副腎皮質ホルモンの動態に関する研究
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In order to elucidate the role of the renin angiotensin system and ACTH in the biosynthetic pathway of aldosterone (Ald) and cortisol (F), 18 healthy subjects (13 males and 5 females aged 18 - 37) were studied during the changes in circadian rhythm of various plasma corticoids before and after dexamethasone (dexa) administration during daily life. Furthermore, changes in various plasma corticoids after exogenous angiotensin II (A II) and ACTH injection during pre and post dexa administration were investigated. <BR>The results were as follows : <BR>1. Diurnal variation of various corticoids. <BR>a. Under usual active life, progesterone (P), deoxycorticosterone (DOC), corticosterone (B), 17-OHprogesterone (17-OHP), deoxycortisol (S) and F demonstrated distinct circadian rhythm. However, a few subjects failed to show the same results. Ald demonstrated no circadian rhythm and plasma renin activity (PRA) remained unchanged. <BR>b. After suppression of endogenous ACTH by continuous 2 mg/day dexa administration during usual active life, S, F and B were significantly suppressed in the 2nd, 4th and 7th day causing complete disappearance of the circadian rhythm, but slight suppression of P, DOC, Ald and 17-OHP were observed. <BR>2. Changes in various corticoids during continuous A II (5 - 20 ng/kg/min) infusion. <BR>a. A II induced significant increment of Aid. But precursors like P, DOC and B either remained unchanged or diminished gradually. 17-OHP, S and F remained either unchanged or declined. PRA was suppressed slightly. <BR>b. A II infusion after 2mg dexa administration raised Ald significantly. Furthermore, B also showed an increment, although within the range of low concentration. The remaining corticoids were not affected by A II infusion. <BR>3. Changes observed in various corticoids after 250pg ACTH injection. <BR>a. ACTH caused a significant increment of various corticoids within 30 mins after injecttion which maintained a high value until 180 mins. The increment of 17-OHP, S, F and B was associated with a strong effect, while P, DOC and Ald were found slightly weak. The maximum response of Ald and F was observed within 30-60 mins and within 90 mins respectively. PRA remained unchanged. <BR>b. The response to ACTH after 2mg dexa administration showed an abrupt elevation of 17-OHP, S, F, P, DOC, B and Ald within 30 mins. Later, most of the corticoids showed a gradual increase with plateau formation except Ald. The responses of these corticoids demonstrated no remarkable differences without dexa administration. <BR>c. ACTH injection after a continous 2mg/day dexa administration for 7 days demonstrated a remarkable decrease of S, F and B compared to the responses during 2mg dexa administration. Almost no change to slight decrement was noticeable in 17-OHP, P and DOC. Ald responded to a greater or the same degree. PRA remained unchanged. <BR>With the above results, the author concluded as follows. <BR>Under the daily activity, corticoids failed to demonstrate circadian rhythm in a few subjects. After dexa administration, degrees of suppression varied depending on the type of corticoids. By A II infusion under dexa administration, B responded slightly, but A II failed to increase corticoids before DOC in biosynthetic pathway of Ald. Various corticoids responded in different degrees to ACTH. Furthermore, the suppressive response of the corticoids to ACTH after 7 days of dexa administration also varied with the type of corticoids.
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