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 response 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.
Bladon
P T
PT
Department of Pathology, Victoria Hospital, Blackpool, UK.
Rowlands
T E
TE
Whittaker
J A
JA
Oakey
R E
RE
D000328:Adult; D002097:C-Reactive Protein / Q000378:metabolism; D002352:Carrier Proteins / Q000097:blood; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007249:Inflammation / Q000097:blood*; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011485:Protein Binding; D012016:Reference Values; D012680:Sensitivity and Specificity; D012685:Sepharose / Q000031:analogs & derivatives*
D002352:Carrier Proteins; C028326:concanavalin A-sepharose; C027091:cortisol binding globulin; D002097:C-Reactive Protein; D012685:Sepharose; D006854:Hydrocortisone