Dopaminergic control of 18-hydroxycorticosterone responses to posture, isometric exercise, and diuretic administration in normal man.

This study investigates dopaminergic mechanisms involved in the control of corticosteroid secretion in man. The responses of plasma 18-hydroxycorticosterone (18-OHB) and aldosterone levels to upright posture and isometric handgrip exercise and furosemide administration as well as PRA and catecholamine responses to posture and exercise were evaluated in six normal subjects with and without bromocriptine (BEC) treatment. To evaluate the role of PRL suppression by BEC in affecting corticosteroid responses, we evaluated the effect of BEC on plasma 18-OHB and aldosterone responses to 20 mg furosemide in two subjects with autoimmune hypoprolactinemia. BEC (2.5 mg, three times a day for 4 days) markedly suppressed basal levels of 18-OHB, but not aldosterone, in the six normal subjects as well as the two subjects with autoimmune hypoprolactinemia. BEC also suppressed the 18-OHB and aldosterone responses to upright posture, isometric exercise, and furosemide administration without altering electrolytes, PRA, or plasma cortisol levels. Additionally, BEC suppressed basal levels of PRL, norepinephrine, and epinephrine as well as norepinephrine and blood pressure responses to upright posture and isometric exercise in the normal subjects. These results offer additional evidence that dopaminergic mechanisms modulate the secretion of 18-OHB and aldosterone, perhaps indirectly via inhibitory effects of dopaminergic pathways on catecholamine secretion.