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Radioimmunoassay of cortisone in serum, urine, and saliva to assess the status of the cortisol–cortisone shuttle

¹ Laboratoire de Biochimie Hormonale, Hôpital Saint-Louis, 75010 Paris, France.

² Laboratoire de Chimie Organique

³ Service de Néphrologie, Hôpital Foch, 92151 Suresnes, France.

⁴ Laboratoire d'Explorations Endocriniennes, Hôpital Trousseau, 75012 Paris, France.

⁵ Service des Molécules Marquées, CEA/Saclay, 91191 Gif-sur-Yvette, France.

⁶ Department of Biochemistry and National Diagnostics Centre, University College, Galway, Ireland.

⁷ Biochimie, Faculté de Pharmacie, 75006 Paris, France.
^a Address correspondence to this author at: Laboratoire de Biochimie Hormonale, Hôpital Saint-Louis, 1 ave. Claude-Vellefaux, 75475 Paris cédex 10, France. Fax + 33 1 42 49 42 80; e-mail bio.horm.fiet{at}chu-stlouis.fr

We have developed a new assay for cortisone (E) in serum, saliva, and urine involving Celite^® chromatography followed by RIA with ¹²⁵I-labeled E and scintillation proximity assay. The chromatography step separates cortisol (F) from E, and in combination with their RIAs, permits assessment of the status of the F–E shuttle. We report the results of basal, postcorticotropin (ACTH), and postdexamethasone E and F concentrations and their circadian fluctuations in the serum, saliva, and urine of healthy volunteers. The serum and urine F/E ratios were increased in patients with ectopic ACTH secretion, whereas in adrenal adenoma and Cushing disease only the urinary ratio was increased. In chronic renal insufficiency this ratio was increased in serum (23.5 ± 3.9) but diminished in saliva (0.38 ± 0.11), and in apparent mineralocorticoid excess the ratios were high in serum (44.3 ± 9.3) and urine (5.35 ± 0.85) compared with those of healthy subjects (serum 9.8 ± 3.5, urine 0.52 ± 0.29, saliva 0.52 ± 0.29).

Key Words: indexing terms: scintillation proximity assay • apparent mineralocorticoid excess • 11ß-hydroxysteroid dehydrogenase • Cushing syndrome

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