Prolactin, LH, FSH, GH and cortisol response to surgery and the effect of epidural analgesia

1980 ◽  
Vol 94 (2) ◽  
pp. 151-154 ◽  
Author(s):  
Claus Hagen ◽  
Mogens R. Brandt ◽  
Henrik Kehlet

Abstract. The prolactin, LH, FSH, growth hormone and cortisol responses to surgical stress were studied in female patients receiving halothane (general) anaesthesia or epidural analgesia. Plasma cortisol, prolactin, and growth hormone concentrations increased during surgery, and post-operatively in patients operated under general anaesthesia, but not in patients operated during epidural analgesia. Gonadotrophin concentrations were unchanged in the general anaesthesia group until 9 h after stimulation when levels decreased slightly. In contrast plasma gonadotrophin levels decreased immediately after the administration of epidural analgesia and during the following 9 h. It is concluded that neurogenic blockade inhibits the anterior pituitary response to surgial stress.

1995 ◽  
Vol 268 (4) ◽  
pp. E623-E629 ◽  
Author(s):  
J. Schwartz ◽  
F. Kleftogiannis ◽  
R. Jacobs ◽  
G. D. Thorburn ◽  
S. R. Crosby ◽  
...  

Adrenocorticotropic hormone (ACTH) is synthesized in the corticotrophs as a precursor, pro-opiomelanocortin (POMC), which is processed via proACTH to ACTH. Both precursors and ACTH are secreted. Although the steroidogenic activity of ACTH is well characterized, that of the precursors is not. This study assessed the capacity of POMC and proACTH to alter cortisol synthesis. POMC and proACTH were prepared by subjecting medium, conditioned by exposure to DMS-79 cells, to Sephadex chromatography, and the bioactivity was assessed in cultured-dissociated ovine adrenal cells. Alone neither POMC (< or = 2.6 nM) nor proACTH (< or = 0.7 nM) showed any consistent acute (6 h) stimulatory or inhibitory action on cortisol in either fetal or adult cells. In contrast, in fetal cells the precursors inhibited steroidogenic response to ACTH-(1-24). POMC at 2.6 nM, but not lower concentrations, decreased the cortisol responses to 0.01, 0.1, and 1 nM ACTH by at least 50%. ProACTH (0.70 and 0.23 nM) decreased the responses to ACTH at 0.01 nM by 89 and 67%, respectively, and at 0.1 nM by 49 and 34%, respectively. At 1 nM ACTH only 0.7 nM proACTH decreased the response to ACTH (by 69%). In contrast, in adult adrenal cells, the precursors did not significantly reduce the response to ACTH (range 0.01-1 nM). Therefore, these data indicate that POMC and proACTH can inhibit the cortisol response to ACTH in fetal adrenal cells, an effect that is concentration dependent. The data suggest that precursors may play a physiological role, possibly regulating fetal plasma cortisol concentrations.


1994 ◽  
Vol 76 (3) ◽  
pp. 1302-1309 ◽  
Author(s):  
M. J. De Souza ◽  
A. A. Luciano ◽  
J. C. Arce ◽  
L. M. Demers ◽  
A. B. Loucks

To investigate mechanisms of blunted adrenocortical responsiveness to exercise and mild hypercortisolism in amenorrheic runners, adrenocorticotropic hormone [ACTH-(1–24) 0.25 mg Cortrosyn] stimulation tests were performed in the presence and absence of overnight dexamethasone (1 mg) suppression (DX and NDX condition, respectively) in six eumenorrheic sedentary women (ES), nine eumenorrheic runners (ER), and nine amenorrheic runners (AR). Before the NDX stimulation test, plasma cortisol was higher (P < 0.001) in AR than in ER and ES. The cortisol response to the NDX stimulation test was blunted (P < 0.001) in AR but reached similar (P > 0.7) peak levels in all groups. Dexamethasone suppressed (P < 0.001) cortisol to similar (P > 0.5) levels (approximately 20 nmol/l) in all groups. In AR, cortisol responses to the DX test were larger (P < 0.03) than to the NDX test and similar (P > 0.6) in the three groups, again reaching comparable (P > 0.8) peak levels. The blunted cortisol response to stimulation in AR in the presence of their mild hypercortisolism appears to be due to a normal limitation in maximal adrenal secretory capacity. Extrapituitary modulators of adrenal responsiveness to ACTH may explain the mild hypercortisolism observed in AR, but limitations of these tests prevent a central negative-feedback defect or an intrinsic adrenal abnormality from being excluded until results of additional studies with even lower doses of dexamethasone and submaximal doses of ACTH-(1-24) are available.


2002 ◽  
Vol 174 (3) ◽  
pp. 387-394 ◽  
Author(s):  
AE Rigamonti ◽  
SM Bonomo ◽  
SG Cella ◽  
EE Muller

GH-releasing peptides (GHRPs), a class of small synthetic peptide and non-peptide compounds, act on specific receptors at both the pituitary and the hypothalamic level to stimulate GH release in both humans and other animals. GHRPs, like corticotropin-releasing hormone (CRH), also possess acute ACTH- and cortisol-releasing activity, although the mechanisms underlying the stimulatory effect of GHRPs on the hypothalamo-pituitary-adrenal (HPA) axis are still unclear. In recent years, studies in humans and other animals have provided evidence that the rebound GH rise which follows withdrawal of an infusion of somatostatin (SS) (SSIW) is due, at least in part, to the functional activation of GH-releasing hormone (GHRH) neurons of the recipient organism. Unexpectedly, in humans, SS infusion, at a dose inhibiting basal GH secretion, has been associated with an activation of the HPA axis, leading to the hypothesis that this response was mediated, at least in part, by a central nervous system ACTH-releasing mechanism activated by the SS-induced decrease in GH secretion. Interestingly, the rebound GH rise which follows SSIW was magnified by the administration, before SS withdrawal, of a GHRP, implying that the SSIW approach could also be exploited to investigate in vivo the functional interaction in the process of GH and/or ACTH/cortisol secretion between endogenous GHRH (and/or other ACTH-releasing mechanisms) and GHRPs. In the present study, six young beagle dogs were given, on different occasions, at the beginning and at the end of a 3-h i.v. infusion of SS or saline (SAL), a bolus of physiological SAL or a GHRP compound, EP51216. SSIW induced a GH rebound rise without affecting plasma cortisol concentrations, while the withdrawal of SAL infusion was ineffective on either hormone paradigm. Administration of EP51216 at the beginning of SAL infusion evoked release of both GH and cortisol, whereas EP51216 administration at the withdrawal of SAL infusion evoked somatotroph and cortisol responses which were reduced in amplitude and duration. SS infusion significantly reduced the secretion of GH elicited by EP51216 but did not affect the rise of plasma cortisol levels. Interestingly, SSIW resulted in a marked enhancement of the somatotroph and cortisol responses evoked by EP51216. The marked rise of plasma GH levels induced by the GHRP after SSIW recalled that occurring after acute combined administration of recombinant human GHRH and EP51216, implying that exogenously delivered GHRP had synergized with the endogenous GHRH release triggered by SSIW. In contrast, acute combined administration of GHRH and the GHRP induced a cortisol response not different from that induced by GHRP alone, indicating that endogenous GHRH release was not involved in the enhanced cortisol response following EP51216 administration after SSIW. Similarly, the direct involvement of endogenous CRH could be ruled out, since i.v. administration of ovine CRH after SSIW evoked cortisol peak levels not different from those evoked by CRH at the withdrawal of SAL infusion. In conclusion, enhancement of the GH response to EP51216 alone by SSIW, to an extent reminiscent of that following combined administration of GHRH and EP61216, reinforces the view that SSIW elicits release of endogenous GHRH. Further studies are indeed necessary for a better understanding of the mechanisms underlying the enhanced cortisol response, since from now on the involvement of endogenous GHRH or CRH can be ruled out.


1988 ◽  
Vol 16 (6) ◽  
pp. 403-412 ◽  
Author(s):  
K. Mikawa ◽  
M. Kusunoki ◽  
H. Obara ◽  
S. Iwai

Five patients with acromegaly and five patients with prolactinoma undergoing general anaesthesia were studied. Concentrations of plasma growth hormone in patients with acromegaly and concentrations of plasma prolactin in patients with prolactinoma were measured before anaesthesia, when 250 mg levodopa was administered orally, and after anaesthesia when dopamine was infused intravenously at a rate of 5 μg/kg-min. There was no difference in hormonal (growth hormone or prolactin) response to either treatment in the anaesthetized and the awake states. These findings indicate that the functioning of dopamine receptors in the anterior pituitary is not affected by anaesthesia.


2004 ◽  
Vol 34 (1) ◽  
pp. 169-172 ◽  
Author(s):  
T. G. DINAN ◽  
S. O'BRIEN ◽  
E. LAVELLE ◽  
L. V. SCOTT

Background. In situations of chronic stress vasopressin plays an important role in regulating the hypothalamic–pituitary–adrenal axis. The aim of the current study was to investigate the role of anterior pituitary vasopressin V3 receptors in maintaining the hypercortisolism seen in melancholic depression.Method. Fourteen patients with major depression and 14 age- and sex-matched healthy comparison subjects were recruited. Desmopressin (ddAVP) 10 μg was given intravenously and ACTH and cortisol release was monitored for 120 min.Results. The mean±S.E.M. ACTH response in the depressives was 28·4±4·3 ng/l and in the healthy subjects was 18·8±4·9 ng/l (P=0·04). The mean±S.E.M. cortisol response in the depressives was 261·8±46·5 nmol/l and in the healthy subjects was 107·3±26·1 nmol/l (P<0·01).Conclusions. Patients with major depression have augmented ACTH and cortisol responses to desmopressin indicating enhanced V3 responsivity.


1991 ◽  
Vol 125 (5) ◽  
pp. 556-562 ◽  
Author(s):  
S. G. Matthews ◽  
R. F. Parrott

Abstract. Two experiments were carried out using adult castrated sheep prepared with jugular vein catheters. In Experiment 1, sheep (N=8) were injected iv with saline vehicle, vehicle + 15 or 30 μg oCRH, or subjected to 120 min mild physical stress (restraint), following a 48 h period during which water was freely available or withheld. Blood samples were taken for 30 min before and 120 min after oCRH injection, and before and during restraint, and the plasma analysed for AVP and cortisol content. Levels of AVP increased by over 500% after dehydration, but were unaffected by oCRH or restraint. In contrast, plasma cortisol was unchanged after dehydration, but increased after oCRH and restraint. Moreover, these cortisol responses were significantly greater when the sheep were dehydrated. In Experiment 2, euhydrated sheep (N =6) were infused iv with saline vehicle or vehicle + AVP for a 5-h pretreatment period, followed by a 2-h experimental period in which the animals were injected with 15 μg oCRH or subjected to 120 min restraint, as in Experiment 1. Blood samples were taken throughout the experiment from a contralateral catheter and the plasma analysed for AVP and cortisol content. The AVP infusion produced plasma levels of the hormone approximately twice those seen after 48 h dehydration in Experiment 1, but did not affect cortisol secretion. Furthermore, the cortisol response to oCRH, or restraint, was not enhanced by the AVP infusion. These results suggest that pituitary responsiveness to exogenous or endogenous CRH (restraint stress) may be enhanced in sheep by dehydration through a mechanism that does not involve an adrenal or pituitary action of circulating AVP.


1992 ◽  
Vol 262 (3) ◽  
pp. E319-E324 ◽  
Author(s):  
D. R. Kerr ◽  
M. I. Castro ◽  
N. M. Rawashdeh ◽  
J. C. Rose

To determine whether an initial ovine corticotropin-releasing factor (oCRF) injection modifies adrenocorticotropic hormone (ACTH) and cortisol responses to a second injection and to establish whether the effect changes throughout gestation, we studied chronically cannulated fetal lambs of 103-113 and 133-137 days gestation. Experimental groups underwent an injection (500 ng/kg iv) of oCRF, arterial blood sampling for 6 h, then a similar oCRF injection followed by sampling. In control studies, vehicle was the initial injection. After the first oCRF injection, plasma cortisol levels went from 1.7 +/- 0.4 to 9.5 +/- 5.2 (SE) ng/ml ("immature") and from 22.3 +/- 4.9 to 52.5 +/- 5.8 ng/ml ("mature"), remaining elevated for 6 h. In immature fetuses, the first oCRF injection did not alter the ACTH response to a second injection. Cortisol increases were reduced. In mature animals, ACTH and cortisol response to oCRF were eliminated by prior oCRF. Thus a large increase in cortisol after oCRF in mature fetuses is associated with inhibition of the ACTH response to a second oCRF injection, whereas in immature animals a small increase in cortisol after the first oCRF injection is not.


1995 ◽  
Vol 61 (1) ◽  
pp. 77-83 ◽  
Author(s):  
W. Haresign ◽  
R. J. Williams ◽  
M. Khalid ◽  
R. Rodway

AbstractTwo experiments were performed to monitor the stress responses of sheep to intra-uterine insemination by laparoscopy and its associated handling procedures. The results of experiment 1 indicated that both restraint alone and full laparoscopic intra-uterine insemination in animals which had been sedated with 0·2 mg/kg diazepam promoted similar, significant (P < 0·001) short-lived increase in heart rate and plasma cortisol concentrations, but there was no effect of treatment on plasma β-endorphin concentrations. Experiment 2 compared restraint and full laparoscopy, with and without sedation in a 2 × 2 factorial design. The heart rate and cortisol responses following restraint and full laparoscopy were not significantly different, although laparoscopy tended (P = 0·06) to increase the duration of the heart rate response. Sedation with diazepam significantly (P<0·05) increased the duration of the heart rate response but attenuated (P < 0·05) the amplitude of the cortisol response. These results indicate that laparoscopic intra-uterine insemination does cause sheep to mount a typical stress response, but that most of this is attributable to the restraint required to effect insemination. However, the magnitude of the stress responses recorded were much lower than those reported to follow many other husbandry procedures.


1992 ◽  
Vol 22 (2) ◽  
pp. 317-329 ◽  
Author(s):  
M. Maes ◽  
M. Claes ◽  
M. Vandewoude ◽  
C. Schotte ◽  
M. Martin ◽  
...  

SYNOPSISSeveral authors have reported attenuated adrenocorticotropin hormone (ACTH) responses to corticotropin releasing factor (CRF) administration in melancholic patients as compared with healthy controls. In order to explore the integrity of the hypothalamic–pituitary–adrenal (HPA)-axis in melancholics, we examined the following parameters in 98 subjects: the ACTH; β-endorphin; and cortisol responses to ovine CRF (oCRF) (100 μg/i.v.); and the postdexamethasone cortisol values. We found significant lower CRF-induced ACTH responses in melancholic patients as opposed to healthy controls and minor depressives, while major depressives occupied an intermediate position. The psychopathological correlates of the blunted CRF-induced ACTH responses were feelings of worthlessness, self-reproach, or excessive guilt. The CRF-stimulated β-endorphin and cortisol response did not differ between the study samples. Higher baseline plasma cortisol was associated with attenuated CRF-induced ACTH responses, but these effects were not pertinent to melancholia. There were no relationships between the disordered oCRF test results, and postdexamethasone cortisol values, age, body size, sex and severity of illness. The diagnostic power of the oCRF and the dexamethasone suppression test for melancholia is enhanced when both test results are combined.


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