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      Pyridostigmine Enhances Even if it Does Not Normalize the Growth Hormone Responses to Growth Hormone-Releasing Hormone in Patients with Cushing’s Disease

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          Abstract

          Subjects with Cushing’s disease have diminished growth hormone (GH) response to growth hormone-releasing hormone (GHRH). The aim of our study was to investigate the underlying mechanism of this diminished GH response in these patients using pyridostigmine (PD), an acetylcholinesterase inhibitor, which is reported to increase GH secretion by reducing somatostatin tone. Eight subjects with untreated Cushing’s disease (caused by a pituitary adenoma) and 6 control subjects received GHRH 100 µg in 1 ml of saline, as intravenous bolus injection 60 min after (1) placebo (2 tablets, p.o.) or (2) PD (120 mg, p.o.). After GHRH plus placebo, the GH peak (mean ± SEM) was significantly lower in subjects with Cushing’s disease (2.4 ± 0.5 µg/l) compared to control subjects (25.1 ± 1.8 µg/l, p < 0.05). After GHRH plus PD, the GH peak was significantly enhanced both in subjects with Cushing’s disease (7.1 ± 2.3 µg/l, p < 0.05) and in control subjects (42.3 ± 4.3 µg/l, p < 0.05). In patients with Cushing’s disease, the GH response to GHRH plus PD was lower with respect to the GH response to GHRH alone in normal subjects. We conclude that hypercortisolism may cause a decrease in central cholinergic tone which is in turn hypothesized to be responsible of an enhanced somatostatin release from the hypothalamus. However, other metabolic or central nervous system alterations may act synergistically with hypercortisolism in causing GH inhibition in patients with Cushing’s disease.

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          Author and article information

          Journal
          HRE
          Horm Res Paediatr
          10.1159/issn.1663-2818
          Hormone Research in Paediatrics
          S. Karger AG
          1663-2818
          1663-2826
          1991
          1991
          02 December 2008
          : 35
          : 3-4
          : 99-103
          Affiliations
          Cattedra di aClinica Medica and cChimica, Università di Brescia, Italia bServizio di Endocrinologia, Ospedale Fatebenefratelli, Milano, Italia; dDepartment of Health Sciences, University of Wisconsin, Milwaukee, USA
          Article
          181882 Horm Res 1991;35:99–103
          10.1159/000181882
          1806475
          © 1991 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Pages: 5
          Categories
          Original Paper

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