AgResearch Limited, Ruakura Research Centre, Private Bag 3123, Hamilton, New Zealand.
Steroid & Immunobiochemistry Laboratory, Canterbury Health Laboratories, Christchurch, New Zealand.
J Steroid Biochem Mol Biol. 2014 May;141:16-25. doi: 10.1016/j.jsbmb.2013.12.015. Epub 2013 Dec 25.
Cortisol bound to corticosteroid binding globulin (CBG) contributes up to 90% of the total cortisol concentration in circulation. Therefore, changes in the binding kinetics of cortisol to CBG can potentially impact on the concentration of free cortisol, the only form that is responsible for the physiological function of the hormone. When CBG is cleaved into elastase-cleaved CBG (eCBG) by the activity of neutrophil elastase, its affinity for cortisol is reduced. Therefore, when eCBG coexists with intact CBG (iCBG) in plasma, the calculation of free cortisol concentration based on the formulae that considers only one CBG pool with the same affinity for cortisol may be inappropriate. In this study, we developed in vivo and in vitro models of cortisol partitioning which considers two CBG pools, iCBG and eCBG, with different affinities for cortisol, and deduce a new formula for calculating plasma free cortisol concentration. The formula provides better estimates of free cortisol concentration than previously used formulae when measurements of the concentrations of the two CBG forms are available. The model can also be used to estimate the affinity of CBG and albumin for cortisol in different clinical groups. We found no significant difference in the estimated affinity of CBG and albumin for cortisol in normal, sepsis and septic shock groups, although free cortisol was higher in sepsis and septic shock groups. The in vivo model also demonstrated that the concentration of interstitial free cortisol is increased locally at a site of inflammation where iCBG is cleaved to form eCBG by the activity of elastase released by neutrophils. This supports the argument that the cleavage of iCBG at sites of inflammation leads to more lower-affinity eCBG and may be a mechanism that permits the local concentration of free cortisol to increase at these sites, while allowing basal free cortisol concentrations at other sites to remain unaffected.
皮质醇与皮质类固醇结合球蛋白(CBG)结合,占循环总皮质醇浓度的 90%。因此,皮质醇与 CBG 结合动力学的变化可能会影响游离皮质醇的浓度,而游离皮质醇是激素发挥生理功能的唯一形式。当 CBG 被中性粒细胞弹性蛋白酶的活性切割成弹性蛋白酶切割的 CBG(eCBG)时,其与皮质醇的亲和力降低。因此,当 eCBG 与完整的 CBG(iCBG)共存于血浆中时,基于仅考虑具有相同皮质醇亲和力的一个 CBG 池的公式来计算游离皮质醇浓度可能是不合适的。在这项研究中,我们开发了考虑到两种 CBG 池(iCBG 和 eCBG)的皮质醇分配的体内和体外模型,这两种 CBG 池对皮质醇的亲和力不同,并推导出一种新的公式来计算血浆游离皮质醇浓度。与以前使用的公式相比,当可测量两种 CBG 形式的浓度时,该公式可提供更准确的游离皮质醇浓度估计值。该模型还可用于估计不同临床组中 CBG 和白蛋白对皮质醇的亲和力。我们发现,在正常、脓毒症和感染性休克组中,CBG 和白蛋白对皮质醇的估计亲和力没有显著差异,尽管脓毒症和感染性休克组中的游离皮质醇水平较高。体内模型还表明,在炎症部位,iCBG 被中性粒细胞释放的弹性蛋白酶切割形成 eCBG 的部位,局部间质游离皮质醇的浓度增加。这支持了这样一种观点,即炎症部位 iCBG 的切割导致更多低亲和力的 eCBG,这可能是一种机制,允许游离皮质醇在这些部位的局部浓度增加,而其他部位的基础游离皮质醇浓度不受影响。