Release of melanotroph- and corticotroph-type proopiomelanocortin derivatives into blood after administration of corticotropin-releasing hormone in patients with septic shock without adrenocortical insufficiency.

摘要: The aim of the study was to assess adequacy pituitary function by determining plasma concentrations corticotroph-type (corticotropin, beta-endorphin immunoreactive material [beta-END IRM], authentic beta-END, and beta-lipotropin IRM) as well melanotroph-type (alpha-melanocyte-stimulating hormone [alpha-MSH] N-acetyl-beta-END [Nac-beta-END] proopiomelanocortin (POMC) derivatives in patients under septic shock upon administration corticotropin-releasing (CRH). objectives were whether an insufficient release corticotroph- or POMC from into cardiovascular compartment correlates with 28-day mortality rate. Seventeen but without adrenocortical insufficiency 16 healthy volunteers enrolled study, CRH stimulation tests performed i.v. bolus injection 100 microg human CRH. After treatment CRH, increased survivors nonsurvivors, such alpha-MSH Nac-beta-END IRM only contrast nonsurvivors. suppressed dexamethasone not In shock, response terms impaired nonsurvivors compared controls. Reduced responses invalid suppression reflect a state dysfunction system Considering anticytokine anti-inflammatory effects alpha-MSH, this may increase risk death shock.