Influence of topical corticosteroids on hormones in urine and plasma.

In the present study the effects on endogenous hormones of application of topical corticosteroids are investigated. Radioimmunological assays of the hormones cortisol, adrenocorticotrophic hormone (ACTH) and alpha-melanocyte stimulating hormone (alpha-MSH) before, during and after a large-area treatment with topical corticosteroids (30 g/d 0.025% fluocinolone acetonide ointment for 9 days) are performed in eight patients suffering from extensive inflammatory dermatoses (7 cases of eczema, 1 case of psoriasis). Cortisol was measured in plasma daily under treatment. In addition, gas chromatographic and mass spectrometric determinations of urocorticoids and uroandrogens are carried out in 24-h urine. A distinct, treatment-induced suppression of the endogenous steroid production was significant (-42.7%, p less than or equal to 0.05) within the first four days and diminished (-24.4%, p less than or equal to 0.10) after nine days' steroid therapy. The suppression of the plasma ACTH was also significant (-23.1%, p less than or equal to 0.05). The alpha-MSH level did not show any alterations. The measured urocorticoids showed an average fall of -38.9% (p less than or equal to 0.05). It is noteworthy that despite continued steroid treatment the marked initial suppression of the endogenous steroid production diminishes. It is possible that a therapy-induced "normalization" of the epidermis brings about a diminished steroid influx and thus a lower systemic load. Under the therapy conditions chosen here, the androgen metabolites in the urine did not show any significant fluctuations.

Seasonal rhythm of the plasma level of alpha-melanocyte stimulating hormone.

The present results indicate the presence of a seasonal rhythm of immunoreactive alpha-melanocyte stimulating hormone (alpha-MSH) in 20- to 40-year-old subjects of skin type I (light color of skin and eyes, red hair, no tanning after sun exposure) and skin type II (light color of skin, eyes, and hair, rare tanning) with raised levels of alpha-MSH in summer and low levels in winter. With increasing age of the investigated subjects, the seasonal rhythm seems to be lost. In subjects with skin type III (light skin, brown eyes and black hair, strong pigmentation after sun exposure) alpha-MSH shows only insignificant variations over the whole year. A seasonal rhythm of ACTH could not be demonstrated. A diurnal rhythm could be seen for ACTH, but not for alpha-MSH. To summarize, one can suppose that the seasonal rhythm of alpha-MSH is controlled by a varying UV exposure of the integument which is different over the whole year.

[Endocrinologic reactions following exposure to fluorescent lamps]. / Endokrinologische Reaktionen nach Leuchtstoff-lampenexposition.

Some reports on an increase of malignant skin tumors following fluorescent lighting made us investigate the systemic effects after exposure to fluorescent rays. Fluorescent rays induce small wavy fluctuations of the plasma concentration of alpha-MSH within normal ranges. Some test persons revealed a steep increase of cortisol values shortly after beginning of fluorescent lighting, indicating that fluorescent rays may induce endocrinological reactions. The significance of these findings with regard to the development of diseases, however, cannot be assessed by now.

[Chemiluminescence measurement in AIDS, lymphadenopathy and hemophilia patients]. / Chemilumineszenzmessung bei AIDS, Lymphadenopathie- und Hämophiliepatienten.

In order to reveal the activity of polymorphonuclear neutrophil leukocytes (PMNL) representing the first step of defence against infections, measurements of chemiluminescence (CL) were performed in patients suffering from acquired immune deficiency syndrome (AIDS), lymphadenopathy, or hemophilia. In comparison with healthy controls, AIDS patients revealed significant reduction (about 50 per cent) of phagocytic, i.e. CL activity of neutrophils, which had been induced by Zymosan. Only part of the patients suffering from lymphadenopathy answered with decreased granulocyte activity on the application of Zymosan. If concanavalin A was used as stimulant of metabolic activity of PMNL-independently of phagocytosis-again AIDS and some of the lymphadenopathy patients showed a markedly reduced neutrophil response. In conclusion it should be stated that there is some evidence for at least two defects of cellular immunity associated with AIDS and to some extent, with AIDS-endangered homosexuals suffering from lymphadenopathy: first the defect of PMNL to answer to concanavalin A with increased metabolic activity, and secondly the defect of PMNL to start phagocytosis induced by Zymosan with a subsequent release of oxygen radicals which are measurable as chemiluminescence. The appraisal of granulocyte activity by means of measurements of chemiluminescence might become an additional criterion for AIDS diagnostics.

[Endocrinological reactions following UV A whole body irradiation]. / Endokrinologische Reaktionen nach UV A-Ganzkörperbestrahlungen.

The basal secretion of proteo-hormones alpha-MSH and ACTH in plasma as well as the changes of the plasma concentrations following UV A-whole-body irradiation were investigated on 40 young male volunteers with different pigmentation levels (Caucasians: skin types I, II, III. Blacks: skin type VI). Significantly lower mean basic values of alpha-MSH and ACTH of light-haired persons in comparison with dark-haired and black persons (p less than 0,05) were demonstrated. We observed furthermore a significant increase of these proteo-hormones (alpha-MSH: skin type I: 26,7%, skin type II: 22,7%) in persons less pigmented within a short time after UV A whole-body irradiation in contrast to the more pigmented volunteers. These results prove a cutaneous peripheral sensor for UV A-rays, reacting with a different sensitivity depending on disposition and inducing endocrinological reactions. How this cutaneous-hypothalamic-pituitary stimulus mediation functions in detail is not completely revealed up to now. In what respect the present results, which can be explained as a consequence of evolutionary development, have a connection with the induction of melanoma remains to be seen.

[Effect of ultraviolet rays on alpha-MSH plasma concentration]. / Der Einfluss ultravioletter Strahlen auf die alpha-MSH Plasmakonzentration.

Influence of Ultraviolet Rays on alpha-MSH Plasmaconcentration. Ultraviolet total-body irradiation induces changes of alpha-MSH plasmaconcentration dependent on wave-length of the source of radiation as well as skin type of the volunteers. Following UV-A total-body irradiation, we observed a significant increase of the proteohormone alpha-MSH, whereas UV-B rays did not change the plasma concentration. With regard to persons showing skin type I or II, we found low alpha-MSH basic values which were significantly increased 1 hour after UV-A irradiation; in contrast, more pigmented volunteers (skin type III or VI) showed far higher basic values but only little increase after UV-A irradiation.

The relationship between alpha-MSH level and coat color in white Camarque horses.

White horses are subject to age-dependent coat depigmentation. They are dark gray or black at birth and lose their coloring between their second and fourth year. Beginning at about age 10 their coat takes on a characteristic silver-gray coloring. The purpose of this paper was to find out to what extent the endogenic alpha-MSH level changes with the change in pigmentation. alpha-MSH plasma levels were determined by radioimmunologic analysis in 3 age groups of white Camarque horses: age group 1 consisted of dark horses with a mean age of 1.2 years and a mean alpha-MSH level of 106.4 pg/ml +/- 18.2, age group 2 consisted of gray horses with a mean age of 7.5 years and with a mean alpha-MSH level of 73.6 pg/ml +/- 4.8, and age group 3 consisted of silver-gray horses with a mean age of 13.5 years and a mean alpha-MSH level of 65.0 pg/ml +/- 5.3. Highly significant differences (p less than 0.001) were found between the means of age group 1 and age group 2 and between the means of age group 1 and age group 3. Determination of the ACTH plasma levels in this breed of horses showed no statistically significant differences between the various age groups. Determination of alpha-MSH and ACTH levels in a control group (n = 56) of other breeds of horses (10 black, 28 brown, and 18 sorrel) resulted in no significant differences for either hormone with regard to age or coat color. On the basis of these results it may be concluded that the degree of coat pigmentation in white Camarque horses correlates directly with the alpha-MSH plasma level.

[Modification of alpha-MSH by UVA irradiation of the skin]. / Die Beeinflussung des alpha-MSH durch UVA-Bestrahlungen der Haut.

On 40 healthy male volunteers with different pigmentation level (Caucasians: skin types I-III, negroes: skin type VI) the basal alpha-MSH-secretion as well as the influence of UV-A-wholebody-irradiation (6 J/cm2) on alpha-MSH-serum concentration were measured. The mean basic values of red-haired and blondes are with 73,0 respectively 71,6 pg/ml significantly lower than the mean values of negroes with 99,6 pg/ml. After UV-A-irradiation the alpha-MSH mean values within one hour among red-haired persons increase 26,7%, among blondes increase 22,6%. Dark-haired caucasians (skin type III) as well as negroes show no significant changes in alpha-MSH serum level. These results support a peripheral sensor for UV-A-rays which induce a hypothalamic-pituitary response (alpha-MSH secretion) obviously on a nervous way. One can point out that genetic and/or racial characteristics influence this central-nervous reaction due to UV-A-irradiation of the skin. The connection between the development of malignant melanoma and the UV-A-induced changes of alpha-MSH level is discussed.

[Psoriasis and haemodialysis: changes in plasma hormone concentration as a possible therapeutic mechanism (author's transl)]. / Psoriasis und Hämodialyse. Veränderungen von Hormonkonzentrationen im Plasma als möglicher therapeutischer Mechanismus.

Free dehydroepiandrosterone (DHEA), DHEA sulphate, testosterone, LH and FSH were measured in plasma from 67 patients with renal disease before and after haemodialysis or haemofiltration. Plasma concentration of the steroid hormones was lower in patients with renal failure than in normal controls, while that of the gonadotrophic hormones was elevated. After haemodialysis or haemofiltration DHEA sulphate level in plasma decreased, free DHEA increased significantly reaching almost the initial value of the control group. There was no change in concentration of the other steroid and gonadotrophic hormones. The likely mechanism is that haemodialysis removes DHEA deficiency in patients with psoriasis which is assumed to be an aetiopathogenetic factor in the disease.