Abnormal Lactation Research Articles

Total Barley Maiya Alkaloids Prevent Increased Prolactin Levels Caused by Antipsychotic Drugs and Reduce Dopamine Receptor D2 via Epigenetic Mechanisms.

Background: The dopamine D2 receptor (DRD2) plays an important role in the increased prolactin (PRL) levels associated with the pathogenesis of antipsychotic drugs (ADs). Elevated prolactin levels can affect people’s quality of life. Maiya alkaloids has been used to treat diseases associated with high PRL levels. Maiya, is a processed product of the mature fruits of Hordeum vulgare L. (a gramineous plant) after sprouting and drying and also a common Chinese herbal drug used in the clinic, is traditionally used to treat abnormal lactation, and is currently used clinically for the treatment of abnormal PRL levels. Aims: Epigenetic mechanisms can be related to DRD2 expression. We investigated the role of DRD2 methylation in the induction of PRL expression by ADs and the mechanism underlying the effects of total barley maiya alkaloids (TBMA) on this induction. Methods: The methylation rate of DRD2 in 46 people with schizophrenia who took risperidone was detected by MassARRAY sequencing. Humans were long term users of Ris. Seventy Sprague Dawley female rats were divided into seven groups. A rat model of risperidone-induced PRL was established, and the potential protective effects of TBMA and its components [e.g., hordenine (Hor)] on these increased PRL levels were investigated. The PRL concentration was detected by Enzyme-linked immunosorbent assay. PRL, DRD2, and DNA methyltransferase (DNMT1, DNMT3α, and DNMT3β) protein and mRNA expression were detected by western blotting and real-time polymerase chain reaction (RT-PCR), respectively. The positive rate of methylation in the DRD2 promoter region of rats was detected by MassARRAY sequencing. Results: Clinical studies showed that the positive rate of DRD2 methylation associated with increased PRL levels induced by ADs was significantly higher than in the normal prolactinemia (NPRL) group. In vivo and vitro, TBMA and Hor inhibited this induction of PRL expression and increased DRD2 expression by inhibiting the expression of the DNMTs. Conclusions: TBMA and hordenine increased DRD2 expression by inhibiting DNMT-dependent DRD2 methylation.

Abnormal Lactation Lengths and its Consequences on Performance of Crossbred Cattle

Background: The study was conducted to unravel the consequences of abnormal lactation lengths (Extremely short, short, prolong and extremely prolong lactation length) on production and reproduction traits of crossbred cattle (Red Dane x Sahiwal x Holstein Friesian), which otherwise remains unutilized in routine breeding data analysis owing to normalization and standardization of lactation lengths. Methods: The performance data of 2541 lactations of 1001 crossbred cattle, sired by 146 bulls over a period of 30 years maintained at the Livestock Farms of Guru Angad Dev Veterinary and Animal Sciences University (GADVASU), Ludhiana were used for this study. The data on production and reproduction traits were analysed using general linear model procedures based on extremely short ( less than 102 days), short (102-179 days), prolong (483 - 560 days) and extremely prolong (≥ 560 days) lactation lengths on the basis of mean lactation length and its standard deviation. Result: Result indicated that the alteration of lactation lengths affected all important performance traits of crossbred cattle in contemporary as well as in next lactation. The values of 305 days milk yield, lactation milk yield, average fat (%), 305 days fat yield and lactation fat yield of contemporary lactation cycle were higher (P≤0.05) for the extremely prolong lactation length and reduced for shorter lactations. Similar trend was seen for next lactation cycle of the animal having abnormal lactation length in previous lactation cycle for all traits except calf birth weight, whereas days to reach peak yield and fat yield traits were not significantly affected by lactation length classes. The preferred lactation length for crossbred cattle for optimum performance was concluded as 180 to 483 days ranging one standard deviation from mean lactation length, covering more than 72% of population; however, it needs further studies to break it into groups in terms of productive life and economical merits. Farmers should avoid breeding of animal having extremely short and short lactation lengths, as their production and reproductive traits are lower in successive production cycle.

Corticosteroid Injections: A Review of Sex-Related Side Effects.

Corticosteroid injections are used as a nonoperative modality to combat acute inflammation when conservative treatments fail. As female patients are regularly seen by orthopedic physicians, it is essential to identify and understand potential sex-related side effects. The aim of this article is to examine available literature for sex-related side effects of orthopedic-related corticosteroid injections. Although the incidence is low, sex-related side effects, such as abnormal menstruation, lactation disturbances, facial flushing, and hirsutism, are associated with corticosteroid injections. Physicians should be aware of these female-specific side effects and relay this information as part of the informed consent process. [Orthopedics. 2017; 40(2):e211-e215.].

Identified factors influencing the occurrence of abnormal lactation curves in Iranian buffaloes

Atypical lactation curves (ALCs), mostly characterized by the lack of any distinguished peak, are the subject of this study. Logistic regression was used to assess the influences of some non-genetic factors on the occurrence of ALCs in Iranian buffaloes. The data set consisted of 24,679 lactation records from 11,478 buffaloes that calved during the years 1996 to 2012. As a reasonable statistical criterion, odds and odds ratio were used to evaluate the probable differences between the various levels of the factors. Genetic analysis of the ALC trait was also carried out using Bayesian approach to estimate heritability and repeatability parameters. The results revealed that almost 44% of the lactation curves were atypical. All factors but ecotype factor had significant effects on the occurrence of ALCs. The frequency of ALCs increased until the third parity and decreased afterward, therefore the highest and the lowest values of the trait were observed in the third and 10th parities, respectively. Unlike the parity effect, ageing of the buffaloes caused the odds values to be continually increasing. The incidence of the ALCs for buffaloes calved out of season (July to December) was more likely (almost 15%) than those calved in season (January to June). The structure of the data also affected the trait significantly, such that the lactations with 4 recorded test-days were 1.75 times more likely to have atypical curves than those with 8 recorded test-days. Heritability and repeatability of the occurrence of ALCs were estimated very low and were 0.020 and 0.036, respectively.

Unexplained Massive Galactorrhea following Bilateral Subpectoral Breast Augmentation: Report of a Case

Galactorrhea, although a fairly common condition in a gravid or recently postpartum female, is rarely seen as a complication of breast augmentation or reduction. Although sporadic cases have been documented in the literature after cosmetic and reconstructive breast surgery, documented evidence of the cause of the abnormal lactation, save the identification of a pituitary prolactinoma, remains speculative at best. This case report involves a 32 y.o. Hispanic female who underwent elective bilateral subpectoral saline breast augmentation and developed massive galactorrhea in the immediate postoperative period.

Genotype by Environment Interaction for Yield and Somatic Cell Score with Alternative Environmental Definitions

Differential genetic expression in high and low opportunity Sicilian Holstein-Friesian and Brown Swiss herd environments was investigated using endogenous and exogenous variables in a set of three definitions. Results of genetic by environmental interaction were compared using alternative environmental definitions: within herd-year standard deviation for mature equivalent milk yield (HYSD), detectable incidence of normal vs. abnormal (peakless) lactation and herds clustered by causal relationships from high and low frequency use of nutrition, milking, health and animal handling practices. Data for genetic analysis consisted of first-lactation standardized yields of milk, fat and protein, and weighted somatic cell score for 8897 daughters of 825 Holstein-Friesian sires and 1143 daughters of 220 Brown Swiss sires. Components of covariance, heritabilities, and genetic correlations were estimated using bivariate and multivariate sire models for average and contrasting environments for each definition. Sire variances for yields were consistently smaller in the low opportunity environments of both breeds. Except for differential incidence of abnormal lactation in Friesian herds, correlated yield response in less privileged environments was 0.41 to 0.81 as much as in high opportunity environments, a substantial loss. Genetic correlations between HYSD environments for yield traits of Friesian were 0.48 to 0.66 but exceeded 0.80 for other definitions. Less correlated response in somatic cell score was also predicted for environments with low use of yield-enhancing practices (0.66 for Friesian and 0.61 for Brown Swiss), which may have resulted from less health care and poorer milking management. Therefore, unfavorable management interactions likely foster unequal gains from selection in contrasting environments defined exogenously or by incidence of peakless lactation. Conversely, greater genetic as well as phenotypic response is expected from additional inputs of nutrition, health care and milking management.

Targeted Inhibition of Osteopontin Expression in the Mammary Gland Causes Abnormal Morphogenesis and Lactation Deficiency

Osteopontin (OPN) is a sialic acid-rich, adhesive, extracellular matrix (ECM) protein with Arg-Gly-Asp cell-binding sequence that interacts with several integrins, including alpha(v)beta(3). Since the ECM is a key regulator of mammary gland morphogenesis, and mammary epithelial cells express OPN at elevated levels, we sought to determine whether this protein plays a role in the postnatal mammary gland development. By generating transgenic mice that express OPN antisense-RNA (AS-OPN mice) in the mammary epithelia we achieved suppression of OPN production in this organ. The pregnant AS-OPN mice displayed a lack of mammary alveolar structures, a drastic reduction in the synthesis of beta-casein, whey acidic milk protein, and lactation deficiency. In agreement with these findings, we uncovered that a mammary cell line, NMuMG, which undergoes both structural and functional differentiation on ECM-coated plates, when transfected with an antisense OPN-cDNA construct, failed to undergo such differentiation. Furthermore, the results of gel-invasion assays demonstrated that these cells manifest elevated matrix metalloproteinase (MMP) activity when OPN expression is significantly reduced. The identity of this proteinase as MMP-2 is confirmed by Western blotting, zymography, and inhibition of its activity by a specific inhibitor, TIMP-2. Taken together, our results demonstrate, for the first time, an essential role of OPN in mammary gland differentiation and that the molecular mechanism(s) of its action, at least in part, involves down-regulation of MMP-2.

Distribution of growth hormone isoforms in sera from women with normal ovarian function, galactorrhea, and normoprolactinemia

To demonstrate if GH concentrations and molecular heterogeneity of GH correlates with the presence of galactorrhea in normoprolactinemic women with normal ovarian function. Aliquots of sera from women with normal ovarian function and normoprolactinemic galactorrhea were subjected to gel filtration chromatography, and the fractions were assayed for GH by the use of radioimmunoassay. Molecular weight of isoforms was calculated on a calibration curve obtained with molecular markers. The molecular variants were characterized on the basis of elution volume, molecular weight (MW), and partition coefficient. Basal serum GH levels were moderately elevated in all six normoprolactinemic women exhibiting galactorrhea. Chromatographic study of sera from these normoprolactinemic women showed the predominance of 40 to 50 kd molecular forms of GH as well as some very low MW GH isoforms. This pattern was different from that obtained in sera from normal women without galactorrhea who presented a predominance of heavier (> 60 kd) isoforms eluted before the GH labeled standard. The monomeric forms were present in less proportion but there was no significant difference as compared with galactorrheic group. Our investigation demonstrated elevated GH basal serum levels is normoprolactinemic women with galactorrhea, and chromatography in gel showed a low proportion of the large MW GH variants associated with a higher proportion of the dimeric forms and very low MW forms of GH. This is different from normal women without galactorrhea who had a predominance of heavier MW GH variants and lesser proportion of < 16 kd isoforms. It is concluded that an increased GH secretion may be responsible for abnormal lactation despite normal PRL levels in some women with normal ovarian function.

Now what?

Now what?

Uremic Galactorrhea: an Endocrine Profile

Abnormal lactation (galactorrhea) was observed in 5 female patients with renal failure. This appeared in association with amenorrhea in the terminal stage of renal failure. Lactation gradually decreas

Diagnosis and treatment of abnormal lactation.

The literature on conditions associated with abnormal lactation is reviewed. Abnormal pituitary prolactin secretion (hPRL) is not always related to lactation. This makes it difficult to classify galactorrhea-amenorrhea on the basis of pituitary dysfunction of hPRL secretion. Pharmacologic doses of estrogen can enhance hPRL secretion and promote breast enlargement when administered with intermittent thyrotrophin-releasing hormone (TRH). Withdrawal of medication results in milk production and letdown. hPRL is thought to have a free role in the uptake of estrogens by the mammary cells. A single injection of 150 mg of medroxyprogesterone acetate every 3 months increases lactation and duration of breast-feeding. The discontinuation of oral contraceptive use may result in galactorrhea-amenorrhea in some women. Nonsteroidal drugs such as reserpine tricyclic antidepressants methyldopa and opiates can cause abnormal lactation. Abnormal lactation may also accompany treatment for precocious puberty the McCune-Albright syndrome and the juvenile postabortion period. Chromophobe adenoma acromegaly Forbes-Albright syndrome occult pituitary neoplasia and pseudoneoplasia and hypothyroidism are associated with abnormal lactation. Some of the newer tests for the study of pituitary function in cases of abnormal lactation include the TRH stimulation test the phenothiazine stimulation test and the L-dopa test. The L-arginine infusion test and the insulin tolerance test are useful for the dissociation of growth hormone- and hPRL-secreting tumors. The successful removal of pituitary adenomas has been reported to restore cyclic gonadotropin secretion and cause galactorrhea to disappear. L-dopa and ergocryptine (CB-154) therapy have been successful in treating postpill amenorrhea-galactorrhea though L-dopa treatment has numerous undesirable side effects. It is suggested that prolactin secretion directly influences the secretion of cyclic gonadotropins and that the suppression of cyclic gonadotropin secretion and hyperprolactinemia are mainly indications of a disorder of catecholamine asecretion. Drugs that inhibit hPRL secretion should not be used to treat galactorrhea-amenorrhea without a thorough and exhaustive evaluation of prolactin secretion estrogen production and cyclic gonadotropin secretion.

Drugs that affect the breast and lactation.

Drugs that are known to affect breast morphology or breast secretion may be classified into 2 major groups: 1) drugs having a central action on the pituitary or hypothalamus and 2) steroids and several other compounds that act peripherally. Drugs in the 1st group affect lactation through stimulation or suppression of the lactogenic pituitary hormone prolactin. Their action may be directly on the pituitary or indirectly on the hypothalamus where the secretion of hypothalamic prolactin-inhibiting factor is affected. Drugs in the 2nd group act peripherally by exerting their action mainly at the level of breast tubules and acini. The most frequently used are estrogens which stimulate growth of the breast and suppress lactation, and suppress breast cancer in some women. Centrally acting drugs which cause galactorrhea also cause an increase in prolactin secretion, but the presence of estrogen-primed breast tissue is needed. A list of such drugs (including rauwolfia and phenothiazine derivatives, and opiates) is given. The most common mechanism of action by which psychotropic drugs increase prolactin secretion is by interfering with formation or release of dopamine from hypothalamus neurons and its subsequent action via an alpha-adrenergic receptor on hypothalamic cells that secrete prolactin-inhibiting factor. Reserpine and other rauwolfia drugs deplete hypothalamic neurons of catecholamines and prevent their reuptake by nerve endings. Phenothiazines interfere with the action of catecholamines at the alpha-adrenergic receptor sites. Prolonged use of drugs that stimulate pituitary activity may lead to formation of microadenomas of the pituitary. Continuation of galactorrhea for more than 2 weeks after stopping therapy suggest this result. L-dopa suppresses abnormal lactation by reduction in serum prolactin levels. Br-ergocryptine, an ergot derivative, has galactorrhea-blocking and prolactin-suppressing activity but is devoid of alpha-adrenergic activity. Barbiturates and pyridoxine may cause decrease in milk flow of nursing mothers. Peripherally acting drugs consist of estrogen, progesterone, and androgen as well as hypoglycemic-producing agents, thyroid hormone, corticosteroids, and spironolactone. Estrogen is the only steroid effective in suppression of puerperal lactation. There are several steroids effective in causing remission of breast cancer. The presence of an intact pituitary is apparently necessary if estrogens are to be effective in breast cancer. Corticosteroids may be effective in patients insenstive to sex hormones. Cytotoxic agents may be more effective when used in combination with corticosteroids. Galactorrhea occurring in a nulliparous woman taking oral contraceptives is always abnormal and suggests the possibility of a pitutitary tumor. Women with postpill galactorrhea-amenorrhea may also have such tumors. All cases of galactorrhea when sex hormones have been used should be studied for pituitary tumor.

Pituitary prolactin in pregnancy and normal and abnormal lactation.

Departments of Medicine and Obstetrics and Gynecology, McGill University, Royal Victoria Hospital, Montreal, Canada

Abnormal lactation.

Journal Article Abnormal Lactation Get access HELEN MARIESKIND, M.P.H. HELEN MARIESKIND, M.P.H. School of Public Health, University of CalforniaLos Angeles, California, 90024 Search for other works by this author on: Oxford Academic PubMed Google Scholar Journal of Tropical Pediatrics, Volume 19, Issue 2, June 1973, Pages 123–128, https://doi.org/10.1093/tropej/19.2.123 Published: 01 June 1973

Effect of oestrogen upon parturition, maternal behaviour and lactation in ovariectomized pregnant rats.

SUMMARY Ovariectomy of rats on day 20 of pregnancy impaired parturition and lactation. All rats showed prolonged delivery with many foetuses born dead and the mothers were unable to rear the young. Treatment with oestradiol benzoate (0·5 or 1 μg) in a single dose permitted normal delivery and lactation when the hormone was injected immediately after ovariectomy. Oestrogen administered the day after ovariectomy was not effective. The administration of prolactin and corticotrophin to ovariectomized pregnant rats did not prevent abnormal parturition but lactation improved in 50% of the mothers. A group of animals ovariectomized on day 20 was treated with oxytocin every 2 h on day 22 starting at 08.00 h. This treatment did not facilitate parturition and lactation. Maternal behaviour, which was always present in the other groups, was also impaired by this treatment. When ovariectomy was performed on the evening of day 21 of pregnancy, a partial impairment of parturition was observed but lactation was normal in seven out of eight rats. The results indicate that oestrogen is essential near term for normal parturition and lactation. The absence of the steroid may make the uteri less sensitive to oxytocic substances and also affect milk ejection.

Endocrine manifestation of pulmonary carcinoma in a Nigerian.

Bronchogenic carcinoma is an uncommon neoplasm in the Nigerian. Endocrine manifestations of pulmonary neoplasm are even more uncommon in Nigerians or elsewhere. The association of gonadotrophin activity with an anaplastic carcinoma of the lung in a 25-year-old Nigerian housewife forms the basis for this communication. The successful removal of a left lower lobe neoplasm in the patient who had manifested with menometrorrhagia and abnormal breast lactation was followed by a normal pregnancy and delivery of a normal baby boy within 12 months following the lobectomy.

Human prolactin.

IN 1954, Forbes et al.1 described a syndrome of abnormal lactation and amenorrhea in 15 patients, many of whom had pituitary tumors. Although the authors suggested that the tumors were producing excessive quantities of prolactin, only recently has enough evidence accumulated to substantiate the existence of the human hormone. In lower vertebrate forms, on the other hand, it has long been realized that pituitary prolactin is an important hormone with diverse functions in reproductive physiology.2 In the euryhaline fish, which migrate from salt to fresh water during reproduction, prolactin inhibits sodium efflux, preventing a dilutional hyponatremic state. Hypophysectomized fish cannot . . .

Abnormal Lactation with Cushing's Syndrome—A Case Report1

ABSTRACT A 29-yr-old patient with abnormal lactation was studied on several occasions. The onset of abnormal lactation followed a normal pregnancy. During the first hospitalization the sella turcica and various urinary and plasma steroid levels were within normal limits and a diagnosis of Chiari-Frommel syndrome was made. Subsequently, the patient developed headaches and visual disturbances and showed an enlarged sella turcica due to a chromophobe adenoma of the pituitary. At this time urinary steroids and cortisol secretion rate showed marked elevation. This case represents a Chiari-Frommel syndrome which ultimately developed in complex of hyperadrenocorticism, secondary amenorrhea and persistent lactation.

Spectrum of nonpuerperal galactorrhea: report of two cases evolving through the various syndromes.

ABSTRACT Unphysiologic lactation with amenorrhea is a poorly understood disorder which is further confused by loosely applied eponyms. This report details the clinical course of 2 patients who manifested symptoms of the various accepted syndromes of inappropriate lactation and subsequently developed Cushing's syndrome with enlargement of the sella. Chromophobe adenomas were removed from both patients, with resolution of lactation and Cushing's syndrome. These cases demonstrate both the importance of prolonged follow up of abnormal lactation and the artificiality of the present eponymic classification. It is suggested that lactation associated with Cushing's syndrome is indicative of an underlying pituitary tumor, even in the absence of sellar enlargement.

Galactorrhea and Abnormal Menses Associated With a Long-Acting Progesterone

WE RECENTLY reported the propensity of medroxyprogesterone acetate (Depo-Provera) for causing missed abortion. 1 Subsequent menstrual abnormalities were noted in 15 of 22 such patients, observations also noted by others. 2-4 During our investigation of 58 patients treated with medroxyprogesterone, we uncovered another endocrine abnormality—persistent puerperal galactorrhea. Although other drugs have been associated with this condition, we know of no published report of abnormal lactation associated with medroxyprogresterone. This communication will present five cases in which galactorrhea developed following administration of medroxyprogesterone, as well as the menstrual response in the 36 cases not previously reported. Methods and Materials During 1964 and 1965, fifty-seven patients who received medroxyprogesterone for threatened abortion were investigated. The women ranged in age from 21 to 41 years and in parity from 0 to 10. Fifty or 100 mg weekly doses of medroxyprogresterone acetate were initiated during the first trimester in 44 patients and during the