Haemodynamic, hormonal and renal effects of adrenocorticotrophic hormone in sodium-restricted man

The effect of a dietary sodium restriction (15 mmol/day) on the development of adrenocorticotrophic hormone (ACTH) hypertension was examined in six normal male subjects. When ACTH (1 mg/day) was given for 5 days to subjects on a sodium-restricted diet, systolic blood pressure rose (116 +/- 4 to 125 +/- 4 mmHg, P less than 0.001), while diastolic blood pressure was unchanged. There was a modest antinatriuresis (cumulative Na+ balance, 59 +/- 2 mmol) which was reflected in a small rise in exchangeable body sodium (65 +/- 15 mmol); plasma concentrations of active renin and angiotensin II both fell during ACTH treatment. Plasma volume rose (2.8 +/- 0.2 to 3.6 +/- 0.16 l, P less than 0.01) while extracellular fluid volume was unchanged. Plasma concentration of atrial natriuretic peptide (ANP) rose to more than twice basal. Glomerular filtration rate (inulin clearance) increased (111 +/- 9 to 131 +/- 7 ml/min, P less than 0.001), renal plasma flow, measured as the rate of para-aminohippurate (PAH) clearance, was unaltered and calculated filtration fraction rose. Dietary sodium restriction did not, therefore, prevent an ACTH-induced increase in blood pressure. The increase in plasma volume with ACTH is not dependent on renal sodium retention and is associated with increased concentrations of ANP. When these data are compared with findings previously reported in subjects given the same dose of ACTH when on normal or high sodium intakes, it is clear that, although the action of ACTH in raising blood pressure is not dependent on exogenous sodium or extracellular fluid volume expansion, sodium retention can modify the level of blood pressure attained.     

Centrally induced cardiovascular and sympathetic responses to adrenocorticotrophic hormone

To investigate the effects of adrenocorticotrophic hormone on central cardiovascular regulation, an intracerebroventricular injection of the drug was given to male Wistar rats. With doses of 1 microgram and 10 micrograms per rat, blood pressure began to rise within 1 min, attaining a maximum value 5-10 min later. Both heart rate and abdominal sympathetic nerve activity increased simultaneously with the rise in blood pressure. Injection into the fourth ventricle or intravenous administration of the drug elicited no appreciable cardiovascular responses. These results suggest that endogenous adrenocorticotrophic hormone produced locally in the hypothalamus may participate in central cardiovascular regulation by increasing sympathetic outflow.     

Co-localisation of prostaglandin endoperoxide synthase and immunoreactive adrenocorticotrophic hormone in ovine foetal pituitary

Previous studies have shown that both an intact hypothalamic-pituitary-adrenal axis and prostaglandin E(2) (PGE(2)) are involved in the timing of parturition in sheep. PGE(2) is known to be synthesised by the placenta but has also been found in the foetal brain and pituitary. We propose that the enzymes necessary for production of PGE(2) are found in the ovine foetal pituitary and may be able to exert an autocrine and/or paracrine influence on corticotropes, resulting in an increased secretion of immunoreactive adrenocorticotrophin (irACTH). Pituitary tissues from foetal sheep, of gestational ages 119-126 days, were examined by immunohistochemistry. Primary antibodies for prostaglandin H synthase-1 and -2 (PGHS-1 and PGHS-2), microsomal prostaglandin endoperoxide synthase (mPGES) and irACTH were used to probe expressed proteins and Alexa-Fluor red- and green-fluorescent secondary antibodies were used to visualise the bound primary antibody. Staining for PGHS-1, PGHS-2 and mPGES was found throughout the foetal anterior pituitary. PGHS-1 and mPGES were widely distributed, including but not restricted to corticotropes. PGHS-2 was less widely distributed but occasionally was found in cells adjacent to corticotropes. The results indicate that locally produced prostaglandins may have an influence on the secretion of ACTH, independent of placental PGE(2).     

Changes in myocardial metabolism induced by ethanol administration

The utilization of ethyl alcohol in the myocardium and the reactions connected with its metabolism were investigated in rabbits which were given over a period of two months a 30% ethanol solution per os in a dosage of 1 g/kg body weight, and in a control group. Alcohol intoxication led to a reduction of the reserve of oxidized nicotinamide coenzymes, to an intensification of glycolytic processes, to slowed down utilization of substrates in the citric acid cycle and to an accumulation of less-oxidized metabolism products (dihydroxyacetone phosphate, lactate, pyruvate, malate, oxaloacetate, 2-oxoglutarate). A change was also observed in the myocardial microstructure. Metabolic changes are evidently one of the links of the pathogenetic mechanism of alcohol intoxication, which cause disorders in cardiac activity diagnosed as alcoholic myocardial dystrophy.     

Ghrelin administration affects circulating pituitary and gastro-entero-pancreatic hormones in acromegaly

OBJECTIVE: Ghrelin, a gut-brain peptide involved in the control of energy homeostasis, affects antero-pituitary and gastro-entero-pancreatic (GEP) hormone secretion in healthy subjects. We aimed to verify whether such hormonal responses are retained in acromegaly, a disease characterized by high GH, subnormal ghrelin and abnormal GEP hormone levels. DESIGN AND METHODS: The effect of ghrelin (3.3 microg/kg given after overnight fasting as an i.v. bolus) on GH, prolactin (PRL), adrenocorticotropin (ACTH), cortisol, insulin, glucose, total somatostatin (SS) and pancreatic polypeptide (PP) circulating levels were evaluated in seven non-diabetic patients with newly diagnosed acromegaly and in nine healthy controls. RESULTS: Ghrelin elicited a prompt, marked increase of serum GH and PRL levels in all normal (from 1.6+/-0.6 to 52.9+/-7.8 and from 9.7+/-0.8 to 24.2+/-4.8 microg/l (means+/-S.E.M.), respectively) and acromegalic subjects (from 11.2+/-4.9 to 91.6+/-21.0 and from 42.9+/-26.1 to 113.8+/-79.0 microg/l, respectively). Both plasma ACTH and serum cortisol levels rose significantly in the controls, whereas the cortisol response was blunted in the acromegalic patients. Glucose levels rose earlier and insulin levels fell later in all subjects, with a significantly greater net insulin decrease in acromegalic than in healthy subjects (-80+/-21 vs -17+/-4 pmol/l, P<0.01). A prompt PP rise and a biphasic SS response occurred in all controls, whereas in the acromegalic group the PP response (from 26.1+/-5.0 to 92.2+/-39.0 pmol/l) and the SS response (from 11.9+/-3.0 to 19.7+/-4.0 ng/l) were quite variable. CONCLUSIONS: Ghrelin affects both pituitary and GEP hormones in acromegalic patients as in normal subjects. These findings suggest that ghrelin actions on the energy balance are mediated by complex interactive endocrine loops that involve also the gut and pancreas.     

Starvation-induced alterations of circulating thyroid hormone concentrations in man.

Serum concentrations of triiodothyronine (T3), thyroxine (T4), and TSH were examined in seven men and seven women of normal weight during a 60-hr fast. Similar studies were conducted in two women who received daily for 1 mo before and during a similar fast, 0.4 mg and 0.5 mg of 1-thyroxine. The serum concentrations of T3 decreased in each of the untreated normal subjects (sign test of significance, P less than 0.001). The mean control concentration of T3 in women was 152 +/- 9 ng/100 ml (X +/- SEM); after 24 hr of fasting, 131 +/- 31 ng/100 ml; and at the termination of the fast, 90 +/- 15 ng/100 ml. The latter value differed from the control value with a p value of less than 0.01. Similar changes of T3 concentration occurred in men (mean basal T = 160 +/- 11 ng/100 ml; mean at termination of fast = 87 +/- 16 ng/100 ml). The range of decrease for T3 in all subjects varied from 24% to 55%. The mean T4 concentration at the beginning of the fast was 6.9 +/- 0.9, and at the termination of the fast, 7.5 +/- 0.6 (p = NS). TSH concentrations remained unchanged (Control, 3.8 +/- 0.45 muU/ml; at 60 hr, 4.0 +/- 0.26 muU/ml, p = NS). Studies in two women who received, before and during a fast, T4, indicate that a decreased peripheral conversion of T4 to T3 is the most likely mechanism responsible for this change.     

Further studies on the significance of circulating platelet aggregates induced by somatostatin in man

The aim of the present study was to further evaluate the significance of circulating platelet aggregates induced by somatostatin in insulin-dependent diabetic subjects. Eight insulin-dependent diabetics and eight normals were infused with somatostatin at increasing doses (250, 500, and 750 microgram/h), each dose for 30 min. In diabetics, somatostatin induced the appearance in blood of platelet aggregates in a dose-dependent fashion, the highest level being observed with the highest dose (750 microgram/h), p less than 0.005). In normals, circulating platelet aggregates were detected only with the infusion of the highest rate of somatostatin (p less than 0.025). This effect of somatostatin was reversible, since it tended to disappear 30 min after the infusion was stopped. In six additional insulin-dependent diabetics, a previous infusion of phentolamine (0.5 mg/min) completely prevented the appearance of platelet aggregates by somatostatin. No significant variation of the aggregation response to both ADP and collagen and the platelet count was seen in both experiments. Somatostatin, as expected, reduced the basal concentration of plasma glucose, glucagon, and C-peptide in both diabetics and normals. On the basis of these results, we suggest that somatostatin has some proaggregating capacity in vivo, probably by interacting with adrenergic mechanisms.     

Effects of gamma-aminobutyric acid receptor agonists on the secretion of growth hormone, luteinizing hormone, adrenocorticotrophic hormone and thyroid-stimulating hormone from the rat pituitary gland in vitro

The effects of the gamma-aminobutyric acid receptor agonists muscimol and baclofen were investigated on the secretion of GH, LH, ACTH and TSH from the anterior pituitary in vitro using a rapid superfusion system. A bicuculline-sensitive stimulatory effect of muscimol was demonstrated on the secretion of GH, LH and ACTH but not TSH. Baclofen had no effect on the basal secretion of any of the hormones, but inhibited LH-releasing hormone-stimulated release of LH and K+- and Ba2+-stimulated release of ACTH. The benzodiazepine Roll-6896 and the barbiturate secobarbital were found to potentiate the effect of muscimol on GH secretion. These results demonstrate the presence of GABAA receptors on somatotrophs, gonadotrophs and corticotrophs, and the presence of GABAB receptors on gonadotrophs and corticotrophs. Thyrotrophs appear devoid of GABA receptors.     

The modulation of circulating parathyroid hormone immunoheterogeneity in man by ionized calcium concentration.

Twenty normal individuals received 2-h iv infusions of CaCl2 and Na2 ethylenediamine tetra-acetate, with sampling every 15 min. PTH was measured by means of an intact hormone assay (I) and two carboxylterminal assays structured to react mostly with mid (M) or late (L) carboxylterminal fragments. A mathematical model was used to fit the sigmoidal relationship between ionized calcium (CA++) and PTH values. The influence of Ca++ on circulating PTH immunoheterogeneity was assessed via changes in L/I, M/I, and M/L ratios. Results are reported as means +/- SD. Response to hypocalcemia was highest with M (57.8 +/- 26.4 pmol/L, P less than 0.005 vs. L or I) and higher with L (20.1 +/- 5.6 pmol/L; P less than 0.0005 vs. I) than with I (14.1 +/- 6.4 pmol/L). L/I, M/I, and M/L decreased from 2.43 +/- 0.56 to 1.54 +/- 0.19 (P less than 0.0005), 8.44 +/- 2.38 to 4.36 +/- 4.07 (P less than 0.0005), and 3.49 +/- 0.71 to 2.86 +/- 0.76 (P less than 0.005), respectively, during Na2 ethylenediamine tetra-acetate infusion. Nonsuppressible PTH was again higher with M (13.7 +/- 4.8 pmol/L; P less than 0.0005 vs. L or I) and higher with L (2.8 +/- 0.7 pmol/L, P less than 0.0005 vs. I) than with I (0.5 +/- 0.3 pmol/L). L/I, M/I, and M/L ratios increased from 2.47 +/- 0.97 to 5.35 +/- 2.09 (P less than 0.0005), 8.90 +/- 3.10 to 29.56 +/- 14.89 (P less than 0.0005), and 3.62 +/- 0.90 to 5.30 +/- 1.91 (P less than 0.005) during CaCl2 infusion. The set-point for PTH stimulation by calcium was similar for M (1.15 +/- 0.035 mmol/L) and L (1.175 +/- 0.041 mmol/L) but significantly higher with the I assay (1.184 +/- 0.31 mmol/L; P less than 0.0005 vs. M). The M/I, L/I, and M/L ratio set-points were similar at 1.28 +/- 0.01, 1.27 +/- 0.01, and 1.29 +/- 0.02 mmol/L. Thus, even if proportionately more intact PTH and less carboxylterminal fragments are produced and secreted during hypocalcemia, the latter still predominate in the circulation. Furthermore, at high calcium values, secretion of fragments is less well inhibited than that of intact hormone. The lower secretion and higher ratio set-points suggest that the secretion and intracellular degradation of PTH have different sensitivities to inhibition by calcium.