Plasma Cortisone Concentration as Measured by Radioimmunoassay

Srivastava, Laxmi S.; Werk, Emile E.; Thrasher, Katherine; Sholiton, Leon J.; Kozera, Richard; Nolten, Wolfram E.; Knowles, Harvey C.

doi:10.1210/jcem-36-5-937

Cited by 47 publications

(21 citation statements)

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“…But it must be taken into account that our protein expression data is semi-quantitative at best and needs to be interpreted with care. Nevertheless, our data are supported by earlier clinical studies: patients with chronic renal failure have a prolonged plasma cortisol half-life (2.9 h compared with 2.1 h in controls) (43), and plasma cortisone concentrations have been shown to be inversely correlated with plasma creatinine concentrations (37,39,40,44).…”

Section: Discussionsupporting

confidence: 87%

Expression of renal 11β-hydroxysteroid dehydrogenase type 2 is decreased in patients with impaired renal function

et al. 2005

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Objective: Renal 11b-hydroxysteroid dehydrogenase type 2 (11b-HSD2) enables selective access of aldosterone to the mineralocorticoid receptor (MR). Impaired 11b-HSD2 activity has been suggested in patients with hypertension as well as in patients with renal disease, where it may contribute to sodium retention, oedema and hypertension. To date, these studies have relied upon urinary cortisol (F) metabolite levels as surrogate markers of renal 11b-HSD2 activity. Methods: We have directly analysed renal 11b-HSD2 mRNA expression in 95 patients undergoing kidney biopsy using TaqMan real-time PCR. Serum and 24-h urine samples were used to document underlying renal function and endocrine parameters. Urinary F and cortisone (E) metabolites were analysed using gas chromatography/mass spectrometry. Results: Expression of 11b-HSD2 did not correlate with blood pressure or urinary Na/K ratio, but a significant positive correlation with creatinine clearance was observed (r ¼ 0.284; P , 0.01). Immunofluorescence and confocal laser microscopy confirmed decreased 11b-HSD2 expression in patients with impaired renal function. For the first time, we showed that 11b-HSD2 mRNA expression correlated negatively with the urinary free (UF) F/E (UFF/UFE) ratio (r ¼ 0.276; P , 0.05) as well as with the urinary tetrahydrocortisol þ 5a-tetrahydrocortisol/tetrahydrocortisone ((THF þ aTHF)/THE) ratio (r ¼ 0.256; P , 0.05). No difference in 11b-HSD2 mRNA expression or in the UFF/UFE ratio was found between groups with no proteinuria, microalbuminuria, moderate or severe proteinuria. In contrast, the urinary (THF þ aTHF)/THE ratio increased significantly (P , 0.05) in patients with severe albuminuria, suggesting increased hepatic 11b-HSD1 in those patients. Conclusions: These data suggest that renal 11b-HSD2 expression may be represented only marginally better, if at all, by the UFF/UFE than by the (THF þ aTHF)/THE ratio. Reduced renal 11b-HSD2 expression may lead to occupancy of the MR by glucocorticoids such as cortisol and may contribute to the increased sodium retention seen in patients with impaired renal function.European Journal of Endocrinology 153 291-299

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Section: Discussionsupporting

confidence: 87%

Expression of renal 11β-hydroxysteroid dehydrogenase type 2 is decreased in patients with impaired renal function

et al. 2005

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“…This was surprising, given that Bush et al (1968) described a liver enzyme in vivo which was capable of reductase activity, converting cortisone to cortisol. Isotopic studies (Hellman et al 1971) and clinical studies measuring cortisol/cortisone (F/E) levels in patients with renal disease (Srivastava et al 1973, Whitworth et al 1989 confirmed that the kidney was an important site for cortisol to cortisone conversion.…”

Section: Introductionmentioning

confidence: 99%

11β-Hydroxysteroid dehydrogenase and the pre-receptor regulation of corticosteroid hormone action

Draper¹,

Stewart²

2005

Journal of Endocrinology

347

294

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“…It has long been known that a similar change in the pattern of metabolites occurs after surgery and burns [19] and in infection, when there is also impaired conversion of injected labelled cortisol to cortisone [20]. However, this effect can be reproduced by administration of ACTH or even cortisol in volunteers [ 191 and it seems that plasma cortisone never rises in proportion to cortisol [21]; this may contribute to the tendency for U F F excretion always to rise more than FPR. It is conceivable that excessive impairment of renal cortisone production occurs in the elderly after injury and further work is needed on this point; unfortunately the method for measuring FPR did not permit determination of the ratio of cortisol to cortisone metabolites in the urine.…”

Section: Discussionmentioning

confidence: 99%

Increased rates of cortisol production and urinary free cortisol excretion in elderly women 2 weeks after proximal femur fracture

Barton

Weijers

Horan

1993

Eur J Clin Investigation

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Abstract. Cortisol production rate and urinary free cortisol excretion have been measured in healthy elderly women and elderly women about two weeks after upper femur fracture. Plasma cortisol was determined mid-morning, at the start of urine collection. All three variables were higher in the injured patients than in the control subjects. Urinary free cortisol excretion showed the greatest rise and was correlated with cortisol production rate in the patients. In the control subjects there was no correlation and nearly all the points fell below the regression line for the injured patients, indicating that urinary free cortisol excretion rose in relation to cortisol production rate after injury. Measurement of creatinine clearance showed that this was not due to an increased glomerular filtration rate, and a possible explanation is decreased metabolic clearance of cortisol. Plasma cortisol was not significantly correlated with either cortisol production rate or urinary free cortisol excretion.

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Plasma Cortisone Concentration as Measured by Radioimmunoassay

Cited by 47 publications

References 0 publications

Expression of renal 11β-hydroxysteroid dehydrogenase type 2 is decreased in patients with impaired renal function

Expression of renal 11β-hydroxysteroid dehydrogenase type 2 is decreased in patients with impaired renal function

11β-Hydroxysteroid dehydrogenase and the pre-receptor regulation of corticosteroid hormone action

Increased rates of cortisol production and urinary free cortisol excretion in elderly women 2 weeks after proximal femur fracture

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