Figure 1

Schematic overview of the hypothalamic-pituitary-adrenal (HPA) axis. A) Schematic overview of the hypothalamic-pituitary-adrenal (HPA) axis. Depicted is the physiological hierarchical pathway to cortisol-secretion from the zona fasciculata of the adrenal cortex including negative feed-back loop. Also shown are the most prominent effects of cortisol. B) Schematic overview of HPA axis in pathologically de-regulated CS-patients. Pathological condition may lead to CRH, ACTH, and cortisol overproduction and impaired negative feed-back loop. Also shown are most hazardous clinical side-effects of hypercortisolism and target of cortisol blockade.