Evidence map›Paper›PMID 33295155›Full record

ReviewBrain and behavior2021

Molecular links between endocrine, nervous and immune system during chronic stress.

Roberto Zefferino, Sante Di Gioia, Massimo Conese

Open access · goldAbstract readReview
In one paragraph

Review in Brain and behavior, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 107 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
107citing papers in PubMed, 1 pooled it
7.4field-weighted citation impact, top 2% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

107 citing papers in PubMed, 1 synthesis or guideline pooled it, 183 citations in OpenAlex.

  1. Pooled it
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  11. Stress and resilience: cortisol hypo-response to acute stress in non-resilient individuals.Journal of neural transmission (Vienna, Austria : 1996) · 2026
    Article
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  16. Energy Allocation Resilience and Endocrine Integration.International journal of molecular sciences · 2026
    Review
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47 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

3 authors at 1 institution in 1 country.

Roberto ZefferinoDepartment of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.ORCID 0000-0001-9398-7139
Sante Di GioiaDepartment of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.ORCID 0000-0001-7246-5622
Massimo ConeseDepartment of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.ORCID 0000-0003-3465-6641
University of Foggia · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe stress response is different in various individuals, however, the mechanisms that could explain these distinct effects are not well known and the molecular correlates have been considered one at the time. Particular harmful conditions occur if the subject, instead to cope the stressful events, succumb to them, in this case, a cascade reaction happens that through different signaling causes a specific reaction named "sickness behaviour." The aim of this article is to review the complex relations among important molecules belonging to Central nervous system (CNS), immune system (IS), and endocrine system (ES) during the chronic stress response.

methodsAfter having verified the state of art concerning the function of cortisol, norepinephrine (NE), interleukin (IL)-1β and melatonin, we describe as they work together.

resultsWe propose a speculative hypothesis concerning the complex interplay of these signaling molecules during chronic stress, highlighting the role of IL-1β as main biomarker of this effects, indeed, during chronic stress its increment transforms this inflammatory signal into a nervous signal (NE), in turn, this uses the ES (melatonin and cortisol) to counterbalance again IL-1β. During cortisol resistance, a vicious loop occurs that increments all mediators, unbalancing IS, ES, and CNS networks. This IL-1β increase would occur above all when the individual succumbs to stressful events, showing the Sickness Behaviour Symptoms. IL-1β might, through melatonin and vice versa, determine sleep disorders too.

conclusionThe molecular links here outlined could explain how stress plays a role in etiopathogenesis of several diseases through this complex interplay.

Indexed as

Circadian RhythmMelatoninEndocrine SystemHumansHydrocortisoneImmune SystemInterleukin-1betaHydrocortisoneInterleukin-1betaMelatonincircadian rhythmcortisolinterleukin-1βmelatoninsickness behavior

Identifiers

PMID33295155
PMCPMC7882157
OpenAlexW3110755388

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.