Finkelstein J S, Badger T M, O'Dea L S, Spratt D I, Crowley W F
Vincent Memorial Research Laboratories, Massachusetts General Hospital, Boston 02114.
J Clin Invest. 1988 Jun;81(6):1725-33. doi: 10.1172/JCI113512.
The effects of decreasing the frequency of pulsatile gonadotropin-releasing hormone (GnRH) stimulation on pituitary responsiveness were studied in (a) men with isolated GnRH deficiency who had achieved normal sex steroid levels during prior long-term pulsatile GnRH replacement and (b) perifused dispersed pituitary cells from male rats in the absence of sex steroids. In three groups of four GnRH-deficient men, the frequency of GnRH stimulation was decreased at weekly intervals from (a) every 2-3-4 h (group I), (b) every 2-8 h without testosterone replacement (group II), or (c) every 2-8 h with testosterone replacement (group III). In three groups of three columns of perifused dispersed pituitary cells, pulses of GnRH were administered every 2, 4, or 8 h. In groups I and II, mean area under the luteinizing hormone (LH) curve increased (P less than 0.025) and serum testosterone levels fell (P less than 0.035) as the frequency of GnRH stimulation was decreased. In group III, the area under the LH curve also increased (P less than 0.01) although serum testosterone levels were constant, thereby demonstrating that the increase in pituitary responsiveness to slow frequencies of GnRH stimulation occurs independently of changes in the sex steroid hormonal milieu. The area under the LH curve also increased in the perifused dispersed rat pituitary cells when the frequency of GnRH administration was decreased to every 8 h (P less than 0.05), thus demonstrating that the enhanced pituitary responsiveness to slow frequencies of GnRH stimulation is maintained even in the complete absence of gonadal steroids. Nadir LH levels fell in all three groups (P less than 0.01) as the frequency of GnRH stimulation was decreased. In contrast, mean peak LH levels, the rate of LH rise, and the rate of endogenous LH decay were constant as the frequency of GnRH stimulation was decreased. Finally, as the GnRH interpulse interval increased, mean LH levels fell, and mean follicle-stimulating hormone levels were stable or fell. These results indicate that (a) pituitary responsiveness to GnRH increases at slower frequencies of GnRH stimulation in models both in vivo and in vitro, (b) these changes in pituitary responsiveness occur independently of changes in gonadal steroid secretion, and (c) the increases in LH pulse amplitude and area under the curve at slow frequencies of GnRH stimulation are due to decreases in nadir, but not peak, LH levels. Slowing of the frequency of GnRH secretion may be an important independent variable in the control of pituitary gonadotropin secretion.
在以下两种情况下研究了降低脉冲式促性腺激素释放激素(GnRH)刺激频率对垂体反应性的影响:(a)患有孤立性GnRH缺乏症的男性,这些男性在先前长期脉冲式GnRH替代治疗期间已达到正常性类固醇水平;(b)在没有性类固醇的情况下,对来自雄性大鼠的分散垂体细胞进行灌流培养。在三组各四名GnRH缺乏症男性中,GnRH刺激频率每隔一周降低一次,分别为:(a)每2 - 3 - 4小时一次(第一组);(b)每2 - 8小时一次且不进行睾酮替代(第二组);(c)每2 - 8小时一次且进行睾酮替代(第三组)。在三组各三列灌流培养的分散垂体细胞中,GnRH脉冲每2、4或8小时给药一次。在第一组和第二组中,随着GnRH刺激频率降低,促黄体生成素(LH)曲线下平均面积增加(P < 0.025),血清睾酮水平下降(P < 0.035)。在第三组中,尽管血清睾酮水平保持恒定,但LH曲线下面积也增加(P < 0.01),从而表明垂体对GnRH刺激低频的反应性增加独立于性类固醇激素环境的变化。当GnRH给药频率降至每8小时一次时,灌流培养的分散大鼠垂体细胞中LH曲线下面积也增加(P < 0.05),这表明即使在完全没有性腺类固醇的情况下,垂体对GnRH刺激低频的增强反应性仍然存在。随着GnRH刺激频率降低,所有三组的LH最低水平均下降(P < 0.01)。相反,随着GnRH刺激频率降低,LH平均峰值水平、LH上升速率和内源性LH衰减速率保持恒定。最后,随着GnRH脉冲间隔增加,LH平均水平下降,促卵泡生成素平均水平稳定或下降。这些结果表明:(a)在体内和体外模型中,垂体对GnRH的反应性在GnRH刺激频率较低时增加;(b)垂体反应性的这些变化独立于性腺类固醇分泌的变化;(c)在GnRH刺激低频时,LH脉冲幅度和曲线下面积的增加是由于LH最低水平的降低,而不是峰值水平的降低。GnRH分泌频率的减慢可能是控制垂体促性腺激素分泌的一个重要独立变量。