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促黄体生成素在控制人黄体分泌抑制素和孕酮中的重要性。

The importance of luteinizing hormone in the control of inhibin and progesterone secretion by the human corpus luteum.

作者信息

McLachlan R I, Cohen N L, Vale W W, Rivier J E, Burger H G, Bremner W J, Soules M R

机构信息

Department of Medicine, University of Washington, Seattle 98195.

出版信息

J Clin Endocrinol Metab. 1989 Jun;68(6):1078-85. doi: 10.1210/jcem-68-6-1078.

Abstract

Serum inhibin levels rise markedly during the luteal phase of the human menstrual cycle and are closely correlated with serum progesterone (P) levels, suggesting that the corpus luteum (CL) secretes inhibin. While FSH is the major regulator of inhibin secretion by the granulosa cells, the control of CL inhibin secretion is unclear. We hypothesized that, like P, CL inhibin secretion would be LH dependent. To examine this possibility, normal women were given the GnRH antagonist [Ac-D2Nal1, D4CL Phe2, D3Pal3, Arg5, DGlu6 (AA), DAla10]GnRH (Nal-Glu antagonist) for 3 consecutive days commencing on day 6-8 of the luteal phase. The daily doses were 2.5 (n = 3), 10 (n = 4), and 25 micrograms/kg (n = 5), sc. Serum LH levels fell 2 h after injection, and the fall was maximal (70-74%) at 6 h; the degree of suppression was not dose dependent. The duration of suppression was dose related, being less than 12 h, between 12, and 24 h, and more than 24 h for the 2.5, 10, and 25 micrograms/kg doses, respectively. Serum FSH levels declined by 22-43%, but the effect was not dose related. Serum P levels fell by 42-45% 8 h after each dose of antagonist. They returned to baseline 24 h after the 2.5 micrograms/kg dose, but after both the 10 and 25 micrograms/kg doses serum P levels continued to fall, and menstrual bleeding commenced within 48-72 h after the first antagonist injection. Serum inhibin levels were not altered relative to normal cycles by the 2.5 micrograms/kg dose, but fell by 48% and 58%, and 62% and 73% respectively, 48 and 72 h after the 10 and 25 micrograms/kg doses, respectively. Serum P and inhibin levels correlated closely in all women. To examine the relative roles of FSH and LH in the control of CL function, Nal-Glu antagonist (25 micrograms/kg, sc) was administered at 0 and 24 h commencing on day 6-8 of the luteal phase, in combination with either human menopausal gonadotropin (hMG; 150 IU, im, every 12 h) or hCG (1500 IU, im, once), both commencing at 0 h. hMG administration led to a rapid (by 2 h) and marked (3- to 9-fold) rise in serum FSH levels, whereas serum LH remained low, similar to antagonist alone treatment cycless.(ABSTRACT TRUNCATED AT 400 WORDS)

摘要

在人类月经周期的黄体期,血清抑制素水平显著升高,且与血清孕酮(P)水平密切相关,这表明黄体(CL)分泌抑制素。虽然促卵泡生成素(FSH)是颗粒细胞分泌抑制素的主要调节因子,但CL抑制素分泌的调控尚不清楚。我们推测,与P一样,CL抑制素的分泌将依赖于促黄体生成素(LH)。为了检验这种可能性,从黄体期第6 - 8天开始,连续3天给正常女性皮下注射促性腺激素释放激素(GnRH)拮抗剂[Ac - D2Nal1, D4CL Phe2, D3Pal3, Arg5, DGlu6 (AA), DAla10]GnRH(那法瑞林拮抗剂)。每日剂量分别为2.5(n = 3)、10(n = 4)和25微克/千克(n = 5)。注射后2小时血清LH水平下降,6小时时下降幅度最大(70 - 74%);抑制程度与剂量无关。抑制持续时间与剂量相关,2.5、10和25微克/千克剂量的抑制持续时间分别小于12小时、12至24小时和超过24小时。血清FSH水平下降了22 - 43%,但该效应与剂量无关。每次注射拮抗剂8小时后,血清P水平下降42 - 45%。2.5微克/千克剂量后24小时血清P水平恢复至基线,但10和25微克/千克剂量后血清P水平持续下降,且在首次注射拮抗剂后48 - 72小时内开始月经出血。2.5微克/千克剂量时血清抑制素水平相对于正常周期未改变,但10和25微克/千克剂量后48小时和72小时,血清抑制素水平分别下降了48%、58%以及62%、73%。所有女性的血清P和抑制素水平密切相关。为了研究FSH和LH在CL功能调控中的相对作用,从黄体期第6 - 8天开始,在0小时和24小时皮下注射那法瑞林拮抗剂(25微克/千克),同时分别联合人绝经期促性腺激素(hMG;150国际单位,每12小时肌肉注射一次)或hCG(1500国际单位,肌肉注射一次),两者均从0小时开始。给予hMG导致血清FSH水平迅速(2小时内)且显著(3至9倍)升高,而血清LH仍维持在低水平,类似于单独使用拮抗剂治疗的周期。(摘要截断于400字)

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