Effect of meclastine, an H1-antihistamine, on plasma ACTH in adrenal insufficiency

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Abstract
To evaluate the possible role of endogenous histamine in ACTH secretion the effect of the H1 antagonist meclastine on plasma ACTH in patients with ACTH hypersecretion was investigated. Seven patients with primary adrenal insufficiency (group 1) and 5 patients with ACTH dependent Cushing''s syndrome (group 2) were given an i.v. infusion of meclastine (4.8 mg/90 min). In patients of group 2 plasma ACTH was unaffected by meclastine infusion. In patients of group 1 with intact steroid feedback meclastine was followed by a significant drop in plasma ACTH as compared with ACTH levels after saline infusion (46.0 .+-. 4.6% vs. 85.0 .+-. 7.0%, P < 0.01). Apparently histamine is involved in the control of ACTH secretion, possibly by stimulation of corticotropin releasing factor release.