Abraham R R, Campbell E A, Gillham B, Thody A J, Altaher A R, Prysor-Jones A, Wynn V, Jones M T, Jenkins J
Clin Endocrinol (Oxf). 1986 Jul;25(1):75-85. doi: 10.1111/j.1365-2265.1986.tb03597.x.
The circulating levels of ACTH and alpha-melanocyte stimulating hormone (alpha-MSH) were measured in 9 patients with Nelson's syndrome after the administration of saline, ovine corticotrophin releasing factor (oCRF), bromocriptine or TRH. The concentrations of ACTH were grossly elevated and alpha-MSH levels ranged from undetectable to higher than the normal range. In seven of eight subjects there was a rapid corticotrophic response, but no change in the alpha-MSH level, following oCRF. This response was delayed in one subject. Following oCRF injection, the plasma oCRF profile was variable but circulating oCRF was detectable even at the end of the experiment in all cases. There was no significant change in circulating ACTH or alpha-MSH following either bromocriptine or TRH. Cultured tumour cells from one case of Cushing's disease showed a corticotrophic response but no change in alpha-MSH to oCRF and the response was enhanced by vasopressin. Bromocriptine added to the same tumour depressed ACTH secretion without affecting the output of alpha-MSH. The present data suggest that the tumours in these subjects are responsive to oCRF and arise from corticotrophs rather than melanotrophs.
对9例纳尔逊综合征患者在给予生理盐水、羊促肾上腺皮质激素释放因子（oCRF）、溴隐亭或促甲状腺激素释放激素（TRH）后，测定了促肾上腺皮质激素（ACTH）和α-黑素细胞刺激素（α-MSH）的循环水平。ACTH浓度显著升高，α-MSH水平从检测不到到高于正常范围不等。在8名受试者中的7名中，注射oCRF后促肾上腺皮质激素反应迅速，但α-MSH水平无变化。1名受试者的这种反应延迟。注射oCRF后，血浆oCRF曲线各不相同，但在所有病例中，即使在实验结束时循环中的oCRF仍可检测到。溴隐亭或TRH给药后，循环中的ACTH或α-MSH均无显著变化。来自1例库欣病患者的培养肿瘤细胞对oCRF有促肾上腺皮质激素反应，但α-MSH无变化，血管加压素可增强这种反应。向同一肿瘤中添加溴隐亭可抑制ACTH分泌，而不影响α-MSH的分泌。目前的数据表明，这些受试者的肿瘤对oCRF有反应，起源于促肾上腺皮质激素细胞而非黑素细胞。
