Since the introduction of corticotrophin (ACTH) into therapy in 1949 the hormone has usually been assayed by the ascorbic acid depletion method of Sayers et al. (1948), in which the fall in the concentration of ascorbic acid in the adrenals of hypophysectomized rats is a linear function of the logarithm of the dose ACTH, given intravenously. In therapy, however, corticotrophin is, as a rule, given subcutaneously or intramuscularly and only occasionally intravenously as a continuous infusion. In recent years clinical and experimental observations were made which demonstrated that the expected potency of ACTH-preparations did not always equal their clinical effect, when injected extravascularly, i. e. subcutaneously or intramuscularly. The therapeutic value of corticotrophin preparations obtained by different chemical procedures varied from 25 % to about 300 % of that expected from the determination of potency by the ascorbic acid depletion method. However, if used for continuous intravenous infusion, no variation in the clinical effect from the labelled potency greater than that within the error of the assay itself could be observed. These findings are extensively discussed by Wolfson (1953) and Fisher et al. (1953). Wolfson distinguishes three main types of corticotrophin: Crude corticotrophin (the first international corticotrophin standard La-l-A; the U. S. P. corticotrophin reference standard), which chemically is a glacial acetic acid extract of anterior pituitary of mammals. Corticotrophin A (ACTX, purified corticotrophin, high-potency corticotrophin, Type I-purified ACTH of Thompson and Fisher), which chemically is crude corticotrophin purified by adsorption on oxycellulose and subjected to little or no acid or peptic hydrolysis. Corticotrophin B (Actide corticotrophin), which is prepared by the use of acid or peptic hydrolysis or both.
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