Leo Sher, M.D.

Our research article, “Modified dexamethasone suppression-corticotropin-releasing hormone stimulation test: A pilot study of young healthy volunteers and implications for alcoholism research in adolescents and young adults” was published 15 years ago in the January-March 2006 issue of the International Journal of Adolescent Medicine and Health (1).

The dexamethasone suppression test (DST) is the most frequently used test to assess HPA-system function in psychiatric disorders. This neuroendocrine test consists of the administration of a low dose of dexamethasone at 11 pm and the measurement of cortisol levels at one or more time points on the following day. After corticotropin-releasing hormone (CRH) became available for clinical studies, the DST was combined with CRH administration. In this test, patients are pretreated with a single dose of dexamethasone at 11 pm and receive human CRH intravenously at 3 pm the following day. The resulting DST-CRH test proved to be much more sensitive in detecting HPA system alterations than the DST.

We have modified the DST-CRH test and used ovine CRH instead of human CRH in a pilot study of a group of young healthy volunteers. The mean age of the participants was 25.2±7.5 years. The mean cortisol level rose 494% from 1.6±1.1 ng/ml to 7.9±2.7 ng/ml. The mean adrenocorticotropic hormone (ACTH) level rose 402% from 4.4±0.5 pg/ml to 17.7±6.3 pg/ml. Results indicated that the modified the DST-CRH test produced results similar to the results obtained with human CRH. This suggested that ovine CRH can be used in psychiatric research.

The results of our study where we compared cortisol and ACTH responses in major depression and healthy volunteers to the DEX-CRH test were published later (2).

Reference

1. Sher L, Cooper TB, Mann JJ, Oquendo MA. Modified dexamethasone suppression-corticotropin-releasing hormone stimulation test: A pilot study of young healthy volunteers and implications for alcoholism research in adolescents and young adults. Int J Adolesc Med Health. 2006 Jan-Mar;18(1):133-7. doi: 10.1515/ijamh.2006.18.1.133.
2. Sher L, Oquendo MA, Burke AK, Cooper TB, Mann JJ. Combined dexamethasone suppression-corticotrophin-releasing hormone stimulation test in medication-free major depression and healthy volunteers. J Affect Disord. 2013 Dec;151(3):1108-12. doi: 10.1016/j.jad.2013.06.049. Epub 2013 Jul 15.