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Currently, effective interventions or preventive measures are still lacking. Notably, patients with liver disease commonly experience brief acute stress prior to surgery; however, the impact of acute stress on HIRI remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A 30\u2010min restraint stress was used to simulate acute restraint stress (ARS). Hematoxylin\u2013eosin staining and ELISA were employed to assess HIRI. Immunofluorescence staining and electrophysiology were applied to evaluate neuronal activation. Chemogenetic manipulation was utilized to verify the role of corticotropin\u2010releasing hormone (CRH) neurons in the hypothalamic paraventricular nucleus (PVN) in ARS\u2010mediated attenuation of HIRI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The results showed that ARS significantly ameliorated liver injury, reduced the liver enzyme levels (ALT and AST), and down\u2010regulated the inflammatory factors expression in HIRI mice. Furthermore, we found that ARS alleviated HIRI by activating the hypothalamic\u2013pituitary\u2013adrenal (HPA) axis to release corticosterone, rather than through the sympathetic nervous system. PVN\n                      <jats:sup>CRH<\/jats:sup>\n                      represented a critical subpopulation responding to ARS. Chemogenetic activation of PVN\n                      <jats:sup>CRH<\/jats:sup>\n                      neurons mimicked the protective effect of ARS against HIRI, whereas chemogenetic inhibition of these neurons abolished this protection.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Our findings demonstrate that PVN\n                      <jats:sup>CRH<\/jats:sup>\n                      neurons mediate the protective effect of ARS against HIRI by activating the HPA axis to release corticosterone. This work may provide key insights for developing perioperative strategies to prevent HIRI.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cns.70749","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T15:57:49Z","timestamp":1768406269000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Acute Stress Attenuates Hepatic Ischemia\u2013Reperfusion Injury via Hypothalamic CRH Neuron\u2010Induced HPA Axis Activation"],"prefix":"10.1002","volume":"32","author":[{"given":"Xiaoqi","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Renji Hospital Shanghai Jiao Tong University School of Medicine  Shanghai China"},{"name":"Key Laboratory of Anesthesiology (Shanghai Jiao Tong University) Ministry of Education  Shanghai 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