Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UNIPROT:P01189 (beta-endorphin)
 21,003 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In the present paper evidences are provided for the changes occurring in blood opioid neuropeptides in patients with Itsenko-Cushing's disease), who were treated with an antiserotonin drug, cyproheptadine (peritol). An increase in the plasma contents of beta-endorphin and beta-lipotrophin in the above patients has been found to be one of the factors conditioning an enhanced activity of the hypothalamic-pituitary-adrenal system. Treatment of the patients suffering from Itsenko-Cushing's disease with cyproheptadine (peritol) resulted in a decrease of the plasma beta-endorphin and beta-lipotropin, as well as a display in 60% of cases of clinical and laboratory remission. Absence of the clinical remission in some patients treated with peritol indicated a need for intervention in the metabolism of other monoamines involved in the modulation of the action of opioid neuropeptides on the activity of the hypothalamic-pituitary system.
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PMID:Effect of the antiserotonin drug, cyproheptadine, on plasma beta-endorphin and beta-lipotropin in patients with Itsenko-Cushing's disease. 299 88

Pituitary adenomas may produce local endocrine and neurological effects, as well as systemic metabolic complications due to hormonal hypersecretion. Medical therapy with pharmacological agents has been developed and is based on the neurotransmitter regulation of normal pituitary hormonal secretion. 189 patients with secretory pituitary adenomas underwent medical therapy for the hypersecretory state. 156 of these were prolactin-secreting adenomas, 16 of which were in males. The response of bromocriptine was almost universal with lowering of serum prolactin and reversal of the clinical symptoms, as well as tumor shrinkage of most large adenomas with suprasellar extension. 23 patients with acromegaly were treated with bromocriptine, with 11 noting clinical improvement, and decreased tumor size in two. Five patients with Cushing's disease were treated with cyproheptadine, with only one showing a biochemical and clinical improvement. Two patients with Nelson's syndrome each had progressive tumor growth stabilized with cyproheptadine and bromocriptine in one, and sodium valproate in the other. There appears to be a role for medical therapy in the majority of prolactin-secreting pituitary tumors, some growth hormone secreting pituitary tumors, and selected adrenocorticotropin secreting-pituitary tumors.
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PMID:The medical treatment of the hypersecreting pituitary gland. 299 35

The status of the immune system was studied in 36 patients with the Itsenko-Cushing disease (10 at the initial stage, 12 in the period of recurrence, 14 during remission) and in 20 healthy persons comparing the corticotropin and hydrocortisone content in the plasma. The level of T lymphocytes was lowered at the initial stage of disease (40.6 +/- 3.4%) as well as during recurrence and remission (37.8 +/- 3.9 and 44.5 +/- 4.6%, respectively) as compared to this level in the healthy persons (60.5 +/- 3.6%). The content of B lymphocytes was lowered in all 3 groups (4.3 +/- 0.8,2.9 +/- 0.5 and 4.8 +/- 0.7%, respectively; in the group of healthy persons, it was 19.2 +/- 3.0%). The phagocytic activity of leukocytes was lowered at the initial stage of disease (39.0 +/- 7.6%) and during recurrence (36.7 +/- 4.5%) as compared to that of the healthy persons (44.6 +/- 1.5%). The hydrocortisone sensitive population of T lymphocytes was decreased 1.5-2 times. An increase in the corticotropin level (148.1 +/- 16.9 and 85.2 +/- 19.7 pg/ml, respectively; in health 47.9 +/- 3.8 pg/ml) and in the hydrocortisone level (142.5 +/- 11.1 and 181.3 +/- 20.5 ng/ml, respectively; in health 79 +/- 23 ng/ml) was marked simultaneously in the patients of these 2 groups. During remission (corticotropin and hydrocortisone normal levels), immunological indicators did not completely return to normal, thus suggesting a stable disorder of the cell immunity.
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PMID:[Immunologic indices in Itsenko-Cushing disease]. 299 71

Endogenous opiates may be important in the control of ACTH secretion in men. The effect of opiate receptor blockade by naloxone on ACTH, beta-endorphin-like substance and cortisol release was studied in healthy women and in 9 patients with Cushing's disease. In the healthy subjects, ACTH, beta-endorphin and cortisol levels were increased in response to naloxone. However, in 3 our of the 9 patients with Cushing's disease, a paradoxical decrease in serum ACTH, cortisol and beta-endorphin concentrations was observed after naloxone administration. In the patients with a paradoxical response to naloxone, transsphenoidal microadenomectomy was ineffective.
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PMID:The effect of naloxone on ATCH and beta-endorphin in patients with Cushing's disease. 299 30

Corticotropin releasing factor (CRF) is a newly sequenced peptide first isolated from sheep hypothalami and thought to be an important modulator of both the pituitary-adrenal axis and the sympathetic nervous system. We administered intravenous, intramuscular, and intracerebroventricular CRH to non-human primates and measured plasma ACTH, beta endorphin, cortisol, GH and PRL responses to CRF. In addition, we determined the pharmacokinetic properties of I125 in these primates. We administered CRF as an intravenous bolus or as a continuous infusion to normal volunteers and as an intravenous bolus to patients with disorders of the hypothalamic-pituitary-adrenal axis, such as Cushing's syndrome and adrenal insufficiency, and patients with endogenous depression and mild hypercortisolism, and assessed their plasma ACTH, cortisol, GH and PRL responses. In addition, we determined the pharmacokinetic properties of CRF in man by measuring CRF immunoreactivity in plasma. CRF given intravenously to primates or man is a slowly metabolized, long-acting, secretagogue of ACTH, beta-endorphin and cortisol. When given intracerebroventricularly to primates it stimulates the hypothalamic-pituitary-adrenal axis without escaping into the plasma and it is actively cleared in the CNS. It does not cross the blood brain barrier appreciably when given intravenously. CRF given to primates and men as an intravenous continuous infusion has only mild ACTH stimulating effects and this may be due to an intact cortisol negative feedback system. Finally, CRF causes characteristic plasma hormone responses in patients with Cushing's disease, adrenal insufficiency and depression.
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PMID:Corticotropin releasing factor: basic studies and clinical applications. 299 71

The cytoplasmic secretory granules of corticotrophs in the anterior pituitary are basophil in trichrome stains and periodic acid-Schiff positive in the histochemical stain for glycoprotein due to their content of the glycosylated 16 000 N-terminal fragment of the precursor protein proopiomelanocorticotrophin (POC). The granules show a positive immunocytochemical reaction to antibodies raised against ACTH, beta-endorphin and N-terminal fragments of POC. A small subset of corticotrophs contains immunoreactive alpha MSH in addition. Immunocytochemistry shows the corticotrophs to constitute about 15-20% of the anterior pituitary cells arranged both singly and in clumps. They are distributed in the median wedge and anteriorly, laterally and posteriorly adjacent to the pars nervosa which is often 'invaded' by corticotroph basophils. The alpha MSH subset is prominent in the rudimentary intermediate lobe and is scattered anteriorly in the pituitary of the human fetus. Crooke cell hyalinization is associated with pathologically maintained hypercortisolaemia and with glucosteroid therapy. The hyalinization is demonstrated in ultrastructure to be due to massive accumulation of intermediate cytoplasmic filaments 7-8 nm in diameter that are normally present in only small number. The change is associated with a varying degree of loss of secretory granules. In untreated Addison's disease there is a marked increase in the number of corticotrophs, many of which are arranged in distended alveoli to form micronodules. The vast majority of cases of pituitary-dependent Cushing's disease and all cases of Nelson's syndrome are associated with a basophil or chromophobe adenoma. These give a positive immunocytochemical reaction with anti-ACTH, beta-endorphin and N-terminal POC. In ultrastructure the cells of the chromophobe adenomas are seen to contain sparse secretory granules that are usually smaller than those in the chromophil adenomas. There are only very few reports of pituitary-dependent Cushing's disease found to be due to immunocytochemically confirmed corticotroph hyperplasia with or without a corticotroph adenoma. A few cases have been described in which the adenoma cells show Crooke's hyalinization, associated in one example with secretion of a big ACTH found more typically in ectopic ACTH-secreting tumours. A group of cases due to corticotroph adenoma has been reported whose excessive ACTH secretion is reduced by treatment with the dopamine agonist bromocriptine, in which it is suggested that the tumour cells arise from a subset of corticotrophs of pars intermedia origin.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Histopathology of the pituitary. 300 76

The authors presented the results of a study of the level of corticotropin and cortisol in the blood at different time after a single intake of peritol or parlodel in 48 patients with Icenko-Cushing disease at the active stage. Corticotropin and cortisol concentrations were determined by radioimmunoassay with the help of standard kits. The study showed a different sensitivity of patients with Icenko-Cushing disease to peritol and parlodel. According to the expression of the reaction of the hypophyseal-adrenal system all the patients were divided into the following groups: with a noticeable reaction to one or both drugs, with a slightly noticeable decrease in the level of hormones or a paradoxical reaction to the drugs. A single test with inhibitors of hypophyseal corticotropic function provided an opportunity for an individual choice of an effective drug for pathogenetic treatment of patients with Icenko-Cushing disease. The optimum time for blood examination to determine the concentration of corticotropin was 1 and 2 hrs, the level of cortisol 2-4 hrs after the intake of peritol and parlodel.
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PMID:[Criteria for the selection of drugs for the pathogenetic treatment of Itsenko-Cushing disease]. 300 46

The ACTH and cortisol responses to 100 micrograms ovine corticotropin-releasing hormone (CRH) in 19 consecutive patients with Cushing's disease were compared with those in 13 normal subjects. In 2 patients with Cushing's disease, plasma ACTH and cortisol did not increase after CRH administration. Compared to the normal subjects, maximal ACTH increments [135 +/- 25 (+/- SEM) vs. 42 +/- 6 pg/ml; P less than 0.001, by Wilcoxon's two-sample test] and maximal cortisol increments (17.7 +/- 1.8 vs. 9.4 +/- 1.1 micrograms/100 ml; P less than 0.01 by Wilcoxon's test) after CRH were significantly higher in the 17 CRH-responsive patients with Cushing's disease. In the normal subjects, there was a significant negative correlation between the basal cortisol level and the maximal ACTH (r = -0.65; P less than 0.05, by Spearman's rank correlation test) and cortisol (r = -0.95; P less than 0.001, by Spearman's test) responses to CRH. In contrast, in the CRH-responsive Cushing patients, there was no significant correlation between the basal cortisol level and the maximal ACTH (r = 0.10; P greater than 0.10, by Spearman's test) and cortisol (r = 0.14; P greater than 0.10, by Spearman's test) increments after CRH treatment. In the normal subjects, there was no significant correlation between the basal ACTH level and the maximal ACTH increments after CRH administration (r = -0.24; P greater than 0.10, by Spearman's test). Again in contrast, in the CRH-responsive Cushing patients, maximal ACTH increments after CRH treatment correlated positively with basal ACTH levels (r = 0.69; P less than 0.005, by Spearman's test). Moreover, in these patients, the maximal ACTH increments after CRH were positively correlated with the ACTH levels after suppression with higher and lower doses of dexamethasone. We conclude that in Cushing's disease, unlike in normal subjects, circulating cortisol is not the major modulator of ACTH and cortisol responses to CRH, and that in these patients, responsivity of ACTH to CRH and lack of suppressibility by dexamethasone are related phenomena.
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PMID:Responsivity of adrenocorticotropin to corticotropin-releasing hormone and lack of suppressibility by dexamethasone are related phenomena in Cushing's disease. 300 53

Nelson's syndrome develops in 10-15% of patients with Cushing's disease who undergo bilateral adrenalectomy. Whether the pituitary tumors of Nelson's syndrome are autonomous or are regulated by hypothalamic signals or glucocorticoids is controversial. We, therefore, compared the plasma ACTH responses to synthetic ovine corticotropin-releasing hormone (CRH) in 11 patients with Nelson's syndrome, 1 patient with Cushing's disease who had had bilateral adrenalectomy and did not have Nelson's syndrome, 14 patients with Cushing's disease, and 27 normal subjects. The plasma ACTH response to CRH in 10 patients with Nelson's syndrome was markedly increased and prolonged compared to the responses of normal subjects or patients with Cushing's disease. In 4 patients with Nelson's syndrome, plasma ACTH and cortisol concentrations also were determined at frequent intervals for 10-24 h during continuous infusions of 0.15 M saline or CRH (1 microgram/kg X h). There was no desensitization of ACTH secretion during short term continuous infusion of CRH. Exogenous cortisol inhibited CRH-stimulated ACTH secretion. These findings suggest that the ACTH response to CRH of patients with ACTH-secreting tumors of Nelson's syndrome differs from the response of those who have the microadenomas of Cushing's disease in two ways: the magnitude is greater, and the response is prolonged. These differences can be explained by the greater size of the tumor and the reduced glucocorticoid feedback in adrenalectomized patients with Nelson's syndrome.
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PMID:Corticotropin-releasing hormone (CRH) stimulation in Nelson's syndrome: response of adrenocorticotropin secretion to pulse injection and continuous infusion of CRH. 300 52

Primary depression can be associated with substantial hypercortisolism, thus prompting some researchers to suggest that depression shares pathophysiologic features with Cushing's disease. Clinically, depression can be difficult or impossible to distinguish from mild or early Cushing's disease that is associated with depressive features. The purpose of this study was to evaluate whether the pituitary-adrenal responses to ovine corticotropin-releasing hormone could help to clarify the mechanism of hypercortisolism in depression and in Cushing's disease and to assist in the differential diagnosis of these disorders. As compared with controls (n = 34), depressed patients (n = 30) had basal hypercortisolism (P less than 0.001) that was associated with attenuated plasma ACTH responses to ovine corticotropin-releasing hormone (P less than 0.001). This indicates that in patients with depression, the corticotroph cell in the pituitary responds appropriately to the negative feedback of high cortisol levels. In contrast, patients with Cushing's disease (n = 29) had plasma ACTH hyperresponsiveness to ovine corticotropin-releasing hormone (P less than 0.001), despite basal hypercortisolism (P less than 0.001), which indicates a gross impairment of the mechanism by which cortisol exerts negative feedback on the pituitary. Less than 25 percent of the patients with depression or Cushing's disease had peak ACTH responses that overlapped. We conclude that the pathophysiologic features of hypercortisolism in depression and Cushing's disease are distinct in each of the disorders and that the ovine corticotropin-releasing hormone stimulation test can be helpful in their differential diagnosis.
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PMID:Responses to corticotropin-releasing hormone in the hypercortisolism of depression and Cushing's disease. Pathophysiologic and diagnostic implications. 301 Jan 8


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