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Centre for Endocrinology, WHRI, Barts and the London Queen Mary School of Medicine and Dentistry, First Floor John Vane Science Centre, Charterhouse Square, London EC1M 6BQ, UK. j.p.hinson@qmul.ac.uk
Considering the wide range of chemicals known to disrupt adrenal function and the physiological importance of the adrenal cortex, it is surprising that endocrine disruption of the adrenal gland has not been more widely researched. The chemical nature of adrenal disruptors is highly varied, and there are features of the adrenal structure and function, which render it particularly vulnerable to toxic attack. However, the homeostatic mechanisms inherent in the hypothalamo-pituitary-adrenal axis mean that only the most catastrophic effects are recognized as adrenal disruption, such as in the case of etomidate. In order to detect potentially significant but milder forms of toxic disruption of adrenal function a new approach is needed; this requires the use of more sophisticated approaches than simply measuring one hormone at one time point. New methodologies are also needed, such as the use of human adrenal cell lines for the screening of toxins and for mechanistic investigation of adrenal disruptors. This review focuses on mechanisms of adrenal toxicity and on the challenges facing researchers in this important field.
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