Marova Eugenia I, Goncharov Nikolay P, Kolesnikova Galina S, Arapova Svetlana D, Lapshina Anastasiya M
National Research Center for Endocrinology of the Russian Academy of Medical Sciences, Moscow, Russia.
Hormones (Athens). 2008 Jul-Sep;7(3):243-50. doi: 10.14310/horm.2002.1204.
The purpose of this study was to evaluate the direct action of desmopressin (agonist of vasopressin) on the hypophysis and the three zones of the adrenal cortex in patients with different forms of hypercortisolism.
Forty-three patients with hypercortisolism-21 with Cushing's disease (14 females, 7 males), 11 with extrapituitary, ectopic tumours (5 females, 6 males), and 11 with ACTH-independent Cushing's syndrome (6 females, 5 males)-were evaluated. The response of the pituitary and adrenal glands was assessed by measuring plasma levels of adrenocorticotropic hormone (ACTH), cortisol, aldosterone, and dehydroepiandrosterone sulfate (DHEAS) at baseline and at 15, 30, 60, 90, and 120 min after the administration of desmopressin.
We observed two main modes of secretory response: (1) elevation of the ACTH level followed by a rise of one, two or all three adrenal steroids, and (2) ACTH-independent elevation of adrenal steroids in various combinations.
In a number of patients with hypercortisolism, the adrenal cortex responded to desmopressin administration by enhanced synthesis and secretion of glucocorticoids (cortisol), mineralocorticoids (aldosterone), and adrenal androgens (DHEAS) without a concomitant rise in ACTH. These findings suggest the presence of "ectopic" vasopressin receptors in the human adrenal cortex.
本研究旨在评估去氨加压素（血管加压素激动剂）对不同形式皮质醇增多症患者垂体及肾上腺皮质三个带的直接作用。
对43例皮质醇增多症患者进行了评估，其中21例为库欣病患者（14例女性，7例男性），11例为垂体外异位肿瘤患者（5例女性，6例男性），11例为促肾上腺皮质激素非依赖性库欣综合征患者（6例女性，5例男性）。通过在给予去氨加压素前及给药后15、30、60、90和120分钟测量血浆促肾上腺皮质激素（ACTH）、皮质醇、醛固酮和硫酸脱氢表雄酮（DHEAS）水平，评估垂体和肾上腺的反应。
我们观察到两种主要的分泌反应模式：（1）ACTH水平升高，随后一种、两种或所有三种肾上腺类固醇升高；（2）肾上腺类固醇以各种组合出现ACTH非依赖性升高。
在一些皮质醇增多症患者中，肾上腺皮质对去氨加压素给药的反应是糖皮质激素（皮质醇）、盐皮质激素（醛固酮）和肾上腺雄激素（DHEAS）的合成和分泌增强，而ACTH没有相应升高。这些发现提示人肾上腺皮质中存在“异位”血管加压素受体。
