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. 2017 Dec 11;8:342. doi: 10.3389/fendo.2017.00342

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Copyright © 2017 Triebel, Robles-Osorio, Garcia-Franco, Martínez de la Escalera, Clapp and Bertsch.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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The figure illustrates the key principles employed by two current clinical studies with interventions into the regulation of the prolactin/vasoinhibin axis axis. (A) One trial evaluates the effect of levosulpiride on retinal outcomes in patients with diabetic macular edema and diabetic retinopathy. Levosulpiride, a dopamine D2-receptor antagonist, is used to induce an increase of pituitary prolactin (PRL)-secretion via antagonization of the inhibiting effect of dopamine on PRL-secretion (disinhibition of PRL-release). PRL can enter the eye and be cleaved to vasoinhibins, with beneficial effects in retinal outcomes in terms of reducing retinal vasopermeability and their vascular endothelial growth factor-antagonism. (B) Another trial evaluated the effect of bromocriptine on the left ventricular function in patients with peripartum cardiomyopathy. Bromocriptine was used to inhibit pituitary PRL-secretion by dopamine D2-receptor agonism. Vasoinhibins can no longer be produced by proteolytic cleavage of PRL, and their detrimental effect of the vascularization of the myocard is reduced.