Cosyntropin exhibits the full corticosteroidogenic activity of natural AC TH. Various studies have shown that the biologic activity of AC TH resides in the N- terminal portion of the molecule and that the 1-20 amino acid residue is the minimal sequence retaining full activity. Partial or complete loss of activity is noted with progressive shortening of the chain beyond 20 amino acid residue. For example, the decrement from 20 to 19 results in a 70% loss of potency. The pharmacologic profile of Cosyntropin is similar to that of purified natural AC TH. It has been established that 0.25 mg of Cosyntropin will stimulate the adrenal cortex maximally and to the same extent as 25 units of natural AC TH. Cosyntropin has less immunogenic activity than AC TH because the amino acid sequence having most of the antigenic activity of AC TH, i.e., amino acids 25-39, is not present in cosyntropin. The extra-adrenal effects which natural AC TH and Cosyntropin have in common include increased melanotropic activity, increased grow hormone secretion and an adipokinetic effect. These are considered to be without physiological or clinical significance.

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