Hypothalamic-pituitary-adrenal axis interaction with prostaglandins

1. The major PGE2 plasma metabolite, 15-keto-13, 14-dihydro-PGE (PGEM) was measured during metyrapone, dexamethasone and ACTH tests in order to elucidate if plasma PGE was affected by short term changes of the hypothalamic-pituitary adrenal axis function in man. 2. Plasma PGEM, serum cortisol and serum 11-deoxycortisol were determined by RIA. 3. Metyrapone (an inhibitor of adrenal 11 beta-hydroxylase), 250-1000 mg was given orally at 4 hour intervals for 20 hours. PGEM, cortisol and 11-deoxycortisol were measured before and 10 and 22 hours after the start of metyrapone in 10 patients evaluated for pituitary disease. 4. Dexamethasone, 1 mg orally, was given at 23 hours on day one and 25 IU (1-24) ACTH were given iv at 8 hours on day two. Blood was drawn for determination of PGEM and cortisol at 8 hours day one, and 8 hours day two. After the ACTH injection, blood was drawn at 90 minutes (for PGEM) and at 120 minutes (for PGEM and cortisol). 10 subjects aged 21-62 years were studied. 5. Plasma PGEM levels were significantly increased after metyrapone, concomitantly with the lowering of serum cortisol levels. 6. No difference in the PGEM increase between patients with normal or subnormal 11-deoxycortisol response was found. 7. A significant increase in plasma PGEM levels was found when serum cortisol was suppressed 9 hours after dexamethasone administration. 8. Glucocorticoids inhibit synthesis of eicosanoids and the present results suggest that short term decrease in cortisol may stimulate PG synthesis.