Control of adrenocortical growth in vivo

Adrenocortical growth is discussed with respect to its relation to body weight, elevated ACTH (provoked by sustained stress, adrenal enzyme deficiency, and adrenal enucleation), and unilateral adrenalectomy. It seems likely that these three conditions under which adrenal growth occurs are each controlled and mediated by different agents. Least is known about the growth of adrenals with the growth of the organism; however, because treatment with growth hormone is known to stimulate adrenal mitogenesis, and because adrenals grow in proportion to body growth by increasing cell number, it is proposed that this growth may be mediated by growth hormone (via somatomedin). ACTH causes primarily adrenocortical cellular hypertrophy which is subsequently followed by hyperplasia. It has been shown that the application of a sustained stressor, induction of adrenal enzyme deficiency and adrenal enucleation all result in persistent elevation in circulating ACTH levels and adrenal growth. It appears that the stimulus to ACTH secretion is a virtual or real decrease in corticosteroid feedback signal, and that ACTH secretion is regulated by corticosteroid levels. An additional humoral factor may be triggered by adrenal enucleation, and the possibility that a fragment of the N-terminal peptide of the ACTH precursor molecule plays this role is entertained. Finally, the evidence that the proliferative adrenal growth after unilateral adrenalectomy is mediated by afferent and crossed efferent neural pathways, and is regulated by aldosterone, pineal peptides and exposure to constant light is discussed.