title: Adrenocortical responses and family history of alcoholism.
abstract: BACKGROUND
  This study was designed to assess whether nonalcoholic offspring from families with a high density of alcohol-dependent individuals have altered hypothalamic-pituitary-adrenal (HPA) axis dynamics compared with nonalcoholic subjects without a family history of alcohol dependence.
  
  
  METHODS
  Seventy-eight nonalcoholic subjects aged 18 to 25 were enrolled in the protocol. Thirty-nine subjects were offspring from families with a high density of alcohol dependence and were designated as family history-positive (FHP) subjects. Thirty-nine subjects were biological offspring of nonalcohol-dependent parents and were designated as family history-negative (FHN) subjects. Subjects received naloxone hydrochloride (0 and 125 microg/kg) and cosyntropin (0, 0.25 microg, and 250 microg) in double-blind, randomized order and cortisol was monitored. A subset of subjects (11 FHP, 11 FHN) was admitted to the General Clinical Research Center to measure serum cortisol levels every 30 min for 24 hr.
  
  
  RESULTS
  FHP subjects had an increased cortisol response to opioid receptor blockade induced by naloxone. However, no group differences in cortisol were uncovered during administration of cosyntropin or during monitoring of the cortisol circadian profile.
  
  
  CONCLUSIONS
  These observations suggest that differences in the cortisol dynamics between FHP and FHN subjects are unmasked by opioid receptor blockade directed at the hypothalamus, but not when cortisol levels are directly provoked at the level of the adrenal gland. In addition, unprovoked cortisol secretion monitored over a 24-hr interval cannot distinguish FHP from FHN subjects.
authors.affiliation: Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA. gwand@welchlink.welch.jhu.edu
authors.forename: G S
authors.initials: GS
authors.lastname: Wand
authors.forename: D
authors.initials: D
authors.lastname: Mangold
authors.forename: M
authors.initials: M
authors.lastname: Ali
authors.forename: P
authors.initials: P
authors.lastname: Giggey
mesh_terms: D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000097:blood* / Q000235:genetics; D015415:Biomarkers / Q000097:blood; D002940:Circadian Rhythm; D003366:Cosyntropin; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007030:Hypothalamo-Hypophyseal System / Q000187:drug effects / Q000378:metabolism*; D008297:Male; D009270:Naloxone; D009292:Narcotic Antagonists; D010913:Pituitary-Adrenal System / Q000187:drug effects / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D009292:Narcotic Antagonists; D003366:Cosyntropin; D009270:Naloxone; D006854:Hydrocortisone