This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Elias, L. L. K. Articles by Moreira, A. C. Search for Related Content PubMed PubMed Citation Articles by Elias, L. L. K. Articles by Moreira, A. C.

Effect of Plasma Osmolality on Pituitary-Adrenal Responses to Corticotropin-Releasing Hormone and Atrial Natriuretic Peptide Changes in Central Diabetes Insipidus¹

Endocrinology Division, Department of Medicine (L.L.K.E., P.C.L.E., A.C.M.); and Department of Physiology (J.A.R.), Faculty of Medicine, 14049–900, Ribeirão Preto, Brazil

Address all correspondence and requests for reprints to: Ayrton C. Moreira, Department of Medicine, Faculty of Medicine, 14049–900, Ribeirão Preto, SP, Brazil.

The objective of the present study was to examine the effect of changes in plasma osmolality (pOsm) on the responses of the pituitary-adrenal axis to CRH and atrial natriuretic peptide (ANP) release in patients with central diabetes insipidus (DI). Eight normal subjects and six DI patients were subjected to human CRH (hCRH) (1 µg/kg) stimulation alone or associated with isotonic volume loading (0.9% NaCl, 12 mL·kg·60 min) or an osmotic stimulus (5% NaCl, 0.06 mL·kg/min·120 min). The DI group showed significantly increased pOsm and undetectable or low plasma arginine vasopressin (AVP) during all tests. In the control group, pOsm and plasma AVP increased only during the osmotic stimulus. The DI group presented lower plasma ANP levels than controls during osmotic stimulus and isotonic volume loading. The lower ANP secretion in DI patients corroborates the importance of neurohypophyseal hormones in ANP regulation. Basal plasma ACTH and cortisol levels did not differ between controls and DI. The latter group presented a higher ACTH response than controls during stimulation with hCRH alone [area under the curve (AUC) 1138 ± 99 vs. 709 ± 62 pmol·L/min] and hCRH/5% NaCl (AUC 1602 ± 209 vs. 1158 ± 187 pmol·L·min). The DI cortisol AUC were higher than controls during stimulation with hCRH alone (65,471 ± 6,070 vs. 48,062 ± 3,476 nmol·L·min) and hCRH/5% NaCl (89,005 ± 10,043 vs. 62,105 ± 5,600 nmol·L·min). The highest ACTH and cortisol responses to hCRH in both groups were obtained with hCRH/5% NaCl. There was a significant correlation between mean pOsm and ACTH response to hCRH (r = 0.62). The increased responses to hCRH with increasing pOsm were present in control subjects and in patients with DI. However, at any given level of pOsm, there was no difference in ACTH response between controls and DI. These data indicate that the acute increases in pOsm augmented the ACTH and cortisol responses to hCRH that involve other factors besides magnocellular AVP.

This article has been cited by other articles:

				W. L. Reis, A. Giusti-Paiva, R. R. Ventura, L. O. Margatho, D. A. Gomes, L. L. K. Elias, and J. Antunes-Rodrigues Neuroendocrinology/Endocrinology: Central nitric oxide blocks vasopressin, oxytocin and atrial natriuretic peptide release and antidiuretic and natriuretic responses induced by central angiotensin II in conscious rats Exp Physiol, September 1, 2007; 92(5): 903 - 911. [Abstract] [Full Text] [PDF]

				A. P. de Magalhaes-Nunes, D. Badaue-Passos Jr, R. R. Ventura, D. da Silva Guedes Jr, J. P. Araujo, P. C. Granadeiro, H. K. Milanez-Barbosa, R. H. da Costa-e-Sousa, M. A. de Medeiros, J. Antunes-Rodrigues, et al. Neuroendocrinology/Endocrinology: Sertraline, a selective serotonin reuptake inhibitor, affects thirst, salt appetite and plasma levels of oxytocin and vasopressin in rats Exp Physiol, September 1, 2007; 92(5): 913 - 922. [Abstract] [Full Text] [PDF]

				L. O. Margatho, A. Giusti-Paiva, J. V. Menani, L. L. K. Elias, L. M. Vivas, and J. Antunes-Rodrigues Serotonergic mechanisms of the lateral parabrachial nucleus in renal and hormonal responses to isotonic blood volume expansion Am J Physiol Regulatory Integrative Comp Physiol, March 1, 2007; 292(3): R1190 - R1197. [Abstract] [Full Text] [PDF]

				F. V. Durlo, M. Castro, L. L. K. Elias, and J. Antunes-Rodrigues Interaction of prolactin, ANPergic, oxytocinergic and adrenal systems in response to extracellular volume expansion in rats Exp Physiol, September 1, 2004; 89(5): 541 - 548. [Abstract] [Full Text] [PDF]

				J. ANTUNES-RODRIGUES, M. DE CASTRO, L. L. K. ELIAS, M. M. VALENCA, and S. M. McCANN Neuroendocrine Control of Body Fluid Metabolism Physiol Rev, January 1, 2004; 84(1): 169 - 208. [Abstract] [Full Text] [PDF]

				E. Itagaki, S. Ozawa, S. Yamaguchi, K. Ushikawa, T. Tashiro, H. Katahira, M. Takizawa, K. Yoshimoto, S. Murakawa, and H. Ishida Increases in Plasma ACTH and Cortisol after Hypertonic Saline Infusion in Patients with Central Diabetes Insipidus J. Clin. Endocrinol. Metab., December 1, 2001; 86(12): 5749 - 5754. [Abstract] [Full Text] [PDF]

				A. Lacroix, N. N'Diaye, J. Tremblay, and P. Hamet Ectopic and Abnormal Hormone Receptors in Adrenal Cushing's Syndrome Endocr. Rev., February 1, 2001; 22(1): 75 - 110. [Abstract] [Full Text]

				P. A. Deuster, J. S. Petrides, A. Singh, G. P. Chrousos, and M. Poth Endocrine Response to High-Intensity Exercise: Dose-Dependent Effects of Dexamethasone J. Clin. Endocrinol. Metab., March 1, 2000; 85(3): 1066 - 1073. [Abstract] [Full Text]

				R. Pivonello, A. Faggiano, C. Di Somma, M. Klain, M. Filippella, M. Salvatore, G. Lombardi, and A. Colao Effect of a Short-Term Treatment with Alendronate on Bone Density and Bone Markers in Patients with Central Diabetes Insipidus J. Clin. Endocrinol. Metab., July 1, 1999; 84(7): 2349 - 2352. [Abstract] [Full Text]

				R. Pivonello, A. Colao, C. Di Somma, G. Facciolli, M. Klain, A. Faggiano, M. Salvatore, and G. Lombardi Impairment of Bone Status in Patients with Central Diabetes Insipidus J. Clin. Endocrinol. Metab., July 1, 1998; 83(7): 2275 - 2280. [Abstract] [Full Text]