Pulmonary disposition of cortisol.

High-dose corticosteroid therapy is used in various lung diseases, yet it is not known if the drug enters the alveolar acinus. Cortisol levels, expressed as a function of albumin concentration, were measured in serum and bronchoalveolar lavage fluid in 12 patients with lung disease. There was a linear relation of cortisol concentration between blood level and bronchoalveolar lavage fluid level when expressed in relation to the albumin concentration (r = 0.93, p less than 0.001). Incremental doses of intravenous hydrocortisone reach alveolar structures in a concentration directly related to the circulating blood levels.