Does increased cortisol relative to adrenocorticotropic hormone predict improvement during anti-tumor necrosis factor therapy in rheumatoid arthritis?
This is the first study in a human chronic inflammatory disease to demonstrate that inflammation-induced TNF interferes with HPA axis integrity, which is linked to the disease outcome. These findings position the HPA axis centrally in the vicious circle of perpetuation of chronic inflammation.
Our results suggest that danazol exerts a suppressive effect on gonadotropin secretion acting at the hypothalamic level.