Marini M, Rey F, Gomez F
Division d'endocrinologie et biochimie clinique, Département de médecine interne, CHUV, Lausanne.
Schweiz Med Wochenschr. 1991 May 4;121(18):653-9.
CRH (corticotropin-releasing hormone) is a hypothalamic polypeptide that stimulates ACTH secretion by the anterior pituitary and, subsequently, cortisol secretion by the adrenal cortex. CRH test administration is indicated in the differential diagnosis of Cushing syndrome and in the assessment of corticotropic function in different pituitary conditions. Both human CRH (hCRH) and ovine CRH (oCRH) can be used by i.v. injection. Intrinsic ACTH-releasing activities of the two molecular forms are similar. Nevertheless, and contrary to hCRH, oCRH does not interact with the human CRH specific binding protein (CRH-BP) and the use of this ovine form could be useful in testing pituitary function while avoiding possible changes in peptide activity due to protein binding. The present study was conducted in 3 distinct groups of human volunteers to evaluated the ACTH and cortisol responses to i.v. oCRH (1 micrograms per kg body weight) at noon (oCRH test). 24 healthy, nonobese subjects, not under medication, participated in the study. The first group consisted of 8 young men, the second of 8 women of childbearing age and the third of 8 menopausal women. Tolerance to the oCRH test was excellent in all 3 groups. A significant increase in plasma ACTH and cortisol was observed in all the subjects, with peak occurrence for ACTH between 15 and 60 minutes after oCRH and between 20 and 120 minutes for cortisol. The responses were not sex-related among the young subjects, but the menopausal women displayed a higher cortisol increase than the other 2 groups.
促肾上腺皮质激素释放激素(CRH)是一种下丘脑多肽,可刺激垂体前叶分泌促肾上腺皮质激素(ACTH),随后刺激肾上腺皮质分泌皮质醇。CRH试验给药适用于库欣综合征的鉴别诊断以及评估不同垂体疾病中的促肾上腺皮质激素功能。人CRH(hCRH)和羊CRH(oCRH)均可通过静脉注射使用。两种分子形式的内在促肾上腺皮质激素释放活性相似。然而,与hCRH不同,oCRH不与人CRH特异性结合蛋白(CRH-BP)相互作用,使用这种羊形式可能有助于检测垂体功能,同时避免由于蛋白质结合导致的肽活性可能变化。本研究在3组不同的人类志愿者中进行,以评估中午静脉注射oCRH(每千克体重1微克)后的促肾上腺皮质激素和皮质醇反应(oCRH试验)。24名健康、非肥胖且未接受药物治疗的受试者参与了研究。第一组由8名年轻男性组成,第二组由8名育龄女性组成,第三组由8名绝经后女性组成。所有3组对oCRH试验的耐受性都很好。所有受试者的血浆促肾上腺皮质激素和皮质醇均显著增加,促肾上腺皮质激素在oCRH注射后15至60分钟达到峰值,皮质醇在20至120分钟达到峰值。年轻受试者的反应与性别无关,但绝经后女性的皮质醇增加高于其他两组。