Lewis D A, Sherman B M, kathol R G
J Clin Endocrinol Metab. 1984 Mar;58(3):570-3. doi: 10.1210/jcem-58-3-570.
Five normal men were given infusions of saline and three doses (6, 12, and 18 micrograms/kg) of physostigmine, a centrally acting anticholinesterase, after pretreatment with glycopyrrolate, a peripheral cholinergic antagonist. There was no increase in basal ACTH or cortisol concentrations in any of the subjects after saline or the two smaller doses of physostigmine. However, each subject had a marked increase in ACTH and cortisol levels after the largest dose of physostigmine. These changes were preceded in each subject by the occurrence of noxious side effects and were accompanied by a rise in PRL levels in four of the subjects. Four subjects who received physostigmine (12 micrograms/kg) without glycopyrrolate pretreatment also experienced noxious side effects; these symptoms were followed by elevations in ACTH, cortisol, and PRL levels. These findings suggest that physostigmine stimulates ACTH and cortisol secretion through a stress-mediated effect rather than through a specific cholinergic mechanism. Consequently, physostigmine is not a reliable tool for investigating the cholinergic regulation of ACTH and cortisol.
五名正常男性在使用外周胆碱能拮抗剂格隆溴铵预处理后，接受了生理盐水输注以及三种剂量（6、12和18微克/千克）的毒扁豆碱（一种中枢作用的抗胆碱酯酶药）输注。在输注生理盐水或两种较小剂量的毒扁豆碱后，任何受试者的基础促肾上腺皮质激素（ACTH）或皮质醇浓度均未升高。然而，在接受最大剂量的毒扁豆碱后，每个受试者的ACTH和皮质醇水平均显著升高。在每个受试者中，这些变化之前都出现了有害的副作用，并且在四名受试者中伴随着催乳素（PRL）水平的升高。四名未经过格隆溴铵预处理而接受毒扁豆碱（12微克/千克）的受试者也出现了有害的副作用；这些症状随后伴随着ACTH、皮质醇和PRL水平的升高。这些发现表明，毒扁豆碱通过应激介导的效应而非特定的胆碱能机制刺激ACTH和皮质醇分泌。因此，毒扁豆碱不是研究ACTH和皮质醇胆碱能调节的可靠工具。
