Effects of eight-hour intravenous infusions of ACTH and the adrenocortical steroids in normal man. I. Basal gastric secretion, and plasma and urinary pepsinogen.

While there appears to be general agreement that adrenocortical deficiency results in a reduction of gastric secretory activity both in man (1-6) and in animals (7-11), no such unanimity of opinion exists regarding the effects of increased activity of the adrenal cortex on gastric secretion. Whereas some studies have shown that the administration of ACTH or of adrenocortical steroids may increase gastric acid and pepsin secretion (1214), others have failed to show any significant increase in acid or pepsin output by the stomach during the administration of ACTH (15-17) or cortisone or hydrocortisone (18, 19). Part of the confusion regarding any stimulant effect of increased adrenocortical activity stems from the use of urinary pepsinogen (uropepsin) levels as an index of gastric secretion. In this study the effects of 8-hour infusions of ACTH, hydrocortisone, corticosterone, prednisolone, and aldosterone in normal males on the volume, acid, pepsin, and viscosity of gastric juice were studied, together with simultaneous measurements of blood and urinary pepsinogen. These results were compared with the effects of infusion of the vehicle alone and contrasted to the effects of a 4-hour infusion of histamine. The results indicate that in general the hormones did not produce stimulation of gastric secretion compared with a known stimulant such as histamine. An analysis of changes in urinary pepsinogen excretion indicates that the glucocorticoids in1 Presented before the National Meeting of the American Federation for Clinical Research at Atlantic City, May 1, 1955.