ACTH-provoked cortisol peaks during sleep and their effect on the endogenous secretory activity

The effects of low physiological doses of ACTH on nocturnal plasma cortisol patterns were investigated in six male subjects. Concomitant sleep EEG recordings were analysed in relation to the cortisol level. 250 ng ACTH1-24 (Synacthène), injected through an indwelling catheter at a period of low adreno-cortical activity (2400 h), induced a cortisol peak followed by a four to five-hour period without any cortisol secretion. The same dose of ACTH injected at 0430 h, when cortisol secretory activity was high, did not entirely abolish endogenous secretion, which was diminished for a shorter time (2.5 hr). The ACTH-provoked cortisol peaks of comparable size to endogenous secretory peaks, can suppress cortisol secretion for several hours. This suppressive capacity depends on timing in relation to high or low secretory activity periods. However, spontaneous cortisol peaks have no appreciable effect on further secretory episodes. This difference in suppressive capacities suggests that the 24 hr cortisol rhythm is regulated independently of such feedback mechanisms.