Measurement of cytokines in the cavernous sinus plasma from patients with cushing's disease

In order to know more about the in vivo secretion of various cytokines from the human pituitary, this study measured the concentrations of interleukin (IL)-1alpha, IL-1beta, IL-2, IL-6, tumor necrosis factor-alpha and IL-1 receptor antagonist (ra) in both the peripheral blood and the cavernous sinus (CS) plasma from six patients with Cushing's disease before and after an intravenous bolus injection of human corticotropin-releasing hormone (CRH, 100 microg). As a routine procedure for the diagnosis of Cushing's disease, adrenocorticotropin (ACTH) levels were also determined in the same samples. In four of the six patients, unstimulated levels of IL-1ra in the CS ipsilateral to the ACTH-secreting adenoma were higher than those in the peripheral blood, with a ratio ofor = 1.5:1, even though CRH was without effect on the cytokine's concentration in the CS. In contrast, no consistent data were obtained for any of the remaining five cytokines. These results demonstrate for the first time that the in vivo release of IL-1ra is detectable in at least some corticotroph adenomas, and also suggest a possible role of the cytokine in physiological and pathophysiological processes occurring in the human pituitary.