ArticleJournal of the Royal Society, Interface2022
Modelling the dynamic interaction of systemic inflammation and the hypothalamic-pituitary-adrenal (HPA) axis during and after cardiac surgery.
Article in Journal of the Royal Society, Interface, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 19 citations in OpenAlex.
- Effects of Liposomal Bupivacaine for Superficial Parasternial Intercostal Plane Block on Postoperative Stress and Analgesia in Patients Undergoing Median Sternotomy: A Prospective, Randomized, Double-Blind Trial.Drug design, development and therapy · 2026Trial
- Regulation of ultradian pulsatility and stress responses in the human hypothalamic-pituitary-adrenal axis.Journal of neuroendocrinology · 2026Article
- The Gut-Reproduction-Oral-Immune Axis: Microbial Dysbiosis as a Shared Driver in Polycystic Ovary Syndrome and Endometriosis.Current microbiology · 2026Review
- Comparative Effectiveness of Mind-Body Exercise Modalities on Pain Intensity and Fatigue in Patients with Non-Neuropathic Cancer-Related Pain: A Systematic Review and Network Meta-Analysis.Journal of pain research · 2026Review
- Tracking inflammation status for improving patient prognosis: A review of current methods, unmet clinical needs and opportunities.Biotechnology advances · 2025Review
- Role of gut microbiota in neuroinflammation: a focus on perioperative neurocognitive disorders.Frontiers in cellular and infection microbiology · 2025Review
- Facing stress and inflammation: From the cell to the planet.World journal of experimental medicine · 2024Review
- Decoding a Hidden Energy State Based on Marked Point Process Cortisol Secretory Events During Cardiac Surgery.2024 IEEE International Conference on E-health Networking, Application & Services (HealthCom) · 2024Article
- Electroacupuncture Ameliorates Hypothalamic‒Pituitary‒Adrenal Axis Dysfunction Induced by Surgical Trauma in Mice Through the Hypothalamic Oxytocin System.Neurochemical research · 2023Article
- Sparse Deconvolution and Causality Analysis of Inflammatory Markers During Cardiac Surgery.Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference · 2023Article
- Characterizing Alterations in Cortisol Secretion During Cardiac Surgery.Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference · 2023Article
- Acute Pancreatitis as an Unusual Culprit of Diabetic Ketoacidosis in a Nondiabetic: A Case-Based Review.Case reports in endocrinology · 2023Article
- Graves' disease as a driver of depression: a mechanistic insight.Frontiers in endocrinology · 2023Review
- Misaligned hormonal rhythmicity: Mechanisms of origin and their clinical significance.Journal of neuroendocrinology · 2022Review
- Modelling the dynamic interaction of systemic inflammation and the hypothalamic-pituitary-adrenal (HPA) axis during and after cardiac surgery.Journal of the Royal Society, Interface · 2022Article
Corrections and comments
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Authors and funding
10 authors at 4 institutions in 1 country.
Funding
Abstract
Major surgery and critical illness produce a potentially life-threatening systemic inflammatory response. The hypothalamic-pituitary-adrenal (HPA) axis is one of the key physiological systems that counterbalances this systemic inflammation through changes in adrenocorticotrophic hormone (ACTH) and cortisol. These hormones normally exhibit highly correlated ultradian pulsatility with an amplitude modulated by circadian processes. However, these dynamics are disrupted by major surgery and critical illness. In this work, we characterize the inflammatory, ACTH and cortisol responses of patients undergoing cardiac surgery and show that the HPA axis response can be classified into one of three phenotypes: single-pulse, two-pulse and multiple-pulse dynamics. We develop a mathematical model of cortisol secretion and metabolism that predicts the physiological mechanisms responsible for these different phenotypes. We show that the effects of inflammatory mediators are important only in the single-pulse pattern in which normal pulsatility is lost-suggesting that this phenotype could be indicative of the greatest inflammatory response. Investigating whether and how these phenotypes are correlated with clinical outcomes will be critical to patient prognosis and designing interventions to improve recovery.
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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.