Direct and Indirect Estimation of Pituitary Adrenocorticotropin Reserves in Man Following Adrenal Steroid Therapy*

Suppression of the Pituitary-ACTH Response In Man By Administration of ACTH or Cortisol*†

“…Heretofore the primary evidence that this stimulus produces increased release of ACTH has been the rise in urinary excretion of steroid metabolites (8,11,(19)(20)(21). In the present investigation, the plasma level of substance S was used as a relative index of the pituitary response to the Metopirone test.…”

Hypothalamo‐pituitary Adrenocortical Function in the Rat After Treatment With Betamethasone

“…However, the present work suggests that there is a reduction in adrenal activity since 48 h after overnight treatment with betamethasone, despite the hypersecretion of ACTH which then occurs, there is no concomitant rise in plasma corticosterone concentration. Adrenocortical insensitivity to ACTH is believed to be the direct result of abnormally low circulating concentrations of the hormone (Holub, Jailer, Kitay & Frantz, 1959;Daly et al, 1967) and hence the delay in the development of adrenal insensitivity may be explained by the persistence for at least 24 h of an abnormally low blood ACTH concentration.…”

Use of Methopyrapone (Su-4885) in the Study of Pituitary-Adrenal Response in Patients Under Corticosteroid Treatment

“…Once again, no definite conclusions could be made from the length of time during which the patients had been under corticosteroid therapy. In this connection it should be noted that Holub et al (12) found no response in a patient who had been taking corticosteroids for ten years, a similarly negative response being reported by Gold et al (20) in another patient who had been receiving corticosteroid treatment for seven years. On the other hand, case 22 of our series responded well notwithstanding having been taking corticosteroids for ten years.…”

“…Numerous authors have commented upon the adverse reaction of corticosteroid treatments on the pituitaryadrenal system, paying special attention to the "pathogenesis" of such response, i.e., whether such perturbation takes place in the hypophysis, in the adrenals or in both glands simultaneously (11)(12)(13)(14)(15)(16)(17)(18).…”

“…Nevertheless, Schuster and Williams (19) observed a relation between the response of the pituitaryadrenal system to the administration of a pyrogenic agent and the doses of corticosteroids. Similarly, Holub et al (12) postulate that the depletion in hypophysial ACTH might vary directly with the amount of corticosteroids.…”