Yogev L, Gottreich A, Homonnai Z T, Yavetz H, Paz G F
Institute for the Study of Fertility, Serlin Maternity Hospital, Tel Aviv Medical Centre, Israel.
Proc Soc Exp Biol Med. 1990 Oct;195(1):22-5. doi: 10.3181/00379727-195-43105.
Previous studies with naltrexone (Nalt), a "long-lasting" opioid antagonist, demonstrated a rapid increase in luteinizing hormone (LH) secretion which gradually declined, reaching baseline values after 1 hr. A second Nalt challenge, 120 min later, caused only a blunted response. This poor reaction has been shown in this study not to be due to lack of pituitary responsiveness, because LH-releasing hormone treatment revealed a normal response. A time-response study was carried out in order to establish the refractory period length, by administering a second Nalt injection at 0 hr (immediately after the first injection) and at 2, 4, 8, 16, and 24 hr after the first bolus. Partial responsiveness could be achieved 2 and 4 hr after the first challenge. However, only after 8 hr was a full response recorded. The diurnal changes in serum LH (nadir at 18.00 hr) did not affect the response to Nalt challenge. It is suggested that in the presence of a Nalt blockade, nonopioid systems are able to "normalize" LH blood levels. However, when Nalt blood levels have fallen sufficiently to allow the endogenous opioid system to take primary control again, then a second Nalt injection will provoke a renewed response.
先前使用“长效”阿片类拮抗剂纳曲酮(Nalt)的研究表明,促黄体生成素(LH)分泌迅速增加,随后逐渐下降,1小时后达到基线值。120分钟后再次给予纳曲酮激发试验,仅引起反应减弱。本研究表明,这种不良反应并非由于垂体反应性不足,因为促性腺激素释放激素治疗显示反应正常。为了确定不应期的长度,进行了一项时间反应研究,在首次推注后0小时(即首次注射后立即)以及在2、4、8、16和24小时给予第二次纳曲酮注射。在首次激发试验后2小时和4小时可实现部分反应性。然而,仅在8小时后才记录到完全反应。血清LH的昼夜变化(最低点在18:00时)不影响对纳曲酮激发试验的反应。研究表明,在纳曲酮阻断的情况下,非阿片类系统能够使LH血水平“正常化”。然而,当纳曲酮血水平充分下降,使内源性阿片类系统再次占据主导控制地位时,第二次注射纳曲酮将引发再次反应。