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dc.contributor.authorLewis, J.en
dc.contributor.authorBagley, C.en
dc.contributor.authorElder, P.en
dc.contributor.authorBachmann, A.en
dc.contributor.authorTorpy, D.en
dc.identifier.citationClinica Chimica Acta, 2005; 359(1-2):189-194en
dc.description.abstract<h4>Background</h4>In normal plasma free cortisol accounts for less than 6% of the total with 80-90% bound to corticosteroid-binding globulin (CBG) and the remainder associated albumin. However little is known about the distribution of free cortisol in plasma where CBG is inactivated or in congenital CBG deficiency.<h4>Methods and results</h4>Here we describe ligand binding experiments revealing that while free cortisol in unstressed individuals is less than 6% of total cortisol this rises markedly to 25% when CBG is totally inactivated by heat. Similar elevations of the free cortisol fraction were noted in a patient with a rare genetically determined complete lack of CBG (mean 32% on frequent circadian sampling). Following heat inactivation of CBG or in the congenital absence of CBG, there is a shift in cortisol binding from CBG to albumin. That this shift occurs is further supported by experiments adding [3H]-cortisol to physiological human serum albumin solutions, where 25% of cortisol remained in the free fraction.<h4>Conclusion</h4>Taken together the data provide strong evidence that when CBG is inactivated or congenitally absent then more than 25% of the total cortisol appears in the free fraction with the remainder associated with albumin. The proportion of free cortisol measured in plasma thus reflects a simple measure of functional corticosteroid-binding globulin.en
dc.publisherElsevier Science BVen
dc.subjectHumans; Hydrocortisone; Serum Albumin; Transcortin; Ligands; Enzyme-Linked Immunosorbent Assayen
dc.titlePlasma free cortisol fraction reflects levels of functioning corticosteroid-binding globulinen
dc.typeJournal articleen
pubs.library.collectionMedicine publicationsen
Appears in Collections:Medicine publications

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