American Society of Hirudotherapy

GILZ: a new link between the hypothalamic pituitary adrenal axis and rheumatoid arthritis?

Review published in Immunology and cell biology (2014)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Narrative reviewDrug DevelopmentSafety & Infection ControlEades LE et al. · Immunology and cell biology, 2014

Abstract

The hypothalamic-pituitary-adrenal (HPA) axis is an important regulator of the stress response. In healthy individuals, the HPA axis maintains an equilibrium, ensuring that endogenous glucocorticoid (GC) levels remain within the normal range. However, hypofunction of the HPA axis may have a role in the development of inflammatory diseases, such as rheumatoid arthritis (RA). Glucocorticoid-induced leucine zipper (GILZ) is an anti-inflammatory protein, the expression of which is upregulated by GC. Although GILZ mediates the anti-inflammatory effects of GC, it may not be associated with the adverse effects that are frequently caused by exogenous GC administration. This has raised interest in GILZ potentiation as a therapeutic approach in diseases such as RA, which may mimic the anti-inflammatory effects of GC without causing harmful side effects. This review will outline the involvement of the HPA axis in RA, as a prelude to highlighting emerging evidence regarding the role of GILZ in inflammation control and RA.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeJournal ArticleReview
Indexed MeSH termsAnimalsArthritis, RheumatoidGlucocorticoidsHumansHypothalamo-Hypophyseal SystemInflammationLeucine ZippersPituitary-Adrenal System

Summary

The hypothalamic-pituitary-adrenal (HPA) axis is an important regulator of the stress response.

Why This Matters for Hirudotherapy

This review explores the role of the hypothalamic-pituitary-adrenal axis and the anti-inflammatory protein Glucocorticoid-induced leucine zipper (GILZ) in rheumatoid arthritis, discussing GILZ potentiation as a strategy to mimic glucocorticoid anti-inflammatory effects without harmful side effects. The article discusses endocrine pathways, GILZ expression regulation by glucocorticoids, and GILZ as an emerging target for inflammation control in RA. The abstract makes no reference to leeches, hirudotherapy, or leech-derived molecules. Consequently, its relevance to the American Society of Hirudotherapy is entirely indirect, limited to the shared clinical context of identifying new anti-inflammatory treatment strategies.

Citation

GILZ: a new link between the hypothalamic pituitary adrenal axis and rheumatoid arthritis?

Eades LE et al. · Immunology and cell biology, 2014

DOI

Added to ASH library: May 27, 2026 · Site last updated: June 18, 2026

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