Suda T
Department of Medicine, Tokyo Women's Medical College, Japan.
Nihon Naibunpi Gakkai Zasshi. 1994 Jan 20;70(1):17-24. doi: 10.1507/endocrine1927.70.1_17.
To differentiate between ectopic ACTH syndrome and Cushing's disease, we examined the gene expression of CRF, POMC and glucocorticoid receptor in pituitary adenomas and in ectopic ACTH-producing tumors. CRF increased plasma ACTH levels in all patients with Cushing's disease and in some patients with ectopic ACTH syndrome whose tumors contained CRF and CRF mRNA. In CRF non-responders, no CRF was detected in tumors that contained no CRF mRNA or contained only long-size CRF mRNA. Dexamethasone (Dex) decreased plasma ACTH levels in all patients with Cushing's disease and in the patients with ectopic ACTH-producing bronchial carcinoid. These tumors contained glucocorticoid receptor mRNA. CRF increased and Dex decreased ACTH release and POMC mRNA levels in pituitary adenoma and bronchial carcinoid cells. PMA increased POMC mRNA levels only in carcinoid cells. These results reveal characteristics of ectopic ACTH-producing tumors: long-size CRF mRNA, PMA-induced POMC gene expression, two ectopic ACTH syndrome subtypes (tumors containing ACTH with CRF and tumors without CRF), and Dex-induced decrease in ACTH release and POMC mRNA levels in some bronchial carcinoid.
为了鉴别异位促肾上腺皮质激素（ACTH）综合征和库欣病，我们检测了垂体腺瘤和异位分泌ACTH肿瘤中促肾上腺皮质激素释放因子（CRF）、阿黑皮素原（POMC）和糖皮质激素受体的基因表达。CRF使所有库欣病患者以及部分肿瘤含有CRF和CRF mRNA的异位ACTH综合征患者的血浆ACTH水平升高。在CRF无反应者中，在不含CRF mRNA或仅含长链CRF mRNA的肿瘤中未检测到CRF。地塞米松（Dex）使所有库欣病患者以及分泌ACTH的支气管类癌患者的血浆ACTH水平降低。这些肿瘤含有糖皮质激素受体mRNA。CRF使垂体腺瘤和支气管类癌细胞中的ACTH释放及POMC mRNA水平升高，而Dex则使其降低。佛波酯（PMA）仅使类癌细胞中的POMC mRNA水平升高。这些结果揭示了异位分泌ACTH肿瘤的特征：长链CRF mRNA、PMA诱导的POMC基因表达、两种异位ACTH综合征亚型（含ACTH伴CRF的肿瘤和不含CRF的肿瘤）以及Dex诱导部分支气管类癌中ACTH释放和POMC mRNA水平降低。
