Catecholamine-glucocorticoid interactions during surgical stress

Robert Udelsman, David S. Goldstein, Donald (Lynn) Loriaux, George P. Chrousos

Research output: Contribution to journalArticle

60 Citations (Scopus)

Abstract

The stress response involves activation of the hypothalamic-pituitary adrenal axis and the sympathetic nervous system. To study the relative contributions of glucocorticoids, epinephrine, norepinephrine, and dopamine to homeostasis, we examined the effects of cortisol and epinephrine deficiency on the norepinephrine and dopamine responses to surgical stress in nonhuman primates. Adult male cynomolgus monkeys (n = 7-8/group)underwent bilateral or sham adrenalectomy and were maintained for 4 months on physiologic glucocorticoid (hydrocortisone phosphate, 32 mg/M2/day) and mineralocorticoid (DOCA pivalate, 1 mg/day) replacement, or placebo injections, respestively. The adrenalectomized monkeys were then stratified into three groups receiving subphysiologic (× 1 10), physiologic (×1), or supraphysiologic (×10) glucocorticoid replacement. A cholecystectomy was performed 4 days later and the pre-, intra-, and postoperative plasma catecholamine levels were measured. Adrenalectomized animals had markedly decreased plasma epinephrine concentrations and accentuated plasma norepinephrine and dopamine responses to cholecystectomy, when compared to shamadrenalectomized controls. The magnitude of the norepinephrine accentuation was inversely related to the dose of cortisol administered preceding surgery. Norepinephrine and dopamine failed to completely normalize even at the high dose of glucocorticoid replacement which had been calculated to be similar to the cortisol production rate during maximal stress. Thus, surgical stress in the setting of inadequate glucocorticoid (cortisol) replacement and epinephrine deficiency, stimulates additional sympathetic activity, probably as an adaptive mechanism to maintain homeostasis. Both norepinephrine and dopamine are recruited to compensate for the glucocorticoid and epinephrine deficiency. Glucocorticoid administration decreases but does not normalize this compensatory sympathetic activity.

Original languageEnglish (US)
Pages (from-to)539-545
Number of pages7
JournalJournal of Surgical Research
Volume43
Issue number6
DOIs
StatePublished - 1987
Externally publishedYes

Fingerprint

Glucocorticoids
Catecholamines
Epinephrine
Hydrocortisone
Dopamine
Norepinephrine
Cholecystectomy
Homeostasis
Mineralocorticoids
Macaca fascicularis
Adrenalectomy
Sympathetic Nervous System
Primates
Haplorhini
Phosphates
Placebos
Injections

ASJC Scopus subject areas

  • Surgery

Cite this

Catecholamine-glucocorticoid interactions during surgical stress. / Udelsman, Robert; Goldstein, David S.; Loriaux, Donald (Lynn); Chrousos, George P.

In: Journal of Surgical Research, Vol. 43, No. 6, 1987, p. 539-545.

Research output: Contribution to journalArticle

Udelsman, Robert ; Goldstein, David S. ; Loriaux, Donald (Lynn) ; Chrousos, George P. / Catecholamine-glucocorticoid interactions during surgical stress. In: Journal of Surgical Research. 1987 ; Vol. 43, No. 6. pp. 539-545.
@article{0b5e9d12671c4e7d81cd1303cf3a9fcb,
title = "Catecholamine-glucocorticoid interactions during surgical stress",
abstract = "The stress response involves activation of the hypothalamic-pituitary adrenal axis and the sympathetic nervous system. To study the relative contributions of glucocorticoids, epinephrine, norepinephrine, and dopamine to homeostasis, we examined the effects of cortisol and epinephrine deficiency on the norepinephrine and dopamine responses to surgical stress in nonhuman primates. Adult male cynomolgus monkeys (n = 7-8/group)underwent bilateral or sham adrenalectomy and were maintained for 4 months on physiologic glucocorticoid (hydrocortisone phosphate, 32 mg/M2/day) and mineralocorticoid (DOCA pivalate, 1 mg/day) replacement, or placebo injections, respestively. The adrenalectomized monkeys were then stratified into three groups receiving subphysiologic (× 1 10), physiologic (×1), or supraphysiologic (×10) glucocorticoid replacement. A cholecystectomy was performed 4 days later and the pre-, intra-, and postoperative plasma catecholamine levels were measured. Adrenalectomized animals had markedly decreased plasma epinephrine concentrations and accentuated plasma norepinephrine and dopamine responses to cholecystectomy, when compared to shamadrenalectomized controls. The magnitude of the norepinephrine accentuation was inversely related to the dose of cortisol administered preceding surgery. Norepinephrine and dopamine failed to completely normalize even at the high dose of glucocorticoid replacement which had been calculated to be similar to the cortisol production rate during maximal stress. Thus, surgical stress in the setting of inadequate glucocorticoid (cortisol) replacement and epinephrine deficiency, stimulates additional sympathetic activity, probably as an adaptive mechanism to maintain homeostasis. Both norepinephrine and dopamine are recruited to compensate for the glucocorticoid and epinephrine deficiency. Glucocorticoid administration decreases but does not normalize this compensatory sympathetic activity.",
author = "Robert Udelsman and Goldstein, {David S.} and Loriaux, {Donald (Lynn)} and Chrousos, {George P.}",
year = "1987",
doi = "10.1016/0022-4804(87)90128-4",
language = "English (US)",
volume = "43",
pages = "539--545",
journal = "Journal of Surgical Research",
issn = "0022-4804",
publisher = "Academic Press Inc.",
number = "6",

}

TY - JOUR

T1 - Catecholamine-glucocorticoid interactions during surgical stress

AU - Udelsman, Robert

AU - Goldstein, David S.

AU - Loriaux, Donald (Lynn)

AU - Chrousos, George P.

PY - 1987

Y1 - 1987

N2 - The stress response involves activation of the hypothalamic-pituitary adrenal axis and the sympathetic nervous system. To study the relative contributions of glucocorticoids, epinephrine, norepinephrine, and dopamine to homeostasis, we examined the effects of cortisol and epinephrine deficiency on the norepinephrine and dopamine responses to surgical stress in nonhuman primates. Adult male cynomolgus monkeys (n = 7-8/group)underwent bilateral or sham adrenalectomy and were maintained for 4 months on physiologic glucocorticoid (hydrocortisone phosphate, 32 mg/M2/day) and mineralocorticoid (DOCA pivalate, 1 mg/day) replacement, or placebo injections, respestively. The adrenalectomized monkeys were then stratified into three groups receiving subphysiologic (× 1 10), physiologic (×1), or supraphysiologic (×10) glucocorticoid replacement. A cholecystectomy was performed 4 days later and the pre-, intra-, and postoperative plasma catecholamine levels were measured. Adrenalectomized animals had markedly decreased plasma epinephrine concentrations and accentuated plasma norepinephrine and dopamine responses to cholecystectomy, when compared to shamadrenalectomized controls. The magnitude of the norepinephrine accentuation was inversely related to the dose of cortisol administered preceding surgery. Norepinephrine and dopamine failed to completely normalize even at the high dose of glucocorticoid replacement which had been calculated to be similar to the cortisol production rate during maximal stress. Thus, surgical stress in the setting of inadequate glucocorticoid (cortisol) replacement and epinephrine deficiency, stimulates additional sympathetic activity, probably as an adaptive mechanism to maintain homeostasis. Both norepinephrine and dopamine are recruited to compensate for the glucocorticoid and epinephrine deficiency. Glucocorticoid administration decreases but does not normalize this compensatory sympathetic activity.

AB - The stress response involves activation of the hypothalamic-pituitary adrenal axis and the sympathetic nervous system. To study the relative contributions of glucocorticoids, epinephrine, norepinephrine, and dopamine to homeostasis, we examined the effects of cortisol and epinephrine deficiency on the norepinephrine and dopamine responses to surgical stress in nonhuman primates. Adult male cynomolgus monkeys (n = 7-8/group)underwent bilateral or sham adrenalectomy and were maintained for 4 months on physiologic glucocorticoid (hydrocortisone phosphate, 32 mg/M2/day) and mineralocorticoid (DOCA pivalate, 1 mg/day) replacement, or placebo injections, respestively. The adrenalectomized monkeys were then stratified into three groups receiving subphysiologic (× 1 10), physiologic (×1), or supraphysiologic (×10) glucocorticoid replacement. A cholecystectomy was performed 4 days later and the pre-, intra-, and postoperative plasma catecholamine levels were measured. Adrenalectomized animals had markedly decreased plasma epinephrine concentrations and accentuated plasma norepinephrine and dopamine responses to cholecystectomy, when compared to shamadrenalectomized controls. The magnitude of the norepinephrine accentuation was inversely related to the dose of cortisol administered preceding surgery. Norepinephrine and dopamine failed to completely normalize even at the high dose of glucocorticoid replacement which had been calculated to be similar to the cortisol production rate during maximal stress. Thus, surgical stress in the setting of inadequate glucocorticoid (cortisol) replacement and epinephrine deficiency, stimulates additional sympathetic activity, probably as an adaptive mechanism to maintain homeostasis. Both norepinephrine and dopamine are recruited to compensate for the glucocorticoid and epinephrine deficiency. Glucocorticoid administration decreases but does not normalize this compensatory sympathetic activity.

UR - http://www.scopus.com/inward/record.url?scp=0023556420&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0023556420&partnerID=8YFLogxK

U2 - 10.1016/0022-4804(87)90128-4

DO - 10.1016/0022-4804(87)90128-4

M3 - Article

C2 - 3695455

AN - SCOPUS:0023556420

VL - 43

SP - 539

EP - 545

JO - Journal of Surgical Research

JF - Journal of Surgical Research

SN - 0022-4804

IS - 6

ER -