Pituitary Responsiveness to Stress After Corticoid Therapy

Ferriman, David; Page, B. H.

doi:10.1016/s0140-6736(60)92847-6

Cited by 20 publications

(4 citation statements)

References 12 publications

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“…Tests based upon the rise of plasma steroid levels (Bliss et al 1954) or urinary steroid excretion (Ferriman & Page, 1960), after the injection of a pyrogen, over¬ come these limitations. They are dependent upon the integrity of the entire axis and no response occurs, for example, in patients with severe hypopituitarism (Melby, 1959).…”

Section: Resultsmentioning

confidence: 99%

The Adrenocortical Response to Insulin-Induced Hypoglycaemia

Landon¹,

Wynn²,

James³

1963

Journal of Endocrinology

155

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The adrenocortical response to stress as shown by an increase of the plasma cortisol concentration during insulin-induced hypoglycaemia has been studied. The response was found to depend upon the degree and duration of the hypoglycaemia and upon the integrity of the entire hypothalamopituitary-adrenal axis. Thus, there was no response in subjects in whom the blood sugar did not fall below 40 mg./100 ml., nor in patients with severe hypothalamic or pituitary disorders.The test was quick and simple to perform and did not require admission to hospital; it would seem to be of considerable value in the investigation of patients with suspected endocrine disease.

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Section: Resultsmentioning

confidence: 99%

The Adrenocortical Response to Insulin-Induced Hypoglycaemia

Landon¹,

Wynn²,

James³

1963

Journal of Endocrinology

155

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“…Hence the administration of ACTH as an ' aid' to the withdrawal of corticosteroids may be harmful. There is clinical 811 evidence in support of this view (Bacon, Beardwell, Myles, Daly & Savage, 1966;Carreon, Canary, Meyer & Kyle, 1960;Ferriman & Page, 1960), but it is not uncommon practice to use ACTH during the withdrawal of corticosteroids (Thompson, 1970;Today's Drugs, 1969a, b). The finding that the HPA system may be unable to respond to stress long after a normal circadian rhythm in pituitary adrenocortical activity has returned may also be of clinical relevance.…”

Section: Discussionmentioning

confidence: 99%

Effect of prolonged treatment with tetracosactrin on hypothalamo‐pituitary‐adrenal function in the rat

Hodges

Mitchley

1971

British J Pharmacology

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Summary1. The functional integrity of the hypothalamo-pituitary adrenal (HPA) system was assessed in rats after prolonged treatment with tetracosactrin. 2. Adrenal size and sensitivity to corticotrophin were increased. 3. Both the circadian rhythm and the stress-induced increase in HPA activity were inhibited. The circadian rhythm recovered before the response to stress. 4. Tetracosactrin given after betamethasone treatment delayed the return of a normal HPA response to stress. 5. Suppression of HPA activity appeared to be the result of a direct action of tetracosactrin and not entirely due to the elevations in the plasma corticosterone concentration which it caused.

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“…However, recovery of HPA function was rapid whereas after cortisol it was slow. Such differences in the properties of corticosteroids may help to explain the fact that, in man, corticosteroid induced suppression of HPA function has been variously reported to take hours, weeks or months to recover (Roe, Mitchell & Pennington, 1966;Ferriman & Page, 1960;Graber, Ney, Nicholson, Island & Liddle, 1965). Impairment of HPA function following prolonged corticosteroid therapy may be due to failure of the pituitary gland to secrete ACTH as well as to insensitivity of the adrenal cortex to the hormone.…”

Section: Discussionmentioning

confidence: 99%

Recovery of hypothalamo‐pituitary‐adrenal function in the rat after prolonged treatment with betamethasone

Hodges

Mitchley

1970

British J Pharmacology

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Summary1. Betamethasone caused growth retardation, adrenal atrophy and impaired hypothalamo-pituitary-adrenal (HPA) activity in the rat. 2. In spite of the profound impairment, recovery of normal HPA function was rapid, but the growth retardation persisted.3. The ability of the pituitary gland to secrete basal corticotrophin (ACTH), recovered more rapidly and the adrenocorticotrophic response to stress less rapidly than the ability of the adrenal cortex to respond to ACTH. 4. The degree of HPA suppression was not determined by the total dose of steroid. 5. The possible significance of the results is discussed.

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Pituitary Responsiveness to Stress After Corticoid Therapy

Cited by 20 publications

References 12 publications

The Adrenocortical Response to Insulin-Induced Hypoglycaemia

The Adrenocortical Response to Insulin-Induced Hypoglycaemia

Effect of prolonged treatment with tetracosactrin on hypothalamo‐pituitary‐adrenal function in the rat

Recovery of hypothalamo‐pituitary‐adrenal function in the rat after prolonged treatment with betamethasone

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