ACTH 1–17 and pituitary-adrenal function in human

  • Francesco Cavagnini
  • Roldano Fossati
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In this study we have compared the effects of the ACTH 1–17 analogue, alsactide (Synchrodyn® 1–17,) and of the ACTH 1–24 fragment, on the dynamics of ACTH-cortisol secretion. In 2 healthy women, 100 μg alsactide injected i.m. at 0700 caused a much greater and sustained cortisol secretion than 100 μg ACTH 1–24. However, adrenocortical stimulation effected by alsactide terminated within 24 h, since plasma cortisol levels recorded 24 h after alsactide injection were even lower than the corresponding values of the previous day. In 8 other women, daily administration of 100 μg alsactide at 0700 for 15-days resulted in a significant blunting (p<0.05) of the ACTH secretion in response to insulin-induced hypoglycemia. This finding is even more meaningful in view of the more marked blood glucose fall (p<0.01) observed in the post treatment insulin tolerance test. Both baseline and insulin-stimulated cortisol levels were reduced after alsactide (p<0.02) so that cortisol increments above baseline were of comparable magnitude before and after treatment with the ACTH analogue. In 8 additional women, no significant changes in the cortisol response to hypoglycemia, in spite of more profound blood glucose fall (p<0.05), were noted after a 15-day treatment with 250 μg ACTH 1–24 daily. In all, these findings show that ACTH 1–17, compared to ACTH 1–24, effects a much more potent stimulation of cortisol secretion which, however, terminates within 24 h. Protracted administration of this compound, at the dose of 100 μg daily, causes a partial inhibition of the CRF-ACTH reactivity to insulin-induced hypoglycemia. Further studies are needed to define proper dosage and daily time of administration of this ACTH analogue for an optimized clinical use.


ACTH 1–17 ACTH 1–24 ACTH analogues ACTH-related peptides Alsactide Hypothalamo-pituilary-adrenal axis 


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© Springer-Verlag 1984

Authors and Affiliations

  • Francesco Cavagnini
    • 1
  • Roldano Fossati
    • 1
  1. 1.Istituto di Clinica Medica I Padiglione GranelliUniversità degli Studi di MilanoMilanoItaly

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