       Document 0187
 DOCN  M9630187
 TI    [Stimulus of the hypophyseal-adrenocortical axis with corticotropin
       releasing hormone (CRH) in acquired immunodeficiency syndrome. Evidence
       for activation of the immune-neuroendocrine system]
 DT    9603
 AU    Lewi DS; Kater CE; Moreira AC; Disciplina de Doencas Infecciosas, Escola
       Paulista de Medicina,; Sao Paulo.
 SO    Rev Assoc Med Bras. 1995 Mar-Apr;41(2):109-18. Unique Identifier :
       AIDSLINE MED/96045785
 AB    Ten-20% of patients with AIDS may present clinical evidence of primary
       or secondary adrenal insufficiency. PURPOSE--To evaluate the
       hypothalamic-pituitary-adrenocortical axis (HPAA) with CRH in patients
       with AIDS. METHODS--We studied 20 patients with AIDS and 17 normal
       subjects (NS) with exogenous ACTH (cosyntropin, 250 micrograms IV bolus)
       followed one week later by ovine corticotropin releasing hormone (oCRH 1
       microgram/kg BW IV bolus). Basal and 60' cortisol (micrograms/dL) were
       determined in the former whereas ACTH (pg/mL) and cortisol were measured
       every 15-30' for 2 hours in the latter. RESULTS--Basal and peak values
       (mean +/- SD) of ACTH and cortisol for both tests were: cosyntropin test
       (AIDS x NS): basal cortisol 22.5 +/- 7.1 x 10.6 +/- 3.6 (p < 0.01), peak
       36.0 +/- 12.8 x 28.3 +/- 7.6 (p < 0.05); oCRH test: basal ACTH 42.2 +/-
       33.5 x 28.9 +/- 12.7 (NS), peak 104.7 +/- 62.2 x 59.3 +/- 17.6 (p <
       0.05); basal cortisol 19.7 +/- 9.0 x 10.1 +/- 3.4 (p < 0.01), peak 27.5
       +/- 8.9 x 18.3 +/- 5.1 (p < 0.05). CONCLUSION--AIDS patients had
       elevated basal and CRH stimulated ACTH levels and an intact
       glucocorticoid pathway with elevated basal and peak cortisol levels to
       both stimulation tests. This situation is probably due to the stressful
       disease condition, where lymphokines may play a role activating the
       hypothalamic-pituitary axis.
 DE    Acquired Immunodeficiency Syndrome/IMMUNOLOGY/*PHYSIOPATHOLOGY
       Adolescence  Adult  Aged  Comparative Study
       Corticotropin/BLOOD/*DIAGNOSTIC USE  Corticotropin-Releasing
       Hormone/BLOOD/*DIAGNOSTIC USE  Cosyntropin/DIAGNOSTIC USE  English
       Abstract  Human  Hydrocortisone/BLOOD/*DIAGNOSTIC USE
       Hypothalamo-Hypophyseal System/*PHYSIOPATHOLOGY  Male  Middle Age
       Pituitary-Adrenal System/*PHYSIOPATHOLOGY  Support, Non-U.S. Gov't
       JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

