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Nebennierenrinde und Glucocorticoide

  • B. Allolio
  • W. Arlt
  • S. R. Bornstein
  • M. Reincke

Zusammenfassung

Die Nebenniere ist für die Synthese von über 50 verschiedenen Steroiden verantwortlich. Sie besteht aus 3 Schichten, der Zona glomerulosa, der Zona fasciculata, und der Zona reticularis, die als Kompartimente der Mineralocorticoide, Glucocorticoide und Androgene dienen (Abb.3-1).

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Literatur

Literatur zu Abschn. 3.1

  1. Bornstein S.R. (1996) The adrenal functional unit. Thieme, StuttgartGoogle Scholar
  2. Bornstein S.R., Chrousos G.P. (1999) Clinical review 104: Adrenocorticotropin (ACTH)-and non-ACTH-mediated regulation of the adrenal cortex: neural and immune inputs. J Clin Endocrinol Metab 84(5):1729–1736PubMedCrossRefGoogle Scholar
  3. Bornstein S.R., Ehrhart M., Scherbaum W.A., Pfeiffer E.F. (1990) Adrenocortical atrophy of hypophysectomized rats can be reduced by corticotropin releasing hormone (CRH) Cell Tissue Res 260: 161–166PubMedCrossRefGoogle Scholar
  4. Bornstein S.R., Ehrhart-Bornstein M., Güse-Behling H. and Scherbaum W.A. (1992) Structure and dynamics of adrenal mitochondria following stimulation with corticotropin releasing hormone (CRH). Anat Rec 234: 255–262PubMedCrossRefGoogle Scholar
  5. Bornstein S.R., Ehrhart-Bornstein M., Scherbaum W. A., Pfeiffer E.F., Holst J.J. (1990) Effects of splanchnic nerve stimulation on the adrenal cortex may be media ted by chromaffin cells in a paracrine manner. Endocrinology 127: 900–906PubMedCrossRefGoogle Scholar
  6. Ehrhart-Bornstein M., Hinson J.P., Bornstein S.R., Scherbaum W.A., Vinson G.P. (1998) Intraadrenal interactions in the regulation of adrenocortical steroidogenesis. Endocr Rev 19(2):101–143PubMedCrossRefGoogle Scholar
  7. Speiser P.W., New M.I., White P.C. (1995) Congenital adrenal hyperplasia. In: Weintraub B.D. (eds) Molecular. Endocrinology: Basic concepts and clinical correlations, Raven, New YorkGoogle Scholar
  8. Steffgen J., Ehrhart-Bornstein M., Herkommer B., Güse-Behling H., Franz H.E., Scherbaum W.A., Bornstein S.R. (1996) Evidence for a probenecid inhibitable exchange transport system involved in the release mechanism of cortisol in bovine adrenocortical cells. Cell Phys Biochem 6: 82–90CrossRefGoogle Scholar
  9. Strauss J.F. 3rd, Kallen C.B., Christenson L.K., Watari H., Devoto L., Arakane F., Kiriakidou M., Sugawara T. (1999) The steroidogenic acute regulatory protein (StAR): a window into the complexities of intracellular cholesterol traffikking. Recent Prog Honn Res 54: 369–394Google Scholar
  10. Thomson M. (1998) Molecular and cellular mechanisms used in the acute phase of stimulated steroidogenesis. Horm Metab Res 30(1):16–28PubMedCrossRefGoogle Scholar
  11. Usadel H., Bornstein S.R., Ehrhart-Bornstein M., Kreysch H., Gand Scherbaum W.A. (1993) Gap junctions in the adrenal cortex. Horm Metab Res 101: 371–373Google Scholar

Literatur zu Abschn. 3.2 und 3.3

  1. Ahonen P., Myllarniemi S., Sipila I., Perheentupa J. (1990) Clinical variation of autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy. N Engl J Med 322: 1829–1836PubMedCrossRefGoogle Scholar
  2. Allolio B., Kaulen D., Deuß U., Hipp F.X., Winkelmann W. (1985) Vergleich von Hydrocortison und Cortisonacetat in der Substitutionstherapie der Nebennierenrindeninsuffizienz. Akt Endokr Stoffw 6: 35–39Google Scholar
  3. Allolio B., Rosenthal C., Schulte H.M. (1990) Überwachung der Substitutionstherapie bei Nebennierenrinden (NNR)-Insuffizienz. In: Allolio B., Schulte H.M. (Hrsg) Moderne Diagnostik und therapeutische Strategien bei Nebennierenerkrankungen. Schattauer, StuttgartGoogle Scholar
  4. Arlt W., Callies F., van Vlijmen J.C. et al. (1999) Dehydroepiandrosterone replacement in women with adrenal insufficiency. N Engl J Med 14: 1013–1020CrossRefGoogle Scholar
  5. Betterle C., Greggio N.A., Volpato M. (1998) Clinical Review: Autoimmune polyglandular syndrome Type I. J Clin Endocrinol Metab 83: 1049–1055PubMedCrossRefGoogle Scholar
  6. Bornstein S.R., Ehrhart-Bornstein M., Guse-Behling H., Scherbaum W.A. (1992) Structure and dynamics of adrenal mitochondria following stimulation withGoogle Scholar
  7. Buxi T.B., Vohra R.B., Sujatha B. et al. (1992) CT in adrenal enlargement due to tuberculosis: a review of the literature with five new cases. Clin Imaging 16: 102–108PubMedCrossRefGoogle Scholar
  8. Dickstein G., Shechner C., Nicholson W.E. et al. (1991) Adrenocorticotropin stimulation test: effects of basal cortisollevel, time of day, and suggested new sensitive low dose test. J Clin Endocrinol Metab 72: 773–778PubMedCrossRefGoogle Scholar
  9. Esteban N.V., Loughlin T., Yergey A.L. et al. (1991) Daily cortisol production rate in man determined by stable isotope dilution/mass spectrometry. J Clin Endocrinol Metab 72, 39–45PubMedCrossRefGoogle Scholar
  10. Grinspoon S.K., Biller B.M.K. (1994) Clinical review 62: Laboratory assessment of adrenal insufficiency. J Clin Endocrinol Metab 79: 923–931PubMedCrossRefGoogle Scholar
  11. Hangaard J., Andersen M., Grodum E. et al. (1996) Pulsatile thyrotropin secretion in patients with Addison’s disease during variable glucocorticoid therapy. J Clin Endocrinol Metab 81: 2502–2507PubMedCrossRefGoogle Scholar
  12. Irvine W.J., Barnes E.W. (1972) Adrenocortical insufficiency.Clin Endocrinol Metab 1: 549–594CrossRefGoogle Scholar
  13. Kong M.F., Jeffcoate W. (1994) Eighty-six cases of Addison’s disease. Clin Endocrinol 41: 757–761CrossRefGoogle Scholar
  14. Morales A.J., Nolan J.J., Nelson J.C. et al. (1994) Effects of replacement dose of dehydroepiandrosterone in men and women of advancing age. J Clin Endocrinol Metab 78: 1360–1367PubMedCrossRefGoogle Scholar
  15. Moser H.W. (1995) Clinical and therapeutic aspects of adrenoleukodystrophy and adrenomyeloneuropathy J Neuropathol Exp Neurol 54: 740–745PubMedCrossRefGoogle Scholar
  16. Nagamine K., Peterson P., Scott H.S. et al. (1997) Positional cloning of the APECED gene. Nat Genet 17:393–398PubMedCrossRefGoogle Scholar
  17. Nerup J. (1974) Addison’s disease-clinical studiesA report of 108 cases. Acta Endocrinol 76: 127–141PubMedGoogle Scholar
  18. Neufeld M., Maclaren N.K., Blizzard R.M. (1981) Two types of autoimmune Addison’s disease associated with different polyglandular autoimmune (PGA) syndromes. Medicine 60:355–362PubMedCrossRefGoogle Scholar
  19. Oelkers W. (1996) Current concepts: Adrenal insufficiency N Engl J Med 335:1206–1212PubMedCrossRefGoogle Scholar
  20. Oelkers W. (1996) Dose-response aspects in the clinical assessment of the hypothalamo-pituitary-adrenal axis, and the low dose adrenocorticotropin test. Eur J Endocrinol 135: 27–33PubMedCrossRefGoogle Scholar
  21. Piedrola G., Casado J.L., Lopez E. et al. (1996) Clinical features of adrenal insufficiency in patients with acquired immunodeficiency syndrome. Clinical Endocrinology 45: 97–101PubMedCrossRefGoogle Scholar
  22. Schlaghecke R., Kornely E., Santen R.T. et al. (1992) The effect of long-term glucocorticoid therapy on pituitary-adrenal responses to exogenous corticotropin-releasing hormone. N Engl J Med 326: 226–230PubMedCrossRefGoogle Scholar
  23. Schulte H.M., Mönig H., Benker G. et al. (1987) Pharmacokinetics of aldosterone in patients with Addison’s disease: effect of rifampicin treatment on glucocorticoid and mineralocorticoid metabolism. Clin Endocrinol 27: 655–662CrossRefGoogle Scholar
  24. Stewart P.M., Corrie I., Seckl J.R. et al. (1988) A rational approach for assessing the hypothalamo-pituitary-adrenal axis. Lancet 1(8596): 1208–1210PubMedCrossRefGoogle Scholar
  25. Thodou E., Asa S.L., Kontogeorgos G. et al. (1995) Clinical case seminar: L ymphocytic hyophysitis: clinicopathological findings. J Clin Endocrinol Metab 80: 2302–2311PubMedCrossRefGoogle Scholar
  26. Uibo R., Aavik E., Peterson P. et al. (1994) Autoantibodies to cytochrome P450 enzymes P450scc, P450c17, and P450c21 in auto immune polyglandular disease types I and II and in isolated Addison’s disease. J Clin Endocrinol Metab 78:323–328PubMedCrossRefGoogle Scholar
  27. Zanaria E., Monatelli F., Bardoni B. et al. (1994) An unusual member of the nuclear hormone receptor superfamily responsible for X-linked adrenal hypoplasia congenita. Nature 372: 635–641PubMedCrossRefGoogle Scholar
  28. Zelissen P.M., Bast E.I., Croughs R.J. (1995) Associated autoimmunity in Addision’s disease. J Autoimmun 8: 121–130PubMedCrossRefGoogle Scholar

Literatur zu Abschn. 3.4 bis 3.7

  1. Allolio, B., Arlt W., Reincke M. (1996) Medical therapy of Cushing’s syndrome. In: Werder K. von Fahlbusch R. (Hrsg) Pituitary adenomas: From basic research to diagnosis and therapy. Elsevier, Amsterdam, S 223–229Google Scholar
  2. Aron D.C., Findling J.W., Tyrell J.B. (1987) Cushing’s disease. Endocrin Metab Clin North Am 16: 705–730Google Scholar
  3. Buchfelder M., Fahlbusch R. (1988) Therapiekonzepte bei Hypophysenadenomen aus neurochirurgischer Sicht. In: Bamberg M., Sack H. (Hrsg) Therapie primärer Hirntumoren. Zuckerschwerdt, München, S 132–146Google Scholar
  4. Buchfelder M. (1993) The accuracy ofCT and MR evaluation of the sella turcica for detection of adrenokorticotropic hormone-secreting adenomas in Cushing disease. AJNR14: 1183–1190PubMedGoogle Scholar
  5. Chrousos G.P., Schulte H.M., Oldfield E.H., Cuder G.B. jr., Gold P.W., Loriaux D.L. (1984) The corticotropin releasing factor stimulation test: an aid in the differential diagnosis of Cushing’s syndrome. New Engl J Med 310: 622–627PubMedCrossRefGoogle Scholar
  6. Dorn L.D., Burgess E.S., Friedman T.C., Dubbert B., Gold P.W., Chrousos G.P. (1997)The longitudinal course of psychopathology in Cushing’s syndrome after correction of hypercortisolism. J ClinEndocrinol Metab 82: 912–919CrossRefGoogle Scholar
  7. Estrada I., Boronat M., Mielgo M. et al. (1997) The long-term outcome of pituitary irradiation after unsuccessful transsphenoidal surgery in Cushing’s disease. N Engl J Med 172: 172–178CrossRefGoogle Scholar
  8. Garz G., Luning M., Melzer B. (1985) Computed tomographie incidental finding of a hormone-inactive adrenal cortex adenoma. Radiol Diagn (Berl) 26: 761–766Google Scholar
  9. Glazer H.S., Weyman P.I., Sagel S.S., Levitt R.G., McClennan B.L. (1982) Nonfunctioning adrenal masses: incidental discovery on computed tomography. AJR Am J Roentgenol 139:81–85PubMedCrossRefGoogle Scholar
  10. Hall W. A., Luciano M.G., Doppman J.L., Patronas N.I., Oldfield E.H. (1994) Pituitary magnetic resonance imaging in normal human volunteers: occult adenomas in the general population. Ann Intern Med 120:817–820PubMedCrossRefGoogle Scholar
  11. Hensen J., Harsch I., Sachse R. et al. (1997) Adrenal gland incidentaloma is not a „time bomb“-arguments for follow-up control. Zentralbl Chir 122: 487–493PubMedGoogle Scholar
  12. Kley H.K., Wagner H., Jaresch S., Jungbluth R., Schlaghecke R. (1990) Endokrin inaktive Nebennierentumoren. In: Allolio B., Schulte H.M. (eds) Moderne Diagnostik und therapeutische Strategien bei Nebennierenerkrankungen. Schattauer, Stuttgart, S 216–222Google Scholar
  13. Kern, W., Fehm H.L. (1990) Das Nebennierenrindenkarzinom. In: Allolio B., Schulte H.M. (Hrsg) Moderne Diagnostik und therapeutische Strategie bei Nebennierenerkrankungen. Schattauer, Stuttgart, S198–209Google Scholar
  14. Lacroix A., Bolte E., Tremblay J. et al. (1992) Gastric inhibitory polypeptide-dependent cortisol hypersecretion: a new cause of Cushing’s syndrome. N Engl J Med 327: 974–980PubMedCrossRefGoogle Scholar
  15. Leibowitz G., Tsu A., Chayen S.D., Salameh M., Raz I., Cerasi E., Gross D.J. (1996) Pre-clinical Cushing’s syndrome: an unexpected frequent cause of poor glycaemic control in obese diabetic patients. Clin Endocrinol 44: 717–722CrossRefGoogle Scholar
  16. Newell-Price J., Trainer P., Perry L., Wass J., Grossman A., Besser M.(1995) A single sleeping midnigt cortisol has 100% sensitivity for the diagnosis of Cushing’s syndrome. Clin Endocrinol 43: 545–550CrossRefGoogle Scholar
  17. Nieman L.K., Chrousos G.P., Oldfield E.H., Avgerinos P.C., Cuder G.B., Loriaux D.L. (1986) The ovine corticotropin-releasing hormone stimulation test and the dexamethasone suppression test in the differential diagnosis of Cushing’s syndrome. Ann Intern Med 105: 862–867PubMedCrossRefGoogle Scholar
  18. Oldfield E.H., Doppman J.L., Nieman L.K. et al. (1991) Petrosal sinus sampling with an without corticotropin-releasing hormone for the differential diagnosis of Cushing’s syndrome N Engl J Med 325: 897–905PubMedCrossRefGoogle Scholar
  19. Orth D.N. (1995) Cushing’s syndrome. N Engl J Med 332:791–803PubMedCrossRefGoogle Scholar
  20. Reincke M., Allolio B., Winkelmann W. (1988) Das okkulte ektope Cushing-Syndrom. Dtsch Med W ochenschr 113: 1561–1565CrossRefGoogle Scholar
  21. Reincke M., Nieke I., Krestin G.P., Saeger W., Allolio B., Winkelmann W. (1992) Preclinical Cushing’s syndrome in adrenal „Incidentalomas“: Comparison with adrenal Cushing’s syndrome. J Clin Endocrinol Metab 75: 826–832PubMedCrossRefGoogle Scholar
  22. Ross E.J., Linch D.C. (1982) Cushing’s syndrome-Killing disease: Discriminatory value of signs and symptoms aiding early diagnosis. Lancet 2: 646–649PubMedCrossRefGoogle Scholar
  23. Schulte, H.M., Benker G., Reinwein D., Sippell W.G., Allolio B. (1990) Infusion of low-dose etomidate: correction of hypercortisolemia in patients with Cushing’s syndrome and dose-response relationship in normal subjects. J Clin Endocrin 70: 1426–1430CrossRefGoogle Scholar
  24. Shenoy B.V., Carpenter P.C., Carney J.A.(1984) Bilateral primary pigmented nodular adrenocortical disease. Rare cause of the Cushing’s syndrome. Am J Surg Pathol 8: 335–344PubMedCrossRefGoogle Scholar
  25. Tsigos C., Papanicolaou D.A., Chrousos G.P. (1995) Advances in the diagnosis and treatment of Cushing’s syndrome. Baillieres Clin Endocrinol Metabol 9(2):315–336CrossRefGoogle Scholar
  26. Wajchenberg B.L., MendonHa B.B., Liberman B., Albergaria Pereira M.A., Campos Carneiro P., Wakamatsu A., Kirschner M.A. (1994) Ectopic adrenocorticotropic hormone syndrome. Endocr Rev 15: 752–787PubMedGoogle Scholar
  27. Zeiger M.A., Nieman L.K., Cutler G.B., Chrousos G.P., Doppman J.L., Travis W.D., Norton J.A. (1991) Primary bilateral adrenocortical causes of Cushing’s syndrome. Surgery 110: 1106–1115PubMedGoogle Scholar

Literatur zu Abschn. 3.8 und 3.9

  1. Arlt W., Reincke M., Winkelmann W., Allolio B. (1990) Klinik und Therapie des Nebennierenrindenkarzinoms. Therapiewoche 40: 2400–2604Google Scholar
  2. Bergenstal D.M., Hertz R., Lipsett M.B., Moy R.H. (1960) Chemotherapy of adrenokortical carcinoma with o,p’-DDD. Ann Intern Med 63: 672–682Google Scholar
  3. Beuschlein F., Reincke M., Karl M. et al. (1994) Clonal composition of human adrenocortical neoplasms. Cancer Res 54: 4927–4932PubMedGoogle Scholar
  4. Dobbie J.W. (1969) Adrenocortical nodular hyperplasia: the ageing adrenal. J Pathol 99: 1–18PubMedCrossRefGoogle Scholar
  5. Dralle H., Scheumann G.F.W., Nashan B., Brabant G. (1994) Review: recent developments in adrenal surgery. Acta Chir Belg 94: 137–140PubMedGoogle Scholar
  6. Fernimdez-Real J.M., Engel W.R., Sima R. et al. (1998) Study of glucose tolerance in consecutive patients harbouring incidental adrenal tumours. Clin Endocrinol 49: 53–61CrossRefGoogle Scholar
  7. Garz G., Luning M., Melzer B. (1985) Computertomographische Zufallsbefunde von hormoninaktiven Nebennierenandenomen. Radiol Diagn (Berlin) 26:761–766Google Scholar
  8. Glazer H.S., Weyman P.J., Sagel S.S., Levitt R.G., McClennan (1988) Nonfunctioning adrenal masses. Am J Radiol 109: 613–618Google Scholar
  9. Johnson D.H., Greco F.A. (1986) Treatment of metastatic adrenal cortical carcinoma with cisplatin and etoposide (VP-16). Cancer 58:2198–2202PubMedCrossRefGoogle Scholar
  10. Kloos R.T., Gross M.D., Francis I.R., Korobkin M., Shapiro B. (1995) Incidentally discovered adrenal masse. Endocr Rev 16:460PubMedGoogle Scholar
  11. Krestin G.P., Friedmann G., Fischbach R., Neufang K.F., Allolio B. (1991) Evaluation of adrenal masses in oncologic patients: dynamic contrast-enhancement MR vs CT. Comput Assist Tomogr 15:104–110CrossRefGoogle Scholar
  12. Nader S., Hickey R.C., Sellin R.V., Samaan N.A. (1983) Adrenal cortical carcinoma. A study of 77 cases. Cancer 52: 707–711PubMedCrossRefGoogle Scholar
  13. Reincke M., Nieke J., Krestin G.P., Saeger W., Allolio B., Winkelmann W. (1992) Preclinical Cushing’s syndrome in adrenal „incidentalomas“: comparison with adrenal Cushing’s syndrome. J Clin Endocrinol Metab 75: 826–832PubMedCrossRefGoogle Scholar
  14. Reincke M., Allolio B. (1995) Das Nebenniereninzidentalom: Die Kunst der Beschränkung in Diagnostik und Therapie. Dtsch Arzteblatt 92: 764–770Google Scholar
  15. Reincke M., Fassnacht M., Väth S., Mora P., Allolio B. (1996) Adrenal incidentalomas: a manifestation of the metabolie syndrome? Endocr Res 22(4):757–761PubMedGoogle Scholar
  16. Reincke M., Allolio B. (1997) Molekularbiologie der zufällig diagnostizierten Nebennierenraumforderung. Zentralbl Chir 122: 430–437PubMedGoogle Scholar
  17. Stark S., Pavel M., Sachse R. et al. (1994) Endocrine inactive adrenocortical adenomas (ACA) are a conditon of the elderly. Exp Clin Endocrinol 102 (Suppl 1):180–184Google Scholar
  18. Terzolo M., Osella G., Ali A. et al. (1996) Different patterns of steroid secretion in patients with adrenal incidentalomas. J Clin Endocrinol Metab 81: 740–744PubMedCrossRefGoogle Scholar

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© Springer-Verlag Berlin Heidelberg 2001

Authors and Affiliations

  • B. Allolio
  • W. Arlt
  • S. R. Bornstein
  • M. Reincke

There are no affiliations available

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