Radioimmunoassay of corticotropin-releasing hormone: methodology and clinical application.

Corticotropin-releasing hormone (CRH) levels in the human plasma and cerebrospinal fluid (CSF), and those in the rat hypothalamus, peripheral and hypophyseal portal plasma were studied by a specific h/r CRH RIA and an immunoaffinity procedure. CRH levels in the plasma and CSF were low in patients with hypercortisolemia and those with hypothalamic hypopituitarism, but high in patients with hypocortisolemia except for patients with hypothalamic hypopituitarism. Plasma CRH responded to insulin-induced hypoglycemia (ITT) those with Addison's disease and those with primary hypopituitarism, but not in patients with Cushing's syndrome or in patients with hypothalamic hypopituitarism. The results suggest that the major component of plasma CRH may be of hypothalamic origin, but other extrahypothalamic tissues cannot be ruled out as minor sources of plasma CRH. In addition, the measurement of CRH levels in the plasma and CSF seems to be of value in evaluating the hypothalamic function. The short negative feedback mechanism regulating CRH release was demonstrated in humans and rats. In the absence of the long negative feedback control of ACTH secretion by glucocorticoids, ACTH originating from the pituitary may regulate ACTH secretion form the pituitary through inhibition of CRH release.