Lüdecke D K, Schabet M, Saeger W
Neurosurgery. 1983 May;12(5):549-54. doi: 10.1227/00006123-198305000-00012.
Fragments of adrenocorticotropic hormone (ACTH) cell adenomas and anterior lobes of two patients with Cushing's disease were obtained by transnasal operation. Both patients showed the typical clinical course, with postoperative ACTH deficit and all other pituitary functions intact. Equivalent specimens of tissue were investigated by immunocytology and in a superfusion system. The majority of adenoma cells were ACTH-positive, whereas ACTH-secreting cells of the anterior lobes were mostly inactive and were reduced in number. In vitro, adenomatous tissue showed high ACTH secretion into the superfusion medium, which was increased significantly after vasopressin application. Corticoid feedback was impaired Anterior lobe cells exhibited a significant spontaneous ACTH secretion that was reduced by cortisol, but not stimulated by vasopressin. These results support the concept of an impaired corticoid feedback at the adenoma level in the presence of suppressed ACTH secretion of the para-adenomatous anterior lobe.
通过经鼻手术获取了两名库欣病患者的促肾上腺皮质激素（ACTH）细胞腺瘤碎片和垂体前叶组织。两名患者均呈现典型的临床病程，术后出现ACTH缺乏，而其他垂体功能均保持正常。采用免疫细胞化学方法和超灌注系统对等量的组织标本进行了研究。大部分腺瘤细胞ACTH呈阳性，而垂体前叶分泌ACTH的细胞大多无活性且数量减少。在体外，腺瘤组织向超灌注培养基中分泌大量ACTH，应用血管加压素后分泌量显著增加。皮质激素反馈受损。垂体前叶细胞呈现显著的ACTH自发性分泌，皮质醇可使其分泌减少，但血管加压素不能刺激其分泌。这些结果支持了在腺瘤水平存在皮质激素反馈受损这一概念，此时腺瘤旁垂体前叶的ACTH分泌受到抑制。
