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Review
. 2023 Feb:168:13-19.
doi: 10.1016/j.maturitas.2022.10.006. Epub 2022 Nov 4.

Adrenal aging and its effects on the stress response and immunosenescence

Maria I Stamou  1 , Caitlin Colling  2 , Laura E Dichtel  2
Affiliations
Review

Adrenal aging and its effects on the stress response and immunosenescence

Maria I Stamou et al. Maturitas. 2023 Feb.

Abstract

Normal aging is linked to various endocrine gland changes, including changes in the adrenal glands. Aging is linked to alterations of the hypothalamic-pituitary-adrenal (HPA) axis, including an increase in cortisol levels, a disruption of the negative cortisol feedback, and attenuation of cortisol's diurnal pattern. In addition, secretion of aldosterone and adrenal androgens [dehydroepiandrosterone (DHEA) and DHEA sulfate (DHEAS)] from the adrenal cortex decreases with aging. In this review, we describe normal adrenal function, the adrenal response to stress and immunomodulation in aging individuals as well as the effects of adrenal aging on body composition, metabolic profile, bone health and cognition.

Keywords: Adrenal aging; Adrenal glands; Immunosenescence; Stress.

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Conflict of interest statement

Declaration of competing interest Dr. Dichtel has received drug donation from Pfizer (recent), research support from Perspectum Ltd. (current) and research support/drug donation from Lumos Pharma (current), all per investigator-initiated requests. Dr. Dichtel is a Mass General Brigham Innovation Fellow hosted by Third Rock Ventures a venture capital firm. She remains full-time at MGH during the period of this educational program (anticipated 10/1/2022–9/30/2024). Dr. Dichtel's financial interests were reviewed and are managed by MGH and Mass General Brigham in accordance with their conflict of interest policies.

Figures

Figure 1:
Figure 1:
Flowchart of the review search results
Figure 2:
Figure 2:
Hypothalamic-pituitary-adrenal (HPA) axis response to stress and inflammation. As a response to stress CRH is produced at the hypothalamic level stimulating ACTH production in the pituitary, that in turn leads to increase release of cortisol from the adrenal glands. The HPA axis is also activated in response to inflammation both at the hypothalamic or the pituitary level. (Figure created in biorender.com)
Figure 3:
Figure 3:
The effect of adrenal function changes with aging on immunomodulation Elevated cortisol levels that occur with aging have been shown to alter T-cell trafficking, monocyte and T cell apoptosis and thymic involution, whereas the decrease that is seen the DHEAS levels with aging can lead to altered secretion of interleukins, including IL-2 and IL-6 (Figure created in biorender.com)
See this image and copyright information in PMC

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