Abel K M, Cleare A J
Department of Psychological Medicine, King's College School of Medicine and Dentistry and the Institute of Psychiatry, London, UK.
Psychopharmacology (Berl). 1999 Feb;142(1):68-72. doi: 10.1007/s002130050863.
We tested the hypothesis that D-fenfluramine (DFEN)-elicited cortisol (CORT) release in humans may be mediated by a direct effect on the adrenal gland by pretreating subjects with dexamethasone (DEX), to prevent release of ACTH from the pituitary, followed by a DFEN challenge test. Eight healthy subjects (four males; four female) (mean age = 38.1 +/- 8.4 years (SD)] were studied > 1 week apart (same phase of menstrual cycle) and testing order was randomised. On the with-DEX day (DEX+), subjects took 2 mg DEX orally at 10 p.m.; 30 mg DFEN was then given orally at 9 a.m. and samples were taken at 0-5 h for PRL and CORT. Peak hormone responses (delta values) were calculated by subtracting baseline values from the maximum levels post-DFEN administration. Peak and baseline hormonal values were compared between the two test conditions; DFEN-induced CORT and PRL responses were compared across all time points, with and without DEX. There was no significant difference in delta PRL between the two test conditions (DEX- and DEX+), but delta CORT values were significantly reduced after DEX: mean delta CORT DEX- = 68.4 +/- 26.3 nmol/l; DEX+ = 0.0 nmol/l (all blunted) (df 7,1; P = 0.03). The completely blunted peripheral cortisol response indicates that DFEN cortisol responses are of central origin only.
在人类中，右旋芬氟拉明（DFEN）引发的皮质醇（CORT）释放可能是通过对肾上腺的直接作用介导的。我们先给受试者使用地塞米松（DEX）进行预处理，以阻止垂体释放促肾上腺皮质激素（ACTH），随后进行DFEN激发试验。研究了8名健康受试者（4名男性；4名女性）（平均年龄 = 38.1 ± 8.4岁（标准差）），间隔>1周（月经周期的同一阶段）进行研究，测试顺序随机化。在使用DEX日（DEX+），受试者于晚上10点口服2毫克DEX；然后在上午9点口服30毫克DFEN，并在0 - 5小时采集样本检测催乳素（PRL）和CORT。通过从DFEN给药后的最高水平减去基线值来计算激素峰值反应（差值）。比较两种测试条件下的峰值和基线激素值；比较有和没有DEX时所有时间点的DFEN诱导的CORT和PRL反应。两种测试条件（DEX-和DEX+）下的PRL差值无显著差异，但DEX后CORT差值显著降低：DEX-时平均CORT差值 = 68.4 ± 26.3纳摩尔/升；DEX+时 = 0.0纳摩尔/升（均被抑制）（自由度7,1；P = 0.03）。外周皮质醇反应完全被抑制表明DFEN的皮质醇反应仅源于中枢。
