Response to low-dose pulsatile cortisol in Addison's disease with suspected corticotropinoma

A 65 year old woman with long-standing Addison's disease treated with oral glucocorticoid and mineralocorticoid replacement had persistently high ACTH levels, inadequate suppression of ACTH on low-dose dexamethasone, sellar enlargement, and pigmentation, and thus resembled patients alleged to develop corticotropinomas while on oral replacement for adrenal insufficiency. Since animal studies suggested that rapid rises of corticosteroids within the physiologic range can inhibit ACTH release, we administered brief infusions of cortisol every three hours with total daily dose equal to her chronic dose. Prompt suppression of ACTH and immunoreactive beta-endorphin occurred during each cortisol dose profiled, suggesting a role for ultradian cortisol fluctuations in tonic inhibition of ACTH secretion in humans, and a possible therapeutic benefit of mimicking ultradian cortisol rhythms during replacement therapy.     

A stochastic differential equation model of diurnal cortisol patterns

Circadian modulation of episodic bursts is recognized as the normal physiological pattern of diurnal variation in plasma cortisol levels. The primary physiological factors underlying these diurnal patterns are the ultradian timing of secretory events, circadian modulation of the amplitude of secretory events, infusion of the hormone from the adrenal gland into the plasma, and clearance of the hormone from the plasma by the liver. Each measured plasma cortisol level has an error arising from the cortisol immunoassay. We demonstrate that all of these three physiological principles can be succinctly summarized in a single stochastic differential equation plus measurement error model and show that physiologically consistent ranges of the model parameters can be determined from published reports. We summarize the model parameters in terms of the multivariate Gaussian probability density and establish the plausibility of the model with a series of simulation studies. Our framework makes possible a sensitivity analysis in which all model parameters are allowed to vary simultaneously. The model offers an approach for simultaneously representing cortisol's ultradian, circadian, and kinetic properties. Our modeling paradigm provides a framework for simulation studies and data analysis that should be readily adaptable to the analysis of other endocrine hormone systems.     

Temporal characteristics of cortisol metabolism in adrenalectomized primates

The rhythmicities observed in the plasmatic levels of cortisol are generally attributed to rhythms of production and release of the hormone. Since the plasmatic concentration of any given substance is a function of its production and its removal from the circulation, it is conceivable that the metabolism of cortisol also occurs in an oscillating fashion. To test this hypothesis Rhesus monkeys were submitted to bilateral adrenalectomy; cortisol was replaced at a constant infusion rate while blood was sampled at hourly intervals for the measurement of cortisol plasma levels. Rhythmic oscillations in the cortisol levels were observed. These rhythms exhibited two major components: a circadian and an ultradian component. The authors suggest that these rhythms be considered whenever normal or pathologic hormone rhythmicities are analyzed.     

月经周期不同阶段游离皮质醇昼夜节律的变化

为了研究皮质醇分泌的昼夜节律在月经周期中的变化,实验对15位月经周期正常的育龄期健康妇女,在月经周期的不同阶段分别于24h内每隔两小时采样,检测唾液昼夜游离皮质醇水平。采用非线性回归分析模型分析皮质醇昼夜节律。结果显示,皮质醇昼夜节律在整个月经周期都具有复杂的明显受到亚节律(ultradian)影响的分泌形式;与月经期相比,围排卵期和黄体晚期昼夜节律波峰宽度(peak-width)明显减低(P=0．005与0．031),而昼夜节律波谷(trough)有抬高趋势(P=0．0622与0．066);黄体晚期的亚节律波幅(ultradian amplitude)与月经期相比显著减低(P=0．002)而与围排卵期相比有减低趋势(P=0．05)。这些结果提示月经周期的不同阶段对皮质醇分泌的昼夜节律有影响。     

Diurnal rhythms of free estradiol and cortisol during the normal menstrual cycle in women with major depression

To investigate whether depression is accompanied by changes in diurnal rhythms of free estradiol and cortisol in different phases of the menstrual cycle, we measured these two hormone levels in saliva samples collected every 2 h for 24 h from 15 healthy normally cycling women and 12 age-matched normally cycling women suffering from major depression taking antidepressants. The assessments were repeated four times over one menstrual cycle: during menstruation and in the late follicular/peri-ovulating, early to mid-luteal and late luteal phases, respectively. Quantification with a nonlinear periodic regression model revealed distinct diurnal rhythms in free estradiol and free cortisol in all subjects. For the diurnal cortisol rhythm, significant differences were found in the peak-width and ultradian amplitude among different menstrual phases, both in controls and depressed patients, while no significant differences were found between the two groups. The diurnal estradiol rhythm, on the other hand, was quite consistent among different menstrual phases within both groups, while the depressed patients had overall larger amplitudes than controls, which is negatively correlated with disease duration. Significant positive correlations between the two hormone rhythms were found for 24-h mean level (mesor), peak, and trough in late luteal phase, and for ultradian harmonics in early to mid-luteal phase in controls, but only for ultradian harmonics in late follicular/peri-ovulating phase and for acrophase in the menstruation phase in depressed patients. A sub-analysis was also performed in patients who received Fluoxetine (n = 7). The findings implicate a close correlation between the hypothalamic-pituitary-adrenal axis and the hypothalamic-pituitary-gonadal axis, both of which may be involved in depression.     

THE OCCURRENCE AND FUNCTIONS OF ULTRADIAN RHYTHMS

Ultradian oscillations with periods between 5 min and 4 h have been described in cell-free extracts, single-celled eukaryotes, cultured cells and embryos. Whereas some of these potentially oscillatory systems (e.g. glycolysis) may only exhibit this type of behaviour rarely if at all in vivo , other ultradian oscillators in lower eukaryotes are rhythms and probably have timekeeping functions. Rhythms with ultradian periods of 10 min to 20 h in oxygen consumption and carbon dioxide production have also been studied in endotherm animals: these rhythms may be modified by variations of environmental parameters and by circadian and infradian synchronizers. Interspecies and interstrain differences strongly suggest that these rhythms are endogenous and have a genetic origin. We suggest that the temporal organization of biochemical and physiological processes facilitates optimization of thermodynamic maintenance of the organism within the random fluctuations of its physicochemical environment and contributes to genetic selection.     

Ultradian, circahoral and circadian structures in endothermic vertebrates and humans

1. For more than 30 years many studies have been carried out concerning rhythms with periods approaching 24 hr (circadian rhythms). 2. The latter have been demonstrated as resulting from environmental 24 hr synchronizers (zeitgebers), but they usually persist in the absence of a 24 hr synchronization, which proves their endogenous nature. 3. Biological rhythms with periods less than 20 hr (ultradian rhythms) and particularly those approaching 1 hr (circahoral rhythms) have been determined: for motility, rest-activity, sleep phases, endocrine secretions and other physiological functions. 4. These ultradian and circahoral rhythms have been found in rodents, birds, monkeys and humans. 5. Existing at all stages of ontogeny, they have been proved to be endogenous and species and strain specific. 6. As these ultradian rhythms can be influenced by environmental factors and sometimes by circadian rhythms they are not truly periodic, so therefore cannot be computed by the usual processes of mathematical time analysis.     

Short period leaf movements in Oxalis regnellii

Oxalis regnellii Mig. is a trifoliate plant, and the three leaflets usually show synchronized up and down movements with a circadian period of 26–27 h. The three leaflets can also perform desynchronized ultradian oscillations, and we report on such rhythms under different conditions. A study of the occurrence of ultradian leaf movement rhythms as a function of irradiance is presented. At an irradiance of approximately 1 μW cm⁻², the occurrence was maximal and ca 30%. The periods varied from 5 to 15 h. Four other cases of ultradian rhythms in different conditions are also presented. In one case spontaneous ultradian rhythms occurred, and in another, two of the leaflets showed ultradian rhythms when the third leaflet had received a light pulse. In two more cases, the three leaflets on a leaf were separated by physical cuts along the petiole between the pulvini; in both cases the period was approximately 5 h. Possible mechanisms to explain the ultradian rhythms in Oxalis regnelli are discussed.     

Effect of geomagnetic activity on the rhythm of resistance of rats to hypoxia

The resistance of male Wistar rats to acute hypoxia was estimated from the lifetime at an "altitude" of 11.5 km above sea level from 13 to 21 p.m. and in different seasons of a year. Identical types of rhythms (circaseptan, circasemiseptan, infradian, circadian, and ultradian) of geomagnetic activity and lifetime were revealed. It was found that the periods of basal rhythms either coincide or are multiple. It was shown that the rhythms of geomagnetic activity (including nonbasal rhythms) affect lifetime rhythms (especially ultradian rhythms). As the periods of the rhythms decrease, the number of rhythms for both parameters increase (ultradian rhythms are most numerous), and relative differences in the values of periods (they are minimal for ultradian rhythms) and the amplitudes of rhythms decrease.     

Small Bowel and Plasma Gastrin Rhythms in Cats

The purpose of this experiment was to study the possible role of the gastric antrum and small bowel in the rhythm(s) of plasma gastrin. The cat was used as the laboratory animal. Three groups of cats were provided with a gastric fistula for the study of gastric acid and plasma gastrin rhythms. The first group (N = 7) served as controls. A second group (N = 3) was antrectomized and later subjected to a 80% small bowel resection. Gastric acid secretions were collected every 30 min from 0800 to 2400. Blood samples for determination of gastrin were drawn every 2hr from 0800 to 2400. In control animals a circadian (i.e.<24hr) and 3 ultradian (i.e.<24 hr) rhythms were detected for acid output. In the antrectomized cats, circadian and ultradian rhythms were documented. After small bowel resection circadian and ultradian rhythms in gastric acid secretion were observed. For plasma gastrin, circadian and ultradian rhythms were found in the control cats. In the antrectomized cats no rhythms were observed. After small bowel resection an ultradian rhythm reappeared in these antrectomized cats. Removal of the antrum in the cat induces disappearance of circadian and ultradian rhythms of plasma gastrin but fails to modify the acid rhythms. Small bowel resection results in the reappearance of an ultradian rhythm for plasma gastrin and a shift in acrophase for the circadian rhythm in acid secretion.     

Ultradian rhythm unmasked in the Pdf clock mutant of Drosophila

A diverse range of organisms shows physiological and behavioural rhythms with various periods. Extensive studies have been performed to elucidate the molecular mechanisms of circadian rhythms with an approximately 24 h period in both Drosophila and mammals, while less attention has been paid to ultradian rhythms with shorter periods. We used a video-tracking method to monitor the movement of single flies, and clear ultradian rhythms were detected in the locomotor behaviour of wild type and clock mutant flies kept under constant dark conditions. In particular, the Pigment-dispersing factor mutant (Pdf ⁰¹ ) demonstrated a precise and robust ultradian rhythmicity, which was not temperature compensated. Our results suggest that Drosophila has an endogenous ultradian oscillator that is masked by circadian rhythmic behaviours.     

Small bowel and plasma gastrin rhythms in cats

The purpose of this experiment was to study the possible role of the gastric antrum and small bowel in the rhythm(s) of plasma gastrin. The cat was used as the laboratory animal. Three groups of cats were provided with a gastric fistula for the study of gastric acid and plasma gastrin rhythms. The first group (N = 7) served as controls. A second group (N = 3) was antrectomized and later subjected to a 80% small bowel resection. Gastric acid secretions were collected every 30 min from 0800 to 2400. Blood samples for determination of gastrin were drawn every 2 hr from 0800 to 2400. In control animals a circadian (i.e. approximately 24 hr) and 3 ultradian (i.e. less than 24 hr) rhythms were detected for acid output. In the antrectomized cats, circadian and ultradian rhythms were documented. After small bowel resection circadian and ultradian rhythms in gastric acid secretion were observed. For plasma gastrin, circadian and ultradian rhythms were found in the control cats. In the antrectomized cats no rhythms were observed. After small bowel resection an ultradian rhythm reappeared in these antrectomized cats. Removal of the antrum in the cat induces disappearance of circadian and ultradian rhythms of plasma gastrin but fails to modify the acid rhythms. Small bowel resection results in the reappearance of an ultradian rhythm for plasma gastrin and a shift in acrophase for the circadian rhythm in acid secretion.     

The circahoral rhythm of the functional activity of rat adrenocorticocytes]

Functional manifestations of biological ultradian rhythms in the adrenal cortex were first confirmed on the cytologic level. The cycle of the ultradian rhythm in the cells of the adrenal cortex fascicular zone consisted was determined to involve three phases: accumulation of lipids, delipoidization, and the rest period. A definite volume of cells and their nuclei, certain nuclear-cytoplasmic relations, the number of liposomes and mitochondria on the square unit are characteristic of each phase. The activity of cells is especially high during the second phase which is characterized by the increase in nuclear sizes and nuclear-cytoplasmatic relations, by the decrease in cell volume and in the number of liposomes in their cytoplasm; this is indicative of the rised synthesis and secretion of hormones. It is underlined that the cell volume increases when liposomes are accumulated in the cytoplasm to decrease upon their disappearance.     

Ultradian and Asymmetric Rhythms of Hemispheric Processing Speed

Daily changes in cognitive performance have been documented, both in time of day/effect paradigm studies and in time‐isolation studies. However, in both types of studies, phenomena such as the “post‐lunch dip” have been found that were difficult to explain in terms of theoretical backgrounds. These phenomena may suggest ultradian rhythms in cognitive performance. A number of studies have also shown ultradian and asymmetric rhythms in activity indices of the brain hemispheres. The aim of this study was to test three hypotheses: the first two assumed that there is a significant ultradian frequency in a component of the endogenous rhythm of processing speed, and the third assumed that the ultradian endogenous rhythms of the processing speed (encoding and recognition) of stimuli addressed to the left brain hemisphere differ in period length from those addressed to right hemisphere. During a 24 h constant‐routine experiment, the memory performance of 30 participants was measured eight times (every 2.5–3 h), starting at 06:30 h. Parallel sets of words and pictures were shown to subjects in a random order in either the left or the right visual field on a computer screen. The participants pressed one of two buttons in response to the picture or word, or when answering a question concerning the meaning of a presented stimulus. Cosinor analysis was applied to individual time series data. Two significant ultradian components were found in a majority of the time series. Dominant periods were analyzed using three factor ANOVA. The results showed an asymmetry between both hemispheres in the frequency of ultradian rhythms in encoding speed.     

Ultradian activity rhythms in large groups of newly hatched chicks (Gallus gallus domesticus)

A clutch of young chicks housed with a mother hen exhibit ultradian (within day) rhythms of activity corresponding to the brooding cycle of the hen. In the present study clear evidence was found of ultradian activity rhythms in newly hatched domestic chicks housed in groups larger than natural clutch size without a mother hen or any other obvious external time-keeper. No consistent synchrony was found between groups housed in different pens within the same room. The ultradian rhythms disappeared with time and little evidence of group rhythmicity remained by the third night. This disappearance over time suggests that the presence of a mother hen may be pivotal for the long-term maintenance of these rhythms. The ultradian rhythm of the chicks may also play an important role in the initiation of brooding cycles during the behavioural transition of the mother hen from incubation to brooding. Computer simulations of individual activity rhythms were found to reproduce the observations made on a group basis. This was achievable even when individual chick rhythms were modelled as independent of each other, thus no assumptions of social facilitation are necessary to obtain ultradian activity rhythms on a group level.     

Pulsatile ACTH secretion: variation with time of day and relationship to cortisol

It has long been known that ACTH is secreted in an episodic fashion demonstrating circadian and ultradian rhythms. High intensity venous sampling has recently revealed that in addition to these larger ultradian fluctuations in hormone levels, plasma ACTH in rats demonstrates high frequency, low amplitude oscillations which have been called "micropulses." These micropulses were not detected in previous studies due to sampling intervals of greater than 5 minutes. To investigate the presence of these ACTH micropulses in a primate species, blood samples were drawn from six chair-restrained rhesus monkeys at one-minute intervals for up to 70 minutes and plasma was assayed for immunoreactive ACTH. To assess the variation in ACTH micropulse parameters with time of day and the relationship to cortisol secretion, four of the monkeys were sampled for three 70-minute periods beginning at 0530, 1100, and 1730 hours, and plasma was assayed for immunoreactive ACTH and cortisol. Analysis of the data revealed that ACTH and cortisol are secreted in micropulses in rhesus monkeys with marked individual variation in the pattern of secretion and a concurrence of approximately 75% of ACTH and cortisol micropulses. Difference in pulse amplitude but not frequency appeared to contribute to the circadian variation in mean ACTH levels and a sampling interval of two minutes appeared to be adequate for accurately identifying micropulses of ACTH.     

Circadian and Ultradian Rhythms in Blood Glucose and Plasma Insulin of Healthy Adults

The circadian and ultradian variations of blood glucose and plasma insulin have been characterized individually and as a group phenomenon in five healthy young adults studied while adhering as closely as possible to their usual routine of sleep, activity, meal content and timing. Three complementary methods were used to analyze the data: displaying raw data as a function of time; cosinor method according to Nelson and Halberg; and time series analyses as proposed by De Prins and Malbecq. The subjects were studied in the laboratory and their life routine were controlled, but very close to that of their habitual routine. They had mainly ultradian rhythms of blood glucose (mainly about 6 hr) and circadian rhythms of immunoreactive insulin (I.R.I.). Blood glucose ultradian rhythms seem to be mainly but not exclusively mealtime dependent, while I.R.I, circadian rhythms appear to be primarily endogenous in origin. Therefore, the role played by insulin in the control of blood glucose levels seems to be programmed on a circadian basis rather than by a time independent feedback phenomenon as postulated by the conventional homeostatic hypothesis. The advantage of this chronophysiologic approach is to consider circadian rhythms of both I.R.I. and insulin effectiveness as an adaptive phenomenon able to maintain blood sugar changes in the ultradian domain of rhythms.     

Direct cell-cell communication: a new approach derived from recent data on the nature and self-organisation of ultradian (circahoralian) intracellular rhythms

Recent data concerning ultradian (circahoralian) intracellular rhythms are used to assess the biochemical mechanisms of direct cell-cell communication. New results and theoretical considerations suggest a fractal nature of ultradian rhythms and their self-organisation. The fundamental and innate nature of these rhythms relates to their self-similarity at different levels of cell and tissue organisation. They can be detected in cell-free systems as well as in cells and organs in vivo. Such rhythms are a means of finding an optimal state of cell function rather than achieving a state of absolute stability. As a consequence, oscillations, being irregular and numerous by the set of periods, are resilient to functional overload and injury. Recent data on the maintenance of their fractal structure and, especially on the selection of optimal periods are discussed. The positive role of chaotic dynamics is stressed.The ultradian rhythm of protein synthesis in hepatocytes in vitro was used as a marker of direct cell-cell communication. The system demonstrates cell cooperation and synchronisation throughout the cell population, and suggests that the ultradian rhythms are self-organised. These observations also led to the detection of mechanisms of direct cell-cell communication in which extracellular factors have an essential role. Experimental evidence indicated the involvement of gangliosides and/or catecholamines in this large-scale synchronisation of protein synthesis. The response of all, or a major part, of the cell population is important; after the initial trigger effect, a periodic pattern is retained for some time. The influence of Ca2+-dependent protein kinases on protein phosphorylation can be a final step in the phase modulation of rhythms during cell-cell synchronisation.The intercellular medium plays an important role in self-synchronisation of ultradian rhythms between individual cells. Low cooperative activity of hepatocytes of old rats resulted from altered composition of the intercellular medium rather than direct effects of animal and cellular ageing. Similarly, in the whole body, changes in levels of gangliosides and catecholamines in the blood serum, a natural intercellular medium, can be critical events in age-dependent changes of the serum and accordingly cell-cell synchronisation. Hepatocytes of old rats exhibit some of the properties of young cells following an increase in blood serum ganglioside level, as well as, in in vitro conditions, after the addition of gangliosides to the culture medium.Together with data on ultradian functional and metabolic rhythms, all the material reviewed here allows us to propose a mechanism of direct cell-cell cooperation via the medium in which the cells exist, that supplements the nervous and hormonal central regulation of organ functions. Ultradian intracellular rhythms may thus provide a finer framework within which the integrated dynamics of respiration, heart rate, brain activity, and even behavioural patterns, are brought to an optimal functional pattern. Innate and direct cell-cell cooperation may have been employed as a means of intercellular regulation during the course of metazoan evolution, that preceded nervous regulation and is presently retained in mammals.     

Deconvolution of Serum Cortisol Levels by Using Compressed Sensing

The pulsatile release of cortisol from the adrenal glands is controlled by a hierarchical system that involves corticotropin releasing hormone (CRH) from the hypothalamus, adrenocorticotropin hormone (ACTH) from the pituitary, and cortisol from the adrenal glands. Determining the number, timing, and amplitude of the cortisol secretory events and recovering the infusion and clearance rates from serial measurements of serum cortisol levels is a challenging problem. Despite many years of work on this problem, a complete satisfactory solution has been elusive. We formulate this question as a non-convex optimization problem, and solve it using a coordinate descent algorithm that has a principled combination of (i) compressed sensing for recovering the amplitude and timing of the secretory events, and (ii) generalized cross validation for choosing the regularization parameter. Using only the observed serum cortisol levels, we model cortisol secretion from the adrenal glands using a second-order linear differential equation with pulsatile inputs that represent cortisol pulses released in response to pulses of ACTH. Using our algorithm and the assumption that the number of pulses is between 15 to 22 pulses over 24 hours, we successfully deconvolve both simulated datasets and actual 24-hr serum cortisol datasets sampled every 10 minutes from 10 healthy women. Assuming a one-minute resolution for the secretory events, we obtain physiologically plausible timings and amplitudes of each cortisol secretory event with R ² above 0.92. Identification of the amplitude and timing of pulsatile hormone release allows (i) quantifying of normal and abnormal secretion patterns towards the goal of understanding pathological neuroendocrine states, and (ii) potentially designing optimal approaches for treating hormonal disorders.     

Steroid secretion by ACTH-stimulated human fetal adrenal tissue during the first week in organ culture

Fetal adrenal tissue has been reported to lose its in vivo secretory pattern by virtue of a loss of fetal zone cells after the first week in culture. Consequently, we studied the steroidogenic capacity and the responsiveness to ACTH of human fetal adrenal tissue during the first week in organ culture. The culture medium was removed daily and assayed for cortisol and dehydroisoandrosterone sulfate (DS). First, as the concentration of ACTH in the medium was increased from 0 to 1 micrograms/ml steroid secretion increased. When tissue fragments were maintained in the absence of ACTH for 3 to 4 days, there was a striking increase in steroid secretion upon addition of ACTH to the medium, with larger rates of secretion of cortisol than DS being observed. Second, the steroidogenic capacity of the separate zones of the fetal adrenal gland was assessed. Tissue from the fetal zone secreted large amounts of DS and small amounts of cortisol, whereas neocortex tissue secreted similar quantities of DS and cortisol. Third, fetal zone tissue was maintained the absence of ACTH for 4 days and thereafter ACTH was added to the media for an additional 6 days. In this experiment, there was a marked increase in DS secretion rate after the addition of ACTH and a smaller increase in cortisol secretion.