Lingis M, Richards EM, Keller-Wood M. Differential effects of mineralocorticoid blockade on the hypothalamo-pituitary-adrenal axis in pregnant and nonpregnant ewes. Am J Physiol Endocrinol Metab 300: E592-E599, 2011. First published January 4, 2011; doi:10.1152/ajpendo.00560.2010.-During pregnancy, plasma ACTH and cortisol are chronically increased; this appears to occur through a reset of hypothalamo-pituitary-adrenal (HPA) activity. We have hypothesized that differences in mineralocorticoid receptor activity in pregnancy may alter feedback inhibition of the HPA axis. We tested the effect of MR antagonism in pregnant and nonpregnant ewes infused for 4 h with saline or the MR antagonist canrenoate. Pregnancy significantly increased plasma ACTH, cortisol, angiotensin II, and aldosterone. Infusion of canrenoate increased plasma ACTH, cortisol, and aldosterone in both pregnant and nonpregnant ewes; however, the temporal pattern of these responses differed between these two reproductive states. In nonpregnant ewes, plasma ACTH and cortisol transiently increased at 1 h of infusion, whereas in pregnant ewes the levels gradually increased and were significantly elevated from 2 to 4 h of infusion. MR blockade increased plasma aldosterone from 2 to 4 h in the pregnant ewes but only at 4 h in the nonpregnant ewes. In both pregnant and nonpregnant ewes, the increase in plasma aldosterone was significantly related to the timing and magnitude of the increase in plasma potassium. The results indicate a differential effect of MR activity in pregnant and nonpregnant ewes and suggest that the slow changes in ACTH, cortisol, and aldosterone are likely to be related to blockade of MR effects in the kidney rather than to effects of MR blockade in hippocampus or hypothalamus.cortisol; adrenocorticotropic hormone; pregnancy; canrenoate; aldosterone IN STUDIES OF BOTH WOMEN (8) and ewes (3), basal plasma adrenocorticotropic hormone (ACTH) and cortisol have been shown to increase during pregnancy. The increase in adrenal steroid secretion is critical for normal pregnancy. Reduction of either maternal cortisol or maternal aldosterone results in alterations in maternal and fetal physiology (19 -21). We have hypothesized that there is a change in the regulation of basal ACTH in the pregnant state. Previous studies in our laboratory in adrenalectomized sheep have shown that the concentration for cortisol replacement required to normalize basal plasma ACTH is increased in pregnancy and that replacement of pregnant ewes with cortisol to plasma concentrations similar to those measured in nonpregnant ewes increases both basal and hypotension-stimulated ACTH release (23,26). On the other hand, in studies using adrenal-intact ewes, the inhibition of ACTH produced by raising plasma cortisol above resting levels is not different during pregnancy (23). Therefore, we have hypothesized that during pregnancy the "set point" of the negative feedback regulation by cortisol is increased, and/or a greater increase in cortisol is required in the pregnant s...