It is generally considered that adrenocorticotrophin (ACTH) is the only important factor controlling glucocorticoid secretion from the adrenal (suprarenal) cortex. However, there is actually a considerable body of evidence to suggest that adrenal nerves also have a role in modulating the hypothalamo-pituitary-adrenal (HPA) axis.
Most undergraduate textbooks state that the adrenal cortex, in contrast to the medulla, has no nerve supply (see references cited by Robinson, Perry, Hardy et al. 1977; Migally, 1979). Recent work, however, has demonstrated that the cortex shares with the medulla both efferent post-ganglionic adrenergic and sensory (afferent) nerve endings, some of which run in the splanchnic nerves while others travel to the gland with blood vessels (Holzwarth, Cunningham & Kleitman, 1987; Kesse, Parker & Coupland, 1988; Mohamed, Parker & Coupland, 1988). This confirms a series of anatomical observations stretching back many years (Alpert, 1931; Willard, 1938) describing an
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