Richard B. Raile

Blood Adrenocorticotrophin in Children with Congenital Adrenal Hyperplasia.

Summary The oxycellulose technic has been applied to the analysis of blood ACTH in children. ACTH was not present in detectable quantities in the blood of afebrile children without endocrine disease. ACTH was detected in the blood of untreated, but not of cortisone-treated, children with adrenogenital syndrome.

Studies of 17-hydroxycorticosteroids in children

Summary 1. The blood levels of circulating 17-hydroxycorticosteroids in children with and without evident disease have been studied and are reported. 2. The data obtained do not justify an interpretation that the diseased groups differ significantly from the “well-control” group, with the exception of the group of children with congenital adrenal hyperplasia. 3. Serial values for 17-hydroxycorticosteroids in patients with rheumatic fever receiving hormone therapy are reported.

Studies of 17-hydroxycorticosteroids in children: II. Response of blood levels to the injection of certain hormones

Summary 1. The response of 17-hydroxycorticosteroid plasma levels to the administration of ACTH, cortisone, and epinephrine is reported both in well and in sick children. 2. The injection of ACTH causes a prompt but transient elevation of 17-hydroxycorticosteroid levels. Cortisone administered orally likewise causes a prompt and transient elevation of these levels but cortisone administered intramuscularly in a single dose results in a somewhat variable response. 3. The injection of epinephrine results in no consistent pattern of response of 17-hydroxycorticosteroid plasma levels. On the basis of these data the validity of the previously postulated mechanism of action of epinephrine is questioned. 4. The preliminary data concerning responses of 17-hydroxycorticosteroid plasma levels to these three stimulating agents do not show major differences in the groups of children reported here.

Species Differences in Circulating 17-Hydroxycorticosteroid Concentrations.∗

Summary 1. Quantitative determinations of 17-hydroxycorticosteroid concentrations in the peripheral blood of rabbits, rats, guinea pigs and human subjects were made. 2. Considerable species differences in these concentrations were noted. These differences appear to be quantitative as well as qualitative. 3. Of the species observed, the guinea pig appears to be the best experimental animal for studies of 17-hydroxycorticosteroids.

Comparison of eosinophil and circulating 17-hydroxycorticosteroid responses to epinephrine and ACTH.

Summary 1. A comparison of the responses of eosinophils and of circulating 17-hydroxycorticosteroid plasma concentrations; is presented. 2. In general, responses of eosinophils and 17-hydroxycorticosteroids to the injection of ACTH are adequate, with a reduction of the former and an elevation of the latter. 3. Certain exceptions to this generalization are noted. On the basis of these exceptions the question is raised whether the eosinopenic response to ACTH need be mediated by the mechanism previously accepted. 4. There is a strong suggestion that the eosinopenia in response to epinephrine is not mediated by an increased circulating concentration of 17-hydroxycorticosteroids secreted by the adrenal cortex.

STUDIES OF 17-HYDROXYCORTICOSTEROIDS. V. RESPONSES OF 17-HYDROXYCORTICOSTEROIDS, EOSINOPHILS, AND GLUCOSE TO ACTH AND EPINEPHRINE'

The belief has been rather widespread, because of the similarities between the responses elicited by epinephrine and ACTH, that these agents produce many of their responses by similar mechanisms. There is considerable evidence which tends to support this viewpoint: 1) Both are considered to be essential agents for adequate response of the organism to stressful situations (1-5); 2) both produce eosinopenia, lymphopenia, and depletion of adrenal ascorbic acid and cholesterol (5-10); 3) several authors have presented data indicating that epinephrine stimulation of the anterior pituitary results in release of ACTH (11-13). On the other hand, certain differences between effects of epinephrine and ACTH have been demonstrated clearly: 1) The hyperglycemic responses to these two stimulating agents are produced by different mechanisms (14, 15); 2) recent publications have suggested that this is true also of the eosinopenic response (6, 16-18); 3) the administration of epinephrine produces no increased release of 17-OH-corticosteroid hormones from the adrenal cortex such as that produced by the administration of ACTH (6, 19-21 ). The apparent discrepancies among published data concerning the mechanisms of responses to these two stimulating agents have prompted further study of this problem. In the present report data are presented comparing the responses of eosinophils, blood glucose, and plasma 17-OHcorticosteroids to ACTHand to epinephrine.