The acute effect of a mineralocorticoid receptor agonist on corticotrope secretion in Addison’s disease

Purpose Mineralocorticoid receptors (MR) in the hippocampus display an important role in the control of hypothalamic–pituitary–adrenal (HPA) axis, mediating the ‘‘proactive’’ feedback of glucocorticoids (GC). Fludrocortisone (FC), a potent MR agonist, has been shown to decrease HPA activity through a hippocampal mechanism. Since it has been demonstrated that FC shows a significant inhibition of the HPA axis response to hCRH stimulus in normal subjects, also at doses usually administered as replacement therapy in patients with Addison’s disease, an FC effect at MRs in human pituitary or a GR-pituitary agonism stronger than believed until now has been postulated.