PLASMA ADRENOCORTICOTROPIC HORMONE IN NORMAL SUBJECTS AND PATIENTS WITH ENDOCRINE DISORDERS; WITH OBSERVATIONS ON THE EFFECT OF ADRENAL STEROIDS AND ADRENAL 11β-HYDROXYLASE INHIBITORS

Abstract

Plasma ACTH was determined according to a modification of Lipscomb and Nelson's method in 10 normal subjects and 17 patients with various endocrine disorders.The effect of the administration of glucocorticoids, aldosterone and adrenal 11β-hydroxylase inhibitors on plasma ACTH was also studied.1. Plasma ACTH was not detected in 5 ml of fresh plasma in 10 normal subjects, and no measurable level of plasma ACTH was found in patients with congenital adrenal hyperplasia, Cushing's syndrome and acromegaly.Plasma from 5 Addisonian patients exhibited high ACTH activity.2. The high plasma ACTH level in Addisonian patients was suppressed to undetectable levels by replacement therapy with glucocorticoids.The rapid suppressing activity of glucocorticoid was more directly demonstrated by the intravenous infusion of cortisol.The administration of d-aldosterone acetate also suppressed plasma ACTH to some extent.3.The oral administration of adrenal llβ-hydroxylase inhibitors, SU-4885 and SU-8874, caused an increase in plasma ACTH levels in 2 normal subjects, I patient with Conn's syndrome and 1 patient with Cushing's syndrome, but failed to cause any demonstrable increase in l normal subject, l patient with panhypopituitarism and l patient with Cushing's syndrome.