Abstract
Prolactin secretion was assessed in 23 patients with hypothalamic-pituitary disorders using L-Dopa suppression, chlorpromazine (CPZ), and thyrotropin-releasing hormone (TRH) stimulation tests. Based on the responses to these tests, three groups of patients were identified: those with panhypopituitarism (group I) and those with partial hypopituitarism either with (group II) or without (group III) evidence of hypothalamic involvement.
Panhypopituitary patients (group I) consistently had low serum prolactin values and failed to respond to all tests. Patients with hypothalamic involvement (group II) exhibited (a) elevated basal prolactin values. (b) an increase in serum prolactin after TRH stimulation. (c) blunted response to L-Dopa, and (d) lack of response to chlorpromazine stimulation. Patients with partial hypopituitarism but without hypothalamic involvement (group III) had normal serum prolactin levels and suppressed normally after L-Dopa; although the magnitude of response to both stimulatory agents was significantly lower than normally found the ratio of prolactin levels post-CPZ and TRH (Δ prolactin CPZ/Δ prolactin TRH) was similar to the ratio of normal individuals suggesting that these patients (group III) had a normal hypothalamic-pituitary prolactin axis.
In the 23 patients studied, the most consistent disorder of pituitary function proved to be an abnormal response to one or other of the three tests employed for the evaluation of prolactin secretion. Hence these tests have considerable potential as a sensitive screening procedure in the evaluation of patients suspected of having hypothalamic-pituitary disease.
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Selected References
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- Baghdassarian A., Guyda H., Johanson A., Migeon C. J., Blizzard R. M. Urinary excretion of radioimmunoassayable luteinizing hormone (LH) in normal male children and adults, according to age and stage of sexual development. J Clin Endocrinol Metab. 1970 Oct;31(4):428–435. doi: 10.1210/jcem-31-4-428. [DOI] [PubMed] [Google Scholar]
- Birge C. A., Jacobs L. S., Hammer C. T., Daughaday W. H. Catecholamine inhibition of prolactin secretion by isolated rat adenohypophyses. Endocrinology. 1970 Jan;86(1):120–130. doi: 10.1210/endo-86-1-120. [DOI] [PubMed] [Google Scholar]
- Bowers C. Y., Friesen H. G., Hwang P., Guyda H. J., Folkers K. Prolactin and thyrotropin release in man by synthetic pyroglutamyl-histidyl-prolinamide. Biochem Biophys Res Commun. 1971 Nov;45(4):1033–1041. doi: 10.1016/0006-291x(71)90441-4. [DOI] [PubMed] [Google Scholar]
- Boyd A. E., 3rd, Lebovitz H. E., Feldman J. M. Endocrine function and glucose metabolism in patients with Parkinson's disease and their alternation by L-Dopa. J Clin Endocrinol Metab. 1971 Nov;33(5):829–837. doi: 10.1210/jcem-33-5-829. [DOI] [PubMed] [Google Scholar]
- Costom B. H., Grumbach M. M., Kaplan S. L. Effect of thyrotropin-releasing factor on serum thyroid-stimulating hormone. An approach to distinguishing hypothalamic from pituitary forms of idiopathic hypopituitary dwarfism. J Clin Invest. 1971 Oct;50(10):2219–2225. doi: 10.1172/JCI106717. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Daughaday W. H. Growth hormone assay in acromegaly, gigantism, dwarfism and hypopituitarism. Postgrad Med. 1969 Nov;46(5):84–91. doi: 10.1080/00325481.1969.11697301. [DOI] [PubMed] [Google Scholar]
- Donoso A. O., Bishop W., Fawcett C. P., Krulich L., McCann S. M. Effects of drugs that modify brain monoamine concentrations on plasma gonadotropin and prolactin levels in the rat. Endocrinology. 1971 Sep;89(3):774–784. doi: 10.1210/endo-89-3-774. [DOI] [PubMed] [Google Scholar]
- EVERETT J. W. Luteotrophic function of autografts of the rat hypophysis. Endocrinology. 1954 Jun;54(6):685–690. doi: 10.1210/endo-54-6-685. [DOI] [PubMed] [Google Scholar]
- Eddy R. L., Jones A. L., Chakmakjian Z. H., Silverthorne M. C. Effect of levodopa (L-DOPA) on human hypophyseal tropic hormone release. J Clin Endocrinol Metab. 1971 Oct;33(4):709–712. doi: 10.1210/jcem-33-4-709. [DOI] [PubMed] [Google Scholar]
- Everett G. M., Borcherding J. W. L-dopa: effect on concentrations of dopamine, norepinephrine, and serotonin in brains of mice. Science. 1970 May 15;168(3933):849–850. doi: 10.1126/science.168.3933.849. [DOI] [PubMed] [Google Scholar]
- Foley T. P., Jr, Jacobs L. S., Hoffman W., Daughaday W. H., Blizzard R. M. Human prolactin and thyrotropin concentrations in the serums of normal and hypopituitary children before and after the administration of synthetic thyrotropin-releasing hormone. J Clin Invest. 1972 Aug;51(8):2143–2150. doi: 10.1172/JCI107021. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Friesen H., Guyda H., Hwang P., Tyson J. E., Barbeau A. Functional evaluation of prolactin secretion: a guide to therapy. J Clin Invest. 1972 Mar;51(3):706–709. doi: 10.1172/JCI106859. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Fuxe K., Hökfelt T. Further evidence for the existence of tubero-infundibular dopamine neurons. Acta Physiol Scand. 1966 Jan-Feb;66(1):245–246. doi: 10.1111/j.1748-1716.1966.tb03192.x. [DOI] [PubMed] [Google Scholar]
- Glick S. M. Hypoglycemic threshold for human growth hormone release. J Clin Endocrinol Metab. 1970 May;30(5):619–623. doi: 10.1210/jcem-30-5-619. [DOI] [PubMed] [Google Scholar]
- Hwang P., Guyda H., Friesen H. A radioimmunoassay for human prolactin. Proc Natl Acad Sci U S A. 1971 Aug;68(8):1902–1906. doi: 10.1073/pnas.68.8.1902. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Jacobs L. S., Snyder P. J., Wilber J. F., Utiger R. D., Daughaday W. H. Increased serum prolactin after administration of synthetic thyrotropin releasing hormone (TRH) in man. J Clin Endocrinol Metab. 1971 Dec;33(6):996–998. doi: 10.1210/jcem-33-6-996. [DOI] [PubMed] [Google Scholar]
- Kamberi I. A., Mical R. S., Porter J. C. Effect of anterior pituitary perfusion and intraventricular injection of catecholamines on prolactin release. Endocrinology. 1971 Apr;88(4):1012–1020. doi: 10.1210/endo-88-4-1012. [DOI] [PubMed] [Google Scholar]
- Kansal P. C., Buse J., Talbert O. R., Buse M. G. The effect of L-dopa on plasma growth hormone, insulin, and thyroxine. J Clin Endocrinol Metab. 1972 Jan;34(1):99–105. doi: 10.1210/jcem-34-1-99. [DOI] [PubMed] [Google Scholar]
- Karlberg B., Almqvist S., Werner S. Effects of synthetic pyroglutamyl-histidyl-proline-amide on serum levels of thyrotrophin, cortisol, growth hormone, insulin and PBI in normal subjects and patients with pituitary and thyroid disorders. Acta Endocrinol (Copenh) 1971 Jun;67(2):288–302. doi: 10.1530/acta.0.0670288. [DOI] [PubMed] [Google Scholar]
- Kulin H. E., Grumbach M. M., Kaplan S. L. Changing sensitivity of the pubertal gonadal hypothalamic feedback mechanism in man. Science. 1969 Nov 21;166(3908):1012–1013. doi: 10.1126/science.166.3908.1012. [DOI] [PubMed] [Google Scholar]
- L'Hermite M., Copinschi G., Golstein J., Vanhaelst L., Leclercq R., Bruno O. D. Prolactin release after injection of thyrotrophin-releasing hormone in man. Lancet. 1972 Apr 8;1(7754):763–765. doi: 10.1016/s0140-6736(72)90519-3. [DOI] [PubMed] [Google Scholar]
- LIDDLE G. W., ESTEP H. L., KENDALL J. W., Jr, WILLIAMS W. C., Jr, TOWNES A. W. Clinical application of a new test of pituitary reserve. J Clin Endocrinol Metab. 1959 Aug;19:875–894. doi: 10.1210/jcem-19-8-875. [DOI] [PubMed] [Google Scholar]
- LaBella F. S., Vivian S. R. Effect of synthetic TRF on hormone release from bovine anterior pituitary in vitro. Endocrinology. 1971 Mar;88(3):787–789. doi: 10.1210/endo-88-3-787. [DOI] [PubMed] [Google Scholar]
- Meites J., Nicoll C. S. Adenohypophysis:prolactin. Annu Rev Physiol. 1966;28:57–88. doi: 10.1146/annurev.ph.28.030166.000421. [DOI] [PubMed] [Google Scholar]
- Mishkinsky J., Lajtos Z. K., Sulman F. Initiation of lactation by hypothalamic implantation of perphenazine. Endocrinology. 1966 May;78(5):919–922. doi: 10.1210/endo-78-5-919. [DOI] [PubMed] [Google Scholar]
- Penny R., Guyda H. J., Baghdassarian A., Johanson A. J., Blizzard R. M. Correlation of serum follicular stimulating hormone (FSH) and luteinizing hormone (LH) as measured by radioimmunoassay in disorders of sexual development. J Clin Invest. 1970 Oct;49(10):1847–1852. doi: 10.1172/JCI106402. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Santen R. J., Leonard J. M., Sherins R. J., Gandy H. M., Paulsen C. A. Short- and long-term effects of clomiphene citrate on the pituitary-testicular axis. J Clin Endocrinol Metab. 1971 Dec;33(6):970–979. doi: 10.1210/jcem-33-6-970. [DOI] [PubMed] [Google Scholar]
- Tashjian A. H., Jr, Barowsky N. J., Jensen D. K. Thyrotropin releasing hormone: direct evidence for stimulation of prolactin production by pituitary cells in culture. Biochem Biophys Res Commun. 1971 May 7;43(3):516–523. doi: 10.1016/0006-291x(71)90644-9. [DOI] [PubMed] [Google Scholar]
- Valverde R. C., Chieffo V., Reichlin S. Prolactin releasing factor in porcine and rat hypothalamic tissue. Endocrinology. 1972 Oct;91(4):982–993. doi: 10.1210/endo-91-4-982. [DOI] [PubMed] [Google Scholar]
