Nussey S S, Page S R, Peterson D B, Byrne J, Crosby S R, White A, Ang V T, Jackson R, Jenkins J S
Department of Medicine, St George's Hospital Medical School, London, UK.
Clin Endocrinol (Oxf). 1991 Jan;34(1):51-6. doi: 10.1111/j.1365-2265.1991.tb01735.x.
To examine the relationship between corticotrophin releasing hormone (CRH), arginine vasopressin (AVP) and oxytocin (OXT) we have studied the responses of adenohypophyseal and neurohypophyseal hormones to CRH in eight patients (age 26-64 years, six female) with suspected pituitary-dependent Cushing's syndrome during bilateral, simultaneous inferior petrosal sinus catheterization. Blood samples were taken from both petrosal sinuses and a peripheral vein before, and at 5-min intervals for 15 min after, an intravenous injection of 100 micrograms human CRH1-41. CRH increased sinus AVP concentrations in all eight patients and OXT concentrations in four of five patients studied. Although AVP concentrations often increased in both sinuses, the side of maximal AVP rise was termed side(max-AVP). CRH did not affect peripheral or petrosal sinus mean concentrations of LH, FSH, GH or TSH. While there was no change in mean peripheral concentrations of AVP, OXT, ACTH, ACTH precursors or prolactin after CRH, sinus concentrations of OXT, ACTH and prolactin on side(max-AVP) were markedly elevated over contralateral values. CRH did not increase mean sinus concentrations of ACTH precursors. In seven patients with either no radiological abnormality or the pituitary fossa or a small adenoma the mean ACTH precursor/ACTH ratio in blood sampled from all sites was 2.1 +/- 0.16 (mean +/- SEM, n = 50). In a patient with a large, locally invasive tumour the mean ACTH precursor/ACTH molar ratio was 32.1 +/- 1.3 (n = 12; P less than 0.001), suggesting that alterations in this molar ratio may reflect the biological properties of the tumour. The source of CRH-stimulatable AVP and OXT remains uncertain.(ABSTRACT TRUNCATED AT 250 WORDS)
为研究促肾上腺皮质激素释放激素(CRH)、精氨酸加压素(AVP)和催产素(OXT)之间的关系,我们在8例(年龄26 - 64岁,6例女性)疑似垂体依赖性库欣综合征患者双侧同时进行岩下窦插管时,研究了腺垂体和神经垂体激素对CRH的反应。在静脉注射100微克人CRH1 - 41之前以及之后,每隔5分钟采集双侧岩下窦和外周静脉血样,共采集15分钟。CRH使所有8例患者的窦内AVP浓度升高,在5例研究患者中有4例的OXT浓度升高。尽管两个窦内的AVP浓度常常都升高,但AVP升高幅度最大的一侧被称为最大AVP侧(side(max - AVP))。CRH不影响外周或岩下窦LH、FSH、GH或TSH的平均浓度。CRH注射后,外周AVP、OXT、促肾上腺皮质激素(ACTH)、ACTH前体或催乳素的平均浓度没有变化,但最大AVP侧的OXT、ACTH和催乳素的窦内浓度明显高于对侧。CRH没有增加ACTH前体的平均窦内浓度。在7例无影像学异常或垂体窝正常或有小腺瘤的患者中,从所有部位采集的血样中ACTH前体/ACTH的平均比值为2.1±0.16(平均值±标准误,n = 50)。在1例有大的局部侵袭性肿瘤的患者中,ACTH前体/ACTH的平均摩尔比值为32.1±1.3(n = 12;P<0.001),这表明该摩尔比值的改变可能反映肿瘤的生物学特性。CRH刺激产生AVP和OXT的来源仍不确定。(摘要截短于250字)