A mechanistic investigation into the emergent functional dynamics of the HPA axis

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Rhythmic or oscillating activity is everywhere in nature and is absolutely fundamental to our own physiology. Some bodily rhythms are very obvious to us, such as the beating of our heart and our daily sleep-wake cycle, but the vast majority of rhythmic processes inside the body are not so obvious. When these oscillations change in some way or become disrupted, this can have major consequences for our well-being. Examples of this include the emergence of abnormal rhythms in brain activity that can be seen in patients suffering from epilepsy or Parkinson's disease.Hormonal signalling is governed by rhythmic activity with many hormones following a daily cycle. A good example of this is the vital steroid hormone cortisol, one of the most important hormones that enables us to respond rapidly and appropriately to stressful situations. Cortisol levels are low during periods of rest (sleep) but increase early in the morning to prepare the body for daily activity. In addition to this daily rhythm, we now know that levels of cortisol are actually oscillating much more rapidly every hour or so throughout the day, with larger pulses occurring in the morning.Recent research has demonstrated that cortisol oscillations are critical for healthy bodily function as they control the activity of many important genes and ensure that the body is in an ideal state to respond to stress. Remarkably, patients undergoing hormone replacement or steroid therapy for inflammatory or malignant disease are typically still being exposed to constant levels of potent, long-acting, synthetic steroids. This pattern of delivery was developed before the importance of cortisol pulsatility became clear, and may well limit efficacy of treatment as well as contribute to the very high levels of side effects associated with the long-term use of synthetic steroids.Exposure to early-life stress or excessively large or prolonged periods of stress can substantially disrupt cortisol oscillations. This in turn has major consequences for regions of the brain that control our behaviour and also increases susceptibility to many diseases. Given that stress and stress-related illness are rapidly-increasing features of modern society, it is crucial that we gain a deeper understanding of how the body regulates the dynamic pattern of cortisol production. In my research, I am employing mathematical modelling approaches in combination with state-of-the-art experimental technologies to address a number of key questions: How are cortisol rhythms generated? What changes occur in the body that lead to the abnormal rhythms we see in disease? What consequences do these disrupted rhythms have for our physiological and mental well-being? Can abnormal rhythms be "normalised"? Providing answers to these questions will not only transform our understanding of cortisol signalling in both health and disease, but will also be important for developing novel treatment strategies in the clinic that take into account timing of hormone delivery to patients undergoing long-term steroid therapy.