Veldhuis J D, Worgul T J, Monsaert R, Hammond J M
J Endocrinol Invest. 1981 Jan-Mar;4(1):31-6. doi: 10.1007/BF03349410.
We investigated the participation by endogenous opioid peptides in the control of prolactin and gonadotropin secretion in 5 normal men and 6 normal women, and in 4 men and 5 women with persisting hyperprolactinemia following transsphenoidal pituitary microsurgery for prolactinomas. Iv administration of the specific opiate-receptor antagonist, naloxone hydrochloride (0.2 mg/kg bolus), failed to affect serially sampled serum prolactin levels in normal male or female subjects. With prolactinoma patients, naloxone suppressed hyperprolactinemia to 37% and 32% of mean control values in 2 of 4 males, but in none of 6 females. When luteinizing hormone was serially sampled under the same conditions, 5 of 5 normal males (but no female, normal or abnormal) demonstrated a monophasic increase in serum LH concentrations after injection of the antagonist. The LH peak was 55 +/- 4% above basal levels (p less than 0.01). In contrast to normal men, only one of 4 hyperprolactinemic male patients manifested a stimulatory response of LH to naloxone. Among all 20 subjects, none exhibited a change in FSH levels acutely after naloxone. These data suggest that: i) naloxone will not fulfill its postulated role as an ideal therapy of hyperprolactinemia and hypogonadotropism, at least in women; ii) endogenous opioids may participate in the neuroendocrine regulation of LH secretion in the normal human, iii) male-female differences may modify the role of endogenous opioids; and iv) some male patients with hyperprolactinemia exhibit defective opioid-related neuroregulation of LH secretion.
我们研究了内源性阿片肽在5名正常男性和6名正常女性以及4名男性和5名女性中的作用，这些女性和男性在因泌乳素瘤接受经蝶窦垂体显微手术后持续存在高泌乳素血症。静脉注射特异性阿片受体拮抗剂盐酸纳洛酮（0.2mg/kg推注），未能影响正常男性或女性受试者连续采样的血清泌乳素水平。对于泌乳素瘤患者，纳洛酮使4名男性中的2名患者的高泌乳素血症分别降至平均对照值的37%和32%，但6名女性中无一例出现这种情况。在相同条件下连续采样促黄体生成素时，5名正常男性中有5名（但正常或异常的女性均未出现）在注射拮抗剂后血清促黄体生成素浓度出现单相升高。促黄体生成素峰值比基础水平高55±4%（p<0.01）。与正常男性不同，4名高泌乳素血症男性患者中只有1名对纳洛酮表现出促黄体生成素的刺激反应。在所有20名受试者中，纳洛酮注射后无一例促卵泡生成素水平出现急性变化。这些数据表明：i）纳洛酮至少在女性中不能发挥其作为高泌乳素血症和性腺功能减退理想治疗方法的假定作用；ii）内源性阿片类物质可能参与正常人体内促黄体生成素分泌的神经内分泌调节；iii）男女差异可能改变内源性阿片类物质的作用；iv）一些高泌乳素血症男性患者表现出与阿片类物质相关的促黄体生成素分泌神经调节缺陷。
