Increased adrenal androgen secretion with inhibition of 11beta-hydroxylase in HIV-infected women

Adrenal androgen production is reduced in association with disease severity in HIV-infected women. This response may be maladaptive in terms of maintenance of lean body mass, functional status, and immune function. The aim of this study was to assess whether the use of an adrenal enzyme inhibitor of 11beta-hydroxylase might increase androgen production in this population. We conducted a randomized, double-blind, placebo-controlled study of metyrapone (500 mg p.o. qid) or placebo for 2 wk in 10 HIV-infected women with AIDS wasting [weight <90% ideal body weight (IBW) or weight loss >10%] and reduced androgen levels. Basal and ACTH-stimulated androgen, mineralocorticoid, and glucocorticoid levels were measured at baseline and after 14 days of treatment. Subjects were similar in age (40.9 +/- 0.9 yr), weight (91.7 +/- 3.5% IBW) and hormone concentrations at study entry. Total testosterone (84 +/- 54 vs. -0.4 +/- 2 ng/dl, P = 0.024), free testosterone (6.5 +/- 2.8 vs. 0.1 +/- 0.1 pg/ml, P = 0.024), DHEA (5.0 +/- 3.2 vs. -0.6 +/- 0.5 microg/l, P = 0.024), and 11-deoxycortisol (2,145 +/- 820 vs. -14 +/- 22 ng/dl, P = 0.024) levels increased in response to metyrapone compared with placebo treatment. In response to ACTH, significant increases in the DHEA/cortisol ratio (174 +/- 48 vs. 3 +/- 3, P = 0.008) were seen in the metyrapone group compared with placebo. Blood pressure and electrolytes did not change, and signs of adrenal insufficiency were not apparent. These data demonstrate that inhibition of 11beta-hydroxylase with metyrapone increases adrenal androgen secretion in HIV-infected women. Further studies are needed to assess the physiological effects of this strategy to increase anabolic hormone levels in severe stress, including detailed testing to rule out the potential risk of concomitant adrenal insufficiency.     

Physiological changes in rat hypothalamic CRF: Circadian,stress and steroid suppression

Hypothalamic CRF-like immunoreactivity was measured in the a.m. and p.m., after systemic dexamethasone administration or after either stress in adult male rats. Measurement of plasma corticosterone levels revealed the expected circadian rhythmicity, suppression after dexamethasone administration and increase after ether stress. The hypothalamic content of CRF-like immunoreactivity was significantly decreased in the p.m. and after dexamethasone administration. However, no change in hypothalamic CRF-like immunoreactivity was observed after ether stress. The results are consistent with an increased release in the p.m. and decreased synthesis of hypothalamic CRF after systemic dexamethasone administration. The observation that there is no change in content of hypothalamic CRF-like immunoreactivity after ether stress could be due to the fact that the animals were stressed by handling. The results show that this immunoreactivity present in the hypothalamus is altered by changes in the hypothalamic-pituitaryadrenal axis and thus suggest that this peptide is a physiologically significant CRF in the rat.     

Prolactin stimulates and potentiates adrenal steroid secretion in vitro

Prolactin, alone and in combination with ACTH, was tested for its ability to release steroids from rat adrenocortical slices superfused in vitro. The hormone possessed weak activity alone (minimal responsive dose = 1 U), but was able to potentiate the ACTH-stimulated corticoid release at much lower doses (significant response over ACTH alone at 0.01 U prolactin). This latter dosage was calculated to be within the physiologic range of prolactin in blood. Analysis of individual steroids in superfusate by RIA revealed that aldosterone release was most sensitive to prolactin, followed by corticosterone, androstenedione, and progesterone. We conclude that prolactin is an adrenocortical secretagogue of physiological relevance in the rat, and that it could play a role in enhancing the action of ACTH to acutely release steroids.     

Increased hepatic triacylglycerol secretion in fasted rats with ventromedial hypothalamic lesions.

Adult female rats with lesions in the ventromedial hypothalamic area and sham-operated controls were given Triton WR 1339 intravenously after 24 h without food for measurement of liver triacylglycerol secretion rate. Tritiated water was injected for measurement of lipogenesis in liver, perirenal and subcutaneous adipose tissues in vivo. The experiments were performed on unrestrained animals with a chronically implnted venous heart cannula after 24 h without food. By the use of this technique, anesthesia and handling of the animals during the experiments was avoided. The following differences in the lesioned animals compared to the sham-operated controls were found: relative hypertriglyceridemia. A significant increase of triacylglycerol accumulation in the plasma. Increased incorporation of 3H FROM 3H20 into liver fatty acids. The experiments demonstrate that hepatic lipid synthesis during fasting is greater in the lesioned than in the control animals, but not high enough to account for the increased triacylglycerol secretion. A shift in the hepatic metabolism of fatty acids, leading to greater triacylglycerol formation at the expense of other processes is therefore suggested. The possible role of insulin in these metabolic changes is discussed.     

新生大鼠下丘脑CRF和AVP神经元对急性低氧的应答

目的:观察肾上腺摘除新生大鼠下丘脑促肾上腺皮质激素释放激素(CRF)和精氨酸加压素(AVP)神经元对急性低氧的应答.方法:在低压氧舱中模拟高海拔低氧,用放免法测定AVP和CRP含量.结果:新生大鼠暴露于急性低氧环境下(模拟5 000 m和7 000 m海拔高度,24 h),其下丘脑CRP在3 d和7 d龄大鼠中无明显变化,但14d、21 d和28 d时低于对照;下丘脑AVP在3 d大鼠中亦无变化,但14 d时低于对照,7 d、21 d及28 d时高于对照.两者对低氧的应答模式随日龄而变化.摘除肾上腺后,14 d、21 d及28 d大鼠下丘脑CRF和AVP含量均显著低于同龄完整大鼠,此时暴露于急性低氧环境下,CRF和AVP无进一步的变化.结论:摘除肾上腺抑制下丘脑CRF和AVP的发育,影响它们对低氧应激的正常应答.     

Production of antiserum to CRF associated with adrenal atrophy in a rabbit

Corticotropin releasing factor (CRF) was recently isolated from ovine hypothalami by its ability to stimulate adrenocorticotropin (ACTH) and β-endorphin release from dispersed rat pituitary cells. Intramuscular injection of synthetic ovine CRF conugated to bovine thyroglobulin with 1-ethyl-3(3-dimethylaminopropyl) carbodiimide and emulsified with Freund's complete adjuvant into a random bred New Zealand white rabbit resulted in antiserum production to CRF associated with adrenal atrophy. A decrease in the level of plasma coticosteroids was associated with an increase in mean total binding of ¹²⁵I-N-Tyr-CRF. Upon sacrifice, a decrease in pituitary content of ACTH and a decrease in adrenal weight and content of corticosteroids was observed in the rabbit producing antiserum to CRF. Adrenal atrophy was histologically verified with an observed decrease in the adrenal cortical zone not reflected in the zona glomerulosa. Individual cells were relatively larger either with more abundant pale cytoplasm or with distinctly vacuolated cytoplasm. The results presented here are consistent with a physiologically necessary role for this CRF or peptides with similar structures in the hypothalamic-pituitary-adrenal axis.     

Effect of prostaglandins on steroid secretion by human fetal adrenal tissue

In the present investigation we evaluated the effect of prostaglandins on the rate of steroid secretion by human fetal adrenal (HFA) tissue. Prostaglandins F2 alpha and E2 (10 micrograms/ml) were added to the culture medium in the presence or absence of ACTH (1 micrograms/ml). The medium was assayed for content of cortisol (F), dehydroepiandrosterone sulfate (DS) and pregnenolone sulfate (PS) by radioimmunoassay. When HFA tissue fragments were maintained in the absence of ACTH, F secretion was low; PGF2 alpha but not PGE2 suppressed F secretion by 60-65%. When ACTH was added to the culture medium, the secretion rate of F increased 15-fold, whereas DS and PS secretion was maintained at or near initial rates of secretion. The addition of PGF2 alpha to the culture medium containing ACTH resulted in a 80% decrease in F secretion, but PGE2 only suppressed F secretion by 50%. In contrast, PGE2 or PGF2 alpha had little effect on the rate of DS or PS secretion either in the presence or absence of ACTH. In conclusion, prostaglandins appear to inhibit the secretion of F, but not of DS or PS by the HFA.     

Plasma levels of C19 steroid glucuronides in pre-menopausal women with non-classical congenital adrenal hyperplasia.

Recent reports have thrown doubt on the role of measurements of plasma 5 alpha-androstane-3 alpha,17 beta-diol glucuronide (3 alpha-diolG) as a marker of peripheral androgen metabolism in women with polycystic ovarian syndrome and idiopathic hirsutism. It has been suggested that a plasma profile of C19 steroid glucuronides may be more informative. While preliminary data indicates that both 3 alpha-diolG and androsterone G (ADTG) may arise from adrenal steroid precursors, there have been no reports of C19 steroid glucuronides in women with non-classical, or late-onset congenital adrenal hyperplasia (NC-CAH), who constitute a significant proportion of the hirsute female population. We therefore measured plasma levels of 3 alpha-diolG, ADTG and dihydrotestosterone G (DHTG) before and following a standard Cortrosyn test in 15 symptomatic and 3 asymptomatic NC-CAH patients, 5 heterozygote carriers for 21-hydroxylase deficiency (NCHETS) and 18 normal women. The effects of chronic glucocorticoid (GCR) therapy (greater than 3 months) on the C19 steroid glucuronide profile in the symptomatic patients was also investigated. Baseline plasma levels of all 3 glucuronides were significantly (P less than 0.001) higher in symptomatic patients compared with either normals or NCHETS. However, the order of discrimination was ADTG greater than 3 alpha-diolG greater than DHTG. There were no significant differences between steroid glucuronide levels for NCHET and normal women and the C19 steroid glucuronide concentrations for the asymptomatic NC-CAH patients were greater than 2 SD above the normal means. Moderate clinical improvement was observed in all patients receiving oral GCR therapy and was accompanied by approx. 80% suppression of the plasma levels of all 3 C19 steroid glucuronides. This contrasts with a mean suppression of androstenedione of only 50%. However, plasma levels of the C19 steroid glucuronides were not significantly increased in response to a short ACTH stimulation test. This may be explained by the fact that the androgen glucuronides are thought to be peripherally formed metabolites derived from unconjugated glandular secreted androgen precursors and thus their synthesis at 60 min following adrenal stimulation may lag substantially behind that of their respective precursors. There were significant linear correlations between the levels of all 3 glucuronides, but neither correlated with Ferriman-Gallway scores, body mass index or 17-hydroxyprogesterone levels.(ABSTRACT TRUNCATED AT 400 WORDS)     

Does adrenal cortex influence prolactin secretion? Evaluation in hirsute women

To define the role of adrenal hormones on PRL secretion, we investigated 28 women by administering i.v. 0.25 mg. ACTH (h 8.00) every 45' for 135' to better evaluate any relationship between enhanced adrenal steroidogenic activity (both glycoactive and androgenic) and PRL secretion. Blood samples were drawn at 0', 45', 90', 135', and PRL, F, DHEAS, and 170HP were measured by RIA methods. A significant lowering of PRL levels and a concomitant enhancement of steroid plasma levels were found. Our data are in line with those found by some Authors who observed the lack of PRL enhancement after hypoglycemia during glucocorticoid administration and the absence of nocturnal peak of PRL in patients with Cushing's disease. However statistical evaluation (linear analysis regression) of data obtained provides further evidence for the extremely influential role played by adrenal gland hormones on PRL secretion in women.     

Relationship between endogenous cyclic AMP production and steroid hormone secretion in chick adrenal cells

Dispersed chick adrenal cells were incubated with either ACTH, cholera toxin or forskolin. All three agents stimulated cyclic AMP accumulation and secretion of corticosterone and aldosterone by the dispersed cells. The dose-response to ACTH was similar for cyclic AMP and corticosterone but aldosterone secretion appeared to be more sensitive to ACTH stimulation. Concentrations higher than 10(-8) M of ACTH caused suppression of corticosterone output but not of cyclic AMP accumulation or aldosterone secretion. A significant cyclic AMP accumulation occurred within 30 min of exposure to ACTH whereas significant increases in steroid secretion were observed only after 30 min. An early increase (within 30 min) in cyclic AMP accumulation with both cholera toxin and forskolin was not accompanied by any significant stimulation of steroid secretion, which occurred only after 120 min. The results with the avian adrenal cells are consistent with the thesis that steroid production in the adrenocortical cells is stimulated by cyclic AMP-dependent pathways, whereas steroid release may be modulated by others.     

Comparison in male and female rats of ACTH content and response to corticotrophin-releasing factor (CRF) of cultured adenohypophyseal cells and in vivo hypothalamic CRF content.

Although mean ACTH concentration was significantly higher in cultured adenohypophyseal cells from female than from male rats, there was no significant sex difference in the ACTH secretory response of these cells to hypothalamic extract containing CRF. Hypothalamic CRF content in the “basal” state $\text{in}$$\text{vivo}$ was slightly higher in female than $\text{in}$ male rats.     

Increase in daily LH secretion in response to short-term calorie restriction in obese women with PCOS

We hypothesized that short-term calorie restriction would blunt luteinizing hormone (LH) hypersecretion in obese women with polycystic ovary syndrome (PCOS) and thereby ameliorate the anovulatory endocrine milieu. To test this hypothesis, 15 obese patients with PCOS and nine age- and body mass index-matched healthy women underwent 24-h blood sampling to quantitate plasma LH, leptin, and insulin levels. PCOS subjects were prescribed a very low caloric liquid diet (4.2 MJ/day) for 7 days and were then resampled. Basal and pulsatile LH secretion was threefold higher in PCOS subjects, but plasma insulin and leptin levels were not different in the calorie-replete state. Contrary to expectation, calorie restriction enhanced basal and pulsatile LH secretion even further. As expected, plasma glucose, insulin, and leptin concentrations decreased by 18, 75, and 50%, respectively. Serum total testosterone concentration fell by 23%, whereas serum estrone, estradiol, sex hormone-binding globulin (SHBG), and androstenedione concentrations remained unchanged. Enhanced LH secretion in the presence of normal metabolic and hormonal adaptations to calorie restriction points to anomalous feedback control of pituitary LH release in PCOS.     

CRF receptor type 1 mediates continual hypoxia-induced CRF peptide and CRF mRNA expression increase in hypothalamic PVN of rats

We demonstrated previously that hypoxia activated CRF and CRF mRNA in PVN, and CRF receptor 1 (CRFR1) mRNA in rat pituitary. The aim of the study is to test whether the hypoxia-activated CRF and CRF mRNA is associated with triggering CRFR1. Rats were exposed to hypobaric hypoxia at altitude of 2 and 5 km. CRF and CRF mRNA were assayed by immunostaining and in situ hybridization. CRFR1 mRNA was assayed by RT-PCR. Results showed that 5 km continual hypoxia increased CRF and CRF mRNA in PVN, CRFR1 mRNA in pituitary, and plasma corticosterone. The hypoxia-increased CRF, CRF mRNA, CRFR1 mRNA, and corticosterone were blocked by CRFR1 antagonist (CP-154,526), suggesting that CRFR1 in PVN and pituitary are responsible for the hypoxia-increased CRF and CRF mRNA in PVN.