Fig. 3.

Anatomic basis of necroinflammation in the adrenal glands. The adrenal gland blood flow is regulated in a highly controlled manner during physiological conditions and during adrenal stress, such as sepsis and the acute drop of blood pressure. Importantly, the adrenal medulla, the major production site of catecholamines that maintain blood pressure, is supplied by two different sources of areterial blood. A significant fraction of the arterial blood directly reaches the medulla without previous flowthrough of the cortical parenchymal compartment. During DAMP release from either distant organs or the cortical adrenal cells of the zona reticularis, fasciculata and glomerulosa, respectively, the adrenal medulla is the first site of contact, similar to the lungs in systemic vasculature. The adrenal gland, therefore, should be considered a major organ responsible for complications upon diseases that involve necroinflammation