Definition and research guide
This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.
Content available: 4 complete abstracts (842 words), 10 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.
Definition
An anterior pituitary hormone that stimulates the adrenal cortex and its production of corticosteroids. ACTH is a 39-amino acid polypeptide of which the N-terminal 24-amino acid segment is identical in all species and contains the adrenocorticotrophic activity. Upon further tissue-specific processing, ACTH can yield alpha-msh and corticotrophin-like intermediate lobe peptide (CLIP).
Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.
Also known as: Hormone, Adrenocorticotropic; Corticotropin; Corticotropin (1-39); Corticotrophin (1-39); Adrenocorticotrophic Hormone; Hormone, Adrenocorticotrophic; Adrenocorticotropin; 1-39 ACTH.
Where it fits in the MeSH classification
- Broader topics
- Melanocortins
- Narrower topics
- Cosyntropin
- See also
- Petrosal Sinus Sampling; Receptors, Corticotropin
Related concepts
- Adrenal Cortex
- Corticosteroids
- alpha-MSH
Research landscape
PubMed indexes 51,606 records tagged with the MeSH heading “Adrenocorticotropic Hormone” (counts retrieved 2026-10-31). 1,997 of them (3.9%) were published from 2020 onward, and the busiest period so far is through 1999 with 39,546 records.
Reviews account for 3,608 records (7.0%) and meta-analyses for 56. Randomized controlled trials number 1,004 (1.9%) as a share of all records on the topic. Randomized trials make up only a small share of this literature, so much of what is known comes from laboratory, observational or descriptive work.
Show the data
| Period | Records |
|---|---|
| through 1999 | 39,546 |
| 2000-2009 | 6,179 |
| 2010-2019 | 3,884 |
| 2020 onward | 1,997 |
Publication-type chart data
| Type | Records | Share |
|---|---|---|
| Reviews | 3,608 | 7.0% |
| Meta-analyses | 56 | 0.1% |
| Randomized controlled trials | 1,004 | 1.9% |
Method: PubMed query "Adrenocorticotropic Hormone"[MeSH Terms] with publication-type and date filters, retrieved 2026-10-31.
Reading the evidence in drugs and chemicals
Studies of a chemical or drug can answer very different questions: what it is and how it behaves in cells and animals, how the body handles it, and whether it changes outcomes in people. Laboratory and animal findings often do not carry over to patients, and observational studies of exposures are confounded by who uses a substance and why. Nothing on this page is a recommendation to use, avoid, start or stop any substance or medicine; talk to a qualified clinician or pharmacist about your own situation. Check the dose, the species, the comparison group and whether a patient-relevant outcome was measured.
Evidence from open-access studies
These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.
| Study / authors | Year | Source label / design | Europe PMC citations | Licence / source |
|---|---|---|---|---|
| Dynamics of ACTH and Cortisol Secretion and Implications for Disease | 2020 | Review article Design not recorded in structured metadata | 330 | cc by PMID 32060528 · DOI · PMC7240781 |
| A new model for the HPA axis explains dysregulation of stress hormones on the timescale of weeks | 2020 | Research article Design not recorded in structured metadata | 137 | cc by PMID 32672906 · DOI · PMC7364861 |
| Adrenal suppression in patients taking inhaled glucocorticoids is highly prevalent and management can be guided by morning cortisol | 2015 | Research article Design not recorded in structured metadata | 116 | cc by PMID 26294794 · DOI · PMC4588051 |
| The ACTH test fails to diagnose adrenal insufficiency and augments cytokine production in sepsis | 2025 | Research article Design not recorded in structured metadata | 10 | cc by PMID 40048257 · DOI · PMC12016919 |
Dynamics of ACTH and Cortisol Secretion and Implications for Disease [1]
Abstract reading summary — source excerpts
- Opening excerpt
- The past decade has seen several critical advances in our understanding of hypothalamic-pituitary-adrenal (HPA) axis regulation.
- Closing excerpt
- The recent development of a novel chronotherapy, which can deliver both circadian and ultradian patterns, provides great promise for patients on glucocorticoid treatment.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (239 words)
The past decade has seen several critical advances in our understanding of hypothalamic-pituitary-adrenal (HPA) axis regulation. Homeostatic physiological circuits need to integrate multiple internal and external stimuli and provide a dynamic output appropriate for the response parameters of their target tissues. The HPA axis is an example of such a homeostatic system. Recent studies have shown that circadian rhythmicity of the major output of this system-the adrenal glucocorticoid hormones corticosterone in rodent and predominately cortisol in man-comprises varying amplitude pulses that exist due to a subhypothalamic pulse generator. Oscillating endogenous glucocorticoid signals interact with regulatory systems within individual parts of the axis including the adrenal gland itself, where a regulatory network can further modify the pulsatile release of hormone. The HPA axis output is in the form of a dynamic oscillating glucocorticoid signal that needs to be decoded at the cellular level. If the pulsatile signal is abolished by the administration of a long-acting synthetic glucocorticoid, the resulting disruption in physiological regulation has the potential to negatively impact many glucocorticoid-dependent bodily systems. Even subtle alterations to the dynamics of the system, during chronic stress or certain disease states, can potentially result in changes in functional output of multiple cells and tissues throughout the body, altering metabolic processes, behavior, affective state, and cognitive function in susceptible individuals. The recent development of a novel chronotherapy, which can deliver both circadian and ultradian patterns, provides great promise for patients on glucocorticoid treatment.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 32060528 · DOI · PMC7240781
A new model for the HPA axis explains dysregulation of stress hormones on the timescale of weeks [2]
Abstract reading summary — source excerpts
- Opening excerpt
- Stress activates a complex network of hormones known as the hypothalamic-pituitary-adrenal (HPA) axis.
- Closing excerpt
- These findings suggest that gland-mass dynamics may play an important role in the pathophysiology of stress-related disorders.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (172 words)
Stress activates a complex network of hormones known as the hypothalamic-pituitary-adrenal (HPA) axis. The HPA axis is dysregulated in chronic stress and psychiatric disorders, but the origin of this dysregulation is unclear and cannot be explained by current HPA models. To address this, we developed a mathematical model for the HPA axis that incorporates changes in the total functional mass of the HPA hormone-secreting glands. The mass changes are caused by HPA hormones which act as growth factors for the glands in the axis. We find that the HPA axis shows the property of dynamical compensation, where gland masses adjust over weeks to buffer variation in physiological parameters. These mass changes explain the experimental findings on dysregulation of cortisol and ACTH dynamics in alcoholism, anorexia, and postpartum. Dysregulation occurs for a wide range of parameters and is exacerbated by impaired glucocorticoid receptor (GR) feedback, providing an explanation for the implication of GR in mood disorders. These findings suggest that gland-mass dynamics may play an important role in the pathophysiology of stress-related disorders.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 32672906 · DOI · PMC7364861
Adrenal suppression in patients taking inhaled glucocorticoids is highly prevalent and management can be guided by morning cortisol [3]
Abstract reading summary — source excerpts
- Opening excerpt
- ContextUp to 3% of US and UK populations are prescribed glucocorticoids (GC).
- Closing excerpt
- A basal serum cortisol concentration has utility in helping determine which patients should undergo dynamic assessment of adrenal function.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (234 words)
ContextUp to 3% of US and UK populations are prescribed glucocorticoids (GC). Suppression of the hypothalamo-pituitary-adrenal axis with the potential risk of adrenal crisis is a recognized complication of therapy. The 250 μg short Synacthen stimulation test (SST) is the most commonly used dynamic assessment to diagnose adrenal insufficiency. There are challenges to the use of the SST in routine clinical practice, including both the staff and time constraints and a significant recent increase in Synacthen cost.MethodsWe performed a retrospective analysis to determine the prevalence of adrenal suppression due to prescribed GCs and the utility of a morning serum cortisol for rapid assessment of adrenal reserve in the routine clinical setting.ResultsIn total, 2773 patients underwent 3603 SSTs in a large secondary/tertiary centre between 2008 and 2013 and 17.9% (n=496) failed the SST. Of 404 patients taking oral, topical, intranasal or inhaled GC therapy for non-endocrine conditions, 33.2% (n=134) had a subnormal SST response. In patients taking inhaled GCs without additional GC therapy, 20.5% (34/166) failed an SST and suppression of adrenal function increased in a dose-dependent fashion. Using receiver operating characteristic curve analysis in patients currently taking inhaled GCs, a basal cortisol ≥348 nmol/l provided 100% specificity for passing the SST; a cortisol value ConclusionAdrenal suppression due to GC treatment, particularly inhaled GCs, is common. A basal serum cortisol concentration has utility in helping determine which patients should undergo dynamic assessment of adrenal function.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 26294794 · DOI · PMC4588051
The ACTH test fails to diagnose adrenal insufficiency and augments cytokine production in sepsis [4]
Abstract reading summary — source excerpts
- Opening excerpt
- The adrenocorticotropic hormone (ACTH) test diagnoses relative adrenal insufficiency (RAI) or critical illness-related corticosteroid insufficiency (CIRCI).
- Closing excerpt
- These findings suggest that inconclusive GC therapy trials may be due to the problematic nature of the ACTH test rather than ineffectiveness of targeting RAI/CIRCI.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (197 words)
The adrenocorticotropic hormone (ACTH) test diagnoses relative adrenal insufficiency (RAI) or critical illness-related corticosteroid insufficiency (CIRCI). Initially, guidelines recommended corticosteroid/glucocorticoid (GC) therapy for septic patients with RAI, but later trials did not show a survival benefit, leading to updated guidelines that abandon targeting RAI or CIRCI. Recent studies with an RAI mouse model showed a clear survival benefit from GC therapy in mice with RAI, suggesting that inconclusive GC clinical trials might be due to issues with the ACTH test rather than targeting RAI. To investigate, we performed the ACTH test in septic mice. Interestingly, the ACTH test identified most mice as having adrenal insufficiency in early and middle stages of sepsis, even those with a normal adrenal stress response. Surprisingly, the ACTH test increased inflammatory cytokines to lethal levels, moderately increasing mortality in septic mice. This study revealed significant flaws in the ACTH test for diagnosing RAI/CIRCI. It not only fails to correctly identify these conditions, leading to misguided use of GCs, but also induces a lethal inflammatory response in sepsis. These findings suggest that inconclusive GC therapy trials may be due to the problematic nature of the ACTH test rather than ineffectiveness of targeting RAI/CIRCI.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 40048257 · DOI · PMC12016919
Key reviews and meta-analyses
The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.
- Research article In search of relationships between the acute adrenocortical response and fitness [5]
- Research article Dissociation of ACTH and glucocorticoids [6]
- Research article Diagnosis of adrenal insufficiency [7]
- Research article Hypopituitarism [8]
- Research article Clinical review 104: Adrenocorticotropin (ACTH)- and non-ACTH-mediated regulation of the adrenal cortex: neural and immune inputs [9]
- Research article ACTH Stimulation Tests for the Diagnosis of Adrenal Insufficiency: Systematic Review and Meta-Analysis [10]
References
- Lightman SL, Birnie MT, Conway-Campbell BL. Dynamics of ACTH and Cortisol Secretion and Implications for Disease. . 2020. PMID 32060528 · DOI · PMC7240781
- Karin O, Raz M, Tendler A, Bar A, Korem Kohanim Y, Milo T, et al.. A new model for the HPA axis explains dysregulation of stress hormones on the timescale of weeks. . 2020. PMID 32672906 · DOI · PMC7364861
- Woods CP, Argese N, Chapman M, Boot C, Webster R, Dabhi V, et al.. Adrenal suppression in patients taking inhaled glucocorticoids is highly prevalent and management can be guided by morning cortisol. . 2015. PMID 26294794 · DOI · PMC4588051
- Hao D, Wang Q, Ito M, Xue J, Guo L, Huang B, et al.. The ACTH test fails to diagnose adrenal insufficiency and augments cytokine production in sepsis. . 2025. PMID 40048257 · DOI · PMC12016919
- Breuner CW, Patterson SH, Hahn TP. In search of relationships between the acute adrenocortical response and fitness. Gen Comp Endocrinol. 2008. PMID 18602555 · DOI
- Bornstein SR, Engeland WC, Ehrhart-Bornstein M, Herman JP. Dissociation of ACTH and glucocorticoids. Trends Endocrinol Metab. 2008. PMID 18394919 · DOI
- Dorin RI, Qualls CR, Crapo LM. Diagnosis of adrenal insufficiency. Ann Intern Med. 2003. PMID 12899587 · DOI
- Schneider HJ, Aimaretti G, Kreitschmann-Andermahr I, Stalla GK, Ghigo E. Hypopituitarism. Lancet. 2007. PMID 17467517 · DOI
- Bornstein SR, Chrousos GP. Clinical review 104: Adrenocorticotropin (ACTH)- and non-ACTH-mediated regulation of the adrenal cortex: neural and immune inputs. J Clin Endocrinol Metab. 1999. PMID 10323408 · DOI
- Ospina NS, Al Nofal A, Bancos I, Javed A, Benkhadra K, Kapoor E, et al.. ACTH Stimulation Tests for the Diagnosis of Adrenal Insufficiency: Systematic Review and Meta-Analysis. J Clin Endocrinol Metab. 2016. PMID 26649617 · DOI
About this article
- Sources
- NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
- Verification
- Every reference was resolved against PubMed on 2026-10-31; title, year and DOI matched.
- Review state
- automated source verified; no human expert review has been recorded yet.
- Version
- 1, last updated 2026-10-31.
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Evidence strength
EvidenceHelix's computed view of the study designs behind this topic: how common meta-analyses, randomized trials and reviews are, how recent the literature is, and a plain-language reading. It describes the design mix of the literature. It is not a quality appraisal of any study, and it is not medical advice.