Assessment of Tissue Cortisol Activity

Cohen, Jeremy and Venkatesh, Bala (2009) Assessment of Tissue Cortisol Activity. Critical Care and Resuscitation, 11 4: 287-289.


Author Cohen, Jeremy
Venkatesh, Bala
Title Assessment of Tissue Cortisol Activity
Journal name Critical Care and Resuscitation   Check publisher's open access policy
ISSN 1441-2772
Publication date 2009-12-01
Year available 2009
Sub-type Critical review of research, literature review, critical commentary
Volume 11
Issue 4
Start page 287
End page 289
Total pages 3
Editor Peter V van Heerden
Rinaldo Bellomo
Place of publication Australia
Publisher The Australasian Medical Publishing Company
Collection year 2010
Language eng
Subject C1
920106 Endocrine Organs and Diseases (excl. Diabetes)
110310 Intensive Care
Abstract The concept of relative adrenal insufficiency in patients with severe sepsis continues to be controversial. This arises in part from the lack of an accepted "gold standard" for the diagnosis of adrenal insufficiency in the critically ill. Historically, assessment of adrenal function in this population has relied on measurement of plasma total cortisol level, in a blood sample taken either at random or as part of a corticotropin stimulation test. However, an alternative is to focus on the site of glucocorticoid activity within the tissues as a potentially more useful index of functional adrenal status. We review the mechanisms known to affect tissue glucocorticoid activity and examine how they may be modified by critical illness. These include both free and interstitial cortisol concentrations, intracellular cortisol generation, and glucocorticoid-receptor activity and density. Changes in these factors are not reflected in plasma total cortisol concentrations, and more sophisticated techniques, including genetic transcriptional surveys, may be required to reveal the role of glucocorticoid insufficiency in critical illness.
Q-Index Code C1
Q-Index Status Confirmed Code

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: 2010 Higher Education Research Data Collection
School of Medicine Publications
 
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Created: Thu, 22 Apr 2010, 21:48:05 EST by Sia Athanasas on behalf of Anaesthesiology and Critical Care - RBWH