Influence of hypercortisolemia on the acute-phase protein response to endotoxin in humans

Craig S. Rock, Susette M. Coyle, Christopher V. Keogh, Douglas D. Lazarus, Arthur S. Hawes, Maria Leskiw, Lyle L. Moldawer, T. Peter Stein, Stephen F. Lowry

Research output: Contribution to journalArticlepeer-review

48 Scopus citations

Abstract

Background. The response to systemic infection includes the coordinated appearance of hepatic acute-phase proteins, the production of which may be influenced by a counterregulatory hormonal background. This study sought to assess the potential for hypercortisolemic conditions to influence fibrinogen kinetics and other acute-phase protein responses in humans with endotoxemia. Methods. Eleven hospitalized healthy male volunteers underwent two separate determinations of fibrinogen kinetics, one baseline and one after administration of endotoxin (2 ng/kg intravenously; lot EC-5). Seven volunteers were studied without hormonal manipulation and four in the presence of a hypercortisolemic background (hydrocortisone infusion, 3 μg/kg/min). Fibrinogen fractional synthetic rates were estimated from the incorporation of orally administered 15N-glycme, and fibrinogen, C-reactive protein, cortisol, tumor necrosis factor-α, and interleukin-6 levels were also determined. Results. The presence of an antecedent hypercortisolemic background resulted in an attenuated interleukin-6 response, as well as decreased fibrinogen synthesis and C-reactive protein appearance. Conclusions. The current data suggest that glucocorticoid hormonal influences are of importance in the regulation of endotoxin-induced cytokine and acute-phase protein responses.

Original languageEnglish (US)
Pages (from-to)467-474
Number of pages8
JournalSurgery
Volume112
Issue number2
StatePublished - Aug 1992

All Science Journal Classification (ASJC) codes

  • Surgery

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