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Plasma Cortisol: Time to Look Deeper?

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Book cover Intensive Care Medicine

Part of the book series: Yearbook of Intensive Care and Emergency Medicine ((YEARBOOK,volume 2007))

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Abstract

The importance of the stress response in survival from critical illness is not in dispute. Adrenalectomized animals or patients with documented adrenal insufficiency have a high mortality when exposed to physiological stress [1, 2]. However, in the setting of critical illness, attempting to determine what constitutes an appropriate stress response is not straightforward.

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References

  1. Hinshaw LB, Beller BK, Chang AC, et al (1985) Corticosteroid/antibiotic treatment of adrenalectomized dogs challenged with lethal E. coli. Circ Shock 16:265–277

    CAS  PubMed  Google Scholar 

  2. Rothwell PM, Udwadia ZF, Jackson EA, Lawler PJ (1991) Plasma cortisol levels in patients with septic shock. Crit Care Med 19:589–590

    Article  CAS  PubMed  Google Scholar 

  3. Venkatesh B, Prins J, Torpy D, et al (2007) Relative adrenal insufficiency in sepsis: Matchpoint or deuce. Crit Care Resusc (in press)

    Google Scholar 

  4. Hamrahian AH, Oseni TS, Arafah BM. (2004) Measurements of serum free cortisol in critically ill patients. N Engl J Med 350:1629–1638

    Article  CAS  PubMed  Google Scholar 

  5. Ho JT, Al-Musalhi H, Chapman MJ, et al (2006) Septic shock and sepsis: a comparison of total and free plasma cortisol levels. J Clin Endocrinol Metab 91:105–114

    Article  CAS  PubMed  Google Scholar 

  6. Esteban NV, Loughlin T, Yergey AL, et al (1991) Daily cortisol production rate in man determined by stable isotope dilution/mass spectrometry. J Clin Endocrinol Metab 72:39–45

    Article  CAS  PubMed  Google Scholar 

  7. Barton RN, Stoner HB, Watson SM (1987) Relationships among plasma cortisol, adrenocorticotrophin, and severity of injury in recently injured patients. J Trauma 27:384–392

    Article  CAS  PubMed  Google Scholar 

  8. Chernow B, Alexander HR, Smallridge RC, Thompson WR, Cook D, Beardsley D, Fink MP, Lake CR, Fletcher JR (1987) Hormonal responses to graded surgical stress. Arch Intern Med 147:1273–1278

    Article  CAS  PubMed  Google Scholar 

  9. Burchard K (2001) A review of the adrenal cortex and severe inflammation: quest of the “eucorticoid” state. J Trauma 51:800–814

    Article  CAS  PubMed  Google Scholar 

  10. Pemberton PA, Stein PE, Pepys MB, Potter JM, Carrell RW (1988) Hormone binding globulins undergo serpin conformational change in inflammation. Nature 336:257–258

    Article  CAS  PubMed  Google Scholar 

  11. Beishuizen A, Thijs LG, Vermes I (2001) Patterns of corticosteroid-binding globulin and the free cortisol index during septic shock and multitrauma. Intensive Care Med 27:1584–1591

    Article  CAS  PubMed  Google Scholar 

  12. le Roux CW, Chapman GA, Kong WM, Dhillo WS, Jones J, Alaghband-Zadeh J (2003) Free cortisol index is better than serum total cortisol in determining hypothalamic-pituitary-adrenal status in patients undergoing surgery. J Clin Endocrinol Metab 88:2045–2048

    Article  PubMed  Google Scholar 

  13. Draper N, Stewart PM (2005) 11beta-hydroxysteroid dehydrogenase and the pre-receptor regulation of corticosteroid hormone action. J Endocrinol 186:251–271

    Article  CAS  PubMed  Google Scholar 

  14. Amelung D, Hubener HJ, Roka L, Meyerheim G (1953) Conversion of cortisone to compound F. J Clin Endocrinol Metab 13:1125–1126

    Article  CAS  PubMed  Google Scholar 

  15. Seckl JR, Walker BR (2001) Minireview: 11beta-hydroxysteroid dehydrogenase type 1-a tissue-specific amplifier of glucocorticoid action. Endocrinology 142:1371–1376

    Article  CAS  PubMed  Google Scholar 

  16. Dotsch J, Hohenberger I, Peter M, Sippell W, Dorr HG (2000) Evidence for change of 11beta-hydroxysteroid dehydrogenase activity during infancy and childhood. Pediatr Res 48:697–700

    Article  CAS  PubMed  Google Scholar 

  17. Houang M, Morineau G, le Bouc Y, Fiet J, Gourmelen M (1999) The cortisol-cortisone shuttle in children born with intrauterine growth retardation. Pediatr Res 46:189–193

    Article  CAS  PubMed  Google Scholar 

  18. Quinkler M, Zehnder D, Lepenies J, et al (2005) Expression of renal 11beta-hydroxysteroid dehydrogenase type 2 is decreased in patients with impaired renal function. Eur J Endocrinol 153:291–299

    Article  CAS  PubMed  Google Scholar 

  19. Kushnir MM, Neilson R, Roberts WL, Rockwood AL (2004) Cortisol and cortisone analysis in serum and plasma by atmospheric pressure photoionization tandem mass spectrometry. Clin Biochem 37:357–362

    Article  CAS  PubMed  Google Scholar 

  20. Tomlinson JW, Stewart PM (2001) Cortisol metabolism and the role of 11beta-hydroxysteroid dehydrogenase. Best Pract Res Clin Endocrinol Metab 15:61–78

    Article  CAS  PubMed  Google Scholar 

  21. Ferrari P, Lovati E, Frey FJ (2000) The role of the 11beta-hydroxysteroid dehydrogenase type 2 in human hypertension. J Hypertens 18:241–248

    Article  CAS  PubMed  Google Scholar 

  22. Walker EA, Stewart PM (2003) 11beta-hydroxysteroid dehydrogenase: unexpected connections. Trends Endocrinol Metab 14:334–339

    Article  CAS  PubMed  Google Scholar 

  23. White PC, Mune T, Agarwal AK (1997) 11 beta-Hydroxysteroid dehydrogenase and the syndrome of apparent mineralocorticoid excess. Endocr Rev 18:135–156

    Article  CAS  PubMed  Google Scholar 

  24. Mune T, Rogerson FM, Nikkila H, Agarwal AK, White PC (1995) Human hypertension caused by mutations in the kidney isozyme of 11 beta-hydroxysteroid dehydrogenase. Nat Genet 10:394–399

    Article  CAS  PubMed  Google Scholar 

  25. Masuzaki H, Paterson J, Shinyama H, et al (2001) A transgenic model of visceral obesity and the metabolic syndrome. Science 294:2166–2170

    Article  CAS  PubMed  Google Scholar 

  26. Hermanowski-Vosatka A, Balkovec JM, Cheng K, et al (2005) 11beta-HSD1 inhibition ameliorates metabolic syndrome and prevents progression of atherosclerosis in mice. J Exp Med 202:517–527

    Article  CAS  PubMed  Google Scholar 

  27. Cooper MS, Rabbitt EH, Goddard PE, Bartlett WA, Hewison M, Stewart PM (2002) Osteoblastic 11beta-hydroxysteroid dehydrogenase type 1 activity increases with age and glucocorticoid exposure. J Bone Miner Res 17:979–986

    Article  CAS  PubMed  Google Scholar 

  28. Stewart PM, Shackleton CH, Beastall GH, Edwards CR (1990) 5 alpha-reductase activity in polycystic ovary syndrome. Lancet 335:431–433

    Article  CAS  PubMed  Google Scholar 

  29. Young MJ, Moussa L, Dilley R, Funder JW (2003) Early inflammatory responses in experimental cardiac hypertrophy and fibrosis: effects of 11 beta-hydroxysteroid dehydrogenase inactivation. Endocrinology 144:1121–1125

    Article  CAS  PubMed  Google Scholar 

  30. Vogeser M, Zachoval R, Felbinger TW, Jacob K (2002) Increased ratio of serum cortisol to cortisone in acute-phase response. Horm Res 58:172–175

    Article  CAS  PubMed  Google Scholar 

  31. Vogeser M, Groetzner J, Kupper C, Briegel J (2003) The serum cortisol:cortisone ratio in the postoperative acute-phase response. Horm Res 59:293–296

    Article  CAS  PubMed  Google Scholar 

  32. Dotsch J, Dorr HG, Stalla GK, Sippell WG (2001) Effect of glucocorticoid excess on the cortisol/cortisone ratio. Steroids 66:817–820

    Article  CAS  PubMed  Google Scholar 

  33. Cooper MS, Bujalska I, Rabbitt E, et al (2001) Modulation of 11beta-hydroxysteroid dehydrogenase isozymes by proinflammatory cytokines in osteoblasts: an autocrine switch from glucocorticoid inactivation to activation. J Bone Miner Res 16:1037–1044

    Article  CAS  PubMed  Google Scholar 

  34. Heiniger CD, Rochat MK, Frey FJ, Frey BM (2001) TNF-alpha enhances intracellular glucocorticoid availability. FEBS Lett 507:351–356

    Article  CAS  PubMed  Google Scholar 

  35. Cai TQ, Wong B, Mundt SS, Thieringer R, Wright SD, Hermanowski-Vosatka A (2001) Induction of 11beta-hydroxysteroid dehydrogenase type 1 but not −2 in human aortic smooth muscle cells by inflammatory stimuli. J Steroid Biochem Mol Biol 77:117–122

    Article  CAS  PubMed  Google Scholar 

  36. Suzuki S, Tsubochi H, Ishibashi H, et al (2005) Inflammatory mediators down-regulate 11beta-hydroxysteroid dehydrogenase type 2 in a human lung epithelial cell line BEAS-2B and the rat lung. Tohoku J Exp Med 207:293–301

    Article  CAS  PubMed  Google Scholar 

  37. Tomlinson JW, Moore J, Cooper MS, et al (2001) Regulation of expression of 11beta-hydroxysteroid dehydrogenase type 1 in adipose tissue: tissue-specific induction by cytokines. Endocrinology 142:1982–1989

    Article  CAS  PubMed  Google Scholar 

  38. Tomlinson JW, Walker EA, Bujalska IJ, et al (2004) 11beta-hydroxysteroid dehydrogenase type 1: a tissue-specific regulator of glucocorticoid response. Endocr Rev 25:831–866

    Article  CAS  PubMed  Google Scholar 

  39. Hewitt KN, Walker EA, Stewart PM. (2005) Minireview: hexose-6-phosphate dehydrogenase and redox control of 11ta-hydroxysteroid dehydrogenase type 1 activity. Endocrinology 146:2539–2543

    Article  CAS  PubMed  Google Scholar 

  40. Victor VM, Rocha M, De la Fuente M (2004) Immune cells: free radicals and antioxidants in sepsis. Int Immunopharmacol 4:327–347

    Article  CAS  PubMed  Google Scholar 

  41. Ritter C, Andrades M, Guerreiro M, et al (2003) Plasma oxidative parameters and mortality in patients with severe burn injury. Intensive Care Med 29:1380–1383

    Article  PubMed  Google Scholar 

  42. Su X, Vicker N, Ganeshapillai D, et al (2006) Benzothiazole derivatives as novel inhibitors of human 11beta-hydroxysteroid dehydrogenase type 1. Mol Cell Endocrinol 248:214–217

    Article  CAS  PubMed  Google Scholar 

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Cohen, J., Prins, J., Venkatesh, B. (2007). Plasma Cortisol: Time to Look Deeper?. In: Intensive Care Medicine. Yearbook of Intensive Care and Emergency Medicine, vol 2007. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-49433-1_11

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  • DOI: https://doi.org/10.1007/978-3-540-49433-1_11

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-49432-4

  • Online ISBN: 978-3-540-49433-1

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