Barbarino A, Corsello S M, Della Casa S, Tofani A, Sciuto R, Rota C A, Bollanti L, Barini A
Institutes of Endocrinology and Biochemistry (A. Bari), Catholic University School of Medicine, Rome, Italy.
J Clin Endocrinol Metab. 1990 Nov;71(5):1368-74. doi: 10.1210/jcem-71-5-1368.
Recent studies in the rat have shown that intracerebroventricular administration of CRH inhibited spontaneous pulsatile GH secretion and prevented GH-releasing hormone (GHRH)-induced GH release. We have studied the effect of CRH on GHRH-induced GH release in man. In the first study, CRH was injected iv at three different doses (100, 50, or 25 micrograms) at 0800 h together with 50 micrograms GHRH in six men and six women. In a second study, 100 micrograms CRH were given iv at 0800 h, 1 h before the administration of 50 micrograms GHRH in five men and five women. Each subject demonstrated a normal GH response after the administration of 50 micrograms GHRH plus saline. All doses of CRH administered simultaneously with GHRH significantly inhibited GHRH-induced GH release in women [peak value +/- SE after GHRH plus saline, 28.9 +/- 2.9 micrograms/L; after GHRH plus 100 micrograms CRH, 9.9 +/- 0.7 micrograms/L (P less than 0.001); after GHRH plus 50 micrograms CRH, 8.7 +/- 0.8 micrograms/L (P less than 0.001); after GHRH plus 25 microgram CRH, 9.5 +/- 1.6 microgram/L (P less than 0.001]). In contrast, in men, while a dose of 100 micrograms CRH was capable of suppressing GHRH-induced GH secretion (peak value +/- SE, 8.1 +/- 0.6 vs. 20 +/- 2.9 micrograms/L; P less than 0.001), no inhibition was observed after 50- and 25-micrograms doses. When 100 micrograms CRH were injected 1 h before the administration of 50 micrograms GHRH, it strongly inhibited GHRH-induced GH secretion in both men (peak value +/- SE, 6.2 +/- 2.8 vs. 24.6 +/- 5.9 micrograms/L; P less than 0.02) and women (peak value +/- SE, 14.2 +/- 4.5 vs. 37.8 +/- 6.7 micrograms/L; P less than 0.005), and this inhibition lasted up to 2 h post-CRH administration. These results demonstrate that CRH is capable of inhibiting GHRH-induced GH release in both men and women. Furthermore, the findings suggest that a sexual dimorphism in the neuroregulation of GH secretion may be present in man. In view of the inhibitory action of CRH on GH secretion, simultaneous administration of CRH and GHRH for testing should be avoided in clinical practice.
最近在大鼠身上的研究表明,脑室内注射促肾上腺皮质激素释放激素(CRH)可抑制生长激素(GH)的自发性脉冲式分泌,并阻止生长激素释放激素(GHRH)诱导的GH释放。我们研究了CRH对人GHRH诱导的GH释放的影响。在第一项研究中,于08:00时给6名男性和6名女性静脉注射三种不同剂量(100、50或25微克)的CRH,并同时注射50微克GHRH。在第二项研究中,于08:00时给5名男性和5名女性静脉注射100微克CRH,1小时后再注射50微克GHRH。每名受试者在注射50微克GHRH加生理盐水后均表现出正常的GH反应。与GHRH同时给予的所有剂量的CRH均显著抑制了女性中GHRH诱导的GH释放[GHRH加生理盐水后的峰值±标准误,28.9±2.9微克/升;GHRH加100微克CRH后,9.9±0.7微克/升(P<0.001);GHRH加50微克CRH后,8.7±0.8微克/升(P<0.001);GHRH加25微克CRH后,9.5±1.6微克/升(P<0.001)]。相比之下,在男性中,虽然100微克CRH的剂量能够抑制GHRH诱导的GH分泌(峰值±标准误,8.1±0.6对20±2.9微克/升;P<0.001),但50微克和25微克剂量未观察到抑制作用。当在注射50微克GHRH前1小时注射100微克CRH时,它强烈抑制了男性(峰值±标准误,6.2±2.8对24.6±5.9微克/升;P<0.02)和女性(峰值±标准误,14.2±4.5对37.8±6.7微克/升;P<0.005)中GHRH诱导的GH分泌,且这种抑制在注射CRH后持续长达2小时。这些结果表明,CRH能够抑制男性和女性中GHRH诱导的GH释放。此外,这些发现提示,人类GH分泌的神经调节中可能存在性别差异。鉴于CRH对GH分泌的抑制作用,在临床实践中应避免同时给予CRH和GHRH进行检测。