The concentrations of total and protein-unbound plasma cortisol of New World monkeys are higher than those of Old World primates and prosimians. The urinary free-cortisol excretion also is increased markedly. However, there is no physiologic evidence ofincreased cortisol effect. These findings suggest end-organ resistance to glucocorticoids. This was confirmed by showing that the hypothalamic-pituitary adrenal axis is resistant to suppression by dexamethasone. To study this phenomenon, glucocorticoid receptors were examined in circulating mononuclear leukocytes and cultured skin fibroblasts from both New and Old World species. The receptor content is the same in all species, but the New World monkeys have a markedly decreased binding affinity for dexamethasone. Thus, the resistance of these species to the action ofcortisol is due to the decreased binding affinity of the glucocorticoid receptor. This presumed mutation must have occurred after the bifurcation of Old and New World primates (=60 x 106 yr ago) and before the diversion of the New World primates from each other (-15 x 106 yr ago).End-organ resistance to steroid hormones has been described for androgens (1), aldosterone (2), progesterone (3), and vitamin D (4). There are no known examples of resistance to the action ofestradiol and only two examples ofresistance to cortisol. First, the guinea pig has long been known as a "corticoresistant" species (5); second, there is a single example ofresistance to cortisol in man (6, 7). Two New World primates, the squirrel monkey (Saimiri sciureus) (8) Lemurinae or Galaginae were studied. Plasma samples for assay of total and free cortisol, aldosterone, corticosterone, glucose, and electrolytes were obtained between 7:00 and 9:00 a.m. by femoral artery puncture under ketamine anesthesia. Plasma samples were drawn during the 10-to 20-min period of anesthesia. Preliminary studies showed that the plasma cortisol concentrations measured at 2-min intervals were stable during this period of time. Human plasma samples were obtained by venipuncture at the same time of the day and, despite the differences in the sampling, have been used for comparison.Total plasma cortisol (10) and plasma corticosterone (11), aldosterone (12), and dexamethasone (13) were measured by previously described radioimmunoassays. Plasma glucose was measured by the hexokinase method (14). The cortisol not bound to protein (i.e., free) was estimated by equilibrium dialysis at 370C with 1:5 diluted plasma as described (15, 16). The concentration of unbound cortisol was calculated by applying the formula of Slaunwhite (17) and was corrected for the initial dilution.Twenty-four hour urine samples were collected in metabolic cages. Urinary free cortisol was measured by radioimmunoassay as described (18), and 24-hr urinary excretion was calculated.The suppressibility of the hypothalamic-pituitary-adrenal axis was examined by administering dexamethasone sodium phosphate (Decadron). Decadron was given intramuscularly at 8:00 p.m. to squirrel and...