Concomitant Suppression of Plasma ACTH- and β-Endorphin-Like Immunoreactivity by Cyproheptadine, Naloxone, and Somatostatin in the Ectopic ACTH Syndrome

Nakashima, Hiroko; Hirata, Y; Uchihashi, Masahito; Fujita, T; Taniguchi, H; Baba, Shigeaki; Matsukura, S

doi:10.1055/s-2007-1013492

Cited by 4 publications

(1 citation statement)

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“…In sheep, the anterior pituitary was found to secrete POMC peptides in both synchronous and asynchronous patterns: While the most frequent pattern of ultradian secretion involved concordant release of ACTH and I3-LPH/I3-E, the second most frequent pattern consisted of ACTH release alone, with no concomitant secretion of ]3-LPH/I3-E (Engler et al, 1989). In a patient with Cushing's syndrome due to an ectopic ACTH-producing malignant thymoma, a 2-hr infusion of somatostatin suppressed both ACTH and 13-LPH/13-E in concordant fashion; yet, 1 hr later, ACTH remained suppressed, while 13-LPH/13-E had returned to its preinfusion level (Nakashima et al, 1985). Similar dissociations between ACTH and [3-LPH/13-E have been observed in cultures of anterior pituitary cells under basal and stimulated conditions, and several explanations for such results have been suggested, such as differences in radioimmunoassay reactivity of precursor forms of the two peptides, differential rates of degradation, or selective secretion of the peptides (Ham & Smyth, 1985).…”

Section: Discussionmentioning

confidence: 96%

Discordant changes in plasma ACTH and β-lipotropin/β-endorphin levels in Clshing's disease patients with depression

Starkman¹,

Schteingart²,

Schork³

1992

Psychoneuroendocrinology

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Cushing's Disease is often associated with a depressive syndrome, with mood, vegetative, and cognitive abnormalities of variable severity. In 11 patients with (pituitary ACTH-dependent) Cushing's disease (10 women, 1 man), we studied the relationship between severity of the depressive syndrome and concordance of changes in ACTH and 13-1ipotropin/13-endorphin ([~-LPH/13-E) levels at baseline and in response to metyrapone and dexamethasone. For each condition, blood samples were drawn at 0800h, 1200h, 1600h, and 2200h. Six patients were categorized as mildly depressed (mean [+ SD] depressed mood score = 0.17+ 0.4; modified Hamilton Depression scale score = 7.6 + 4.5) and five as severely depressed (mean depressed mood score = 2.4 + 0.5; modified Hamilton Depression scale score = 15 + 5.6) (p< 0.05). ACTH and ~-LPI-I/[3-E were measured by radioimmunoassay. For each experimental condition, changes in levels were scored as concordant if the two peptides moved in parallel between sampling points. There was a relationship between greater severity of depression and more frequent discordant changes in ACTH and [3-LPI-I/~I-E levels: The six patients with mild depression exhibited 23 concordant and 3 discordant change patterns, while the five patients with severe depression showed 8 concordant and 15 discordant patterns. The mean percentage of concordant patterns per patient differed significantly between the two groups (mildly depressed=90.0+ 16.7; severely depressed=34.6 + 8.7 (p<0.001). When each study condition was examined separately, differences in the frequency of concordance between the groups reached significance during the post-metyrapone phase and with 8.0 mg dexamethasone administration. These initial findings, taken together with data in related areas, suggest that greater diversity in regulation and cosecretion of ACTH and ~-LPH/13-E may occur than is currently suspected. Such diversity may play a role in the relationship between HPA axis dysregulation and mood disorders.

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Section: Discussionmentioning

confidence: 96%

Discordant changes in plasma ACTH and β-lipotropin/β-endorphin levels in Clshing's disease patients with depression

Starkman¹,

Schteingart²,

Schork³

1992

Psychoneuroendocrinology

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Carcinoid tumors of the thymus. An immunohistochemical study

Herbst

Kummer

Hofmann

et al. 1987

Cancer

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Five carcinoid tumors of the thymus were screened immunohistochemically for the occurrence of neuropeptides (ACTH, calcitonin, calcitonin gene-related peptide, cholecystokinin, gastrin, neurotensin, somatostatin, substance P), as well as of serotonin, chromogranin A, and neuron-specific enolase. Most of the patients exhibited local symptoms evoked by growing tumor masses in the upper mediastinum without any clinical evidence of endocrine activity. Light and electron microscopic examination showed characteristic uniform large epithelial cells in polar or palisade arrangement, containing variable amounts of electron-dense secretory granules. Only a few of the tested neuropeptide antisera reacted with the investigated tumors. Cholecystokinin-immunoreactive cell populations were seen in all tumors. Expression of neurotensin could be observed in three neoplasms, two of which also exhibited ACTH immunoreactivity. Chromogranin A-immunoreactive cells were found in two neoplasms. Neuron-specific enolase showed strong staining in three tumors, one of the tumors also being immunoreactive for calcitonin. The results were confirmed by control reactions. Apart from the demonstration that conventional marker proteins are not reliable in identifying all carcinoid tumors, the present study proves that the visualization of neuropeptide-immunoreactive cells in thymus carcinoids does not necessarily correspond to the manifestation of the clinical symptoms. Furthermore, each of the investigated neoplasms, as also known from other carcinoid tumors, appears to be able to produce more than one hormone.

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Ectopic Secretion of Peptides of the Proopiomelanocortin Family

Schteingart

1991

Endocrinology and Metabolism Clinics of North America

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Concomitant Suppression of Plasma ACTH- and β-Endorphin-Like Immunoreactivity by Cyproheptadine, Naloxone, and Somatostatin in the Ectopic ACTH Syndrome

Cited by 4 publications

References 1 publication

Discordant changes in plasma ACTH and β-lipotropin/β-endorphin levels in Clshing's disease patients with depression

Discordant changes in plasma ACTH and β-lipotropin/β-endorphin levels in Clshing's disease patients with depression

Carcinoid tumors of the thymus. An immunohistochemical study

Ectopic Secretion of Peptides of the Proopiomelanocortin Family

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