Abstract
ACTH-adrenal activity was assessed in patients by measuring plasma ACTH and 11-deoxycortisol response to a single oral dose of metyrapone. A significantly impaired ACTH and compound-S response was found 2, 7 an 10 days after a single intraarticular injection of synthetic glucocorticoid derivatives.
The ACTH-suppressive effect of an antiandrogenic steroid (cyproterone-acetate) was studied in rats and in man. In normal volunteers a single oral dose of 200 mg of CA impairs ACTH increase after metyrapone. In CA-treated hirsute women the ACTH-stimulation is similarly impaired.
Endogenous oversecretion of ACTH in Addison’s disease and in congenital adrenal hyperplasia is diminsihed by CA. In rats the ACTH-suppressive effect is compared with an equivalent dose of betamethasone in respect to eosinophilia, blood sugar and plasma insulin. This general glucocorticoid effect of CA is much weaker than the equivalent dose of the glucocorticoid.
Even a single local intraarticular administration of a glucocorticoid impairs ACTH stimulation by the negative feedback for more than 10 days. Plasma ACTH and 11-deoxycortisol response to metyrapone is a single, sensitive test of ACTH-adrenal function.
Cyproterone-acetate is not only a potent antiandrogen and antigonadotrophic substance, but an inhibitor of ACTH synthesis and release. This ACTH-suppressive effect is associated with only a weak general metabolic glucocorticoid activity. ACTH-adrenal function must be watched in CA-treated patients. Close monitoring is necessary after withdrawal of the drug. The additional inhibitory activity of CA can be beneficial in selected cases of congenital adrenal hyperplasia.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Bossi, E., Zurbrügg, R. P., Joss, E. E.: Cyproterone-Acetat und Pubertas praecox. Medizinische Mitteilungen Schering 2, 19–25 (1973)
Girard, J., Baumann, J. B.: Cyproterone-acetate. Paediat. Res. 9, 66 (1975)
Girard, J., Baumann, J. B.: Corticotropin releasing hormone adrenocorticotropin suppression by an antiandrogenic drug (cyproterone-acetate), a therapeutic possibility for congenital adrenal hyperplasia. In: Congenital Adrenal Hyperplasia. Lee, P. A., Plotnick, L. P., Kowarski, A. A., Migeon, C. J. (eds.), p. 217–230. Baltimore, London, Tokyo: University Park Press 1977
Girard, J., Baumann, J. B., Bühler, U., Zuppinger, K., Haas, H. G., Staub, J. J., Wyss, H. I.: Cyproterone-acetate and ACTH adrenal function. J. Clin. Endocrinol. Metab. 47, No. 3 (1978)
Girard, J., Baumann, J. B., Graf, S., Van Hees, G., Haas, H. G., Wyss, H. J.: Pharmagological alteration of CRH-ACTH activity. In: Hypothalamic Hormones — Chemistry, Physiology and Clinical. Gupta, D., Voelter, W. (eds.), p. 335–351. Applications. Weinheim, New York: Chemie-Verlag 1978
Glenn, E. M., Richardson, S. L., Bowman, B. J.: Biology activity of 6-alpha-methyl compounds corresponding to progesterone, 17-Alpha-Hydroxyprogesterone Acetate and Compound S. Metabolism 8, 265–284 (1959)
Hellmann, L., Yoshida, K., Zumoff, B., Levin, J., Kream, J., Fukushima, D. K.: The effect of medroxyprogesterone acetate on the pituitary-adrenal axis. J. Clin. Endocrinol. Metab. 42, 912–917 (1976)
Holub, D. A., Katz, F. H., Jailer, J. W.: Inhibition by 6-methyl-17-acetoxy-progesterone of ACTH synthesis and release in the rat. Endocrinology 68, 173–177 (1961)
Jubiz, W., Meikle, A. W., West, C. D., Tyler, F. H.: Single-dose metyrapone test. Arch. Intern. Med. 125, 472 (1970)
Mathews, J. H., Abrams, C. A. L., Morishima, A.: Pituitary adrenal function in ten patients receiving medroxyprogesterone acetate for true precocious puberty. J. Clin. Endocrinol. Metab. 30, 653–658 (1970)
Neri, R. O., Monahan, M. D., Meyer, J. G., Afonso, B. A., Tabachick, I. A.: Biological studies on a anti-androgen (SH 714). Europ. J. Pharmacol. 1, 438–444 (1967)
Neumann, F., Steinbeck, H.: Androgens II and antiandrogens. In: Handbook of Experimental Pharmacology. Eichler, O., Farah, A., Herken, H., Welch, A. D. (eds.), Vol. XXXV/2, p. 235–237 and 278–304. Berlin, Heidelberg, New York: Springer 1974
Neumann, F., Steinbeck, H.: Androgens II and antiandrogens. In: Handbook of Experimental Pharmacology. Eichler, O., Farah, A., Herken, H., Welch, A. D. (eds.), Vol. XXXV/2, p. 425–426. Berlin, Heidelberg, New York: Springer 1974
Staub, J. J., Noelpp, B., Girard, J., Baumann, J. B.: ACTH-release by feedbackmechanism and by stress stimulation. (in press)
Ziegler, B., Lux, B., Kubatsch: The effect of cyproterone-acetate on the adrenal of the male hamsters. Acta Endocrinol. 82, 127–133 (1976)
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1979 Springer-Verlag
About this paper
Cite this paper
Girard, J., Baumann, J.B., Graf, S., van Hees, G., Rosenthal, M., Zuppinger, K. (1979). Assessment of ACTH-Adrenal Activity After Treatment with a Glucocorticoid and an Antiandrogenic Steroid. In: Chambers, P.L., Günzel, P. (eds) Mechanism of Toxic Action on Some Target Organs. Archives of Toxicology, vol 2. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-67265-1_6
Download citation
DOI: https://doi.org/10.1007/978-3-642-67265-1_6
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-540-09305-3
Online ISBN: 978-3-642-67265-1
eBook Packages: Springer Book Archive