Kamilaris T C, DeBold C R, Johnson E O, Mamalaki E, Listwak S J, Calogero A E, Kalogeras K T, Gold P W, Orth D N
Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee 37232.
Endocrinology. 1991 May;128(5):2567-76. doi: 10.1210/endo-128-5-2567.
We report here a study of the plasma ACTH and corticosterone responses to synthetic ovine CRH (oCRH) in hypothyroid and hyperthyroid rats studied 7, 15, and 60 days after either thyroidectomy or the administration of pharmacological doses of T4. The purpose of this study was to further clarify the time-dependent effects of alterations in thyroid status on the functional integrity of the hypothalamic-pituitary-adrenal axis and to aid in the interpretation of the oCRH stimulation test in hypo- and hyperthyroid states. Our data demonstrate that hypothyroid rats have a significant reduction in the cerebrospinal fluid (CSF) levels of corticosterone and a significant decrease in adrenal weight in association with significant increases in the plasma ACTH response to oCRH. On the other hand, the corticosterone response to the ACTH released during the oCRH stimulation test was significantly reduced in hypothyroidism. With increasing duration of thyroidectomy-induced hypothyroidism, there was a progressive fall in CSF corticosterone levels, a progressive increase in the plasma ACTH response to oCRH, and a gradual normalization of the corticosterone responses to the ACTH released during oCRH stimulation. Our findings in hyperthyroid rats were generally the converse of those seen in hypothyroidism. Hence, there was a significant increase in the CSF levels of corticosterone and a significant increase in adrenal weight in association with an initial slight decrease in the ACTH response to oCRH. On the other hand, the corticosterone response to the ACTH released during oCRH stimulation was significantly increased. There was a gradual increase in the magnitude of the rise in CSF corticosterone levels with time, as well as a gradual normalization of adrenocortical responses during oCRH stimulation. The ACTH plasma clearance rates were similar in hypo-, hyper-, and euthyroid rats. Our data do not permit definitive identification of the precise locus in the hypothalamic-pituitary-adrenal axis that is principally affected by experimentally induced alterations in thyroid status. However, these data are most compatible with a subtle hypothyroid-induced centrally mediated adrenal insufficiency and a subtle hyperthyroid-induced centrally mediated hypercortisolism. These data also suggest that alterations in hypothalamic-pituitary-adrenal function in states of disturbed thyroid function become somewhat more pronounced as the duration of thyroid dysfunction increases. The fact that pituitary-adrenal responses to oCRH are consistently altered in states of thyroid dysfunction may be relevant to the clinical interpretation of oCRH stimulation tests.(ABSTRACT TRUNCATED AT 400 WORDS)
我们在此报告一项关于甲状腺功能减退和甲状腺功能亢进大鼠对合成羊促肾上腺皮质激素释放激素(oCRH)的血浆促肾上腺皮质激素(ACTH)和皮质酮反应的研究。这些大鼠在甲状腺切除或给予药理剂量的T4后7、15和60天接受研究。本研究的目的是进一步阐明甲状腺状态改变对下丘脑 - 垂体 - 肾上腺轴功能完整性的时间依赖性影响,并有助于解释甲状腺功能减退和亢进状态下的oCRH刺激试验。我们的数据表明,甲状腺功能减退的大鼠脑脊液(CSF)中皮质酮水平显著降低,肾上腺重量显著减轻,同时血浆ACTH对oCRH的反应显著增加。另一方面,在甲状腺功能减退状态下,oCRH刺激试验期间释放的ACTH所引起的皮质酮反应显著降低。随着甲状腺切除诱导的甲状腺功能减退持续时间的增加,CSF皮质酮水平逐渐下降,血浆ACTH对oCRH的反应逐渐增加,并且oCRH刺激期间释放的ACTH所引起的皮质酮反应逐渐恢复正常。我们在甲状腺功能亢进大鼠中的发现通常与甲状腺功能减退大鼠中的发现相反。因此,CSF中皮质酮水平显著升高,肾上腺重量显著增加,同时ACTH对oCRH的反应最初略有下降。另一方面,oCRH刺激期间释放的ACTH所引起的皮质酮反应显著增加。随着时间的推移,CSF皮质酮水平升高的幅度逐渐增加,并且oCRH刺激期间肾上腺皮质反应逐渐恢复正常。甲状腺功能减退、亢进和正常的大鼠中ACTH的血浆清除率相似。我们的数据无法明确确定下丘脑 - 垂体 - 肾上腺轴中主要受实验诱导的甲状腺状态改变影响的确切位点。然而,这些数据最符合轻微甲状腺功能减退诱导的中枢介导的肾上腺功能不全以及轻微甲状腺功能亢进诱导的中枢介导的高皮质醇血症。这些数据还表明,甲状腺功能紊乱状态下下丘脑 - 垂体 - 肾上腺功能的改变随着甲状腺功能障碍持续时间的增加而变得更加明显。在甲状腺功能紊乱状态下,垂体 - 肾上腺对oCRH的反应持续改变这一事实可能与oCRH刺激试验的临床解释有关。(摘要截断于400字)