Hershel Raff, PhD
Professor of Medicine 
Director of Endocrine Research Laboratory
St. Luke's Medical Center
Training:
PhD, Environmental Physiology
Johns Hopkins University
Post-doctoral Fellowship in Endocrinology
University of California, San Francisco
Contact:
St. Luke’s Medical Center, 2801 W KK River Pky Suite 245, Milwaukee WI 53215
Phone: (414) 649-6411
Fax: (414) 649-5747
Investigative Interests:
Cushing's syndrome, adrenal tumors, fetal and neonatal endocrinology and metabolism
Clinical Research:
My clinical research has two major areas of interest. The first is the development of new methods in the diagnosis and differential diagnosis of Cushing's syndrome. We have developed and championed the use of bedtime salivary cortisol measurement to diagnose endogenous hypercortisolism. The patients sample saliva at home using a special device and mail the samples back to our lab. There are now 12 major studies from the US, Europe, and Japan demonstrating the accuracy and cost-effectiveness of this approach. My laboratory receives clinical samples (through ACL Reference Laboratories) from all over the US. My laboratory also helped develope the inferior petrosal sinus sampling for ACTH technique to differentiate pituitary from ectopic ACTH-dependent Cushing's syndrome. We also developed the method to verify catheter placement using prolactin measurements. Finally, our translational research is evaluating the biochemistry and molecular biology of human steroidogenic adrenal tumors. Laboratory Research: The major interest of my laboratory is to evaluate the endocrine and metabolic adaptations of the fetus, neonate, adolescent, and adult rat to perinatal hypoxia. We have studied the hypothalamic-pituitary-adrenal axis showing a non-ACTH mediated increase in steroidogenesis apparently mediated by a novel neural pathway to the adrenal cortex via sympathetic nerves. We have also demonstrated dramatic effects on the lipid profile (metabolome), hepatic and gastrointestinal function, bone metabolism, growth and the growth hormone axis, and adipokine expression. We are currently studying the effects of spontaneous hypothermia during hypoxia on these humoral systems.
Selected Recent Publications:
Raff H, Jacobson L. Glucocorticoid feedback control of corticotropin (ACTH) in the hypoxic
neonatal rat. J. Endocrinol. 192:453-458, 2007
Bruder ED, Lee JJ, Widmaier EP, Raff H. Microarray and real-time PCR analysis of adrenal gland
gene expression in the 7-day-old rat: effects of hypoxia from birth. Physiol Genomics
29:193-200, 2007.
Usa K, Singh RJ, Netzel BC, Liu Y, Raff H, Liang M. Renal interstitial corticosterone and
11-dehydrocorticosterone in conscious rats. Am J Physiol Renal Physiol 293:F186-F192, 2007.
Rosner W, Auchus RJ, Azziz R, Sluss PM, Raff H. Utility, limitations and pitfalls in measuring
testosterone: an Endocrine Society Position Statement. J. Clin. Endocrinol. Metab. 92:405-413,
2007.
Raff H, Jacobson L, Cullinan WE. Augmented hypothalamic corticotrophin-releasing hormone
mRNA and corticosterone responses to stress in adult rats exposed to perinatal hypoxia. J.
Neuroendocrinol. 19:907-912, 2007
Kidambi S, Raff H, Findling JW. Limitations of nocturnal salivary cortisol and urine free cortisol
in the diagnosis of mild Cushing’s syndrome. Eur J Endocrinol 157:725-731, 2007.
Woods DL, Kovach CR, Raff H, Basmadjian A, Hegadoren KM. Using saliva to measure
endogenous cortisol in nursing home residents with advanced dementia. Research in Nursing &
Health 31:283-194, 2008.
Bruder ED, VanHoof J, Young JB, Raff H. Epidermal growth factor and parathyroid
hormone-related peptide mRNA in the mammary gland and their concentrations in milk: effects
of post-partum hypoxia in lactating rats. Horm Metab Res 40:446-453, 2008.
Raff H. Immulite vs. Scantibodies IRMA Plasma ACTH. Clinical Chemistry 54:1409-1410, 2008
Bruder ED, Taylor JK, Kamer KJ, Raff H. Development of the ACTH and corticosterone response
to acute hypoxia in the neonatal rat. Am J Physiol Regul Integr Comp Physiol
295:R1195-R1203, 2008.
Widmaier EP, Raff H, Strang KT. Vander’s HUMAN PHYSIOLOGY: The Mechanisms of Body
Function, 11th Edition, McGraw-Hill, Boston, 2008, 770 pages.
Raff H. Brock S, Findling JW. Cosyntropin-stimulated salivary cortisol in hospitalized patients
with hypoproteinemia. Endocrine 34:68-74, 2008.
Findling JW, Raff H. Cushing’s Disease: Diagnostic Evaluation. In: DIAGNOSIS AND
MANAGEMENT OF PITUITARY DISORDERS. Swearingen B, Biller BMK, eds. Humana Press,
Totowa NJ, 2008, p187-221.
Raff H, Sluss PM. Pre-analytical issues for testosterone and estradiol assays. Steroids
73:1297-1304, 2008
Carroll T, Raff H, Findling JW. Late-night salivary cortisol measurement in the diagnosis of
Cushing’s syndrome. Nature Clinical Practice Endocrinology & Metabolism 6:344-350, 2008.
Carroll T, Raff H, Findling JW. Late-night salivary cortisol for the diagnosis of Cushing’s
syndrome: a meta-analysis. Endocrine Practice 15:335-342, 2009
Raff H. Utility of salivary cortisol measurements in Cushing’s syndrome and adrenal
insufficiency. J. Clin Endocrinol Metab (in press – 2009)