Aberrant adrenal sensitivity to multiple ligands in unilateral incidentaloma with subclinical autonomous cortisol hypersecretion: a prospective clinical study.

Reznik, Y.; Lefebvre, H.; Rohmer, V.; Charbonnel, B.; Tabarin, A.; Rodien, P.; Lecomte, P.; Bardet, S.; Coffin, C.; Mahoudeau, J.

doi:10.1111/j.1365-2265.2004.02048.x

Cited by 71Adrenal and Paraganglionic TumorsPituitary Gland Disorders and TreatmentsAdrenal Hormones and Disorders

Aberrant adrenal sensitivity to multiple ligands in unilateral incidentaloma with subclinical autonomous cortisol hypersecretion: a prospective clinical study.

Reznik, Y., Lefebvre, H., Rohmer, V., Charbonnel, B., Tabarin, A., Rodien, P., Lecomte, P., Bardet, S. +2 more·2004·Clinical Endocrinology

DOI 10.1111/j.1365-2265.2004.02048.x

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Abstract

BACKGROUND: Incidentally discovered adrenal tumours are frequently associated with subclinical autonomous cortisol hypersecretion of unknown origin. Aberrant hormone receptors have been observed in case reports of overt Cushing's syndrome. The question arises as to whether such receptors may be present in the functioning adrenal incidentaloma, which is common and might be a subclinical stage of Cushing's syndrome. PATIENTS AND METHODS: Twenty-one consecutive patients with a unilateral incidentaloma, the biochemical features of subclinical cortisol hypersecretion and/or the scintigraphic features of an autonomously functioning adrenal adenoma were investigated for plasma cortisol responses to various stimuli: upright posture, meal, combined hypothalamic-hormones, the vasopressin analogue terlipressin, glucagon, angiotensin II, the serotonin 5-HT4 agonist cisapride, and ACTH. Six normal controls were similarly investigated. All subjects were studied during 8 mg per day dexamethasone in order to avoid any ACTH-dependent variation of plasma cortisol. RESULTS: The most constant responses in adrenal incidentalomas were observed after stimulation by terlipressin (18/20 patients, 28-415% cortisol increase) and cisapride (17/21 patients, 25-364% cortisol increase). Eighteen out of 21 patients responded to several stimuli (cortisol increase >or= 25%), and all responded to at least one stimulus other than ACTH, while such responses were absent in the controls. Plasma ACTH remained suppressed in all subjects throughout the study. CONCLUSIONS: Aberrant membrane receptors detected by in vivo stimulation tests appear to be common in autonomously functioning unilateral adrenocortical adenomas. These receptors may be involved in the modulation of cortisol secretion in adrenal incidentaloma, with potential therapeutic consequences for the control of subclinical cortisol hypersecretion.

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Aberrant receptors may be specific pharmacological targets for controlling cortisol secretion.
“Because these aberrant receptors may be specific pharmacological targets for controlling cortisol secretion, their detection deserves particular interest and some protocols have been developed (99).”
From Diagnosis and Treatment of Subclinical Hypercortisolism (2011) · cites this paper as [99]
Receptors for several ligands are abnormally expressed at the membrane of tumoral adrenocortical cells.
“it has been shown that receptors for several ligands are abnormally expressed at the membrane of tumoral adrenocortical cells, such as those for glucose-dependent insulinotropic peptide, catecholamine, vasopressin, serotonin, angiotensin II, leptin, and LH/human chorionic gonadotropin (98 -100).”
From Diagnosis and Treatment of Subclinical Hypercortisolism (2011) · cites this paper as [99]

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Authors: Reznik, Y., Lefebvre, H., Rohmer, V., Charbonnel, B., Tabarin, A., Rodien, P., Lecomte, P., Bardet, S., Coffin, C., & Mahoudeau, J.
Affiliations: Centre Hospitalier Universitaire de Caen Normandie (FR)
Centre Hospitalier Universitaire d'Angers (FR)
Centre François Baclesse (FR)
Corresponding author: Reznik, Y.
ORCID: Reznik, Y.
Charbonnel, B.
Tabarin, A.
Rodien, P.
Venue: Clinical Endocrinology
Publisher: Wiley
Published: 2004-09
Volume: 61
Issue: 3
Pages: 311-319
ISSN: 0300-0664 (ISSN-L)
1365-2265
DOI: 10.1111/j.1365-2265.2004.02048.x
OpenAlex: W2159285527
Cited by: 71
References: 47
Citations by year: 2026: 1 · 2025: 1 · 2024: 1 · 2022: 4 · 2020: 1 · 2019: 5 · 2018: 3 · 2017: 3 · 2016: 6 · 2015: 4 · 2014: 4 · 2013: 2 · 2012: 2
FWCI: 3.79
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor, 2 d)
Locations: Clinical Endocrinology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
Keywords: adrenal incidentaloma, Cushing's syndrome, adrenal adenoma, ACTH stimulation test, glucagon stimulation test, dexamethasone suppression
MeSH terms: Terlipressin, Adenoma, Adrenal Gland Neoplasms, Adrenocorticotropic Hormone, Adult, Aged, Angiotensin II, Eating, Female, Glucagon, Humans, Hydrocortisone, Hypothalamic Hormones, Lypressin, Male, Middle Aged, Posture, Prospective Studies, Stimulation, Chemical, Vasoconstrictor Agents, Case-Control Studies, Serotonin Receptor Agonists, Cisapride, Incidental Findings

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Aberrant adrenal sensitivity to multiple ligands in unilateral incidentaloma with subclinical autonomous cortisol hypersecretion: a prospective clinical study.

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