Hypothalamic–pituitary–adrenal axis Hypothalamic–pituitary–adrenal axis The hypothalamic–pituitary–adrenal axis (HPA axis or HTPA axis) is a complex set of direct influences and feedback interactions among three components: the hypothalamus, the pituitary gland (a pea-shaped structure located below the thalamus), and the adrenal (also called "suprarenal") glands (small, conical organs on top of the kidneys). These organs and their interactions constitute the HPA axis, a major neuroendocrine system that controls reactions to stress and regulates many body processes, including digestion, the immune system, mood and emotions, sexuality, and energy storage and expenditure. It is the common mechanism for interactions among glands, hormones, and parts of
Pituitary pars intermedia dysfunction by corticotropes in the pars distalis of the equine pituitary. In a normal horse, this accounts for the majority of ACTH production. ACTH produced by the pars distalis is subject to negative feedback in a normal horse, so high cortisol levels reduce ACTH production by the pituitary, subsequently reducing cortisol levels. In a horse with PPID, ACTH levels are high as a result of pars intermedia production, but it is not subject to negative feedback regulation. Despite the high levels of ACTH, cortisol levels vary, and are sometimes lower than normal. Additionally, hyperplasia of the adrenal cortex is infrequent. The