A new generation IRMA for ACTH with improved specificity: validation in various physiological and pathological conditions.

Objective: Measurement of plasma ACTH is a key step for the exploration of hypothalamic-pituitary-adrenal disorders. To further improve ACTH recognition a new generation of ACTH IRMA was developed using antibodies directed towards succinylated ACTH (sACTH IRMA).

Design: The usefulness of this assay was compared with that of another commercially available ACTH IRMA assay using intact ACTH (ELSA-ACTH) in various pathophysiological situations: patients with low ACTH plasma levels, high ACTH plasma levels with normal or tumoural pituitaries, or ectopic ACTH syndrome, and pregnant women with high proopiomelanocortin (POMC) plasma levels.

Overnight dexamethasone suppression test: comparison of plasma and salivary cortisol measurement for the screening of Cushing's syndrome.

The overnight 1-mg dexamethasone suppression test is a very good screening test for subjects suspected of having Cushing's syndrome. To simplify the procedure, we evaluated the 1-mg dexamethasone suppression test with measurement of salivary cortisol. We performed this test with plasma and salivary cortisol measurements in 27 patients with Cushing's syndrome and 64 normal controls.

Long-distance and long-term follow-up of a patient with intermittent Cushing's disease by salivary cortisol measurements.

Salivary cortisol is an excellent indicator of the plasma free cortisol concentration in normal and pathological situations. We took advantage of its ease of sampling, allowing multiple collections at home, to follow the course of a patient with Cushing's disease living in North Africa. This 48-year-old woman presented with a clinically moderate hypercortisolism caused by a large basophilic pituitary adenoma.

Salivary cortisol measurement: a practical approach to assess pituitary-adrenal function.

The salivary cortisol concentration is an excellent indicator of the plasma free cortisol concentration. To establish its normal and pathological ranges, salivary cortisol concentrations were measured in 101 normal adults, 18 patients with Cushing's syndrome, and 21 patients with adrenal insufficiency. The normal subjects had a mean (+/- SEM) salivary cortisol concentration of 15.

Hormonal consequences of orchidectomy for carcinoma of the prostate. With special reference to the measurement of free testosterone in saliva and prostatic dihydrotestosterone levels.

22 patients with metastatic carcinoma of the prostate were treated by subcapsular orchidectomy and followed by regular determinations of plasma testosterone, dihydrotestosterone, delta 4-androstenedione, dehydroepiandrosterone sulfate and testosterone estradiol-binding globulin as well as salivary testosterone, which reflects free plasma testosterone. Subcapsular orchidectomy constantly induced a dramatic and stable decrease in testicular androgens without modification of adrenal androgens or testosterone estradiol-binding globulin. Free testosterone levels vary widely for a given value of plasma testosterone, probably due to individual variations of testosterone estradiol-binding globulin.

Hormonal consequences of orchidectomy for carcinoma of the prostate. With special reference to the measurement of free testosterone in the saliva.

22 patients with metastatic carcinoma of the prostate were treated by subcapsular orchidectomy and followed by regular determinations of plasma T, DHT, D4A Dione, SDHEA, and TeBG as well as salivary T which measures the free Testosterone. Subcapsular orchidectomy constantly induced a dramatic and stable decrease of testicular androgens or TeBG. Free Testosterone levels vary widely for a given value of plasma T, probably due to individual variations of TeBG.