Comparative Effects of Prednisone and of Cortisone in Suppressing the Response of the Adrenal Cortex to Exogenous Adrenocorticotropin*

Christy, Nicholas P.; Wallace, Eleanor Z.; Jailer, Joseph W.

doi:10.1210/jcem-16-8-1059

Cited by 83 publications

(18 citation statements)

References 16 publications

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“…per 100 ml., respectively, are within the normal limits (29). DISCUSSION A delay in the rate of clearance of hydrocortisone from plasma of pregnant women near term appears to be well established by earlier work (9,20) and by the present study.…”

Section: Methodssupporting

confidence: 89%

“…Previous studies have shown that administration of 17 alpha, 21 -dihydroxy -delta 1,4 -pregnadiene -3,20 -dione (prednisone) is capable of suppressing the apparently exaggerated response of plasma 17-OHcorticosteroids to ACTH in pregnancy (29), but the degree of suppression is less than that brought about by prednisone in normal subjects. These findings suggest that the pituitary during pregnancy can be influenced by circulating glucocorticoid levels, but that it is perhaps less sensitive than normal to this influence.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

On the Rate of Hydrocortisone Clearance From Plasma in Pregnant Women and in Patients With Laennec's Cirrhosis*

Christy¹,

Wallace²,

W³

et al. 1959

J. Clin. Invest.

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The question of whether or not there is an increase in adrenal cortical secretion during pregnancy remains unsettled. Morphologic studies of the adrenal during gestation have revealed enlargement of the gland in some species (1) and no enlargement in others (2). In the human female, several groups of investigators have observed a progressive rise in the plasma 17-hydroxycorticosteroid (17-OH-corticosteroid) level during pregnancy (3-8). Paper chromatographic studies (9), confirmed in this laboratory (10), have indicated that the elevated plasma 17-OH-corticosteroid level is due to an increase in circulating hydrocortisone, and not to a nonspecific chromogen. Measurement of urinary 17-OH-corticosteroids has given equivocal results. Jayle, Desgrez, Serpicelli and Rozeg (11), Devis (12), Mills (13), and Appleby and Norymberski (14) found that the rise in urinary 17-OH-corticosteroids and 17-ketogenic steroids during pregnancy was of only moderate degree. Contradictory results have been obtained from studies of urinary 11-oxygenated 17-ketosteroids, the principal C19 metabolites of hydrocortisone (15). Dobriner, Lieberman, Rhoads and Taylor (16) crepancy between the finding of elevated plasma and of relatively normal urinary 17-OH-corticosteroid levels in pregnancy, Migeon, Bertrand and Wall investigated the rate of disappearance of injected 4-C14-hydrocortisone from plasma of pregnant women near term and found it to be delayed (20). These workers also observed a reduced rate of appearance of plasma and urine 17-OHcorticosteroid conjugates (glucuronides) after the administration of labeled hydrocortisone. These data suggested that the co-existence of high plasma (unconjugated) 17-OH-corticosteroid values and normal urine (unconjugated plus conjugated) 17-OH-corticosteroid values might be partly explained by the presence in both plasma and urine of a greater proportion of free hydrocortisone and a smaller proportion of conjugated hydrocortisone metabolites than normal (20). Devis (12) and Gray (21) have reported increased amounts of free 17-OH-corticosteroid in the urine of pregnant women. The present report describes studies upon the rate of hydrocortisone clearance from plasma in late pregnancy and in Laennec's cirrhosis, a condition in which hydrocortisone disposal rate is reportedly delayed (22)(23)(24). The data suggest that a delay in hydrocortisone clearance may not completely account for the elevated plasma 17-OHcorticosteroid levels observed in the pregnant state. MATERIALS AND METHODSPatients. Subjects were pregnant women in the third trimester of pregnancy who were not acutely ill and who showed no evidence of rheumatic heart disease, diabetes mellitus or pre-eclampsia. The women were hospitalized for premature rupture of the membranes or in anticipation of elective Caesarian section. Patients with Laennec's cirrhosis were six men and one woman with the typical clinical and laboratory features of parenchy-299

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Section: Methodssupporting

confidence: 89%

Section: Methodsmentioning

confidence: 99%

On the Rate of Hydrocortisone Clearance From Plasma in Pregnant Women and in Patients With Laennec's Cirrhosis*

Christy¹,

Wallace²,

W³

et al. 1959

J. Clin. Invest.

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“…The fact that relatively prolonged administration of chlorpromazine failed to suppress plasma 17-OH-corticosteroid response to exogenous ACTH (in contrast to long-term steroid administration [31] ) is not necessarily incompatible with the inhibitory effect of the drug upon adrenal cortical response to an acute stimulus. The two apparently contradictory findings may perhaps be reconciled by Harris' concept of a dual control of the central nervous system over corticotropin release, one mechanism operating under quiescent conditions, the other under conditions of "stress" (2).…”

Section: Discussionmentioning

confidence: 97%

“…It is obvious that only one of the patients (A. T.) showed a very slightly reduced response. Despite the inhibitory effect of the drug upon plasma corticosteroid response to insulin, it did not bring about a suppression of ACTH-responsiveness of the adrenal cortex as does prolonged steroid administration (31). Similarly, acute administration of the drug, given according to the dose schedule used in the insulin studies, had no suppressive effect upon the response to ACTH.…”

mentioning

confidence: 89%

Inhibitory Effect of Chlorpromazine upon the Adrenal Cortical Response to Insulin Hypoglycemia in Man1

Christy¹,

Longson²,

Horwitz³

et al. 1957

J. Clin. Invest.

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“…Several studies [1][2][3][4] have shown that suppression of HPA axis can occur with high do se corticosteroids for shorter duration and small dose for longer duration. HPA axis suppression is inevitable in patients on 15 mg or more of prednisolone or equivalent for more than 3 weeks and with lower doses of 5-15 mg/day, suppression is variable.…”

Section: Discussionmentioning

confidence: 99%

Unusual cause of nausea and vomiting

Nandakrishna¹,

Muralidhar²,

Vidyasagar³

2016

JCSR

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Comparative Effects of Prednisone and of Cortisone in Suppressing the Response of the Adrenal Cortex to Exogenous Adrenocorticotropin*

Cited by 83 publications

References 16 publications

On the Rate of Hydrocortisone Clearance From Plasma in Pregnant Women and in Patients With Laennec's Cirrhosis*

On the Rate of Hydrocortisone Clearance From Plasma in Pregnant Women and in Patients With Laennec's Cirrhosis*

Inhibitory Effect of Chlorpromazine upon the Adrenal Cortical Response to Insulin Hypoglycemia in Man1

Unusual cause of nausea and vomiting

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