Carrier M, Wild J, Pelletier L C, Copeland J G
Department of Surgery, Montreal Heart Institute, University of Montreal, Quebec, Canada.
Ann Thorac Surg. 1990 Jan;49(1):129-32. doi: 10.1016/0003-4975(90)90370-l.
Prolactin, a pituitary hormone, has been shown to have an active role in the regulation of the immune system. Prolactin receptors have been described on the membrane of lymphocyte cells, and competitive binding to these receptors by cyclosporine and circulating prolactin has been demonstrated. Experimental evidence suggests a synergistic effect of cyclosporine and bromocriptine, an inhibitor of pituitary release of prolactin, on immunosuppression. Between July 1986 and January 1988, 54 patients were randomly assigned to two groups of immunosuppression treatment. Thirty patients (group 1) were administered cyclosporine, azathioprine, and prednisone and 24 patients (group 2), a modified protocol aimed at decreasing the level of circulating prolactin by adding bromocriptine to the immunosuppression regimen. The two groups were similar in regard to age, preoperative diagnosis, and duration of follow-up. Minimal side effects related to bromocriptine were observed. The overall incidences of rejection and infection were similar, although actuarial analysis showed that freedom from these complications among patients treated with bromocriptine was significantly higher throughout the first 2 months after heart transplantation compared with that of patients in the control group. Other variables such as serum cyclosporine levels and lymphocyte counts were similar in both groups. In conclusion, suppression of circulating prolactin by bromocriptine appears to improve the immunosuppressive effect of cyclosporine, at least during the early postoperative period when the risk of rejection and infection is higher, and could be a promising avenue to successful hormonal manipulations of the immune process after organ transplantation.
催乳素是一种垂体激素，已被证明在免疫系统调节中发挥积极作用。淋巴细胞细胞膜上已发现催乳素受体，并且已证实环孢素和循环中的催乳素可竞争性结合这些受体。实验证据表明，环孢素与溴隐亭（一种抑制垂体释放催乳素的药物）在免疫抑制方面具有协同作用。1986年7月至1988年1月期间，54例患者被随机分为两组进行免疫抑制治疗。30例患者（第1组）接受环孢素、硫唑嘌呤和泼尼松治疗，24例患者（第2组）采用改良方案，即在免疫抑制方案中添加溴隐亭以降低循环催乳素水平。两组在年龄、术前诊断和随访时间方面相似。观察到与溴隐亭相关的副作用极小。排斥反应和感染的总体发生率相似，尽管精算分析表明，与对照组患者相比，在心脏移植后的前2个月内，接受溴隐亭治疗的患者无这些并发症的情况明显更好。两组的其他变量，如血清环孢素水平和淋巴细胞计数相似。总之，溴隐亭抑制循环中的催乳素似乎可改善环孢素的免疫抑制作用，至少在术后早期排斥反应和感染风险较高时如此，并且可能是器官移植后成功进行免疫过程激素调控的一条有前景的途径。
