Evidence map›Paper›PMID 31249398›Full record

ReviewNature reviews. Endocrinology2019

The human stress response.

Georgina Russell, Stafford Lightman

Registry-linked trialOpen access · greenAbstract readReview
PubMed Publisher
In one paragraph

Review in Nature reviews. Endocrinology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04482738 (The Acute Response of Glucocorticoids Upon Food Intake), which is not on this map. Cited by 502 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
502citing papers in PubMed, 8 pooled it
31.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04482738 completednot on this mapstarted 2020, after this paper: background citation

The Acute Response of Glucocorticoids Upon Food Intake

TypeobservationalSponsorEleonora SeeligRan2020 to 2021Enrolled36ConditionsOverweight and ObesityArmsHigh-calorie meal
3 · Its place in the literature

Who cites it

502 citing papers in PubMed, 8 syntheses or guidelines pooled it, 923 citations in OpenAlex.

  1. Biological Markers of Burnout Severity: A Systematic Review.Stress and health : journal of the International Society for the Investigation of Stress · 2026
    Pooled it
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  7. Pollution, stress response, and obesity: A systematic review.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2025
    Pooled it
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  9. Trial
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  15. Article
  16. Energy constraint on human health.Trends in endocrinology and metabolism: TEM · 2026
    Review
  17. Review
  18. Prognostic significance of dynamic emotional distress during neoadjuvant therapy and surgery for resectable non-small cell lung cancer.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
    Article
  19. Stressed-out immune cells.Cell genomics · 2026
    Article
  20. Review

442 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors at 2 institutions in 1 country.

Georgina RussellTranslational Health Sciences, Dorothy Hodgkin Building, Bristol Medical School, University of Bristol, Bristol, UK. Georgina.russell@bristol.ac.uk.
Stafford LightmanTranslational Health Sciences, Dorothy Hodgkin Building, Bristol Medical School, University of Bristol, Bristol, UK. Stafford.Lightman@bristol.ac.uk.ORCID http://orcid.org/0000-0002-8546-9646
At Bristol · GBUniversity of Bristol · GB

Funding

Medical Research Council MR/J012548/1
6 · The paper itself

Abstract

The human stress response has evolved to maintain homeostasis under conditions of real or perceived stress. This objective is achieved through autoregulatory neural and hormonal systems in close association with central and peripheral clocks. The hypothalamic-pituitary-adrenal axis is a key regulatory pathway in the maintenance of these homeostatic processes. The end product of this pathway - cortisol - is secreted in a pulsatile pattern, with changes in pulse amplitude creating a circadian pattern. During acute stress, cortisol levels rise and pulsatility is maintained. Although the initial rise in cortisol follows a large surge in adrenocorticotropic hormone levels, if long-term inflammatory stress occurs, adrenocorticotropic hormone levels return to near basal levels while cortisol levels remain raised as a result of increased adrenal sensitivity. In chronic stress, hypothalamic activation of the pituitary changes from corticotropin-releasing hormone-dominant to arginine vasopressin-dominant, and cortisol levels remain raised due at least in part to decreased cortisol metabolism. Acute elevations in cortisol levels are beneficial to promoting survival of the fittest as part of the fight-or-flight response. However, chronic exposure to stress results in reversal of the beneficial effects, with long-term cortisol exposure becoming maladaptive, which can lead to a broad range of problems including the metabolic syndrome, obesity, cancer, mental health disorders, cardiovascular disease and increased susceptibility to infections. Neuroimmunoendocrine modulation in disease states and glucocorticoid-based therapeutics are also discussed.

Indexed as

Circadian RhythmHormone Replacement TherapyHumansHypothalamo-Hypophyseal SystemPituitary-Adrenal SystemStress, PhysiologicalStress, Psychological

Identifiers

PMID31249398
OpenAlexW2954122547

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.