Plasma catecholamines after insulin hypoglycemia in Sheehan's syndrome.

The plasma catecholamine response to hypoglycemia was studied in a group of hypopituitary patients with Sheehan's syndrome before (group A) and after (group B) combined cortisol and thyroid hormone treatment as well as in a group of normal women (group C). The mean basal plasma norepinephrine (NE) level was significantly increased in group A compared to levels in groups B and C, in which values were similar. The mean basal plasma epinephrine (E) level was not significantly altered by hypopituitarism. The plasma NE response to hypoglycemia was similar in the three groups, while the plasma E response was blunted in groups A and B. However, the plasma E response was significantly decreased only in half of the patients. The basal E/NE ratio was similar in the three groups, but it was significantly decreased in groups A and B compared to that in group C at the peak. From these data we conclude that 1) hypopituitarism is characterized in the basal state by increased adrenergic tone, probably related to secondary hypothyroidism; and 2) during hypoglycemia adrenal stimulation is impaired only in some patients. The role of ACTH in the regulation of E secretion is minor. Impaired neurogenic regulation in some patients with Sheehan's syndrome could contribute to their illness.

Oral load of tyrosine or L-dopa and plasma levels of free and sulfoconjugated catecholamines in healthy men.

The levels of free and sulfoconjugated catecholamines were measured in the plasma of fasting, recumbent normal subjects before and after an oral load of the catecholamine precursors tyrosine or L-dopa. Basal values of sulfoconjugated catecholamines, measured in plasma samples diluted 1:100 were 7998 +/- 540 pg/ml for dopamine sulfate, 2938 +/- 281 pg/ml for norepinephrine sulfate, and 2958 +/- 288 pg/ml for epinephrine sulfate (n = 37 tests in 15 men); these basal values are higher than those reported previously. Neither free nor sulfoconjugated catecholamine concentrations were changed by a tyrosine load (100 mg/kg) that induced a doubling of the plasma tyrosine level or by a meal low in phenylalanine and tyrosine (but otherwise supplying constituents of normal nourishment) that induced a greater than 50% reduction in the plasma tyrosine concentration. After an oral load of L-dopa (125 mg) the following were observed. (1) An extremely large increase (greater than 100-fold) in dopamine sulfate levels was noted, an increase that was less marked in the same subjects given L-dopa (125 mg) plus the peripheral dopa-decarboxylase inhibitor carbidopa (12.5 mg); as expected, free dopamine concentration also was increased. (2) Neither free nor sulfoconjugated norepinephrine concentrations were altered. (3) Epinephrine sulfate but not free epinephrine concentration was increased (more than ten-fold) after L-dopa ingestion alone; this result was unexpected and has to be confirmed before considering its physiological meaning, if any.

Free and conjugated catecholamines in digestive tissues of rats.

Using a radioenzymatic technique, the highest concentrations of free catecholamines were found in the duodenum, and the lowest in the liver of untreated rats. When compared to the antrum, the concentration of free dopamine was higher, and that of norepinephrine lower in the fundus. As far as conjugated catecholamines are concerned, the tissue concentrations of both sulfo- and glucurono-conjugates were usually low, and often non detectable, with an exception: the concentration of glucurono-conjugated dopamine was very high in the duodenum, ileum, and liver of untreated rats.

Portal and arterial free and conjugated noradrenaline in two models of portal hypertension in rats.

Free and conjugated noradrenaline concentrations were measured in portal-venous and arterial plasma from sham-operated rats or rats with portal hypertension. Two types of portal hypertension in rats were evaluated: in portal vein stenosed rats, the liver was normal, whereas cirrhosis developed in bile duct ligated rats. In cirrhotic rats, arterial free noradrenaline level was higher than in both sham-operated and portal-stenosed rats, this indicating that enhanced sympathetic nervous activity depends on the development of cirrhosis. In all groups of rats, portal venous plasma free noradrenaline was higher than arterial plasma level, indicating a production of noradrenaline by splanchnic organs. Arterial noradrenaline level may be mainly dependent on this splanchnic production in case of portal hypertension. Sulfoconjugated and glucuronoconjugated noradrenaline plasma levels were similar in the three groups of rats. This shows that alteration in conjugation is not likely to be a major factor in the abnormal circulating levels of free noradrenaline observed in cirrhotic rats.

[Plasma catecholamines, free and conjugated, in the hemodialyzed chronic renal failure patient]. / Catécholamines plasmatiques, libres et conjuguées, chez l'insuffisant rénal chronique hémodialysé.

Free, sulfo and glucuro-conjugated catecholamines (dopamine, noradrenaline and adrenaline) were measured to study their metabolism in 35 non-selected patients with chronic renal failure, and under hemodialysis for various periods of time. Our data demonstrate a statistically significant increase of free dopamine, and free noradrenaline concentration in these patients, while that of free adrenaline was not different from controls. However a careful scrutiny of 35 individual data suggests that sub-groups of patients with either high normal or low plasma free noradrenaline concentration could exist; this likely heterogeneity could be a good explanation for conflicting conclusions provided by previous reports. Suspecting that conjugated catecholamines might be altered in these patients, plasma sulfo and glucuro-conjugated amines were measured. We have found a predictable and highly significant increase of sulfo-conjugated catecholamines; glucuroconjugated dopamine and noradrenaline were unchanged, while glucuroconjugated adrenaline was significantly increased. The physiological meaning, if any, of these new observations on conjugated catecholamines cannot be assessed at the moment.

[Urinary excretion of catecholamines in the dog: physiopathologic hypotheses in man]. / Excrétion urinaire des catécholamines chez le chien: hypothèses physiopathologiques chez l'homme.

Renal handling of free catecholamines (dopamine, norepinephrine and epinephrine) was studied in 36 hydropenic anesthetized mongrel dogs in accordance with the clearance technique. There was no statistically significant correlation between plasma concentrations and either systemic (mean blood pressure, or cardiac output) or renal (clearance of PAH or glomerular filtration rate) hemodynamics. Net tubular transport (NTT) was calculated as the difference between filtered load and urinary excretion for any catecholamine. The mean NTTs of free catecholamines were as follows: --2,72 ng/min for dopamine, --3,18 for norepinephrine, and --1,36 for epinephrine, showing that they are mostly reabsorbed. However the use of averages is misleading inasmuch as tubular transport of free catecholamines is a heterogeneous phenomenon: a secretion appears to predominate when plasma concentrations are low and a reabsorption predominates when they are high. Whether such a heterogeneity is due to either a genetic heterogeneity in mongrel dogs, or an age-related difference is discussed.

Is dopamine a physiological natriuretic hormone in the dog?

Both plasma and urinary dopamine and noradrenaline were measured as free and sulphate conjugates, by a radioenzymatic method, before and during extracellular volume expansion (ECVE) with hypo-, iso- or hyper-tonic fluid (usually sodium chloride solution) in dogs. During ECVE there was a decrease in plasma catecholamine concentration. For all cases except noradrenaline, this is probably due to a dilution phenomenon since when results were expressed as pg/mg of protein, ECVE had no effect. This change in noradrenaline accounted for the increase in the dopamine/noradrenaline ratio. As expected, there was an increase in the urinary excretion of dopamine during ECVE with both iso- and hyper-tonic fluid. This increase was not observed in the group of dogs given hypotonic fluid, although the increase of fractional excretion of sodium was of a similar order of magnitude. The increase in the urinary excretion of dopamine was apparently not affected by an increase in plasma sodium concentration and/or osmolality. The demonstrated dissociation between sodium and dopamine in urine does not support a physiological role for dopamine in renal handling of sodium during ECVE, and raises the question of its specificity.

Dilution of plasma with Tris buffer increases measured catecholamines in plasma.

We investigated the effects of dilution of plasma samples on the measured concentrations of catecholamines. Diluting samples of human plasma 10-, 50-, and 100-fold with Tris buffer (100 mol/L, pH 8.6) improved analytical recovery of internal standards, suggesting that it decreases the commonly observed inhibition of methylation in radioenzymatic assays of catecholamines in plasma. However, the dilution is not associated with a proportional decrease in counted radioactivity. This extra amount of radioactivity, which is unlikely to be nonspecific in origin, accounts for a significant increase in the calculated catecholamine concentration. Tentatively, we suggest that Tris buffer releases both catecholamines and conjugated catecholamines bound to some unidentified low-molecular-mass component of plasma.

Effects of an intravenous infusion of noradrenaline on the plasma concentration of free and sulfoconjugated catecholamines in anesthetized dogs.

Exogenous noradrenaline (NA) was infused intravenously at increasing rate from zero (control) to 10, 25, 50, 100, 200 and 600 ng/kg/min during 20 min in anesthetized and ventilated dogs; the mean (+/- SEM) plasma concentration of free NA was increased from 130 +/- 23 pg/ml (basal) to 7,826 +/- 787 pg/ml. This had no measurable effect on the plasma concentration of dopamine and adrenaline in either free or sulfoconjugated form; a lack of change was also observed in dogs given a 600-ng/kg/min infusion during more than 2 h. The increase of free NA concentration was highly correlated both with the infusion rate, and with the blood pressure. Contrary to expectations, the plasma concentration of NA sulfate decreased in all 5 dogs when plasma NA concentration was progressively increased from basal to about 1,600 pg/ml; beyond this apparently crucial level (i.e. from about 1,600 to 7,826 pg/ml), the response of NA sulfate concentration was erratic, as it was in dogs given a 600-ng/kg/min infusion during more than 2 h. If the response of canine blood pressure is examined in the light of the level of free NA concentration, two mechanisms can be suspected: (1) when the NA level increased from basal to about 1,600 pg/ml, a direct action upon peripheral resistances was likely to be the predominant hypertensive mechanism; (2) beyond about 1,600 pg/ml, a combined effect of NA on both peripheral resistances and cardiac hemodynamics could have a role in the hypertensive process. Thus, a concentration of NA of about 1,600 pg/ml appears to be a landmark for both CA metabolism and circulatory homeostasis. Further studies will have to be carried out to investigate whether this represents the upper physiological concentration in the anesthetized dog.

Plasma free, sulfo- and glucuro-conjugated catecholamines in uremic patients.

The metabolism of catecholamines (CA) in non-selected patients with chronic renal failure and under hemodialysis (CRFh) was studied by measuring the concentration of plasma free, sulfo- and glucuroconjugated CA, dopamine (DA), norepinephrine (NE), and epinephrine (EPI). Our data demonstrate a statistically significant increase of free DA and free NE concentration in CRFh, while that of free EPI was not different from controls. However a careful scrutiny of 35 individual data suggests that sub-groups of patients with either high normal or low plasma-free NE concentration could exist; this likely heterogeneity could be a good explanation for conflicting conclusions provided by previous reports. Suspecting that conjugated CA might be altered in CRFh, plasma sulfo- and glucuro-conjugated DA, NE and EPI were also measured. We have found a predictable and highly significant increase of sulfo-conjugated CA; plasma concentration of glucuro-conjugated DA and NE in CRFh was not different from controls, while that of glucuro-conjugated EPI was significantly increased. The physiological meaning, if any, of these new observations on conjugated CA cannot be assessed at the moment. The effects of hemodialysis were also investigated. Measurements on the arterial and on the venous line showed highly significant differences for tyrosine, free and sulfo-conjugated CA, and a lack of difference for glucuro-conjugated CA. Thus tyrosine, free and sulfo-conjugated CA were eliminated by the artificial kidney, but not glucuro-conjugated amines.(ABSTRACT TRUNCATED AT 250 WORDS)