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Canadian Family Physician 63(4): 278285

The HPA axis involves a neuroendocrine cascade, initiated by corticotrophin-releasing hormone (CRH) and arginine vasopressin (AVP) neurons of the hypothalamic paraventricular nucleus (PVN), which stimulate pituitary adrenocorticotrophic hormone (ACTH) release and subsequent adrenocortical synthesis and secretion of glucocorticoids