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The Pediatric and Reproductive Endocrinology Branch (PREB) performs biomedical research, training, and clinical activities in two large areas: pediatric and reproductive endocrinology, and metabolism. The branch places major emphasis on the physiology and pathophysiology of growth, development, metabolic, immune, and reproductive functions and on the major neurohormonal systems, the hypothalamic-pituitary-adrenal (HPA) and hypothalamic-pituitary-gonadal (HPG) axes, and the autonomic nervous system, which subserves these functions. We study the developmental and static functions of these systems in integrated in vivo systems and at the reduced cellular, subcellular, and genomic levels. Studies of these systems are performed in normal human volunteers throughout the life span and in appropriate animal models; in appropriate cell systems, we also investigate the cellular and molecular actions of key effector molecules in the neurohormonal systems, such as corticotropin-releasing hormone (CRH), arginine-vasopressin (AVP), corticotropin (ACTH), glucocorticoids, gonadotropins, estrogens, progestins, androgens, and the catecholamines.
The PREB studies patients with diseases of the HPA axis, such as pituitary tumors, Cushing syndrome, adrenal insufficiency, ACTH resistance, congenital adrenal hyperplasia (CAH), adrenocortical tumors, glucocorticoid resistance/hypersensitivity, and mineralocorticoid resistance; diseases of the HPG axis, such as hypothalamic hypogonadism, disturbances of the menstrual cycle, ovarian and testicular gonadotropin resistance, endometriosis, and infertility; diseases of the autonomic nervous system, such as pheochromocytoma and catecholamine deficiency; and developmental/psychiatric, metabolic, and immune disorders related to the functions of the HPA and HPG axes and the autonomic system, such as premature adrenarche, eating disorders (including anorexia and bulimia nervosa and adolescent obesity), adolescent conduct disorder, dysthymia and depression, childhood asthma and rheumatoid arthritis, premenstrual tension syndrome, and postpartum and climacteric depression and autoimmunity. The PREB also studies the critical influences of early life stress on the later development of behavioral (dysthymia, depression, dissociative and conduct disorders, and substance abuse) and metabolic disorders (metabolic syndrome X).