Cortisol-binding Capacity Research Articles

Experimental increase in predation risk causes a cascading stress response in free-ranging snowshoe hares.

Extensive research confirms that environmental stressors like predation risk can profoundly affect animal condition and physiology. However, there is a lack of experimental research assessing the suite of physiological responses to risk that may arise under realistic field conditions, leaving a fragmented picture of risk-related physiological change and potential downstream consequences on individuals. We increased predation risk in free-ranging snowshoe hares (Lepus americanus) during two consecutive summers by simulating natural chases using a model predator and monitored hares intensively via radio-telemetry and physiological assays, including measures designed to assess changes in stress physiology and overall condition. Compared to controls, risk-augmented hares had 25.8% higher free plasma cortisol, 15.9% lower cortisol-binding capacity, a greater neutrophil:lymphocyte skew, and a 10.4% increase in glucose. Despite these changes, intra-annual changes in two distinct condition indices, were unaffected by risk exposure. We infer risk-augmented hares compensated for changes in their stress physiology through either compensatory foraging and/or metabolic changes, which allowed them to have comparable condition to controls. Although differences between controls and risk-augmented hares were consistent each year, both groups had heightened stress measures during the second summer, likely reflecting an increase in natural stressors (i.e., predators) in the environment. We show that increased predation risk in free-ranging animals can profoundly alter stress physiology and that compensatory responses may contribute to limiting effects of such changes on condition. Ultimately, our results also highlight the importance of biologically relevant experimental risk manipulations in the wild as a means of assessing physiological responses to natural stressors.

Effect of Age, Season, Body Condition, and Endocrine Status on Serum Free Cortisol Fraction and Insulin Concentration in Horses.

BackgroundIncreased free cortisol fraction is associated with insulin dysregulation (ID) in people with Metabolic Syndrome and Cushing's Disease. Free cortisol has not been investigated in equine endocrine disorders.Hypotheses(1) In healthy horses, sex, age, body condition score (BCS), and season impact free cortisol; (2) free cortisol is increased in horses with Pituitary Pars Intermedia Dysfunction (PPID) or Equine Metabolic Syndrome (EMS).AnimalsFifty‐seven healthy horses; 40 horses and ponies with PPID (n = 20) or EMS (n = 20).MethodsProspective study. Serum collected seasonally from healthy animals and archived serum from PPID and EMS animals was analyzed for insulin, total and free cortisol concentrations, and free cortisol fraction (FCF). Linear mixed models were used to determine effects of age, sex, season, and BCS on hormones in controls. Hormone measurements were compared between disease groups and age‐ and season‐matched controls with t‐tests. EMS and hyperinsulinemic PPID animals were combined in an ID (hyperinsulinemia) group.ResultsFree cortisol concentrations were increased in overweight/obese controls (0.3 ± 0.1 μg/dL) compared to lean controls (0.2 ± 0.1 μg/dL; P = .017). Mean FCF was significantly higher in animals with PPID (8.8 ± 5.8 μg/dL, P = .005) or ID (8.8 ± 10.2 μg/dL, P = .039) than controls (5.0 ± 0.9 μg/dL), but total cortisol concentrations were similar (P ≥ .350) (PPID: 4.2 ± 4.3 μg/dL; ID: 5.0 ± 4.5 μg/dL; controls: 4.6 ± 1.7 and 5.1 ± 2.1 μg/dL).Conclusions and Clinical ImportanceIncreased FCF is associated with obesity in healthy horses and with ID (hyperinsulinemia) in horses and ponies with endocrine disease. Decreased plasma cortisol‐binding capacity could be a component of these endocrine disorders in horses.

Naturally occurring mutations of human corticosteroid-binding globulin.

Corticosteroid-binding globulin (CBG) is encoded by SERPINA6. It is the major plasma binding protein of glucocorticoids and regulates plasma cortisol levels and bioavailability in humans. Several proteases target CBG and disrupt its steroid-binding properties. To date, most genetic deficiencies that alter plasma CBG levels or function have been identified in patients presenting with a variety of clinical conditions. The objective of the study was to test 32 previously uncharacterized nonsynonymous, single-nucleotide polymorphisms in SERPINA6 for their ability to alter CBG production and/or function. Human CBG mutants were produced in Chinese hamster ovary cells for ELISA, cortisol-binding activity measurements, and Western blotting as well as assays of their protease sensitivities. Eight naturally occurring CBG mutants with abnormal production and/or function were identified. Cortisol-binding affinity was markedly reduced for CBG H14Q and CBG H89Y, moderately decreased for CBG I279F, and undetectable for CBG R260L. By contrast, CBG H14R exhibited a decreased cortisol-binding capacity. Comparison of CBG levels in cell extracts and media by Western blotting revealed that CBG I48N and CBG P246Q have secretion defects. Two mutants (CBG I179V and CBG I279F) displayed reduced rates of cortisol-binding activity loss after exposure to three different proteases (neutrophil elastase, chymotrypsin, and LasB produced by Pseudomonas aeruginosa). Our data provide insight into how specific residues affect CBG secretion or function and illustrate the need to consider the various naturally occurring human CBG mutations in clinical evaluations of diseases associated with abnormalities in cortisol levels or activity.

Pseudomonas aeruginosa elastase disrupts the cortisol-binding activity of corticosteroid-binding globulin.

The serine protease inhibitor (SERPIN) family member corticosteroid-binding globulin (CBG) is the main carrier of glucocorticoids in plasma. Human CBG mediates the targeted release of cortisol at sites of inflammation through cleavage of its reactive center loop (RCL) by neutrophil elastase. The RCLs of SERPIN family members are targeted by diverse endogenous and exogenous proteases, including several bacterial proteases. We tested different bacteria for their ability to secrete proteases that disrupt CBG cortisol-binding activity, and characterized the responsible protease and site of CBG cleavage. Serum CBG integrity was assessed by Western blotting and cortisol-binding capacity assay. Effects of time, pH, temperature, and protease inhibitors were tested. Proteolytically active proteins from bacterial media were purified by fast protein liquid chromatography, and the active protease and CBG cleavage sites were identified by mass spectrometry. Among the bacteria tested, medium from Pseudomonas aeruginosa actively disrupted the cortisol-binding activity of CBG. This proteolytic activity was inhibited by zinc chelators and occurred most efficiently at pH 7 and elevated physiological temperature (ie, 41°C). Mass spectrometric analysis of a semi-purified fraction of P. aeruginosa media identified the virulence factor LasB as the responsible protease, and this was confirmed by assaying media from LasB-deficient P. aeruginosa. This metalloprotease cleaves the CBG RCL at a major site, distinct from that targeted by neutrophil elastase. Our results suggest that humoral responses to P. aeruginosa infection are influenced by this pathogen's ability to secrete a protease that promotes the release of the anti-inflammatory steroid, cortisol, from its plasma transport protein.

Two Different Corticosteroid-Binding Globulin Variants that Lack Cortisol-Binding Activity in a Greek Woman

Corticosteroid-binding globulin (CBG), encoded by SERPINA6, is the principal plasma binding protein for cortisol. Most nonsynonymous single-nucleotide polymorphisms that alter the production or function of CBG occur rarely, and their clinical significance remains obscure. Serum and DNA were obtained from a Greek woman with low morning cortisol levels and from family members. SERPINA6 exons were sequenced, and serum CBG was measured by ELISA and cortisol-binding capacity assay. Recombinant CBG variants were produced for detailed functional studies. A novel heterozygous c.1282G>C transversion in exon 5 of SERPINA6, resulting in a p.Trp393Ser (W371S) substitution, was identified in the proband, who was also heterozygous for single-nucleotide polymorphisms encoding the CBG Lyon (D367N) and CBG A224S variants. The proband had no measurable plasma cortisol-binding activity despite a CBG level of 273 nm by ELISA. She inherited CBG W371S from her mother whose plasma cortisol-binding capacity was approximately 50% lower than the CBG measurements by ELISA (314 nm). The proband's father and four children were heterozygous for CBG D367N; their CBG levels by ELISA were normal, but corresponding cortisol-binding capacity measurements were 50% lower. Pedigree analysis revealed that W371S segregates with A224 and that D367N and W371S segregate separately. Recombinant CBG D367N and CBG W371S had no measureable cortisol-binding activity. A new CBG Athens (W371S) variant that lacks cortisol-binding activity has been identified in a carrier of the cortisol-binding deficient CBG Lyon (D367N) variant. Analyses of CBG levels in this pedigree illustrate how immunoassays fail to accurately reflect cortisol-binding activity.

High Frequency ofSERPINA6Polymorphisms that Reduce Plasma Corticosteroid-Binding Globulin Activity in Chinese Subjects

Cortisol is transported by corticosteroid-binding globulin (CBG) in blood. Single nucleotide polymorphisms (SNP) in the human CBG (SERPINA6) gene that disrupt CBG production or steroid binding are considered rare. The objective of the study was to identify and determine the frequency of SNP in SERPINA6 that influence the production or cortisol-binding properties of CBG in Chinese subjects. Blood samples from 2287 anonymous Chinese workers undergoing routine health tests were screened for the SERPINA6 coding sequence polymorphisms. In a pilot study of 108 Chinese women, two nonsynonymous SNP were identified within SERPINA6 exon 2 encoding CBG A51V (n = 3) and CBG E102G (n = 1) variants. Sequence analysis of SERPINA6 exon 2 in a further 137 Chinese women revealed two other individuals with nonsynonymous SNP encoding CBGs R64Q and R64W as well as another CBG A51V carrier. The surprisingly high frequency of heterozygous CBG A51V carriers was confirmed in 1011 Chinese men (1:35) and 1031 other women (1:37). Individuals homozygous for these SNP were not identified. When expressed in Chinese hamster ovary cells, CBG A51V bound steroid normally, but its production/secretion was severely impaired; CBG E102G was produced normally, but its cortisol-binding capacity was abnormally low, whereas CBG R64Q and R64W were produced and bound cortisol normally. Defects in CBG A51V production explain why plasma CBG levels in individuals heterozygous for this variant are approximately 50% lower than normal. The high frequency of CBG A51V will allow clinical consequences of CBG deficiencies to be assessed for the first time in large patient populations.

Novel Corticosteroid-Binding Globulin Variant That Lacks Steroid Binding Activity

Abstract Background: Corticosteroid-binding globulin (CBG) is the principal carrier for glucocorticoids in the circulation and a regulator of their bioavailability. Inherited CBG deficiencies are rarely reported, and only three causative mutations in four families have been described. Patients, Methods, and Results: In a 26-yr-old female with hypotension, fatigue, and undetectable serum cortisol at presentation, we have identified a novel homozygous c.776g>t transversion in exon 3 of the CBG (SERPINA6) gene. This results in a p.Gly237Val substitution that is predicted to influence the positioning of two β-sheets that constitute part of the CBG steroid-binding site. Two siblings were also homozygous for the variant, whereas her mother and an unaffected sibling were heterozygous. No other symptomatic family members were identified apart from the proband. Individuals homozygous for the variant had serum CBG levels below the reference range when measured by RIA, but CBG was unmeasurable in cortisol-binding capacity assays. In the same individuals, we observed very low baseline and stimulated serum cortisol levels but normal free serum and salivary cortisol and plasma ACTH. In a study of ultradian cortisol pulsatility, increased pulse frequency was only observed in the proband. Conclusion: We describe a novel CBG variant that lacks steroid binding. All mutant homozygotes have very low serum cortisol, but normal free cortisol levels. The only biochemical feature to distinguish the symptomatic subject was increased cortisol pulsatility, and we suggest that this may influence glucocorticoid signaling and contribute to symptoms previously associated with CBG deficiency.

Novel Corticosteroid-Binding Globulin Variant That Lacks Steroid Binding Activity

Corticosteroid-binding globulin (CBG) is the principal carrier for glucocorticoids in the circulation and a regulator of their bioavailability. Inherited CBG deficiencies are rarely reported, and only three causative mutations in four families have been described. In a 26-yr-old female with hypotension, fatigue, and undetectable total serum cortisol at presentation, we have identified a novel homozygous c.776g>t transversion in exon 3 of the CBG (SERPINA6) gene. This results in a p.Gly237Val substitution that is predicted to influence the positioning of two β-sheets that constitute part of the CBG steroid-binding site. Two siblings were also homozygous for the variant, whereas her mother and an unaffected sibling were heterozygous. No other symptomatic family members were identified apart from the proband. Individuals homozygous for the variant had serum CBG levels below the reference range when measured by RIA, but CBG was unmeasurable in cortisol-binding capacity assays. In the same individuals, we observed very low baseline and stimulated total serum cortisol levels but normal free serum and salivary cortisol and plasma ACTH. In a study of ultradian cortisol pulsatility, increased pulse frequency was only observed in the proband. We describe a novel CBG variant that lacks steroid binding activity. All mutant homozygotes have very low total serum cortisol, but normal free serum cortisol levels. The only biochemical feature to distinguish the symptomatic subject was increased cortisol pulsatility, and we suggest that this may influence glucocorticoid signaling and contribute to symptoms previously associated with CBG deficiency.

Studies on cortisol substitution therapy in patients with adrenal insufficiency.

To eight patients with Addison's disease 25 mg of cortisone acetate or cortisol, respectively, was given orally. Thereafter blood samples were taken and analysed for total cortisol, "free" (not protein bound) cortisol and ACTH. Furthermore, urine cortisol excretion and the cortisol binding capacity of the plasma were determined. We found that after the substitution therapy the increase of the plasma cortisol was variable and reached its maximum after 45 to 240 minutes. However, if the resorption time was subtracted the individual differences were less pronounced and plasma cortisol levels above 8 micrograms/dl could be maintained for about six hours. When cortisol was taken instead of cortisone acetate the increase of the plasma cortisol was steeper, decreasing then more rapidly. Plasma "free" cortisol ranged from 2.75 to 6.19% in relation to total cortisol and closely paralleled the level of total cortisol in each patient during the course of the experiment. The excretion of unconjugated cortisol in urine amounted to 56.5 +/- 26 micrograms (SE) and was better correlated to the concentration of "free" cortisol than to total plasma cortisol. The behaviour of plasma ACTH levels was variable. Great fluctuations with high morning levels and good suppression was observed in patients having their substitution tablet only in one single morning dose. From these biochemical data recommendations for the substitution therapy in patients with adrenal insufficiency were given.

Predicting a low cortisol response to adrenocorticotrophic hormone in the critically ill: a retrospective cohort study

IntroductionIdentification of risk factors for diminished cortisol response to adrenocorticotrophic hormone (ACTH) in the critically ill could facilitate recognition of relative adrenal insufficiency in these patients. Therefore, we studied predictors of a low cortisol response to ACTH.MethodsA retrospective cohort study was conducted in a general intensive care unit of a university hospital over a three year period. The study included 405 critically ill patients, who underwent a 250 μg ACTH stimulation test because of prolonged hypotension or need for vasopressor/inotropic therapy. Plasma cortisol was measured before and 30 and 60 min after ACTH injection. A low adrenal response was defined as an increase in cortisol of less than 250 nmol/l or a peak cortisol level below 500 nmol/l. Various clinical variables were collected at admission and on the test day.ResultsA low ACTH response occurred in 63% of patients. Predictors, in multivariate analysis, included sepsis at admission, low platelets, low pH and bicarbonate, low albumin levels, high Sequential Organ Failure Assessment score and absence of prior cardiac surgery, and these predictors were independent of baseline cortisol and intubation with etomidate. Baseline cortisol/albumin ratios, as an index of free cortisol, were directly related and increases in cortisol/albumin were inversely related to disease severity indicators such as the Simplified Acute Physiology Score II and Sequential Organ Failure Assessment score (Spearman r = -0.21; P < 0.0001).ConclusionIn critically ill patients, low pH/bicarbonate and platelet count, greater severity of disease and organ failure are predictors of a low adrenocortical response to ACTH, independent of baseline cortisol values and cortisol binding capacity in blood. These findings may help to delineate relative adrenal insufficiency and suggest that adrenocortical suppression occurs as a result of metabolic acidosis and coagulation disturbances.

Cortisol Response to Critical Illness: Effect of Intensive Insulin Therapy

Both excessive and insufficient activation of the hypothalamic-pituitary-adrenal axis in response to critical illness is associated with increased mortality. The objective of the study was to study the effect of intensive insulin therapy, recently shown to reduce mortality and morbidity of critically ill patients, on the cortisol response to critical illness. This was a preplanned subanalysis of a large randomized, controlled study measuring serum total cortisol, cortisol-binding globulin, and albumin and calculating free cortisol levels. The study was conducted at a university hospital surgical intensive care unit. Four hundred fifty-one critically ill patients dependent on intensive care for more than 5 d and 45 control subjects matched for gender, age, height, and weight participated in this study. The intervention was strict blood glucose control to normoglycemia with insulin. Total and calculated free cortisol levels were equally elevated upon admission in both patient groups and thereafter were lower in intensive insulin-treated patients. Lower cortisol levels statistically related to the outcome benefit of intensive insulin therapy. Cortisol-binding globulin levels and structure were affected by critical illness but not insulin therapy, and neither were albumin levels. Administration of hydrocortisone in so-called replacement dose resulted in severalfold higher total and free cortisol levels, indicating that reevaluation of the doses used is warranted. Lower serum cortisol levels in critically ill patients receiving intensive insulin therapy statistically related to improved outcome with this intervention. The lower cortisol levels were not related to altered cortisol-binding capacity.

Reduced plasma cortisol binding to albumin in ocular hypertension and primary open-angle glaucoma

Purpose. To compare plasma cortisol binding as well as total plasma cortisol, free cortisol and percent free cortisol in normals, ocular hypertensives and primary high pressure open-angle glaucomas. Methods. Blood samples were obtained on outpatient visits of 18 normals, 19 ocular hypertensives and 18 primary open-angle glaucomas. Plasma cortisol binding was determined after the endogenous steroids were removed by charcoal absorption. Scatchard analysis was used to determine both the affinity of binding and the cortisol binding capacity of corti-costeroid binding globulin and albumin. Plasma total and free cortisol were measured by radioimmunoassay. Results. Both the ocular hypertensive and the open-angle glaucomas in comparison to normals were found to have a highly significant reduced cortisol binding capacity to albumin (p = 0.006) with a borderline significantly increased binding affinity to plasma corticosteroid binding globulin (p = 0.0495) and no significant difference in binding affinity to albumin or cortisol binding capacity to plasma globulin. Both the ocular hypertensives and the open-angle glaucomas in comparison to normals were found to have significantly elevated levels of free cortisol (p = 0.012) and percent free cortisol (p = 0.003). Multivariate analyses showed that the reduced cortisol binding capacity to albumin was significantly associated with an increased percent free cortisol, with ocular hypertension and open-angle glaucoma and with male gender. Conclusion. Both ocular hypertension and primary open-angle glaucoma are associated with elevated levels of plasma free cortisol which are related to a reduced cortisol binding capacity to albumin.

The presence of cortisol receptors in the human amnion

Cytosol extracts of human amnion tissue contained high affinity binding of cortisol ( K a = 2.48 ± 1.06 × 10 9 M −1; n = 30) and low capacity binding of cortisol ( N max = 279 ± 15.5 fmol mg −1 protein). Kinetic studies of cortisol binding resulted in a similar value of K a to that obtained by Scatchard analysis. Nuclear extracts of amnion tissue contained high affinity binding of cortisol ( K a = 5.8 ± 1.91 × 10 7 M −1) and low binding capacity ( N max = 91.4±21.4 fmol mg −1 protein). K a values were an order of magnitude higher in cytosol than in blood serum when amnion and blood were obtained from the same individuals. Differences in competitive ligand binding, especially dexamethasone, were observed between the amnion receptor and transcortin in serum. Gel permeation chromatography gave only one peak at 320 kDa for amnion receptor and only one peak at 48 kDa for transcortin from serum. When amnion tissue was incubated with or without cortisol, cytosol receptor activity was significantly lower in cortisol treated tissue than in control. The nuclear extracted receptor activity was significantly higher in cortisol treated tissue than control. The K a values from cortisol treated tissue were significantly lower from control. Together the data support the presence of a specific cortisol receptor in the human amnion that is different from transcortin.

3,3′,4,4′-Tetrachlorobiphenyl affects cortisol dynamics and hepatic function in rainbow trout

This study investigates the impact of 3,3′,4,4′-tetrachlorobiphenyl (TCBP), a polychlorinated biphenyl (PCB) congener and cytochrome P-450 inducer, on cortisol dynamics in rainbow trout ( Oncorhynchus mykiss). Trout were given either an intraperitoneal implant of corn oil alone or corn oil containing TCBP (5 mg kg −1 body weight) and sampled 6 weeks later. TCBP-implanted fish had significantly lower condition factor and plasma glucose concentration, whereas plasma cortisol and protein, and hepatocyte protein concentration and liver ethoxyresorufin- O-deethylase (EROD) activity was significantly higher compared with the sham group. There was no significant difference in plasma lactate and amino acid concentration, hepatocyte glycogen content or liver cytosolic cortisol binding affinity or capacity between the two groups. [ 3H]Cortisol uptake was significantly higher in hepatocytes isolated from TCBP-treated fish compared with the sham fish. Also, our preliminary results suggest that the catabolism of [ 3H]cortisol by hepatocytes of TCBP-treated fish was enhanced as noted by a decrease in cortisol-specific radioactivity and an increase in tetrahydrocortisone (a cortisol metabolite) specific radioactivity. These results support a role for TCBP in enhancing cortisol clearance by hepatocytes of trout and suggest that toxicants like PCBs may impair the ability of trout to elicit a physiological response normally associated with cortisol stimulation.

Serum cortisol binding capacity measured with concanavalin A-sepharose in patients with a recent inflammatory response

It has been suggested that elastase released from activated neutrophils degrades cortisol binding globulin. A novel assay for serum cortisol binding capacity was therefore devised and applied to assess whether such degradation was evident in patients showing a recent inflammatory response as indicated by a raised serum C-reactive protein. In 49 patients with evidence (C-reactive protein > 50 mg/l) of a recent inflammatory response, mean serum cortisol binding capacity (288 nmol/l, S.D. = 82.9) was significantly lower ( P < 0.05, t test) than in 48 patients (320 ± 75.8 nmol/l) whose responses was quiescent (C-reactive protein < 6 mg/l) or in 49 healthy controls (335 ± 72.4 nmol/l). Four patients with septic shock had markedly reduced values (167 ± 49.9 nmol/l) but low values were not restricted to this condition. It is concluded that a population experiencing a recent inflammatory response exhibits reduced serum cortisol binding capacity but a role for elastase in this process remains to be defined.

Ontogeny and ultradian rhythms of adrenocorticotropin and cortisol in the late-gestation fetal horse

Fetal maturation and the timing of parturition in both sheep and primates are thought to be controlled by the hypothalamic-pituitary-adrenal axis but little is known about the endocrinology of the equine fetus. We investigated the ontogeny of plasma concentrations of adrenocorticotropic hormone (ACTH), cortisol and corticosteroid binding capacity in the late-gestation fetal horse. We also wished to determine whether there is ultradian rhythmic release of ACTH and cortisol in fetal horses and we compared fetuses to maternal and non-pregnant adult horses. Six fetuses, 278-304 days gestation (term approximately 335), were catheterized and sampled daily until delivery. Mean (+/- S.E.M.) ACTH concentrations increased significantly from 159 +/- 21 to 246 +/- 42 pg/ml over the last 2 days before parturition. Fetal cortisol increased significantly from 3.1 +/- 1.0 to 13.4 +/- 3.7 ng/ml (mean +/- S.E.M.) over the last 9 days before delivery. The slope of regressions for ACTH and cortisol concentrations with respect to time were positive in all subjects and statistically significant in 3 of 6 for ACTH and 5 of 6 for cortisol. Fetal corticosteroid binding capacity declined from 49.5 +/- 20.5 to 16.1 +/- 2.2 ng/ml (mean +/- S.E.M.) over the last 10 days before parturition. However, the greatest changes in ACTH, cortisol and corticosteroid binding capacity occurred very late in gestation, during the last 48 to 72 h before parturition.(ABSTRACT TRUNCATED AT 250 WORDS)

Cortisol feedback regulation of pulsatile ACTH secretion in fetal sheep during late gestation.

In fetal sheep, plasma cortisol and adrenocorticotropic hormone (ACTH) concentrations increase during late gestation to surge within 72 h of birth (approximately 146 days gestation). To determine the feedback role of cortisol in control of pulsatile ACTH secretion, six chronically catheterized fetuses were treated with cortisol (1 microgram/h i.v.) for 96 h at 133 days gestation. Before (133 days), during (134 and 137 days), and after (142 days) cortisol treatment (5-min sampling for 2 h), ACTH pulses were evident in each fetus. At 134 days, ACTH pulse peak, nadir, and estimated secretory rate were significantly increased while frequency, amplitude, mean concentrations, and cortisol binding capacity (CBC) were unchanged. At 137 days, most characteristics of pulsatile ACTH secretion remained enhanced compared with pretreatment controls. At 142 days (96 h postinfusion), ACTH secretion parameters returned to pretreatment levels, but cortisol concentrations remained elevated. Cortisol infusion was then reinitiated at 142 days and, 22-24 h later, parameters of ACTH secretion increased except for amplitude, secretory rate, and CBC activity. The data indicate an absence of cortisol negative feedback regulation of pulsatile ACTH secretion. Rather, the ACTH rise that accompanied cortisol infusion suggests that cortisol exerts a positive feedforward influence on ACTH secretion in the ovine fetus near term.

Cortisol binding capacity of corticosteroid binding globulin in hyperadrenocorticoid and healthy dogs

Corticosteroid binding globulin (CBG) binding capacity and plasma cortisol concentration were determined in 27 dogs with hyperadrenocorticism and in 17 healthy control dogs. Cortisol concentrations were significantly higher in hyperadrenocorticoid dogs than in controls. cbg binding capacity did not differ between the two groups. It is concluded that excessive endogenous cortisol secretion does not induce an increase in cbg binding capacity. Consequently, the determination of cbg binding capacity provides no additional information for the diagnosis of canine Cushing's syndrome.

Effects of carbamazepine on pituitary-adrenal function in healthy volunteers.

Carbamazepine (CBZ) is a widely used therapeutic agent in seizure, pain, and mood disorders. Although CBZ has been shown to inhibit hypothalamic CRH secretion in vitro, limited data suggest that systemic CBZ induces pituitary-adrenal activation. Few data are available to reconcile these effects or clarify their mechanism(s), particularly in healthy human subjects. We report here a study of basal ACTH and cortisol secretion and their responses to ovine CRH administration in nine healthy volunteers, studied both during repeated (2-3 weeks) administration of CBZ and while medication free. CBZ significantly increased mean 24-h urinary free cortisol (mean +/- SE, 197 +/- 17 vs. 137 +/- 24 nmol/day; P less than 0.02) and evening basal total plasma cortisol (113 +/- 17 vs. 83 +/- 14 nmol/L; P less than 0.05) as well as cortisol-binding globulin-binding capacity (497 +/- 36 vs. 433 +/- 28 nmol/L; P less than 0.01). Despite the CBZ-induced hypercortisolism, plasma ACTH responses to CRH during CBZ treatment remained robust, rather than being suppressed by basal hypercortisolism. In fact, during CBZ treatment, we noted a positive correlation between the increase in basal plasma cortisol and the increase in the plasma ACTH response to CRH (r = 0.65; P less than 0.05). We also observed a reduction in cortisol-binding globulin-binding capacity after CRH administration (315 +/- 25 vs. 433 +/- 28 nmol/L; P less than 0.001), which was accentuated by CBZ treatment (342 +/- 19 vs. 497 +/- 36 nmol/L; P less than 0.001; magnitude of fall, -155 +/- 22 nmol/L on CBZ vs. -118 +/- 11 nmol/L off CBZ; P less than 0.05). We conclude that CBZ increases plasma cortisol secretion in healthy volunteers independent of its effect on plasma cortisol-binding capacity. This pituitary-adrenal activation seems to reflect a pituitary, rather than a hypothalamic, effect of CBZ. Hence, despite CBZ-induced hypercortisolism, the ACTH response to CRH remained robust in direct proportion to the CBZ-induced rise in basal plasma cortisol. Thus, we propose that the increased cortisol secretion observed during CBZ treatment reflects a relative inefficacy of glucocorticoid negative feedback at the pituitary. This pituitary-driven increase in cortisol secretion combined with the expected reduction in centrally directed CRH secretion could contribute to the anticonvulsant properties of CBZ.

Seasonal changes in plasma androgens, glucocorticoids and glucocorticoid-binding proteins in the marsupial sugar glider Petaurus breviceps

An investigation spanning two breeding seasons was carried out to examine endocrine changes associated with reproduction in a wild population of the marsupial sugar glider Petaurus breviceps, a small arboreal gliding possum. Using techniques of equilibrium dialysis and polyacrylamide gel electrophoresis at steady-state conditions, a high-affinity, low-capacity glucocorticoid-binding protein was demonstrated in the plasma of Petaurus breviceps. Equilibrium dialysis at 36 degrees C using cortisol gave a high-affinity binding constant of 95 +/- 5.2 litres/mumol for a presumed corticosteroid-binding globulin (CBG) while the binding constant for the cortisol-albumin interaction was 3.5 +/- 0.4 litres/mmol. There was no difference between the sexes in the affinity of binding of cortisol to CBG; however, the cortisol-binding capacity underwent seasonal variation in both sexes. Progesterone was bound strongly to the presumed CBG while neither oestradiol nor aldosterone appeared to be bound with high affinity to P. breviceps plasma. In the males, peaks in the plasma concentration of testosterone coincided with the July-September breeding season in both years. A significant inverse relationship was shown to exist between the plasma testosterone concentration and the CBG-binding capacity. In both sexes an increase occurred in the plasma concentration of free cortisol during the first breeding season, a pattern which was not repeated in the subsequent breeding season, possibly due to a lower population density in that year.