Radioimmunoassayable -corticotropin in normal and malnourished children in the baseline state and with methyrapone testing

ABSTRACT

1.) The radioimmunoassay technique is an easy, sensitive and convenient method for assay of plasma ACTH. For reproducibility of results, plasma extraction is necessary. Plasma ACTH can be measured in 0.5 ml. of normal plasma2) Baseline and metyrapone test corticotropin values are comparable in normal adults and children3) Baseline plasma corticotropin levels are elevated in the malnourished state, the level of elevation is proportional to the degree of malnutrition4)We postulate that a deficiency of a specific nutrient(s) as interpreted as a stressful stimulus by the ACTH secretory apparatus resulting in elevated baseline plasma ACTH levels5) Replacement of this nutrient(s) reversts baseline abnormal levels back to normal. The specific nutrient(s) remain to be identified6) A circadian rhthym of plasma ACTH is demonstrable in normal children. This rythym is dampened in the malnourished state and the amplitude is elevated. Refeeding does not revert this back to normal altho baseline levels at 6:00 A.M. are back to normal. (Conclusions)