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. 2016 Nov 10;10:571. doi: 10.3389/fnhum.2016.00571

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Copyright © 2016 Loonen and Ivanova.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Relationship between the HPA axis and the immune system. The hypothalamic paraventricular nucleus (green) stimulates the production of cortisol from the adrenal gland (gray); cortisol inhibits the production of pro-inflammatory cytokines by immune cells (white and blue), by the mechanism shown in the inset. Cortisol also inhibits (−), and pro-inflammatory cytokines activate (+), the paraventricular nucleus. ACTH, adrenocorticotropic hormone; AVP, arginine vasopressin; CBG, cortisol binding globulin; CRH, corticotropin releasing hormone; GR, glucocorticoid receptor; HSP, heat shock protein; IL-1, interleukin 1; IL-6, interleukin 6; MDR pump, multidrug resistance protein (P-glycoprotein); TNFα, tumor necrosis factor alpha.