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Glucocorticoids contribute fundamentally to the maintenance of basal and stress-related homeostasis in all higher organisms. The major roles of these steroids in physiology are amply matched by their remarkable contributions to pathology. Glucocorticoids influence about 20% of the expressed human genome, and their effects spare almost no organs or tissues. For many years we thought that the numerous actions of glucocorticoids were mediated by a single receptor molecule: the classic glucocorticoid receptor (GR) isoform alpha, a complex, multifunctional domain protein, operating as a ligand-dependent transcription factor. The GR gene, however, encodes two 3' splicing variants, GRalpha and GRbeta, from alternative use of two distinct terminal exons (9alpha and 9beta), and each variant mRNA is translated from at least eight initiation sites into multiple GRalpha and possibly GRbeta isoforms, amounting to a minimum of 16 GR monomers and 256 different homo- or heterodimers. The translational GRalpha isoforms may be produced variably in target tissues, have varying intrinsic transcriptional activities, and influence different complements of glucocorticoid-responsive genes. It is likely that expression and functional differences might also be present between the putative GRbeta translational isoforms. The presence of multiple GR monomers and dimers in different quantities with quantitatively and qualitatively different transcriptional activities suggests that the glucocorticoid signaling system is highly stochastic.
Pheochromocytomas are catecholamine-secreting tumors typically arising in about 90% of cases from adrenomedullary tissue and in about 10% of cases from extraadrenal chromaffin tissue. Those arising from extraadrenal tissue are commonly known as paragangliomas or chemodectomas, but all pheochromocytomas display similar histopathological characteristics. Paragangliomas arise mainly from chromaffin tissue adjacent to sympathetic ganglia of the neck, mediastinum, abdomen, and pelvis. Others may arise from a collection of chromaffin tissue around the origin of the inferior mesenteric artery, the organs of Zuckerkandl. Most represent sporadic tumors and only about 10% of pheochromocytomas are familial. In contrast to sporadic pheochromocytomas that are usually unicentric and unilateral, familial pheochromocytomas are often multicentric and bilateral (1). Pheochromocytomas are rare endocrine tumors, which, according to different reviews and statistics account for approx 0.05% to 0.1% of patients with any degree of sustained hypertension (2). However, this probably accounts for only 50% of persons harboring a pheochromocytoma, when it is considered that about half the patients with pheochromocytomas have only paroxysmal hypertension or are normotensive. Also, despite the low incidence of pheochromocytoma in patients with sustained hypertension, it must also be considered that the prevalence of sustained hypertension in the adult population of Western countries is between 15 and 20% (3,4).
In this video Q & A, we talk to George Chrousos about stress and its impact on chronic non-communicable disorders (NCDs) and early life development. Professor Chrousos also discusses the effects of psychological and economical stressors on health, and suggests ways in which we can learn to cope with stress.
OPINION article Front. Psychol., 20 July 2020Sec. Personality and Social Psychology Volume 11 - 2020 | https://doi.org/10.3389/fpsyg.2020.01553