVN. In the SON, 5-HTT-labeled fibers and OT-labeled cells overlap in the ventromedial subdivision and in the 'capsular' part of the dorsolateral SON. These findings provide neuroanatomic support for the idea that SSRIs' therapeutic effects on social affiliation and anxiety may be mediated in part through components of the OT system.

Corticotropin-releasing hormone and urocortin: redundant or distinctive functions?

Neuropeptides play important roles in synaptic transmission. Among them, the peptides of the corticotropin-releasing hormone (CRH) family present interesting features. The two main mammalian peptides of this family, CRH and urocortin (UCN), signal through the same receptors, CRH-R1 and CRH-R2. The question arises as to whether these peptides have redundant or distinctive functions. The fact that CRH and UCN have high affinity for both receptors has hampered the possibility to define the functional contribution of each peptide. Recent studies conducted on mice deficient in CRH, CRH-R1, CRH-R2 and CRH-R1/CRH-R2, as well as in two different UCN-deficient mice, have added relevant information towards the understanding of the role of this peptide family in the CNS. Our new anatomical evidence of UCN expression in the septum will be discussed in this context.

Involvement and role of the hypothalamo-pituitary-adrenal (HPA) stress axis in animal models of chronic pain and inflammation

Hypothalamo-pituitary-adrenal (HPA) axis changes have been reported in several disease states, including major depressive disorder, rheumatoid arthritis, multiple sclerosis and various other conditions associated with chronic pain. These observations suggest that stress and the HPA axis may play important roles in the pathology of these diseases. In order to contribute to a better understanding of the role that chronic stress may play in human pathology, this review article explores the involvement of the HPA axis in those animal models of chronic pain and inflammation that entail persistent rather than intermittent stress.

The hypothalamo-pituitary-adrenal axis response to experimental traumatic brain injury

Alterations in the hypothalamo-pituitary-adrenal (HPA) axis following traumatic brain injury have not been documented in detail. We used fluid percussion injury (FPI) to evaluate the early changes in components of the HPA axis following experimental traumatic brain injury. Wistar rats were sacrificed at 2 or 4 h following sham or FPI surgery. In situ hybridization histochemistry was used to determine the expression of mRNAs of corticotrophin releasing hormone (CRH) and arginine vasopressin (AVP) in the hypothalamus and pro-opiomelanocortin (POMC) in the pituitary. A group of animals undergoing no surgery were used as control. Repeated blood sampling from an indwelling catheter demonstrated that plasma corticosterone (CORT) levels peaked 30 min following surgery in sham and FPI animals but there was no significant difference in CORT concentration between these groups at any time. Pituitary POMC expression was increased following sham and FPI surgery (compared with control non-operated animals) but with no significant difference between the two groups undergoing surgery. Hypothalamic CRH mRNA expression was significantly higher in animals undergoing FPI compared with sham surgery. Hypothalamic AVP mRNA expression was not significantly increased when compared with control nonoperated animals. These data indicate that the anaesthesia and/or surgery associated with FPI or sham surgery induces a generalised activation of the HPA axis. The selective increase in CRH mRNA in animals undergoing FPI may be due to specific effects of traumatic brain injury rather than a general stress response and may suggest an additional neurotransmitter role for CRH following head injury. The absence of an AVP response suggests that the effects of FPI may be mediated through the CRH-alone-containing subpopulation of neurons.

Differential and age-dependent effects of maternal deprivation on the hypothalamic-pituitary-adrenal axis of brown norway rats from youth to senescence

In this study, the hypothesis was tested that infants deprived from maternal care show persistent changes in hypothalamic-pituitary-adrenal activity. For this purpose, we studied the effect of maternal deprivation in one cohort of the healthy ageing Brown Norway rat strain showing still more than 80% survival rate at 32 months of age. Three-day-old male Brown Norway rats were either maternally deprived for 24 h or remained with the dam. In 3, 12 and 30-32 months (young, adult, senescent) deprived rats and their nondeprived littermates (controls), we determined basal resting and stress-induced plasma adrenocorticotropic hormone (ACTH) and corticosterone as well as corticotropin releasing hormone (CRH) mRNA expression in the paraventricular nucleus (PVN) of the hypothalamus. Mineralocorticoid (MR) and glucocorticoid receptors (GR) in hippocampus and PVN were also assessed using in vitro cytosol binding and in situ hybridization. The effect of ageing per se showed that in the control nondeprived Brown Norway rats, basal corticosterone and ACTH concentrations did not change during life. However, with age, the corticosterone response to novelty stress became progressively attenuated, but prolonged, while there was an age-related increase in the ACTH response. CRH mRNA expression in PVN decreased with age. Hippocampal MR binding and MR mRNA expression in the dentate gyrus were reduced at senescence, as were the GR binding capacities in hippocampus and hypothalamus. Maternal deprivation did not affect survival rate, body weight, nor adrenal weight of the ageing Brown Norway rats. Basal corticosterone and ACTH levels were not affected by deprivation, except for a rise in basal corticosterone concentrations at 3 months. At this age, the corticosterone output in response to novelty was attenuated in the deprived rats. In contrast, a striking surge in novelty stress-induced corticosterone output occurred at midlife while, at senescence, the corticosterone and ACTH responses were attenuated again in the deprived animals, particularly after the more severe restraint stressor. CRH mRNA expression was reduced only during adulthood in the deprived animals. After maternal deprivation, the MR mRNA in dentate gyrus showed a transient midlife rise. GR binding in hypothalamus and hippocampus GR binding was reduced in young rats while, in the senescent deprived animals, a reduced GRmRNA expression was observed in PVN and hippocampal CA1. In conclusion, in the Brown Norway rat, ageing causes a progressive decline in corticosterone output after stress, which is paralleled at senescence by decreased MR and GR mRNA expression in hippocampus and hypothalamus. The long-term effects of maternal deprivation become manifest differently at different ages and depend on test conditions. The deprivation effect culminates in a midlife corticosterone surge and results at senescence in a strongly reduced corticosterone output.

Hypothalamo-pituitary-adrenal axis responses to lipopolysaccharide in male and female rats with adjuvant-induced arthritis

We have previously demonstrated that rats with adjuvant-induced arthritis (AA) are unable to mount a hypothalamo-pituitary-adrenal (HPA) axis response to either psychological or physical stress. In the present study we have taken male and female rats with AA and injected these with lipopolysaccharide (LPS) as an acute immune challenge and assessed the effects of this challenge at all levels of the HPA axis. We have demonstrated that, in contrast to acute stress, there is an activation of the HPA axis in male AA rats in response to acute immune challenge which occurs at all levels of the HPA axis. The hypothalamic and pituitary response to LPS is intact in the female AA rat. However, there appears to be an impaired adrenal responsiveness in the AA female given LPS. The non-AA female is able to respond to LPS suggesting that this defect is not inherent but is a reaction to the development of inflammation. This hyporesponsiveness has major implications for the ability of the organism to survive infections or immune challenges which are potentially life threatening in the absence of release of anti-inflammatory glucocorticoids from the adrenal cortex. The implications of these changes in the female on the subsequent development of the disease and the mechanisms mediating these effects may provide a better understanding of the gender differences underlying susceptibility to autoimmune diseases.

Differential effects of psychological and immunological challenge on the hypothalamo-pituitary-adrenal axis function in adjuvant-induced arthritis

Inability to mount a suitable glucocorticoid response to a stressor can be life-threatening. Rats with hind-paw inflammation, associated with the development of adjuvant-induced arthritis (AA), are unable to mount a hypothalamo-pituitary-adrenal (HPA) axis response to acute stress. In the present study we have compared the effects of acute psychological stress (noise) and acute immunological challenge (lipopolysaccharide [LPS] injection), on the activation of the HPA axis in rats with the chronic inflammatory stress of AA. We conclude that the increase in HPA axis activity in AA is principally due to an increase in corticosterone pulse frequency and not to any alteration in pulse magnitude. The lack of response to acute stress can be accounted for by the increase in pulse frequency and the associated refractory period following each pulse, producing dramatic but specific changes in basal HPA function. These changes may account for the loss of responsiveness to acute stress, but not to acute immunological challenge, because the HPA axis is able to respond to LPS in male rats with AA. However, there appears to be an impaired adrenal responsiveness in female rats with AA that is not inherent, but occurs as a consequence of the development of inflammation.

Early vs. late maternal deprivation differentially alters the endocrine and hypothalamic responses to stress

Twenty-four hours of maternal deprivation results in persistent changes in the ACTH response to mild stress. These effects are dependent on the age of the neonate at the time of deprivation. Pups that were separated from the dam at postnatal days (pnd) 3-4 showed an enhanced stress-induced ACTH response at age 20, while pups deprived at pnd 11-12 displayed an attenuated ACTH response to stress at that time. The present study was designed to test the hypothesis that the immediate effects of deprivation at pnd 3 vs. pnd 11 would provide an explanation for these paradoxical effects observed at day 20. For this purpose, we measured the basal and the stress-induced ACTH and corticosterone (CORT) response at days 4 and 12, following 24 h of maternal deprivation. Furthermore, we examined whether similar differences in c-fos and CRH mRNA expression in the paraventricular nucleus (PVN) accompanied the differences in response characteristics of ACTH at pnd 20. The results indicate that changes in the ACTH and CORT responses were minimal after 24 h of maternal deprivation at day 4, whereas these hormones were markedly elevated following deprivation at day 12. The persistent effects also showed age-dependency: pups deprived early showed at pnd 20 an exaggerated ACTH response. Late deprived juveniles exhibited an attenuated ACTH response to stress at pnd 20 while in both conditions the CORT response was not different from the non-deprived litter mates. These persistent endocrine changes were accompanied by the changes in the neural stress markers. The expressions of c-fos and CRH mRNA in the PVN were at pnd 20 significantly greater in their controls in early-deprived animals. The late deprived juveniles showed a reduced response in these neural markers. In conclusion, the persistent alterations in ACTH are reflected by changes in c-fos and CRH mRNA, but these changes in endocrine and in neural stress markers do not appear to be related to any of the hormonal changes that occur at the time of maternal deprivation.

Evidence for the involvement of corticotrophin-releasing hormone in the pathogenesis of traumatic brain injury

The aim of this study was to investigate the role of the neuropeptide corticotrophin-releasing hormone (CRH) in neurodegeneration induced by traumatic brain injury, using a well characterized model of lateral fluid percussion injury in male, Sprague-Dawley rats. In the first series of experiments, CRH gene expression was assessed by in situ hybridization after traumatic brain injury. A bilateral increase in CRH mRNA in the paraventricular nucleus was observed in rats subjected to traumatic brain injury compared with sham-operated controls. A maximal (40%) increase in hybridization signal was detected 2 h after trauma compared with control rat brains. In addition, marked induction of CRH transcripts was found in the ipsilateral amygdala after trauma, but no increase was detected in the ipsilateral cortex around the area of damage. In a separate experiment, the effects of the CRH antagonist, D-Phe CRH(12-41) (25 microg total dose), or appropriate vehicle injected intracerebroventricularly, was tested on infarct volume caused by brain injury. Repeated intracerebroventricular injection of D-Phe CRH(12-41) significantly reduced, by 45%, the volume of cortical damage in injured rats compared with vehicle-treated, trauma animals. The rapid upregulation of CRH gene expression in the paraventricular nucleus and amygdala following lateral fluid percussion injury and the marked neuroprotection achieved by inhibiting CRH action suggest that CRH is involved directly in the pathogenesis of traumatic brain injury. This observation may have important implications for the development of novel therapeutic strategies for treating the neurological consequences of brain trauma and related conditions.

Effects of Acute Stress or Centrally Injected Interleukin-1beta on Neuropeptide Expression in the Immune System

Acute stress stimulates the expression and release of corticotropin-releasing hormone (CRH) and arginine vasopressin (AVP) from the hypothalamus, and the pro-opiomelanocortin products beta-endorphin and ACTH from the anterior pituitary. These neuropeptides are also expressed in immune tissues, and it has been proposed that they may modulate immune responses to stress through paracrine mechanisms. We subjected rats to restraint stress or central injection of interleukin (IL)-1beta to determine whether these acute stimuli can alter the expression of neuropeptides in the spleen and thymus. Restraint stress significantly increased the contents of all these neuropeptides in thymic, but not splenic, extracts. A single icv injection of IL-1beta increased contents of CRH, AVP, ACTH and beta-endorphin in the spleens of both sham-operated and adrenalectomised (ADX) rats. IL-1beta increased thymic contents of CRH and ACTH in sham-operated rats but these increases were not observed in ADX rats. These results suggest that the effects of IL-1beta on neuropeptide expression in the spleen are independent of glucocorticoids, whereas IL-1beta stimulation of neuropeptide expression in the thymus is dependent on circulating glucocorticoids. There were significant correlations between increases in CRH, ACTH and beta-endorphin in the spleen, and between CRH and ACTH in the thymus, consistent with the suggestion that IL-1beta-induced increases in ACTH and beta-endorphin may be mediated through CRH. These results provide evidence that stressors can directly influence neuropeptide expression in immune tissues. Thus stress may influence immune functions through paracrine mechanisms involving locally synthesised neuropeptides as well as through activation of the hypothalamo-pituitary-adrenal axis.

The hypothalamic-pituitary-adrenal axis in autoimmunity

We have characterized the activation of the HPA axis in the chronic inflammatory stress model of adjuvant-induced arthritis. Alteration in the hypothalamic control mechanism, where CRF is no longer the major corticotrophin-releasing factor, has been noted in a number of other immune-mediated disease models, including experimental allergic encephalomyelitis, eosinophilia myalgia syndrome, systemic lupus erythematosus, and leishmaniasis. These changes occur in both the mouse and the rat, suggesting this may be a common mechanism to chronic immune activation. We have good evidence to suggest that AVP takes over as the major stimulator of the axis. The arthritic rat is unable to mount a response to acute stressors, such as restraint or ip hypertonic saline. However, these animals are able to mount a response to an acute immune challenge. These data provide further evidence for a differential activation of the HPA by acute stress or acute immune stimulation. This presumably reflects an adaptive response to the development of chronic inflammation. We have demonstrated that central neurotransmitter systems are able to influence the severity of peripheral inflammation. In particular we have shown that depletion of serotonin at the time of the development of the inflammatory episode reduces the severity of the inflammation. These findings suggest the possibility of novel therapeutic strategies targeting neurotransmitter systems to alleviate inflammation.

The protective role of the hypothalamic-pituitary-adrenal axis against lethality produced by immune, infectious, and inflammatory stress

We have shown that ADX and HYPOX rats exhibit a markedly increased sensitivity to the lethal effects of IL-1-beta and LPS compared to sham controls with an intact HPAA. These results indicated that the reports of lethal effects of cytokines and LPS which generates cytokines in mice with a compromised HPAA were not idiosyncratic or specific to mice but represented a general response that would have been expected in any organism with a compromised HPAA. We further demonstrated that protection against lethal effects due to IL-1-beta or LPS could be produced by treating ADX rats with glucocorticoid in a quantity estimated to be equivalent to corticosterone secretion provoked during stress. In contrast, we found that acutely stalk-sectioned rats with pituitaries disconnected from hypothalamic regulation did not show a markedly increased susceptibility to lethal effects of LPS as did ADX or HYPOX rats. Although a minority of stalk-sectioned rats were killed by LPS, the majority of rats were protected from lethal actions of LPS. This response suggested that an intact pituitary-adrenal axis without the normal hypothalamic control could still provide significant protection presumably due to generation of cytokines which stimulated the pituitary over several hours. The results from our lethality studies clearly underscore the importance of activating the stress axis and increasing glucocorticoid secretion to protect against potentially lethal effects of cytokines that can be induced by immune, infectious, or inflammatory stimuli. Cytokine-stimulated effects can initially result in beneficial actions to the host by promoting immune/inflammatory responses that are protective in nature and help defend against a variety of invading stimuli (infectious, immune, inflammatory, traumatic, neoplastic). Normally the HPAA responds to cytokine stimulation by ultimately increasing glucocorticoid secretion in order to counterregulate cytokine actions, modulate the host response, and protect the host from excessively catabolic effects of unregulated cytokine generation and actions. For many years, clinicians have recognized that patients with deficient glucocorticoid secretion (e.g., Addison's disease or pituitary ACTH deficiency) require increased glucocorticoid replacement during episodes of fever, infection, or inflammatory stress. However, the reasons why stress-equivalent glucocorticoid replacement were required were not entirely clear. Now, we understand that glucocorticoids are critically important for protecting the host against its own defense mechanisms so that the stimulation of cytokines can facilitate a protective response against an invading insult without also killing the host.