دورية أكاديمية
Adrenocorticotrophic hormone (ACTH) responsiveness to ghrelin increases after 6 months of ketoconazole use in patients with Cushing's disease: comparison with GH-releasing peptide-6 (GHRP-6).
| العنوان: | Adrenocorticotrophic hormone (ACTH) responsiveness to ghrelin increases after 6 months of ketoconazole use in patients with Cushing's disease: comparison with GH-releasing peptide-6 (GHRP-6). |
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| المؤلفون: | Correa-Silva SR; Division of Endocrinology, Universidade Federal de São Paulo, São Paulo, Brazil. dra.silviaregina@terra.com.br, Nascif SO, Molica P, Sá LB, Vieira JG, Lengyel AM |
| المصدر: | Clinical endocrinology [Clin Endocrinol (Oxf)] 2010 Jan; Vol. 72 (1), pp. 70-5. Date of Electronic Publication: 2009 Apr 29. |
| نوع المنشور: | Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: Blackwell Publishing Country of Publication: England NLM ID: 0346653 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1365-2265 (Electronic) Linking ISSN: 03000664 NLM ISO Abbreviation: Clin Endocrinol (Oxf) Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: <2003->: Oxford : Blackwell Publishing Original Publication: Oxford, Blackwell Scientific Publications. |
| مواضيع طبية MeSH: | Adrenocorticotropic Hormone/*metabolism , Ghrelin/*pharmacology , Ketoconazole/*therapeutic use , Oligopeptides/*pharmacology , Pituitary ACTH Hypersecretion/*drug therapy , Pituitary ACTH Hypersecretion/*metabolism, Adenoma/blood ; Adenoma/drug therapy ; Adenoma/metabolism ; Adenoma/urine ; Adrenocorticotropic Hormone/blood ; Adult ; Cushing Syndrome/blood ; Cushing Syndrome/drug therapy ; Cushing Syndrome/etiology ; Cushing Syndrome/metabolism ; Female ; Ghrelin/adverse effects ; Hormone Antagonists/therapeutic use ; Humans ; Hydrocortisone/analysis ; Hydrocortisone/metabolism ; Hydrocortisone/urine ; Male ; Middle Aged ; Oligopeptides/adverse effects ; Pituitary ACTH Hypersecretion/complications ; Pituitary ACTH Hypersecretion/urine ; Pituitary Neoplasms/blood ; Pituitary Neoplasms/drug therapy ; Pituitary Neoplasms/metabolism ; Pituitary Neoplasms/urine ; Time Factors ; Young Adult |
| مستخلص: | Background: In Cushing's disease (CD), adrenocorticotrophic hormone (ACTH)/cortisol responses to growth hormone secretagogues (GHS), such as ghrelin and GHRP-6, are exaggerated. The effect of clinical treatment of hypercortisolism with ketoconazole on ACTH secretion in CD is controversial. There are no studies evaluating ACTH/cortisol responses to GHS after prolonged ketoconazole use in these patients. Objective: To compare ghrelin- and GHRP-6-induced ACTH/cortisol release before and after ketoconazole treatment in patients with CD. Design/patients: Eight untreated patients with CD (BMI: 28.5 +/- 0.8 kg/m(2)) were evaluated before and after 3 and 6 months of ketoconazole treatment and compared with 11 controls (BMI: 25.0 +/- 0.8). Results: After ketoconazole use, mean urinary free cortisol values decreased significantly (before: 613.6 +/- 95.2 nmol/24 h; 3rd month: 170.0 +/- 27.9; 6th month: 107.9 +/- 30.1). The same was observed with basal serum cortisol (before: 612.5 +/- 69.0 nmol/l; 3rd month: 463.5 +/- 44.1; 6th month: 402.8 +/- 44.1) and ghrelin- and GHRP-6-stimulated peak cortisol levels (before: 1183.6 +/- 137.9 and 1045.7 +/- 132.4; 3rd month: 637.3 +/- 69.0 and 767.0 +/- 91.0; 6th month: 689.8 +/- 74.5 and 571.1 +/- 71.7 respectively). An increase in basal ACTH (before: 11.2 +/- 1.6 pmol/l; 6th month: 19.4 +/- 2.7) and in ghrelin-stimulated peak ACTH values occurred after 6 months (before: 59.8 +/- 15.4; 6th month: 112.0 +/- 11.2). GHRP-6-induced ACTH release also increased (before: 60.7 +/- 17.2; 6th month: 78.5 +/- 12.1), although not significantly. Conclusions: The rise in basal ACTH levels during ketoconazole treatment in CD could be because of the activation of normal corticotrophs, which were earlier suppressed by hypercortisolism. The enhanced ACTH responses to ghrelin after ketoconazole in CD could also be due to activation of the hypothalamic-pituitary-adrenal axis and/or to an increase in GHS-receptors expression in the corticotroph adenoma, consequent to reductions in circulating glucocorticoids. |
| المشرفين على المادة: | 0 (Ghrelin) 0 (Hormone Antagonists) 0 (Oligopeptides) 4H7N4I6X6A (growth hormone releasing hexapeptide) 9002-60-2 (Adrenocorticotropic Hormone) R9400W927I (Ketoconazole) WI4X0X7BPJ (Hydrocortisone) |
| تواريخ الأحداث: | Date Created: 20090521 Date Completed: 20100326 Latest Revision: 20181201 |
| رمز التحديث: | 20221213 |
| DOI: | 10.1111/j.1365-2265.2009.03618.x |
| PMID: | 19453623 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1365-2265 |
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| DOI: | 10.1111/j.1365-2265.2009.03618.x |