Iwashita M, Kudo Y, Shinozaki Y, Takeda Y
Maternal and Perinatal Center, Tokyo Women's Medical College, Japan.
Endocr J. 1993 Oct;40(5):539-44. doi: 10.1507/endocrj.40.539.
Hypothalamic decapeptide, gonadotropin-releasing hormone (GnRH) has been found to stimulate human chronic gonadotropin (hCG) secretion by trophoblast cells in vitro. To determine the biological effect of GnRH on the release of hCG in vivo, we studied the effect of the administration of GnRH on the serum levels of human chronic gonadotropin (hCG) during pregnancy. Serum hCG levels were measured before and 15, 30, and 60 min after the intravenous administration of 100 micrograms of GnRH to 22 volunteers with normal pregnancy. Nine of the 12 (75%) women responded to GnRH in the first trimester, while only 1 of the 5 women (20%) responded to GnRH in the second trimester. None of the 5 women tested in the third trimester showed a significant response of hCG to the injection of GnRH. The average increase in hCG during the first, second and third trimester was 160.7 +/- 13.5%, 111.0 +/- 7.4% and 95.0 +/- 2.3%, respectively (mean +/- SEM). Whereas the pregnant courses of all the cases were uneventful and normal, other abnormal pregnancies were also investigated with informed consents. Three patients with missed abortions also showed a significant response of hCG to GnRH (increase: 136.7 +/- 8.5%) when GnRH was administered before curettage of the uterine cavity. However, 4 patients with unruptured ectopic pregnancies did not respond to GnRH stimulation. These findings indicate that GnRH can stimulate the release of hCG by the placenta in vivo, consistent with the previous in vitro study, while the responsiveness depend on gestational age and the implantation site.
下丘脑十肽,即促性腺激素释放激素(GnRH)已被发现在体外能刺激滋养层细胞分泌人绒毛膜促性腺激素(hCG)。为了确定GnRH在体内对hCG释放的生物学效应,我们研究了孕期给予GnRH对人绒毛膜促性腺激素(hCG)血清水平的影响。对22名正常妊娠的志愿者静脉注射100微克GnRH,并在注射前以及注射后15、30和60分钟测量血清hCG水平。12名女性中有9名(75%)在孕早期对GnRH有反应,而5名女性中只有1名(20%)在孕中期对GnRH有反应。在孕晚期测试的5名女性中,没有一人的hCG对注射GnRH有明显反应。孕早期、孕中期和孕晚期hCG的平均升高分别为160.7±13.5%、111.0±7.4%和95.0±2.3%(平均值±标准误)。鉴于所有病例的孕期过程均顺利且正常,在获得知情同意后,我们还对其他异常妊娠情况进行了研究。3名稽留流产患者在刮宫术前给予GnRH时,hCG对GnRH也有明显反应(升高:136.7±8.5%)。然而,4名未破裂异位妊娠患者对GnRH刺激无反应。这些发现表明,GnRH在体内能刺激胎盘释放hCG,这与之前的体外研究结果一致,但其反应性取决于孕周和着床部位。