Serum Adrenocorticotropic Hormone Concentrations Research Articles

Risk factors for testicular adrenal rest tumors in pediatric patients with congenital adrenal hyperplasia

Testicular adrenal rest tumors (TARTs) predominantly occur in patients with congenital adrenal hyperplasia (CAH) and may interfere with the function of the testicles. This study aimed to identify the factors that contribute to the occurrence of TARTs in patients with CAH and influence their volume. This was a comparative cross-sectional study. Male patients aged 0-16 years with CAH were included. Weight, height, bone age determination, biochemical and androgenic profiles, and testicular ultrasound were performed. Patients were divided into those with and without TARTs and the between-group differences were assessed using the Mann-Whitey U test and Fisher's exact test. A ROC curve was created for serum ACTH levels to identify the cut-off point to diagnose TARTs. Variables that influenced the volume of the TARTs were identified using Spearman's correlation coefficient. TARTs were observed in seven (19.4%) of 36 male children with CAH. Of the patients with TARTs, 85.7% were pubertal. Serum concentrations of adrenocorticotropic hormone (ACTH) levels were significantly higher in patients with TARTs than in those without (309.0pg/mL vs. 45.2pg/mL; p=0.006). ACTH levels >200pg/mL were found to predict the presence of TARTs (sensitivity 85.7%; specificity 86.2%) (Figure). The factors found to correlate with TARTs volume were ACTH levels (coefficient 0.004; p=0.009) and the three-year average of serum testosterone levels (coefficient 9.64; p=0.003).] DISCUSSION: The main limitation of this study was the small sample size. However, an ACTH cut-off point to predict insufficient hormonal treatment and consequently the presence of TART had not been described. High ACTH (>200pg/mL) was found to be predictive insufficient hormonal treatment in patients with CAH. The three-year average of serum testosterone levels and ACTH concentrations were correlated with the volume of TARTs.

Adrenocortical System Hormones in Non-Critically Ill COVID-19 Patients.

The effects of COVID-19 on the adrenocortical system and its hormones are not well known. We studied serum cortisol, serum adrenocorticotropic hormone (ACTH), and their ratio in hospitalized non-critically ill COVID-19 patients. A prospective case-control study. The study participants were divided into 2 groups. Group 1 consisted of 74 COVID-19 patients. The second group consisted of 33 healthy persons. Early admission above hormones levels was determined and compared between the study groups. Besides that, COVID-19 patients were grouped according to their Glasgow Coma Score (GCS), CURB-65 score, and intensive care unit (ICU) requirement, and further sub-analyses were performed. There were no significant differences in the mean age or gender distribution in both groups. In the patients' group, the serum ACTH concentration was lower than in the healthy group (p<0.05). On the other hand, the serum cortisol levels and cortisol/ACTH ratio of the patients' group were significantly higher than of the healthy controls (p<0.05, all). Further analyses showed that, although serum cortisol and ACTH levels were not high, the cortisol/ACTH ratio was higher in COVID-19 patients with low GCS (<15) than patients with normal GCS (=15) (p<0.05). In COVID-19 in patients with different CURB-65 scores, the cortisol/ACTH ratio was significantly different (p<0.05), while serum cortisol and ACTH were not different in groups (p>0.05). Serum cortisol levels and cortisol/ACTH ratio were higher but ACTH level was lower in the ICU needed COVID-19 patients than in patients who do not need ICU (p<0.05). Our pilot study results showed that the cortisol/ACTH ratio would be more useful than serum cortisol and/or ACTH levels alone in evaluating the adrenocortical system of COVID-19 patients. Still, further detailed studies are needed to confirm these.

Gut microbiota modulates stress-induced hypertension through the HPA axis

Stress is associated with an increased risk of hypertension, and the incidence of stress-related hypertension has risen rapidly in recent years; however, the underlying mechanisms remain elusive. Gut dysbiosis has been demonstrated to contribute to hypertension and hyperactivation of the hypothalamus-pituitary-adrenal (HPA) axis. Based on our previous findings showing the altered gut microbiota in the rats of stress-induced hypertension (SIH), the present study aims to investigate whether the stress-induced alteration in gut microbiota can lead to the dysfunction of the HPA axis which contributes to the development of SIH. SIH was developed in rats subjected to electric foot-shock combined with buzzer noise stressors. The gut microbiota of rats were deleted by administering an antibiotic cocktail containing ampicillin (1 g/L), vancomycin (500 mg/L), neomycin (1 g/L), and metronidazole (1 g/L) in drinking water. The serum levels of adrenocorticotropic hormone (ACTH) and corticosterone (CORT) were tested using enzyme-linked immunosorbent assay (ELISA). The mRNA expression of glucocorticoid receptor (GR) and corticotropin-releasing factor (CRF), CRFR1 and CRFR2 was detected by quantitative reverse transcription polymerase chain reaction (qRT-PCR). The cellular protein expressions of corticotropin-releasing hormone (CRH), c-fos, and GR were examined by immunohistochemical staining. In the present study, SIH rats showed a hyperactive HPA axis as indicated by the increased CRH expression in the paraventricular nucleus (PVN) of the hypothalamus, the elevated serum ACTH or CORT concentrations, and increased adrenal gland index. The decreased GR expression and increased CRFR1 in the hypothalamus might underlie the hyperactivation of the HPA axis. The microbial deletion by antibiotics mitigated the hyperactivation of the HPA axis and attenuated the stress-induced elevation of blood pressure, indicating that the causal link of gut microbiota to SIH is mediated, at least in part, by the HPA axis activity. Our findings shed new light on the mechanisms underlying SIH.

PO-066 The Function of t Lycium Barbarum Juice Supplemen in Exercise Stress Regulation during Increasing Resistance Training

Objective The purpose of this study was to explore the function of Lycium Barbarum juice on exercise stress regulation when male university students drank Lycium Barbarum juice during increasing resistance exercise, by observing the effects of oral Lycium Barbarum juice on the blood glucose, serum Adrenocorticotropic Hormone (ACTH), insulin and glucagon concentration.&#x0D; Methods 21 to 22, healthy, 28 male university students participated in the study. They were randomly divided into a control group (n=16)and an experimental group(n=12). All participants completed four-stage incremental load movement for a total of 32 days. The exercise intensity of four stages was 60% VO2max, 70% VO2max, 80% VO2max and 90% VO2max, respectively. Each stage was exercised every-other-day, 4 times per stage and 1 hour each time. During the exercise, each subject in the experimental group drank 100 ml of 100% Lycium Barbarum juice before going to bed every day.&#x0D; Before the experiment and the morning after the end of each phase, a participant’s elbow-venous blood was collected to separate the serum. In all serum substances, the concentrations of ACTH, insulin, glucagon were detected by ELISA system. Fasting blood glucose concentration was detected by a blood glucose meter (Kyoto GT-1640 glucose meter, Japan). SPSS 17.0 software was used for statistical analysis.&#x0D; Results 1) The serum ACTH concentration of the subjects continually increased with the progress of the incremental load exercise and reached the highest at the end of the fourth stage. Compared with the increase in the control group (P&lt;0.05), the experimental group was more significant (P&lt;0.01). 2) Compared with before the experiment, both control group and experimental group were no obvious changes of blood glucose concentration in the first and second stages, and the control group was significantly decreased in the third and fourth stages (P&lt;0.05), while the experimental group was not (P&gt;0.05). 3) During the increasing load exercise, the changes of insulin in serum of the participants were basically the same. The insulin level increased significantly at the end of the first stage and decreased successively at the end of the last three stages. At the end of the fourth stage, the serum insulin level of the control group decreased more significantly (P&lt;0.05) than the experimental group (P&gt;0.05). 4) The glucagon concentration in the control group continued to increase with the increase of the load. By contrast, the glucagon concentration in the experimental group gradually decreased at the end of the first stage and then increased at the end of the fourth stage. However, all of the increase and decrease are not statistically significant.&#x0D; Conclusions During increasing resistance exercise, drinking Lycium Barbarum juice can increase the ability of the body to regulate Adrenocorticotropic Hormone (ACTH), insulin and glucagon through the exercise stress regulation systems, the Hypothalamic-Pituitary-Adrenal Cortical Hormone system (HPA) and the Sympathetic-Adrenal Medullary system. It plays an important role in maintaining blood sugar levels during increasing resistance exercise and accelerating post-exercise function recovery after exercise.

Direct activating effects of adrenocorticotropic hormone (ACTH) on brown adipose tissue are attenuated by corticosterone.

Brown adipose tissue (BAT) and brown-like cells in white adipose tissue (WAT) can dissipate energy through thermogenesis, a process mediated by uncoupling protein 1 (UCP1). We investigated whether stress hormones ACTH and corticosterone contribute to BAT activation and browning of WAT. ACTH and corticosterone were studied in male mice exposed to 4 or 23°C for 24 h. Direct effects were studied in T37i mouse brown adipocytes and primary cultured murine BAT and inguinal WAT (iWAT) cells. In vivo effects were studied using (18)F-deoxyglucose positron emission tomography. Cold exposure doubled serum ACTH concentrations (P=0.03) and fecal corticosterone excretion (P=0.008). In T37i cells, ACTH dose-dependently increased Ucp1 mRNA (EC50=1.8 nM) but also induced Ucp1 protein content 88% (P=0.02), glycerol release 32% (P=0.03) and uncoupled respiration 40% (P=0.003). In cultured BAT and iWAT, ACTH elevated Ucp1 mRNA by 3-fold (P=0.03) and 3.7-fold (P=0.01), respectively. In T37i cells, corticosterone prevented induction of Ucp1 mRNA and Ucp1 protein by both ACTH and norepinephrine in a glucocorticoid receptor (GR)-dependent fashion. ACTH and GR antagonist RU486 independently doubled BAT (18)F-deoxyglucose uptake (P=0.0003 and P=0.004, respectively) in vivo. Our results show that ACTH activates BAT and browning of WAT while corticosterone counteracts this.

Effect of electroacupuncture on adrenocortical function under etomidate-based anesthesia

Objective To investigate the effect of electro-acupuncture on adrenocortical function under etomidate-based anesthesia in patients.Methods Eighty ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 30-64 yr,scheduled for elective abdominal surgery,were randomly divided into 4 groups (n =20 each):propofol control group (group P),etomidate group (group E),etomidate + electro-acupuncture group (group EEA),and etomidate + sham electro-acupuncture group (group ES).Anesthesia was induced with midazolam,etomidate,sufentanil and atracurium in E,EEA and ES groups,or with midazolam,propofol,sufentanil and atracurium in group P.The patients were mechanically ventilated after endotracheal intubation.Anesthesia was maintained with iv infusion of etomidate and remifentanil and intermittent iv boluses of atracurium in E,EEA and ES groups,or with iv infusion of propofol and remifentanil and intermittent iv boluses of atracurium in group P.Electro-acupuncture stimulation of Zusanli and Sanyinjiao (frequency 2 Hz /50 Hz,wave length 300 μs) was started from the time before induction of anesthesia and continued until the end of surgery in group EEA.Venous blood samples were taken before induction of anesthesia (T0),at 2 h after beginning of surgery (T1),at the end of surgery (T2) and at 2 h after surgery (T3) for determination of serum cortisol,adrenocorticotropic hormone (ACTH),epinephrine and norepinephrine concentrations.Results Compared with group P,the serum cortisol concentrations were significantly decreased at T1-3,the serum ACTH concentration was increased at T3 in groups E,EEA and ES,and the serum epinephrine levels at T1,2 and norepinephrine levels at T1-3 were decreased in group EEA (P ＜0.05).Compared with group E,the serum cortisol concentrations were significantly increased at T1-3,the serum ACTH concentration was decreased at T3,and the serum epinephrine levels at T1,2 and norepinephrine levels at T1-3 were decreased in group EEA (P ＜ 0.05),and no significant change was found in the parameters mentioned above in group ES (P ＞ 0.05).Conclusion Electro-acupuncture can mitigate etomidate-based anesthesia-induced inhibition of adrenocortical function in patients. Key words: Electroacupuncture; Etomidate; Adrenal cortex function tests

785 PITUITARY-ADRENAL AXIS IS CLOSELY ASSOCIATED WITH THE REGULATION OF ANDROGEN-RESPONSIVE KALLIKREINS DURING CONVENTIONAL ANDROGEN DEPRIVATION THERAPY

You have accessJournal of UrologyProstate Cancer: Basic Research IV1 Apr 2012785 PITUITARY-ADRENAL AXIS IS CLOSELY ASSOCIATED WITH THE REGULATION OF ANDROGEN-RESPONSIVE KALLIKREINS DURING CONVENTIONAL ANDROGEN DEPRIVATION THERAPY Noboru Hara, Tatsuhiko Hoshii, Itsuhiro Takizawa, and Tsutomu Nishiyama Noboru HaraNoboru Hara Niigata, Japan More articles by this author , Tatsuhiko HoshiiTatsuhiko Hoshii Niigata, Japan More articles by this author , Itsuhiro TakizawaItsuhiro Takizawa Niigata, Japan More articles by this author , and Tsutomu NishiyamaTsutomu Nishiyama Niigata, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.873AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Although the pituitary-adrenal axis has been associated with the progression of castration-resistant prostate cancer, their role/contribution remains unclear. This study was performed to elucidate the regulatory mechanism of adrenal androgen synthesis and influence of the pituitary-adrenal axis on adrenal androgens and androgen-responsive kallikreins (KLKs) including KLK3/PSA during conventional androgen deprivation therapy (ADT). METHODS Ninety patients with localized prostate cancer were prospectively studied based on their blood samples before and after ADT using GnRH agonists for 6 months. Serum levels of testosterone/Dihydrotestosterone (DHT), adrenal androgens, and adrenocorticotropic hormone (ACTH) were quantified with highly sensitive assays. Developing an experimental model with LNCaP, 22Rv1, VCaP, PC3, and DU145 cells, the expression levels of KLK 1 to 15 were quantified using Real-time PCR under various androgen concentrations. RESULTS Before ADT, no correlation was found between pituitary hormones and androgens or PSA levels. After ADT, the serum ACTH level was closely correlated with the serum levels of testosterone (p<0.001), dehydroepiandrosterone sulfate (DHEA-S) (p<0.001), androstenedione (p = 0.002), and PSA (p <0.001); both serum DHEA-S and androstenedione levels were also correlated with the serum PSA level (p <0.001 in both). After ADT, androgens and PSA levels decreased compared with those at the baseline (p < 0.001 in all). No difference was noted between the serum levels before and after ADT in ACTH (p = 0.232). With the experimental model using prostate cancer cells, androgen-responsive LNCaP, 22Rv1, and VCaP shared expressions of androgen-dependent KLK2, KLK3/PSA, KLK4, and KLK15, whereas androgen receptor-inactive PC3 and DU145 were deficient in these KLKs. In LNCaP, 22Rv1, and VCaP cells, the transcription of these 4 KLKs was upregulated by DHEA in a concentration-dependent manner (p<0.05 in all). CONCLUSIONS In patients treated with ADT, the pituitary-adrenal axis mediated by ACTH plays a central role in the regulation of androgen synthesis. Both serum ACTH and adrenal androgen concentrations were correlated with the post-treatment PSA level. In androgen receptor-active prostate cancer cells, transcription levels of androgen-responsive KLKs were upregulated by adrenal androgens in a concentration-dependent manner. The present study verified that androgen synthesis mediated by the pituitary-adrenal axis is a potential target for advanced ADT. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e321 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Noboru Hara Niigata, Japan More articles by this author Tatsuhiko Hoshii Niigata, Japan More articles by this author Itsuhiro Takizawa Niigata, Japan More articles by this author Tsutomu Nishiyama Niigata, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Ovarian cyst torsion in a patient with congenital lipoid adrenal hyperplasia

Congenital lipoid adrenal hyperplasia (CLAH) is the most severe form of congenital adrenal hyperplasia, characterized by lack of synthesis of all gonadal and adrenal steroid hormones. Ovarian cysts can develop as complications of CLAH. However, the precise mechanism of development and natural history of such cysts in patients with CLAH have not yet been determined. We recently treated a 14-year-old female patient with CLAH and ovarian cyst torsion. As a neonate, she presented with vomiting, skin pigmentation, and electrolyte imbalance. At that time, her serum adrenocorticotropic hormone concentration was elevated, while 17-hydroxypregnenolone level was normal, as were her normal female external genitalia. Mutation analysis showed that she was homozygous for p.Q258X in the StAR gene. She underwent spontaneous puberty and menstruation. At 14 years of age, she received salpingo-oophorectomy because of ovarian cyst torsion presenting as acute pelvic pain. Ovarian cysts are important clinical manifestations in 46,XX patients with CLAH, although onset time and severity can vary depending on individuals. Thus, patients with CLAH should be carefully monitored for ovarian complications to preserve as much ovarian function as possible.

Duration of transcranial magnetic stimulation effects on the neuroendocrine stress response and coping behavior of adult male rats

Background: Transcranial magnetic stimulation (TMS) is a relatively novel, noninvasive method of altering cerebral electrophysiological activity that produces localized and reversible changes in brain tissue. TMS has been shown to have antidepressant properties in both human trials and animal models. Additionally, TMS may alter hypothalamic–pituitary–adrenal (HPA) function resulting in a normalized dexamethasone suppression test in some depressed subjects and an attenuated stress-induced increase in adrenocorticotropic hormone (ACTH) and a possibly lowered basal corticosterone (CORT) concentration in rats. This research was undertaken to investigate the duration of these behavioral and neuroendocrine effects of TMS in rats. Methods: In this study, serum ACTH, CORT, testosterone, and luteinizing hormone (LH) concentrations following and immobility parameters during a forced-swim test in adult male rats were evaluated immediately and 1, 3, 5, 7, and 14 days subsequent to a 10-day course of once-daily TMS or sham application. Results: TMS animals had significantly higher ACTH and CORT concentrations immediately following the 10-day course of TMS compared to sham controls. Higher CORT concentrations (numerically but not statistically) were displayed by TMS-treated animals 1 and 3 days after the 10-day application course, although there were no significant differences between TMS and sham groups for ACTH or CORT levels 1, 3, 5, 7, and 14 days following application of sham or TMS. No significant differences were found between groups for serum testosterone and LH levels at any given collection time point. Immobility time, a measure of coping ability that is predictive of human antidepressant response, was significantly decreased (i.e., time spent actively swimming was significantly increased) immediately after the 10-day course of TMS. Thereafter, a nonsignificant numerical trend at 1 and 3 days after TMS application for immobility times between the TMS and control groups was observed (TMS<control values). No significant differences in immobility between TMS and control animals were found at subsequent time points. Conclusions: The present findings suggest that the HPA stress axis is significantly altered immediately following a 10-day course of TMS in that a significant increase in ACTH and CORT levels in TMS-treated animals corresponded to a significant decrease in immobility times in the forced-swim test compared to control values. Finally, based upon the obtained results, the TMS effects in rats appear to be of relatively short duration.

Effects of vitamin C and vitamin E on lipid peroxidation, blood serum metabolites, and mineral concentrations of laying hens reared at high ambient temperature.

This study was conducted to determine the effects of vitamin C (L-ascorbic acid) and vitamin E (alpha-tocopherol acetate) on serum concentrations of lipid peroxidation (MDA) and triiodothyronine (T3), thyroxine (T4), adrenocorticotropic hormone (ACTH), and some metabolite and mineral in laying hens reared at high ambient temperatures ranging from 25 degrees C to 35 degrees C. One hundred twenty laying hens (18 wk old; Hy-Line) were divided into 4 groups, 30 hens per group. The laying hens were fed either a basal diet (control) or the basal diet supplemented with either 250 mg of L-ascorbic acid/kg of diet (vitamin C), 250 mg of alpha-tocopherol acetate/kg of diet (vitamin E), or 250 mg of L-ascorbic acid plus 250 mg alpha-tocopherol acetate/kg of diet (combination). Separately or as a combination vitamins C and E increased serum vitamin C and vitamin E concentrations (p < 0.001) but decreased serum MDA concentration (p < 0.05). Serum concentrations of vitamin E and vitamin C were found highest but serum MDA concentration was lowest in the combination group. Supplemental vitamins C and E either separately or in a combination increased serum T3 and T4 concentrations (p < 0.05), whereas decreased serum ACTH concentration (p < 0.01). Serum glucose and cholesterol concentrations decreased, whereas serum protein concentration increased (p < 0.05) when vitamins C and E singly or together were added to the diet. Vitamin C and vitamin E supplementation resulted in an increase in serum concentrations of Ca, P, and K (p < 0.01) but a decrease in serum concentration of Na (p < 0.05). The results of the present study suggest that supplemental vitamin C and vitamin E alter serum lipid peroxidation, vitamin C, vitamin E and metabolite status, and diets supplemented with a combination of these two vitamins offer a good management practice in laying hens reared at high temperatures. In addition, the results suggest that dietary vitamin C and vitamin E act synergistically.

Adrenocorticotropin and growth hormone secretions after intracerebroventricular administration of neostigmine in rats: their relationships to hypothalamic monoaminergic neuronal activities

Serum adrenocorticotropic hormone (ACTH) and growth hormone (GH) concentrations were assessed simultaneously with hypothalamic neuronal activities of norepinephrine (NE), dopamine (DA), and serotonin (5-HT) 60 min after the third cerebroventricular administration of neostigmine (a cholinesterase inhibitor) in awake rats. Serum ACTH and GH concentrations were significantly increased and decreased, respectively. Neostigmine caused significant increases in hypothalamic NE and DA activities and a significant decrease in hypothalamic 5-HT activity. The reciprocal changes of serum ACTH and GH cencentrations were similar to those of hypothalamic NE and 5-HT activities. Multiple regression analyses with stepwise procedure revealed that hypothalamic NE and 5-HT activities were respectively significant determinants of serum ACTH and GH concentrations. Apart from the direct influence of neostigmine on ACTH and GH secretions, it is suggested that the changes in hypothalamic monoaminergic activities play an important role in modulating ACTH and GH secretions following the administration of neostigmine.

Effect of physical training on the responses of serum adrenocorticotropic hormone during prolonged exhausting exercise

The purpose of this study was to investigate the effects of physical training on the responses of serum adrenocorticotropic hormone (ACTH) and cortisol concentration during low-intensity prolonged exercise. Five subjects who had fasted for 12 h cycled at the same absolute intensity that elicited 50% of pre-training maximal oxygen uptake (VO2max), either until exhaustion or for up to 3 h, before and after 7 weeks of vigorous physical training [mean daily energy consumption during training exercise, 531 kcal (2230 kJ)]. In the pretraining test, serum ACTH and cortisol concentrations did not increase during the early part of the exercise. Increases in concentrations of both hormones occurred in all subjects when blood glucose concentration decreased during the later phase of the exercise. The mean values and SEM of serum ACTH and cortisol concentrations at the end of the exercise were 356 ng.l-1, SEM 79 and 438 micrograms.l-1, SEM 36, respectively. After the physical training, VO2max of the subjects improved significantly from the mean value of 50.2 ml.kg-1.min-1, SEM 2.5 to 57.3 ml.kg-1.min-1, SEM 2.0 (P less than 0.05). In the post-training test, exercise time to exhaustion was prolonged in three subjects. Comparing the pre- and post training values observed after the same length of time that the subjects had exercised in the pre-training test, the post-training values of serum ACTH (44 ng.l-1, SEM 3) and cortisol (167 micrograms.l-1, SEM 30) concentration were less than the pre-training value (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)