[Changes in levels of acute phase proteins in patients with central hypercortisolism]

Acute phase protein reaction depends on complex interaction of proinflammatory cytokines and hormones, especially glucocorticoids. Glucocorticoids are essential factors for hepatocellular microenvironment and proteosynthesis during both rest and inflammatory period. Cushing's disease represents a model of glucocorticoid hyperstimulation of acute phase protein synthesis without interleukin-6 and other cytokine influence.

20 patients (age of 38 +/- 11, 11 males, 9 females) with a diagnosis of central hypercorticolism were examined. Plasma levels of 11 acute phase proteins were estimated. These results were compared with plasma ACTH, interleukin-6, and U-cortisol concentrations and correlated to the control group (healthy volunteers, age 30 +/- 5, 13 males, 7 females). Plasma levels of albumin and prealbumin in patients with Cusing's disease were significantly lower. We proved significant elevation of alpha 1-acid glycoprotein, haemopexin, and fibrinogen compared with healthy subjects. The positive correlation of alpha 1-acid glycoprotein and U-cortisol (r = 0.51, p < 0.01), haemopexin and U-cortisol (r = 0.47, p < 0.05) respectively was found.

The interaction between glucocorticoids and proinflammatory cytokines in acute phase protein synthesis depends on permissive effects of corticoids on cytokine signal transduction in hepatocytes. However, our results document that corticoida themselves significantly stimulate acute phase protein synthesis, and this stimulation differs from inflammatory pattern of hepatic proteosynthesis.