Abstract
OBJECTIVE: The purpose of this study was to evaluate the direct action of desmopressin (agonist of vasopressin) on the hypophysis and the three zones of the adrenal cortex in patients with different forms of hypercortisolism. DESIGN: Forty-three patients with hypercortisolism—21 with Cushing’s disease (14 females, 7 males), 11 with extrapituitary, ectopic tumours (5 females, 6 males), and 11 with ACTH-independent Cushing’s syndrome (6 females, 5 males)—were evaluated. The response of the pituitary and adrenal glands was assessed by measuring plasma levels of Adrenocorticotropic Hormone (ACTH), cortisol, aldosterone, and dehydroepiandrosterone sulfate (DHEAS) at baseline and at 15, 30, 60, 90, and 120 min after the administration of desmopressin. RESULTS: We observed two main modes of secretory response: (1) elevation of the ACTH level followed by a rise of one, two or all three adrenal steroids, and (2) ACTH-independent elevation of adrenal steroids in various combinations. CONCLUSION: In a number of patients with hypercortisolism, the adrenal cortex responded to desmopressin administration by enhanced synthesis and secretion of glucocorticoids (cortisol), mineralocorticoids (aldosterone), and adrenal androgens (DHEAS) without a concomitant rise in ACTH. These findings suggest the presence of “ectopic” vasopressin receptors in the human adrenal cortex.
Article PDF
Similar content being viewed by others
References
Ross NS, 1994 Epidemiology of Cushing’s syndrome and subclinical disease. Endocrinol Metab Clin North Am 23: 539–546.
Betragna X, 1994 Proopiomelanocortin-derived peptides. Endocrinol Metab Clin North Am 23: 467–485.
LaCroix A, N’Diaye N, Tremblay J, et al, 2001 Ectopic and abnormal hormone receptors in adrenal Cushing’s syndrome. Endocrin Rev 22: 75–110.
Goncharov N, Kolesnikova G, Vorontsov V, et al, 1996 Use of radioimmunoassay methods in the characterization of steroidogenesis in hormone-producing adrenal cortex tumors. Proc. 6th Symp. On the Analysis of Steroids. Szeged, Hungary; pp, 407–425.
Mune T, Murase H, Yamakita N, et al, 2002 Eutopic overexpression of vasopressin v1a receptor in adrenocorticotropin-independent macromolecular adrenal hyperplasia. J Clin Endocrin Metab 87: 5706–5713.
Schneider EG, 1988 Effect of vasopressin on adrenal steroidogenesis. Am J Physiol 255: 806–811.
Losa M, Mortini P, Dylgjeri S, et al, 2001 Desmopressin stimulation test before and after pituitary surgery in patients with Cushing’s disease. Clin Endocrin (Oxf) 55: 61–68.
Sakai Y, Horiba N, Tozawa F, et al, 1997 Desmopressin stimulation test for diagnosis of ACTH-dependent Cushing’s syndrome. Endocr J 44: 687–695.
Gallo-Payet N, Guillon G, 1998 Regulation of adrenocortical function by vasopressin. Horm Metab Res 30: 360–367.
Bird IM, Nicol M, Williams BC, et al, 1990 Vasopressin stimulates cortisol and phosphoinositide catabolism in cultured bovine adrenal fasciculata/reticularis cells. J Mol Endocrinol 5: 109–116.
Nussdorfer GG, 1996 Paracrine control of adrenal cortical function by medullary chromaffin cells. Pharmacol Rev 48: 495–530.
LaCroix A, Tremblay J, Touyz RM, et al, 1997 Propanol Therapy for ectopic beta-adrenergic receptors in adrenal Cushing’s syndrome. J Clin Endocrinol Metab 82: 2414–2422.
Tsagarakis S, Tsigos C, Vasiliou V, et al, 2002 The desmopressin and combined CRH-desmopressin tests in the different diagnosis of ACTH-dependent Cushing’s syndrome: constraints imposed by the expression of V2 vasopressin receptors in tumors with ectopic ACTH secretion. J Clin Endocrinol Metab 87: 1646–1653.
Cavagnini F, Pecori Giraldi F, 2001 Epidemiology and follow-up of Cushing’s disease. Ann Endocrinol (Paris) 62: 168–172.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Marova, E.I., Goncharov, N.P., Kolesnikova, G.S. et al. The response of corticotropin and adrenal steroids to desmopressin stimulation in patients with various forms of hypercortisolism. Hormones 7, 243–250 (2008). https://doi.org/10.14310/horm.2002.1204
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.14310/horm.2002.1204