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R N Clayton

Introduction

Acromegaly is an uncommon condition with a prevalence in European populations of about 40 per million, and an incidence of four to six new cases per million population per year. The vast majority (99%) of cases of acromegaly are due to a pituitary somatotrophinoma, the occasional rare case being caused by ectopic production of growth hormone-releasing hormone by bronchial carcinoid, pancreatic neuroendocrine, or hypothalamic tumours, giving rise to somatotroph hyperplasia. The onset of the condition is most often very insidious, especially so in the older patient; photographs may reveal evidence of acral expansion 5–10 years before biochemical confirmation of the diagnosis. This long exposure of tissues to excessive secretion of growth hormone (GH) before treatment may be significant with respect to the long-term mortality outcome. Furthermore, it may also explain why about 60–70% of somatotrophinomas are macroadenomas (>1 cm in diameter) at diagnosis, and only a minority (30–40%) are

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R. N. Clayton

Introduction

In the last decade much has been learned about the physiology and cellular biology of gonadotrophin-releasing hormone (GnRH). It is the first of the 'classical' hypothalamic releasing hormones to be widely used in clinical practice and, moreover, in diverse conditions. Its administration in a pulsatile, physiological manner is the most effective treatment for hypogonadotrophic anovulation (for revew see Clayton, 1987). However, greater application, from contraception to cancer therapy, has been achieved by continuous administration of long-acting agonist analogues, which rapidly induce gonadotroph desensitization (see below). While the principal target for GnRH action is the anterior pituitary gonadotroph, GnRH-binding sites and effects have been observed in other tissues. Although this review concentrates on the pituitary, I shall briefly discuss the extrapituitary actions of GnRH at the end.

At the outset it is important to recognize that GnRH has important actions on the gonadotroph in addition to releasing luteinizing hormone (LH). It is

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R. N. Clayton and L. C. Bailey

ABSTRACT

The effect of somatostatin on GH-releasing factor (GRF)-induced desensitization of somatotrophs was studied in vitro. Primary cultures of rat anterior pituitary cells pretreated for 4 or 18 h with GRF(1–40) (100 nmol/l) showed a 50% or greater reduction in maximal GH release when rechallenged with 10 nmol GRF/l. Rechallenge GRF dose–response curves were either very flat, making accurate measurement of the dose giving 50% maximum stimulation (ED50) impossible, or the ED50 concentration was increased from 0·3 nmol/l (untreated) to 2 nmol/l (GRF pretreated). Although GRF pretreatment reduced cellular GH content by 40–50%, correction for this did not restore GRF responsiveness measured in terms of maximal GRF-stimulated/unstimulated GH release (maximal/basal ratio), or the GRF ED50 concentration. Maximal/basal GH release per 4 h from GRF-pretreated cells was reduced when cells were rechallenged with forskolin (5 μmol/l) or calcium ionophore (A23187; 10 μmol/l), to the same extent as when rechallenged with 10 nmol GRF/l. Although this might be explained by a reduction in the pool of releasable GH, an alternative explanation is that pretreatment with GRF disrupts the GH release mechanism(s) at a common step(s) beyond cyclic AMP generation and Ca2+ influx.

Co-incubation of cells with somatostatin and GRF (100 nmol/l) partially reversed the desensitizing action of GRF during both 4- and 18-h pretreatments in a dose-dependent manner, with 1 μmol somatostatin/l being most effective. Maximal GRF (100 nmol/l)-stimulated/basal GH release was 4·4 ± 1·0 (mean ± s.e.m., n = four experiments), 1·55 ± 0·09 and 2·43 ± 0·1 for control, GRF-pretreated (4 h) and GRF plus somatostatin-pretreated cells respectively. Comparable values for cells pretreated for 18 h were 3·66 ± 0·44 (n = three experiments), 1·78 ± 0·28 and 3·04 ± 0·04 for control, GRF- and GRF plus somatostatin-pretreated cells. Somatostatin reduced the 50% depletion of cellular GH caused by GRF pretreatment to 15–20%, as well as attenuating GH released during the pretreatment period by 40 ± 5% (mean ± s.e.m., n = seven experiments). Somatostatin restored somatotroph sensitivity of GRF-desensitized cells indicating that, in addition to reversing depletion of the releasable pool of GH, the counter-regulatory hormone also prevents disruption of post-receptor cellular biochemical events which remain to be identified. These results add to the list of GRF actions inhibited by somatostatin and suggest a potentially important role for somatostatin in vivo to maintain somatotroph responsiveness to GRF.

J. Endocr. (1987) 112, 69–76

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R. N. Clayton and L. C. Bailey

Measurement of pituitary gonadotrophin releasing hormone (Gn-RH) receptor content provides a qualitative index of prior exposure of the pituitary gland to endogenous Gn-RH. The effect of moderate hyperprolactinaemia (serum prolactin = 95–250 μg/l), achieved with three pituitary grafts beneath the renal capsule, on the pituitary Gn-RH receptor content and serum LH responses to gonadectomy of adult rats has been studied. In males the presence of hyperprolactinaemia for 7 days completely prevented the increase in Gn-RH receptor content 3 days after castration and inhibited the serum LH rise by 45%. By 6 days after castration, Gn-RH receptors had increased in the hyperprolactinaemic castrated animals but values were 33% lower than in sham-grafted controls, while the serum LH increase was attenuated by 30%. Pituitary LH content was also lower in grafted castrated animals 6 days after castration. Hyperprolactinaemia for 3 weeks had no effect on Gn-RH receptors or pituitary LH content of intact male rats, although basal serum LH was decreased by 50%. Hyperprolactinaemia also attenuated the increases in Gn-RH receptors, serum LH and pituitary LH which occurred 6 days after ovariectomy in female rats. In all experiments the pituitary content of prolactin was reduced by 80–90% in animals bearing pituitary grafts. These results suggest that hyperprolactinaemia restricts the Gn-RH receptor response to gonadectomy by decreasing endogenous hypothalamic Gn-RH secretion.

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R. N. Clayton and L. C. Bailey

ABSTRACT

The effect of drug-induced hypo- and hyperprolactinaemia on pituitary gonadotrophin releasing hormone receptors (GnRH-R), serum and pituitary gonadotrophins (LH and FSH) and prolactin was investigated in intact adult male and female rats. Hypoprolactinaemia (serum prolactin <20% of control values) resulting from dopamine agonist (bromocriptine) infusion (4 mg/kg per day for 7 days) was accompanied by a 40–50% increase in GnRH-R in both male and female animals, though this was not accompanied by any major change in serum or pituitary LH and FSH. Hyperprolactinaemia (serum prolactin greater than ten times control values) induced by the dopamine receptor antagonist metoclopramide (65 mg/kg per day for 7 days) increased GnRH-R between 35 and 45% in both male and female rats without altering serum gonadotrophins. Domperidone (1 mg twice daily for 14 days) also increased GnRH-R by 50% but only in female rats. Both dopamine antagonists significantly increased pituitary prolactin content. Pituitary FSH increased in female rats treated with both metoclopramide and domperidone.

The stimulatory effects of bromocriptine and metoclopramide on GnRH-R in male rats were prevented by concurrent treatment with a GnRH antiserum, suggesting that the drug effects were mediated through alteration in endogenous GnRH secretion.

Induction of massive (serum prolactin > 2000 μg/l) hyperprolactinaemia in male and female rats with a transplantable prolactin-secreting pituitary tumour did not reduce GnRH-R concentration, although serum gonadotrophins were suppressed and pituitary gonadotrophin content was increased.

These results indicate a dissociation between serum prolactin concentrations and pituitary GnRH receptor content and indicate that dopamine agonist and antagonist agents can influence GnRH-R independently of prolactin, possibly by acting on central dopamine receptors responsible for catecholaminergic regulation of GnRH secretion.

J. Endocr. (1984) 102, 215–223

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G. Saade, D. R. London and R. N. Clayton

ABSTRACT

The effect of oestradiol-17β on the hypothalamo-pituitary axis of intact adult male rats was studied. A single injection of oestradiol did not change the serum LH response to gonadotrophin-releasing hormone (GnRH) 48 h or 7 days after the injection, while administration of oestrogen over 66 days suppressed basal serum LH to <3·1 μg/l and did not enhance the LH response to GnRH at any time.

Treatment of ovariectomized rats with oestradiol capsules, however, enhanced the LH response to GnRH on days 3 and 14 of the treatment as compared with the control group (P<0·02 and P<0·05 respectively). Long-term treatment with oestradiol suppressed intrapituitary LH and FSH contents as well as pituitary GnRH receptors (P<0·0004, P<0·005 and P<0·001 respectively), whereas serum and intrapituitary prolactin levels were increased. To exclude the possible inhibitory effect of hyperprolactinaemia on LH responsiveness to GnRH, oestradiol-implanted rats were treated with bromocriptine. This prevented the rise in serum prolactin, but failed to enhance the LH response to GnRH.

Neither short- nor long-term treatment with oestradiol given under conditions shown to be effective in female animals stimulated the hypothalamo-pituitary-gonadotrophin axis in adult male rats.

J. Endocr. (1987) 114,95–101

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L. S. Young, S. I. Naik and R. N. Clayton

ABSTRACT

Exogenous cyclic adenosine nucleotides increase gonadotrophin-releasing hormone (GnRH) receptors in intact cultured rat pituitary cells in a similar manner to that observed with GnRH itself. In this study the calcium and microtubule dependency of GnRH receptor up-regulation was examined in vitro. Treatment of pituitary cells in Ca2+ and serum-containing media with either GnRH (1 nmol/l), K+ (58 mmol/l) or dibutyryl cyclic AMP (dbcAMP; 1 mmol/l) for 7–10 h routinely resulted in a 50–100% increase in GnRH receptors. Incubation of pituitary cells with the calcium channel blocker verapamil, for 7 h, or the calcium chelator EGTA, for 10 h, had no effect on basal receptor levels but prevented the increase in GnRH receptors stimulated by either GnRH, K+ or dbcAMP. Luteinizing hormone release measured with the same stimulators over a 3-h period was prevented by both verapamil and EGTA. Calcium ionophore (A23187) increased GnRH receptors by 40–60% at low concentrations (10 and 100 nmol/l) while higher concentrations (10 and 100 μmol/l) reduced receptor levels. Luteinizing hormone release was not increased by receptor-stimulating concentrations of A23187, but was by higher concentrations (10 μmol/l). None of these pretreatments, for up to 10 h, impaired the subsequent LH response of the cells to increasing doses of GnRH.

Vinblastine (1 μmol/l did not affect basal receptor levels but markedly reduced the increase in GnRH receptors stimulated by GnRH, K+ and dbcAMP. This concentration of vinblastine had no effect on LH release. These results indicate that receptor stimulation by GnRH, K+ and dbcAMP is a calcium-dependent process requiring the integrity of the microtubule system and there is a different calcium requirement for the processes of GnRH receptor up-regulation and LH secretion.

J. Endocr. (1985) 107, 49–56

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S. I. Naik, G. Saade, A. Detta and R. N. Clayton

ABSTRACT

A single injection of gonadotrophin-releasing hormone (GnRH) (60 ng s.c., 42·9 nmol) induced biphasic GnRH receptor regulation in normal intact adult female mice. A transient 22% receptor decrease occurred 30–60 min after injection of GnRH when peak serum decapeptide concentrations were reached (137 ± 41 (s.e.m.) ng/l). This GnRH receptor decrease occurred shortly after the peak serum LH values at 15–30 min. The subsequent rapid (within 1 h) return of GnRH receptor levels to normal suggested transient receptor occupancy by GnRH rather than true receptor loss. At 8 h after injection of GnRH a significant 35% increase in GnRH receptors was consistently observed, when serum GnRH levels were undetectable and serum LH had returned to basal levels. This receptor increase was not due to increased receptor affinity, and was prevented by a non-specific protein synthesis inhibitor.

Ovariectomy, which caused a 50% fall in GnRH receptors (59·4 ± 4·9 fmol/pituitary gland in intact controls; 26·9 ± 2·6 in ovariectomized mice) abolished the induction by GnRH of its own receptors, although the initial transient decrease occurred over the period of the acute serum LH and FSH rise. Despite a 50% reduction in GnRH receptors in ovariectomized mice, increased serum gonadotrophin levels and responsiveness to GnRH were maintained, indicating dissociation between receptor changes and gonadotrophin levels.

No GnRH receptor up-regulation was observed 8 h after a single GnRH injection (60 ng s.c.) in either intact or orchidectomized normal male mice. However, the same treatment doubled GnRH receptors in GnRH-deficient (hpg) female mice.

While GnRH appears to up-regulate its own receptors by a direct action on pituitary gonadotrophs in the GnRH-deficient mouse its action in the normal female mouse pituitary appears secondary to stimulation of a gonadal product, presumably oestrogens.

J. Endocr. (1985) 107, 41–47

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S. E. Inkster, R. N. Clayton and S. A. Whitehead

ABSTRACT

The effects of neonatal monosodium l-glutamate (MSG) treatment on pituitary responsiveness to LH-releasing hormone (LHRH) and on pituitary LHRH receptors have been investigated in the intact adult female rat. Three- to four-month-old rats treated with MSG (4 mg/g body wt) on days 2, 4, 6, 8 and 10 after birth had significantly reduced ovarian and pituitary weights, showed an absence or disruption of ovarian cyclicity after puberty, and had significantly higher concentrations of serum prolactin despite normal levels of LH. In-vitro pituitary LH responses to LHRH were in the normal range for one group of treated animals whilst in a second group the LH responses were markedly enhanced. In contrast, the total number of pituitary LHRH receptors were significantly reduced in all MSG-treated animals showing that the increased pituitary responsiveness of MSG-treated animals is not attributable to an increase in pituitary LHRH receptors.

J. Endocr. (1985) 107, 9–13

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C. A. Wilson, H. J. Herdon, L. C. Bailey and R. N. Clayton

ABSTRACT

In the long-term castrated rat the negative feedback effect of testosterone is markedly reduced and the raised levels of plasma LH seen in the castrated animals are not suppressed by physiological concentrations of plasma testosterone. In this study we have measured pituitary gonadotrophin-releasing hormone (GnRH) receptor content as well as plasma and pituitary LH on days 1, 10 and 40 after castration and noted the effect of testosterone replacement on these parameters.

We found that the negative feedback effect of physiological concentrations of testosterone on plasma and pituitary LH, pituitary GnRH receptor content and response to exogenous GnRH was attenuated 10 and 40 days after castration. It is suggested that the lack of effect of testosterone in the long-term castrated rat is due to its inability to reduce the pituitary GnRH receptor content. On increasing testosterone to supraphysiological levels, the negative feedback effect was reinstated.

We also found that in rats 40 days after castration, physiological and subphysiological concentrations of testosterone significantly increased pituitary GnRH receptor content and this may explain the previous findings that low concentrations of testosterone can enhance the effect of GnRH and increase plasma LH levels.

J. Endocr. (1986) 108, 441–449