Occurrence of allergic disease in patients with adrenal cortical hypofunction.
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The potentialities of the adrenocortical system and thymic condition after corticotropin use were studied in young children with thymic hyperplasia combined with pneumonia. The results of the hormonal status studies after zinc-corticotropin suspension load indicate the secondary adrenocortical hypofunction. Corticotropin use within 5 to 10 days in a dose of 1 E/kg body weight intramuscularly is adequate to obtain the thymic involution in thymomegaly.
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Experiments were conducted on 30 rats; a study was made of the morphometric and quantitative enzymatico-chemical changes in the glomerular zone of the adrenal cortex in stereotaxic disturbance of the subcomissural organ; there was established a marked atrophy of the glomerular zone, a significant reduction of the diameter of the nuclei of the adrenocorticocytes and depression in these structures of the enzymatic activity of the energy metabolism. Histophysiological characteristics of the glomerular zone can be assessed as its hypofunctional condition and indicates an association between the functional activity of the subcommissural organ and the production of aldosterone.
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To obtain further insight into the distribution and metabolism of exogenous D-serine, we have investigated the effect of the intraperitoneal administration of D-serine (10 mmol/kg) on the concentrations of D- and L-serine in several brain areas and periphery of infant and adult rats. The administration produced a significant augmentation of the D-serine levels not only in the cortex but also in the hippocampus, striatum, cerebellum and periphery. The rapid decline in the enhanced D-serine levels was observed in the periphery and cerebellum, whereas the injection caused a prolonged elevation of the D-serine levels in the cortex and hippocampus. The application caused a slight increase in the L-serine levels in several brain areas and periphery 3 or 6 h after the injection, whereas a significant decrease in the L-serine concentration was observed in the periphery, diencephalon and cerebellum 3 or 7 days after the injection. Because a structural abnormality and N-methyl-D-aspartate (NMDA) receptor hypofunction has been demonstrated in the cortex and hippocampus of schizophrenic subjects, D-serine treatment may offer a new therapeutic approach to diseases related to the hypofunction of NMDA receptors such as schizophrenia.
The adrenals are paired glands that lie in the retroperitoneum and have a close anatomic relation to the kidneys. Each gland has a cortex and a medulla, which act as separate entities. The adrenals are affected by various pathologic conditions, including congenital abnormalities, hypofunction, nodular enlargement, hyperplasia, and malignant and benign tumors. Newer developments in pathologic evaluation are fine-needle aspiration biopsy, immunohistochemistry, and ploidy and oncogene analysis.
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Evidence is reviewed in favour of a close relationship between the pineal hormone, melatonin and ACTH--cortisol in man. Subgroups of patients with Cushing's disease as well as with major depressive disorder have low levels of nocturnal serum melatonin. Depressed patients with an abnormal dexamethasone suppression test (DST) have lower melatonin levels than do patients with a normal DST. Low melatonin levels may be a genetic trait marker for vulnerability to depression. The mechanism may be related to increased corticotropin-releasing factor (CRF), secondary to hypofunction of a pineal factor which physiologically inhibits CRF.
The results of investigations into the changes in the function of the hypothalamus-hypophysis-renal gland system in chronic alcoholics are collated. The review shows that the activity of the hypothalamus-hypophysis-renal gland system is below-normal in at least some alcoholics, but due to conflicting results, it is not possible to decide whether the hypofunction of the adrenal gland is a primary of a secondary effect. The interrelationship between glucocorticosteroids and catecholamines is described and its importance for the adaptability of the organism is stressed. On the basis of the review it may seem advisable to introduce corticosteroid treatment into the therapeutic schema for delerious alcoholic patients and also to apply it on patients with the alcohol withdrawal syndrome if tests show that the function of their hypothalamus-hypophysis-renal gland systems is impaired.
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Idiopathic Addison's disease occurs frequently in association with other organ-specific autoimmune diseases, and autoantibodies to adrenal cortex are markers of this condition. A variable asymptomatic period with subtle adrenal dysfunction may precede the onset of clinical manifestations. We studied the pituitary-adrenal axis by measuring plasma ACTH, cortisol, and 17 alpha-hydroxyprogesterone after ovine CRH (100 micrograms as an iv bolus) stimulation in 19 patients with organ-specific autoimmune disease and adrenal autoantibodies, in whom adrenal steroids were normal under baseline conditions and normally responsive to a standard ACTH stimulation test (250 micrograms). In all subjects, oCRH produced a normal increase in plasma ACTH. Plasma cortisol, which was normoresponsive in 11 subjects, showed little or no increase in 8 subjects. Two of these patients developed overt adrenal failure after 1 yr. The 17 alpha-hydroxyprogesterone response to oCRH, tested in 10 of 19 patients, paralleled that of plasma cortisol, excluding a steroidogenic block at the 21-hydroxylase site. Our data demonstrate the existence of a very early phase of Addison's disease in which adrenal function shows an impaired response to ovine CRH-stimulated ACTH.
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CRH, the principal regulator of the hypothalamic-pituitary-adrenal axis and modulator of autonomic nervous system activity, also participates in the regulation of appetite and energy expenditure. Antalarmin, a pyrrolopyrimidine compound, antagonizes CRH type 1 receptor-mediated effects of CRH, including pituitary ACTH release, stress behaviors, and acute inflammation. We administered antalarmin chronically to evaluate its effects on hypothalamic-pituitary-adrenal axis function and metabolic status. Adult male rats were treated twice daily with 20 mg/kg of i.p. antalarmin or placebo over 11 days. The animals were weighed; plasma ACTH, corticosterone, leptin, and blood glucose levels were determined; and morphometric analyses were performed to determine adrenal size and structure, including sizing, histochemistry, immunohistochemistry, and electron microscopy. Leptin messenger RNA expression in peripheral fat was analyzed by Northern blot. Antalarmin decreased plasma ACTH (mean +/- SD, 2.62 +/- 0.063 pg/ml) and corticosterone concentrations (10.21 +/- 1.80 microg/dl) compared with those in vehicle-treated rats [respectively, 5.3 +/- 2.0 (P < 0.05) and 57.02 +/- 8.86 (P < 0.01)]. Antalarmin had no significant effect on body weight, plasma leptin, or blood glucose concentrations or fat cell leptin messenger RNA levels. The width of the adrenal cortex of animals treated with antalarmin was reduced by 31% compared with that in controls without atrophy of the gland. On the ultrastructural level, adrenocortical cells were in a hypofunctional state characterized by reduced vascularization, increased content of lipid droplets, and tubulovesicular mitochondria with fewer inner membranes. The apoptotic rate was increased in the outer zona fasciculata of animals treated with the antagonist (26.6 +/- 3.58%) compared with that in placebo-treated controls (6.8 +/- 0.91%). We conclude that chronic administration of antalarmin does not affect body weight, carbohydrate metabolism, or leptin expression, whereas it reduces adrenocortical function mildly, without anatomical, clinical, or biochemical evidence of causing adrenal atrophy. These results are promising for future uses of such an antagonist in the clinic.
Male Wistar rats were hypophysectomized 7 days (group 1) and 4-7 weeks (group II) before exposure to hypothermia (4 degrees C for 1 1/2 h). The hypophysectomized rats from group I were devoid of both the posterior lobe and the adenohypophysis, while the rats from group II had the posterior hypophysis but not the adenohypophysis regenerated. A decreased arginine-vasopressin (AVP) blood level in group I (32%) and a very high level of AVP in group II (311%, P less than 0.05) was determined by RIA. The exposure to hypothermia did not influence the AVP plasma level. The thyroid hypofunction was revealed morphometrically in both hypophysectomized groups. Nevertheless, cooling stimulated the thyroid glands in rats of both experimental groups, like it was in the control. Thus, there is no evidence that thyroid gland reaction to hypothermia is affected by AVP. Cooling caused an increase of corticosteroid blood and adrenal cortex content in nonoperated control rats as well as in group II, but not in group I of experimental animals. Hence, it may be assumed that when the adenohypophysis is ablated, a high AVP blood level is necessary to realize the adrenal cortex response to hypothermia.