title: Liquid chromatography-tandem mass spectrometry analysis of human adrenal vein corticosteroids before and after adrenocorticotropic hormone stimulation.
abstract: BACKGROUND
  Although steroid hormones produced by the adrenal gland play critical roles in human physiology, a detailed quantitative analysis of the steroid products has not been reported. The current study uses a single methodology (liquid chromatography-tandem mass spectrometry, LC-MS/MS) to quantify ten corticosteroids in adrenal vein (AV) samples pre- and post-adrenocorticotropic hormone (ACTH) stimulation.
  
  
  METHODS
  Three men and six women with a diagnosis of an adrenal aldosterone-producing adenoma (APA) were included in the study. Serum was collected from the iliac vein (IV) and the AV contralateral to the diseased adrenal. Samples were collected, before and after administration of ACTH. LC-MS/MS was then used to quantify serum concentrations of unconjugated corticosteroids and their precursors.
  
  
  RESULTS
  Prior to ACTH stimulation, the four most abundant steroids in AV were cortisol (90%), cortisone (4%), corticosterone (3%) and 11-deoxycortisol (0.8%). Post-ACTH administration, cortisol remained the major adrenal product (79%); however, corticosterone became the second most abundantly produced adrenal steroid (11%) followed by pregnenolone (2.5%) and 17α-hydroxypregnenolone (2%). ACTH significantly increased the absolute adrenal output of all ten corticosteroids measured (P < 0.05). The four largest post-ACTH increases were pregnenolone (300-fold), progesterone (199-fold), 17α-hydroxypregnenolone (187-fold) and deoxycorticosterone (82-fold).
  
  
  CONCLUSIONS
  Using LC-MS/MS, we successfully measured 10 corticosteroids in peripheral and AV serum samples under pre- and post-ACTH stimulation. This study demonstrates the primary adrenal steroid products and their response to ACTH.
authors.affiliation: Department of Physiology, Georgia Health Sciences University, Augusta, GA 30912, USA.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Juilee
authors.initials: J
authors.lastname: Rege
authors.forename: Fumitoshi
authors.initials: F
authors.lastname: Satoh
authors.forename: Ryo
authors.initials: R
authors.lastname: Morimoto
authors.forename: Michael R
authors.initials: MR
authors.lastname: Kennedy
authors.forename: Clarence N
authors.initials: CN
authors.lastname: Ahlem
authors.forename: Seijiro
authors.initials: S
authors.lastname: Honma
authors.forename: Hironobu
authors.initials: H
authors.lastname: Sasano
authors.forename: William E
authors.initials: WE
authors.lastname: Rainey
mesh_terms: D000305:Adrenal Cortex Hormones / Q000097:blood*; D000324:Adrenocorticotropic Hormone / Q000494:pharmacology*; D002853:Chromatography, Liquid / Q000379:methods*; D005260:Female; D006801:Humans; D007084:Iliac Vein / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D053719:Tandem Mass Spectrometry / Q000379:methods*
chemical_list: D000305:Adrenal Cortex Hormones; D000324:Adrenocorticotropic Hormone