Ectopic adrenocorticotropin (ACTH) and corticotropin-releasing hormone (CRH) production in the adrenal gland: basic and clinical aspects.
The hypothalamic-pituitary-adrenal (HPA) axis is integrated in the human stress system and controls the metabolism of many cell systems in the body. Therefore, hypofunction or hyperfunction of the HPA axis potentially threatens the life of the whole organism. Noncontrolled overproduction of its key regulators, CRH and ACTH, causes dysfunction of the stress system. Ectopic secretion of these compounds may be part of extraadrenal paraneoplastic syndromes caused by various benign or malignant tumors. However, ectopic ACTH and CRH may originate from the adrenal itself. A local CRH/ACTH system exists in the normal human adrenal medulla. Overproduction of CRH and ACTH has been documented in pheochromocytomas causing Cushing's syndrome. Finally, ectopic production of ACTH causing Cushing's syndrome has also been demonstrated in adrenocortical cells. This suggests a marked plasticity within the HPA axis and the neuroendocrine cell system.
Vrezas
Ilias
I
Department of Endocrinology, University Hospital of Duesseldorf, 40225 Duesseldorf, Germany. vrezas@med.uni-duesseldorf.de
Willenberg
Holger S
HS
Mansmann
Georg
G
Hiroi
Naoki
N
Fritzen
Reimar
R
Bornstein
Stefan R
SR
D000306:Adrenal Cortex Neoplasms / Q000378:metabolism; D000310:Adrenal Gland Neoplasms / Q000378:metabolism; D000311:Adrenal Glands / Q000378:metabolism*; D000313:Adrenal Medulla / Q000378:metabolism; D000324:Adrenocorticotropic Hormone / Q000096:biosynthesis*; D000818:Animals; D003346:Corticotropin-Releasing Hormone / Q000096:biosynthesis*; D003480:Cushing Syndrome / Q000378:metabolism; D006729:Hormones, Ectopic / Q000096:biosynthesis*; D006801:Humans
D006729:Hormones, Ectopic; D000324:Adrenocorticotropic Hormone; D003346:Corticotropin-Releasing Hormone