title: Ability of corticotropin releasing hormone to stimulate cortisol secretion independent from pituitary adrenocorticotropin.
abstract: Cortisol secretion by the adrenal cortex is thought to depend upon a preceding release of pituitary ACTH. This concept ignores a large number of observations suggesting important extrapituitary influences on adrenocortical function. The present study was designed to demonstrate the contribution of these extrapituitary mechanisms in the release of cortisol induced by human corticotropin releasing hormone (hCRH) in man. In patients with proven deficiency in pituitary ACTH the functional atrophy of the adrenals had been restored by pretreatment with long-acting ACTH. Fifty-eight hours after the second and last injection of ACTH a CRH test was performed (100 micrograms hCRH intravenously). Administration of hCRH induced a small but significant increase in plasma cortisol. Surprisingly, this rise was preceded by an increase in plasma ACTH similar to the ACTH response observed in the control group. It appeared that hCRH is able to stimulate cortisol release in the absence of pituitary ACTH, presumably by stimulating extrapituitary sources of ACTH.
authors.affiliation: Abteilung Innere Medizin I, Universität Ulm, Germany.
authors.forename: H L
authors.initials: HL
authors.lastname: Fehm
authors.forename: R
authors.initials: R
authors.lastname: Holl
authors.forename: E
authors.initials: E
authors.lastname: Späth-Schwalbe
authors.forename: J
authors.initials: J
authors.lastname: Born
authors.forename: K H
authors.initials: KH
authors.lastname: Voigt
mesh_terms: D000236:Adenoma / Q000601:surgery; D000302:Adrenal Cortex / Q000187:drug effects / Q000378:metabolism*; D000324:Adrenocorticotropic Hormone / Q000097:blood / Q000378:metabolism*; D000328:Adult; D000368:Aged; D003346:Corticotropin-Releasing Hormone / Q000494:pharmacology*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood / Q000378:metabolism*; D007018:Hypopituitarism / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000601:surgery
chemical_list: D000324:Adrenocorticotropic Hormone; D003346:Corticotropin-Releasing Hormone; D006854:Hydrocortisone