Mohammad Helai P, Abbud Rula A, Parlow Al F, Lewin Jonathan S, Nilson John H
Department of Pharmacology, Case Western Reserve University, Cleveland, Ohio 44106, USA.
Endocrinology. 2003 Oct;144(10):4626-36. doi: 10.1210/en.2003-0357. Epub 2003 Jul 17.
The majority of pituitary adenomas in humans are nonmetastasizing, monoclonal neoplasms that occur in approximately 20% of the general population. Their development has been linked to a combination of extrinsic factors and intrinsic defects. We now demonstrate with transgenic mice that targeted and chronic overexpression of LH causes ovarian hyperstimulation and subsequent hyperproliferation of Pit-1-positive cells that culminates in the appearance of functional pituitary adenomas ranging from focal to multifocal expansion of lactotropes, somatotropes, and thyrotropes. Tumors fail to develop in ovariectomized mice, indicating that contributions from the ovary are necessary for adenoma development. Although the link between chronic ovarian hyperstimulation and PRL-secreting adenomas was expected, the involvement of somatotropes and thyrotropes was surprising and suggests that multiple ovarian hormones may contribute to this unusual pathological consequence. In support of this idea, we have found that ovariectomy followed by estrogen replacement results in the expansion of lactotropes selectively in LH overexpressing mice, but not somatotropes and thyrotropes. Collectively, these data indicate that estrogen is sufficient for the formation of lactotrope adenomas only in animals with a hyperstimulated ovary, whereas the appearance of GH- and TSH-secreting adenomas depends on multiple ovarian hormones. Together, our data expand current models of pituitary tumorigenesis by suggesting that chronic ovarian hyperstimulation may underlie the formation of a subset of pituitary adenomas containing lactotropes, somatotropes, and thyrotropes.
人类大多数垂体腺瘤是非转移性单克隆肿瘤,在普通人群中的发生率约为20%。它们的发生与外在因素和内在缺陷的综合作用有关。我们现在通过转基因小鼠证明,靶向性和持续性促黄体生成素(LH)过表达会导致卵巢过度刺激,随后Pit-1阳性细胞过度增殖,最终形成功能性垂体腺瘤,表现为催乳素细胞、生长激素细胞和促甲状腺激素细胞从局灶性到多灶性的扩张。在卵巢切除的小鼠中不会发生肿瘤,这表明卵巢的作用对于腺瘤的发生是必要的。虽然慢性卵巢过度刺激与分泌催乳素的腺瘤之间的联系是预期中的,但生长激素细胞和促甲状腺激素细胞的参与却令人惊讶,这表明多种卵巢激素可能导致了这种不寻常的病理结果。支持这一观点的是,我们发现卵巢切除后进行雌激素替代,只会导致LH过表达小鼠中的催乳素细胞选择性扩张,而生长激素细胞和促甲状腺激素细胞则不会。总体而言,这些数据表明,雌激素仅在卵巢过度刺激的动物中足以形成催乳素细胞腺瘤,而分泌生长激素和促甲状腺激素腺瘤的出现则依赖于多种卵巢激素。总之,我们的数据扩展了当前垂体肿瘤发生的模型,表明慢性卵巢过度刺激可能是包含催乳素细胞、生长激素细胞和促甲状腺激素细胞的一部分垂体腺瘤形成的基础。