Summary:
Background. Acute phase protein reaction depends on complex interaction of proinflammatory cytokines and
hormones, especially glucocorticoids. Glucocorticoids are essential factors for hepatocellular microenvironment and
proteosynthesis during both rest and inflammatory period. Cushing’s disease represents a model of glucocorticoid
hyperstimulation of acute phase protein synthesis without interleukin-6 and other cytokine influence.
Methods and Results. 20 patients (age of 38±11, 11 males, 9 females) with a diagnosis of central hypercorticolism
were examined. Plasma levels of 11 acute phase proteins were estimated. These results were compared with plasma
ACTH, interleukin-6, and U-cortisol concentrations and correlated to the control group (healthy volunteers, age
30±5, 13 males, 7 females). Plasma levels of albumin and prealbumin in patients with Cusing’s disease were
significantly lower. We proved significant elevation of alpha 1 -acid glycoprotein, haemopexin, and fibrinogen
compared with healthy subjects. The positive correlation of alpha 1 -acid glycoprotein and U-cortisol (r=0.51, p<0.01),
haemopexin and U-cortisol (r=0.47, p<0.05) respectively was found.
Conclusions. The interaction between glucocorticoids and proinflammatory cytokines in acute phase protein
synthesis depends on permissive effects of corticoids on cytokine signal transduction in hepatocytes. However, our
results document that corticoida themselves significantly stimulate acute phase protein synthesis, and this stimulation
differs from inflammatory pattern of hepatic proteosynthesis.
Key words:
Cushing’s syndrome, interleukin 6, cortisol, acute phase proteins.
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