Dual mechanism regulating adrenocortical function in man

Secretion of aldosterone and secretion of hydrocortisone by the human adrenal cortex appear to be regulated by distinctly different mechanisms, as shown by the following observations. 1. 1. Sodium deprivation results in large increases in aldosterone output but does not appreciably affect 17-hydroxycorticoid output. 2. 2. Certain diseases (congestive heart failure, cirrhosis and nephrosis) are characterized by an increase in aldosterone output without clinical or laboratory evidence of more general hyper-adrenocorticism. 3. 3. Administration of ACTH results in relatively large increases in hydrocortisone (17-hydroxycorticoid) output but results in only comparatively small increases in aldosterone output. 4. 4. Suppression of ACTH release by administration of cortisone or by damage to the pituitary reduces hydrocortisone secretion to minimal amounts but has relatively little effect on secretion of aldosterone. Thus it appears that the secretion of aldosterone is responsive to changes in water and electrolyte metabolism, whereas the secretion of hydrocortisone is regulated by production of ACTH.