Stress and Uropepsin

Abstract

The changes of uropepsin levels were estimated after the method of West et al. in the administrations of adrenocorticotropic or adrenal hormone, in various kinds of stress and in insulin response test. 1) The average value of uropepsin in 24-hour urine of Addison's disease was significantly lower than that in healthy controls.2) The therapeutic minimal dosis of cortisone in Addison's disease caused only a slight increase of uropepsin excretion, while the larger amounts of cortisone induced a significant rise of uropepsin. The therapeutic dosis of cortisone administered in lymphatic leukemia caused a significant elevation of uropepsin.3) The therapeutic administration of ACTH-gel in nephrotic syndrome caused a significant elevation of uropepsin excretion with the evidences of activation of adrenal cortex, followed by the clinical improvements. Succesive administration of ACTH-gel in the secondary adrenocortical insufficiency complicated in acromegaly induced a gradual increase of uropepsin and urinary total 17-hydroxy-corticods.4) Eight hour intravenous ACTH infusion test were made with nine subjects and uropepsin changes were observed. The cases of normal adrenal response showed a significant increase of uropepsin, while the cases of insufficient response showed no significant increase.5) The levels of uropepsin were estimated with 10 cases of primary thoracoplasty, 8 cases of secondary thoracoplasty and 3 cases of laparotomy. The uropepsin levels were definitely elevated after operations in all cases of primary thoracoplasty and laparotomy, and in 6 cases of secondary thoracoplasty. In five cases of surgical operations, parallel estimations of the level of urinary total 17-hydroxycorticoids were made. The levels of urinary total 17-hydroxycorticoids were significantly elevated simultaneously or prior to the increase of uropepsin.6) In the cases under the other stressors, such as muscular exercise, trauma, exercise in Coni-Island show (rapid shaking of body and psychic tension for fear), and infection of tetanus, the uropepsin significantly increased in the course of stress.7) The changes of uropepsin levels and circulating eosinophil counts were observed after subcutaneous injection of insulin 0.15 units per kg of body weight. The cases of normal eosinopenic response showed a significant increase of uropepsin after 2 and 4 hours of insulin injection, while the cases of abnormal eosinopenic response showed a definite decrease after 4 hours of insulin injection. The saline injected controls showed no significant increase or decrease of uropepsin.8) In conclusion, the change of the excretion level of uropepsin has an intimate relationship to the adrenocortical function, which is likely representing one of clinical indexes for stress. Although the increase of adrenocortical hormone in blood may cause the elavation of uropepsin levels, it can not be always concluded that the adrenocortical function to be accentiated in the actual stress with the increase of uropepsin. These uropepsin change is applicable for a useful index in insulin response test, which may afford an available information concerning the activity of hypothalamo-pituitary adrenocortical system.