Utsumi A, Hanew K, Sugawara A, Shimizu Y, Murakami O, Ikeda H, Yoshinaga K
Second Department of Internal Medicine, Tohoku University, Sendai, Japan.
J Endocrinol Invest. 1992 Mar;15(3):167-71. doi: 10.1007/BF03348697.
It has been reported that paradoxical GH responses to corticotropin-releasing hormone (CRH) occur in only few patients with acromegaly. However, we have observed such responses in 7 of 14 active acromegalic patients. Therefore, we have studied the GH responses to thyrotropin-releasing hormone (TRH) (500 micrograms, iv), gonadotropin-releasing hormone (LHRH) (100 micrograms, iv) and GH-releasing hormone (GHRH) (100 micrograms, iv) in these patients to examine the relationships between the GH responses to CRH and the responses to these hypothalamic hormones. Further, these patients received human CRH (1-41) NH2 (100 micrograms, iv) with or without dexamethasone (Dex) pretreatment (1 mg/100 ml saline, iv, from -30 to +30 min) to study the mechanism of CRH-induced GH secretion, and a perifusion experiment was performed using adenoma tissue obtained at surgery from one patient (10(-7) M CRH and TRH were added) to elucidate whether CRH acts directly at the pituitary level. Aberrant GH responses induced by CRH were found in 7 of 14 (50%) acromegalic patients (TRH responders: 10/13, 77%; LHRH responders: 2/9, 22%; GHRH responders: 10/12, 83%). In these patients, percent GH increment induced by CRH ranged from 81 to 144% (Mean +/- SE, 118 +/- 8%), and the GH peak (19 +/- 3 min) appeared as early as after TRH (23 +/- 4 min, N = 10).(ABSTRACT TRUNCATED AT 250 WORDS)
据报道，仅少数肢端肥大症患者会出现对促肾上腺皮质激素释放激素（CRH）的矛盾性生长激素（GH）反应。然而，我们在14例活动性肢端肥大症患者中的7例观察到了这种反应。因此，我们研究了这些患者对促甲状腺激素释放激素（TRH）（500微克，静脉注射）、促性腺激素释放激素（LHRH）（100微克，静脉注射）和生长激素释放激素（GHRH）（100微克，静脉注射）的GH反应，以检查GH对CRH的反应与对这些下丘脑激素的反应之间的关系。此外，这些患者接受了人CRH（1-41）NH2（100微克，静脉注射），有或没有地塞米松（Dex）预处理（1毫克/100毫升生理盐水，静脉注射，从-30至+30分钟），以研究CRH诱导GH分泌的机制，并使用一名患者手术时获得的腺瘤组织进行了灌流实验（加入10⁻⁷M CRH和TRH），以阐明CRH是否直接作用于垂体水平。在14例肢端肥大症患者中的7例（50%）发现了由CRH诱导的异常GH反应（TRH反应者：10/13，77%；LHRH反应者：2/9，22%；GHRH反应者：10/12，83%）。在这些患者中，CRH诱导的GH增加值百分比范围为81%至144%（平均值±标准误，118±8%），GH峰值（19±3分钟）出现的时间与TRH后最早出现的时间相同（23±4分钟，N = 10）。（摘要截断于250字）
