Department of Pharmaceutical Sciences, Ritsumeikan University, 1-1-1 Nojihigashi, Kusatsu, Shiga, Japan.
Eur J Endocrinol. 2012 Apr;166(4):625-9. doi: 10.1530/EJE-11-1007. Epub 2012 Jan 12.
Macroprolactinaemia is a condition in which serum prolactin (PRL) consists mainly of large molecular weight PRL (macroPRL). The aim of this study was to examine the natural history of macroprolactinaemia.
Six hundred and fifty-four hospital workers participated in this study, including 27 subjects with macroprolactinaemia and 627 controls. MacroPRL and serum PRL concentrations were evaluated over a 4-year period. The ratio of macroPRL was examined by the polyethylene glycol (PEG) method and gel filtration chromatography. IgG-bound PRL and anti-PRL autoantibodies were examined by protein G and (125)I-PRL binding studies respectively.
Over the 4 years of the study, all 27 macroprolactinaemic subjects had persistent macroprolactinaemia without the development of raised free PRL, while none of the 627 controls developed macroprolactinaemia. The ratios of PEG-precipitable PRL and IgG-bound PRL did not significantly change, but (125)I-PRL binding ratios significantly increased. As a whole, total and free serum PRL concentrations did not significantly change in subjects with macroprolactinaemia over the 4-year period. However, hyperprolactinaemia developed in five of the 18 macroprolactinaemic subjects who were initially normoprolactinaemic along with an increase in anti-PRL autoantibody titres. One of the remaining nine macroprolactinaemic subjects who were initially hyperprolactinaemic showed a decrease in serum PRL concentrations, which occurred concomitantly with a decrease in the anti-PRL autoantibody titre.
Macroprolactinaemia may develop before middle age and is likely a chronic condition leading to hyperprolactinaemia.
血清催乳素（PRL）主要由大分子泌乳素（macroPRL）组成的巨泌乳素血症是一种病症。本研究旨在研究巨泌乳素血症的自然史。
本研究共有 654 名医院工作人员参与，包括 27 名巨泌乳素血症患者和 627 名对照。在 4 年的时间里，评估了 macroPRL 和血清 PRL 浓度。通过聚乙二醇（PEG）法和凝胶过滤色谱法检查了 macroPRL 的比例。通过蛋白 G 和（125）I-PRL 结合研究分别检查了 IgG 结合的 PRL 和抗 PRL 自身抗体。
在研究的 4 年中，所有 27 名巨泌乳素血症患者均持续存在巨泌乳素血症，而无游离 PRL 升高，而 627 名对照中无一人发生巨泌乳素血症。PEG 沉淀 PRL 和 IgG 结合 PRL 的比例没有显著变化，但（125）I-PRL 结合比例显著增加。总的来说，在 4 年期间，巨泌乳素血症患者的总血清 PRL 和游离 PRL 浓度没有显著变化。然而，在最初正常的 18 名巨泌乳素血症患者中，有 5 名出现了高泌乳素血症，并伴有抗 PRL 自身抗体滴度升高。在最初高泌乳素血症的 9 名巨泌乳素血症患者中，有 1 名患者的血清 PRL 浓度下降，同时抗 PRL 自身抗体滴度下降。
巨泌乳素血症可能在中年之前发生，并且可能是导致高泌乳素血症的慢性疾病。
