The acute phase response to infection, inflammation, cancer, physico-chemical tissue damage and stress is associated with widespread adaptive alterations in the endocrine system. In a previous paper (1), we have reviewed the regulatory effects of cytokines on the hypothalamicpituitary–adrenal, –testicular and –ovarian axes, on pituitary growth hormone, prolactin, vasopressin and oxytocin secretion, on the renin–angiotensin–aldosterone system and on the placental hormonal system.
Major alterations of substrate mobilization, uptake and metabolism as well as tissue oxidation are results of the endocrine effects of circulating cytokines elicited by the acute phase response. Further, the long-term paracrine effects of synergistically acting proinflammatory cytokines secreted in high local concentrations in a tissue infiltrated by inflammatory cells may alter or inhibit the normal function of mesenchymal and endothelial cells and in some cases even cause cell destruction. There is increasing evidence that these effects of cytokines may contribute to the pathogenesis of immune-mediated target cell