Pretreatment Serum Prolactin Research Articles

Serum prolactin levels in psoriasis and its association with disease activity: a case-control study.

Background:Psoriasis is a T-cell-mediated autoimmune chronic skin disorder in which an environmental factor, perhaps a viral antigen, induces T cells to produce cytokines. These cytokines stimulate keratinocyte proliferation and production of antigenic adhesion molecules in the dermal blood vessels. Several mediators and hormones have been implicated in keratinocyte hyperproliferation and among these hormones, prolactin (PRL) has been found to have an effect on epithelial cells, lymphocytes and keratinocytes, thus an effect on the etiopathogenesis of psoriasis.Aim:The present study was designed to compare serum PRL levels in psoriatic patients with a control group.Settings and Design:This study was a hospital-based case control study, conducted in the department of Dermatology, STD and Leprosy, SMHS Hospital (Associated teaching hospital of Government Medical College Srinagar) over a period of 1 year, from September 2012 to 2013.Materials and Methods:The present study included 60 patients of psoriasis (42 males and 18 females) and 60 controls matched for age and sex. Serum PRL levels of patients and controls were measured by ECLIA and inferences were drawn.Statistical Analysis Used:Statistical significance of the results was carried out by the Chi-square test and the independent samples t-test. Statistical significance was determined at a level of P < 0.05.Results:Serum PRL levels were significantly increased in patients as compared to the control group (P value: 0.002). There was a positive correlation between pretreatment serum PRL levels and PASI score (r value: 0.379; P value: 0.003). An insignificant association was found between the pretreatment PRL level and serum PRL level after treatment (P value: 0.22). Also, a negative correlation between the duration of psoriasis and serum PRL was seen (r value: -0.008; P value: 0.954).Conclusion:PRL may have a role to play in the etiopathogenesis of psoriasis. However, further studies with large sample size should be carried out so as to validate this hypothesis.

Serum prolactin levels in psoriasis and correlation with cutaneous disease activity

Prolactin (PRL), a neuropeptide secreted by the anterior pituitary gland, possesses a variety of physiological actions. It has been implicated as an important immunomodulator and exerts a proliferative effect in cultured human keratinocytes via specific receptors. Some studies have indicated an increase in serum PRL levels in psoriasis and exacerbation of psoriasis when a prolactinoma is present. To evaluate the correlation between serum PRL levels and Psoriasis Area and Severity Index (PASI). Serum PRL levels were measured in 20 patients (10 mean, 10 women, age range 18-88 years) with plaque-type psoriasis before and after a 6-week period of topical treatment with tacalcitol ointment. Results were compared with a group of 20 healthy volunteers. Serum PRL levels were significantly increased in the psoriatic group compared with the control group (P < 0.001) and were significantly reduced after treatment (P = 0.001). There was a correlation between pretreatment serum PRL levels and PASI (r = 0.33; P = 0.02). These results indicate that serum PRL levels may serve as a biological marker of psoriatic disease activity.

Effects of Short‐term Hyper‐ and Hypoprolactinaemia on Hormones of the Pituitary, Gonad and ‐Thyroid Axis and on Semen Quality in Male Beagles

Effects of a short-term hyper- and hypoprolactinaemia on serum concentrations of LH, testosterone and semen quality in six male Beagles were investigated. Blood samples were collected at 3-day intervals for 12 weeks. The time span was divided into five 3-week periods: pre-treatment, metoclopramide (MCP) treatment (0.2 mg/kg orally three times daily), cabergoline (CAB) treatment (5 microg/kg orally once daily), post-treatment 1 and post-treatment 2. In the latter, only semen characteristics were evaluated. Semen parameters were analyzed once per week during the whole 15-week investigation time. At the end of each period, the effects of a single intravenous injection of thyrotropin-releasing hormone (TRH; 10 microg/kg) on the secretion of prolactin (PRL), LH, testosterone, thyroid-stimulating hormone and thyroxine (T4) were investigated. Pre-treatment serum PRL concentration increased under MCP (p < 0.05), followed by a decrease under CAB administration (p < 0.05). Luteinizing hormone and testosterone concentrations were not affected. Except for straight-line sperm velocity, semen quality did not differ between collection periods. A single iv TRH injection induced a significant PRL increase at 20 min in all experimental periods except during CAB treatment. Luteinizing hormone and testosterone did not show clear TRH-related changes. Basic T4 levels were significantly reduced after CAB treatment (p < 0.05). The results of the present study demonstrate that MCP-induced short-term hyperprolactinaemia in male beagles does not seriously affect the hypothalamo-pituitary axis and semen quality.

Giant prolactinomas in men: efficacy of cabergoline treatment.

The term 'giant prolactinoma' can be used for tumours larger than 4 cm in diameter and/or with massive extrasellar extension. Cabergoline (CAB), a long-lasting dopamine agonist (DA), safe and well tolerated, is effective in normalizing PRL levels and inducing tumour shrinkage in micro- and macroprolactinomas. The purpose of this prospective study was to evaluate the efficacy and safety of CAB also for giant prolactinomas. Ten men with giant prolactinomas with a median age of 44.8 years were treated with CAB. Before CAB, four patients had previously undergone transsphenoidal surgery without modifying the parasellar extension of the tumour or their visual defects. Pretreatment serum prolactin (PRL) levels ranged between 1230 and 22 916 micro g/l (mean +/- SEM: 5794 +/- 1996) and tumour volume was between 21.8 and 105.5 cm3 (mean +/- SEM: 50.7 +/- 8.8). CAB was administered at an initial low dose of 0.5 mg three times a week and, in five patients who did not achieve serum PRL normalization, the dose was progressively increased up to 10.5 mg/week. The duration of treatment was 13-68 months (mean 38.9). PRL levels and pituitary target organ hormones were assayed before, after 30 days and then every 3 months after the beginning of CAB treatment. Magnetic resonance imaging (MRI) was carried out before, after 1-3 months, after 6 months and then every 10-12 months to evaluate tumour shrinkage. In every patient, a significant PRL decrease (P = 0.0086) of at least 96% of the pretreatment values occurred (from 5794 +/- 1996 to 77 +/- 38, mean +/- SEM); a persistent normalization of PRL levels was achieved in five out of 10 patients (50%) beginning from the first 3-6 months of CAB treatment (only one patient needed 12 months of therapy). A significant tumour shrinkage (P = 0.0003) was achieved after 12 months of therapy in nine out of 10 patients (90%), with a volume reduction greater than 95% in three, of 50% in four and 25% in two patients. Tumour volume decreased from 50.7 +/- 8.8 to 28.6 +/- 9.4 and then to 22.3 +/- 8.8 cm3 (mean +/- SEM) after 6 and 12 months of CAB treatment, respectively. An improvement of visual field defects (VFD) was obtained in six of the seven patients presenting visual impairment before CAB treatment. Among the eight patients presenting libido and potency (L-P) failure, five normalized their PRL levels. In two of these a complete restoration of libido and potency was observed. Three patients with secondary hypoadrenalism and a patient with secondary hypothyroidism were treated with substitutive therapy during all the study time. The drug was well tolerated by all patients and no one discontinued the therapy. These data suggest that, in giant, aggressive prolactinomas, CAB represents a first-line therapy effective in reducing PRL levels and determining tumour shrinkage.

Nonstandard and adjunctive medical therapies for systemic lupus erythematosus

Nonstandard and adjunctive medical therapies for systemic lupus erythematosus

Recent life stressors and biological markers in newly admitted psychotic patients

The association of recent life stressor severity to putative biological markers of stress was examined in 34 newly admitted patients with acute psychosis. Of the biological variables examined, only pretreatment admission serum cortisol was correlated with stressor severity. Pretreatment serum prolactin, plasma homovanillic acid (HVA), and methoxyhydroxyphen-ethylglycol were not associated with severity of recent life stressors. We controlled for clinical and psychosocial variables that might affect the relationship of stressor severity to biological markers, and found that duration of psychotic symptoms was negatively correlated with stressor severity; however, when both cortisol and duration were entered in a stepwise multiple regression analysis, only pretreatment admission cortisol remained significantly and positively correlated with stressor severity. These findings suggest that serum cortisol may be a useful biological marker when investigating the relationship of life stress to episode onset. In addition, pretreatment HVA was correlated with early neuroleptic response but not with stressor severity, suggesting that HVA has value as a predictor of response independent of recent life stressors.

The effect of the ergoline derivative, CU 32-085, on prolactin secretion in hyperprolactinemic women

Twelve hyperprolactinemic women were administered the α aminoergoline derivative, CU 32-085 (Sandoz, Inc., East Hanover, NJ), in order to determine its effect on prolactin (PRL) secretion. The mean pretreatment serum PRL level was 145.0 ± 11.5 ng/ml. Significant declines of serum PRL occurred with total daily doses of CU 32-085 of 0.1 to 0.5 mg ( P < 0.001). The magnitude of response to therapy was dose-related. In six patients, PRL levels were reduced to less than 25 ng/ml; this effect lasted at least 24 hours after intake of a single dose. In the other six patients, the response was less dramatic. No subjects developed adverse cardiovascular side effects. The results of this study demonstrate that CU 32-085 exhibits a clinically significant dopaminomimetic action on PRL secretion in hyperprolactinemic women.

Increased serum prolactin but normal TSH during prolonged domperidone treatment in children.

The influence of the dopamine receptor blocking agent domperidone on prolactin and TSH secretion was studied in 16 infants, aged 10-360 days, who were treated for gastroesophageal reflux. The pretreatment serum prolactin levels were not statistically different from the levels in age-matched controls and showed the well-known inverse relationship with age. During treatment with domperidone a significant increase in prolactin level was observed on days 1, 4 and 21-28, the mean values on these three days not being statistically different. No correlation could be found between the serum prolactin levels and the corresponding plasma domperidone levels. One infant of this series and three not included in this series developed reversible breast hypertrophy with galactorrhoea in three of them: in none of them was the prolactin level, corrected for age, above 1 SD of the mean. All had received relatively high doses of domperidone. In 13 patients domperidone did not influence TSH secretion.

Sexually differentiated actions of 3-PPP enantiomers on prolactin secretion

The ability of the enantiomers of the atypical dopamine receptor agonist 3-(3-hydroxyphenyl)-N-n-propylpiperidine (3-PPP) to counteract gamma-butyrolactone-induced hyperprolactinemia was compared in male and female rats. Following gamma-butyrolactone (GBL) pretreatment serum prolactin concentrations were higher in female than in male rats. In males (−)-3-PPP tended to be somewhat less effective than (+)-3-PPP in decreasing serum prolactin concentrations (levels after (+)-3-PPP and (−)-3-PPP: 21 % and 33 %, respectively, of levels in GBL-pretreated controls). In females the (−)-form induced a much weaker response than did the (+)-form (levels after (+)-3-PPP and (−)-3-PPP: 8 % and 74 %, respectively, of levels in GBL pretreated controls). Parallel experiments replacing GBL by reserplne yielded similar results. Data are discussed in terms of sex differences in responsiveness of pituitary dopamine receptors.

The relationship between serum prolactin and immunocytochemical staining for prolactin in patients with pituitary macroadenomas.

We have studied the relationship between mean pretreatment levels of serum prolactin and the presence of positive immunohistochemical staining for prolactin in the pituitary tumours of 55 patients. Pretreatment serum prolactin was significantly higher in patients with tumours showing many prolactin immunostaining cells than in those with none (P less than 0.001). When the pretreatment serum prolactin exceeded 6000 mU/l, the tumours contained over 90% of prolactin positive cells; one patient was an exception who had received long-term high dose bromocriptine therapy, and her tumour showed only occasional cells with positive staining. When the pretreatment serum prolactin level was under 2500 mU/l, a tumour was found which showed either no cells or fewer than 1% of cells which stained for prolactin. There was no significant difference in pretreatment serum prolactin levels between 11 patients with craniopharyngiomas and 34 patients with pituitary macroadenomas showing no prolactin immunostaining. Seventy-one percent (32) of the 45 patients with craniopharyngiomas or tumours with negative immunostaining for prolactin, had raised pretreatment serum prolactin levels (above 360 mU/l) although this was usually only slightly elevated; the levels exceeded 2500 mU/l in six (13%) of them (two craniopharyngiomas, four pituitary tumours) but in none did the levels exceed 6000 mU/l. Four of the 55 pituitary tumours showed occasional cells (less than 1%) that stained positively for growth hormone. In none of the patients with these tumours was there evidence of acromegaly or pathologically elevated circulating growth hormone levels.

Altered pulsatile secretion of luteinizing hormone in hypogonadal men with hyperprolactinaemia.

To explore the mechanism for the hypogonadism associated with prolactin hypersecretion in men we examined luteinizing hormone (LH) secretory profiles in four hyperprolactinaemic men before and during treatment with bromocriptine. Pretreatment serum prolactin levels were increased 4-100 fold and serum testosterone levels were low in three men and low-normal in the fourth subject. Mean LH levels were low-normal and the frequency of spontaneous LH secretory episodes was less than normal in three of four men. Bromocriptine reduced serum prolactin levels to normal; subsequently, serum testosterone levels increased and libido and potency improved markedly in each man. The rise in serum testosterone levels was associated with an increase in mean LH concentrations and in LH pulse frequency. Mean follicle-stimulating hormone levels also increased during bromocriptine treatment. Insofar as each LH pulse is believed to reflect a discharge of gonadotrophin releasing hormone from the anterior hypothalamus, our data suggest that a major abnormality in hyperprolactinaemic men with hypogonadism is a disorder of the neuroregulatory mechanism for pulsatile gonadotrophin-releasing hormone secretion.

BROMOCRIPTINE TREATMENT OF OLIGOSPERMIA: A DOUBLE BLIND STUDY

A double blind controlled study of bromocriptine treatment of oligospermia was carried out. Out of fifty-one men who originally volunteered to the study there were forty who took the drug for 12 weeks as requested. All the partners of these men had failed to conceive, and in each case the pretreatment sperm count had been below 40 million/ml on two or several occasions. The pretreatment serum prolactin concentrations were similar in patients given bromocriptine (N = 20) and placebo (N = 20). There were three men in either group whose pretreatment serum prolactin concentration was in excess of 30 micrograms/l, the highest value being 96 micrograms/l. While bromocriptine effectively decreased the serum prolactin concentration, it had no significant effect over placebo on sperm volume, motility and morphology. In the bromocriptine group, sperm count increased to or above 40 million/ml in five out of twenty men, while in the placebo group this occurred in nine out of twenty patients. The plasma testosterone and dihydrotestosterone levels increased slightly during treatment in both groups, but no significant difference was observed between bromocriptine and placebo treated patients. One wife of a bromocriptine-treated man and two wives of placebo-treated men became pregnant during treatment. In this study bromocriptine was no more effective than placebo in the treatment of oligospermia.

L-Dopa effects on serum LH and prolactin in old and young female rats.

Serum LH and prolactin changes in response to an acute systemic L-dopa injection were measured in young (4-6 months) proestrous, estrous and 2nd day diestrous rats, and in aged (23-30 months) constant estrous and pseudopregnant (long diestrous) Long-Evans rats. Serum LH and prolactin were measured by radioimmunoassays in serial blood samples taken before and 15, 60 and 120 min after i.p. injections of 0, 3 or 30 mg of L-dopa. Pretreatment serum prolactin levels were elevated in afternoon samples from young proestrous and estrous rats and in both aged groups. Both the 3- and 30-mg injections caused a reduction in serum prolactin in all groups. The reduction in serum prolactin following 3 mg of L-dopa was less in both the aged groups than in the young rats. The pretreatment serum LH concentration was markedly elevated only on the afternoon of proestrus. The pretreatment serum LH level of the aged constant estrous group was greater than that of either the young estrous or diestrous group. Pretreatment serum LH levels were lower in aged pseudopregnant rats than in young diestrous rats. After the 30-mg L-dopa injection serum LH increased in all groups except the aged pseudopregnant group. Although the increase in LH following L-dopa injection was similar in young estrous and aged constant estrous rats, the increase in serum LH occurred later and lasted longer in the latter group. These data indicate that the hypothalamic-anterior pituitary endocrine control mechanisms are less responsive to acute L-dopa treatment in the aging female rat.