It has been shown that immunoreactive and biologically active GH-releasing hormone (GHRH)-like material is present in rat placenta. To investigate the role of placental GHRH, we measured it in human and rat placenta of different gestational stages, using specific RIA systems. GHRH and somatostatin contents in median eminence, pituitary GH contents, and plasma GHRH levels were also quantified in rats. Immunoreactive GHRH was detectable in rat placenta [13 days of gestation, 1.4 +/- 0.4 (+/- SD); 16 days, 1.4 +/- 0.2; 20 days, 1.7 +/- 0.4 ng/g] but not in human placenta (less than 0.06 ng/g in both full-term and mid-term placenta). GHRH concentrations in rat placenta did not change significantly during pregnancy, but total contents increased progressively in relation to placental growth. GHRH and somatostatin contents in median eminence of pregnant rats were not different from those of control female rats. In contrast, rat pituitary GH contents in pregnant rats were significantly lower than those of control female rats. Immunoreactive GHRH was not detectable in plasma of either pregnant rats or nonpregnant rats. Molecular sieve chromatography revealed two peaks of immunoreactive GHRH in rat placental extracts: a major peak eluted in the position of synthetic rat GHRH and a minor peak in the higher molecular weight region. In contrast, a single peak in the position of rat GHRH was observed in rat median eminence extracts. Detection of immunoreactive GHRH in rat placenta but not in human may suggest that the mechanism of GHRH gene expression in placenta is species specific. Failure of detection of immunoreactive GHRH in rat maternal circulation suggests that placental GHRH may not affect the maternal hypothalamic pituitary axis. Presence of high molecular weight materials of immunoreactive GHRH in rat placenta but not in median eminence suggests that posttranslational processing of the GHRH precursor molecule may be different in the two organs. Placental GHRH may have a paracrine function or may be secreted into fetal circulation and contribute to fetal growth.

The effect of acute and chronic administration of GH on plasma GH responses to GHRH were studied in patients with idiopathic GH deficiency (GHD). Nine untreated GHD patients, 1 untreated patient with postoperative craniopharyngioma, and 7 normal short children were given synthetic human GHRH-44 (100 micrograms, iv) injection before and 2 days after being given a single dose of 4 IU biosynthetic methionyl human GH (mGH), im. Twelve GHD patients, who had been treated with 0.31-0.48 IU/kg.week pituitary-derived hGH (pdGH), im, for 8-79 months, were given GHRH 2 and 14 days after a final injection of 4 IU pdGH. Three other GHD patients were given GHRH before and after 2 yr of pdGH therapy (0.35-0.39 IU/kg.week). The GHRH-induced GH response (max delta GH) was significantly inhibited after mGH administration in the 9 untreated GHD patients [2.7 +/- 0.3 (+/- SE) vs. 4.7 +/- 0.6 micrograms/L; P less than 0.01]. The patient with secondary GH deficiency also had a marked reduction in her peak plasma GH value after mGH administration (from 32.0 to 11.7 micrograms/L). Similarly, the mean max delta GH response in the 7 normal short children was significantly inhibited by prior mGH injection (max delta GH, 12.7 +/- 2.0 vs. 28.8 +/- 4.8 micrograms/L; P less than 0.01). In the 12 treated GHD patients the GHRH-induced GH response on the 2nd day after discontinuation of pdGH therapy was significantly lower than that on the 14th day (max delta GH, 3.4 +/- 1.2 vs. 6.9 +/- 1.6 micrograms/L; P less than 0.02). In the 3 GHD patients who were studied before and after 2 yrs of pdGH therapy, the plasma GH responses were similar. In each group, plasma somatomedin-C levels on the second day after GH administration were slightly but not significantly higher than those before or 14 days after the administration. The GH responses to GHRH given on 2 occasions at 7- to 14-day intervals in individuals not receiving GH were similar in both 9 normal children and 10 GHD patients. These results indicate that acute GH administration inhibits somatotroph function in GHD patients, but chronic GH therapy does not cause irreversible damage to the somatotrophs. The acute inhibition of GHRH-induced GH release after GH administration is more likely due to direct and indirect pituitary inhibition by somatomedin-C and/or somatostatin than decreased GHRH secretion.

The role of endogenous dopamine (DA) on plasma GH secretion was studied using domperidone (DA receptor blocker which does not cross blood brain barrier) in 16 normal subjects. After a bolus injection of domperidone (10 mg, iv.), plasma PRL in 11 cases rose quickly and markedly from the basal level of 9.5+ 1.2 ng/ml (Mean+s.E.) to a maximum of 76.3+ 10.6 ng/ml at 30 min. In contrast, plasma GH in these cases showed a delayed and slight increases to domperidone injection where the values at 90 min and 120 min (3.5+0.8 ng/ml and 3.7+1.0 ng/ml) were significantly higher than those in control study (1.2±0.2 ng/ml and 1.0 ±0.1 ng/ml ; p <0.05; n=8). Domperidone infusion (0.22 mg/min/3 hr) was performed in the remaining 5 subjects. The plasma PRL responses were similar to those in the bolus injection of domperidone. These PRL responses were not modified when L-dopa was administered 30 min after the start of iv infusion of domperidone. Plasma GII showed slight but significant increases 135 min after the infusion compared to control study (4.3± 1.2 ng/ml vs. 1.0+0.1 ng/ml ; p <0.05). By the prior infusion of domperidone plasma GH responses to L-dopa was delayed and blunted, i. e., the occurrence of elevation and peak value of GH delayed by 15 min, and the values at 135 min and 150 min (2.3 ±0.5 ng/ml and 1.5 ±0.2 ng/ml) were significantly lower compared to those in the single L-dopa test (6.3+ 1.2 ng/ml and 5.0+ 1.2 ng/ml ; p <0.02 and 0.05, respectively). These results indicate that in normal subjects L-dopa has stimulatory role on GH secretion mainly at the level of CNS (hypothalamus) and partly at the level of median eminence. It is not plausible that endogenous DA has direct tonic inhibitory effects on pituitary somatotrophs.GH ; domperidone ; L-dopa ; dopamine ; median eminence Human growth hormone (OH) secretion is mainly requlated by hypothalamic OH-releasing hormone (GHRH) and OH-release inhibiting hormone (somatostatin) (Arimura and Culler 1985; Jansson et al. 1985). As plasma OH secretion is impaired in cases with hypothalamic lesion (Chihara et al. 1985), GHRH is thought to be more important than somatostatin in the regulation of OH secretion.

It is not clear whether dopamine (DA) has a central stimulating activity on GH secretion in patients with acromegaly, as it does in normal subjects. To clarify this, we compared the GH inhibitory potencies of DA, which does not cross the blood-brain barrier (BBB), and L-dopa or bromocriptine, which do cross the BBB, in 23 patients with acromegaly. Further, we examined the central effects of L-dopa after selectively blocking peripheral (median eminence and pituitary) DA receptors with domperidone (a DA D2 receptor blocker which does not cross the BBB). After the administration of DA (5 micrograms/kg X min, iv, for 90 min), L-dopa (500 mg, orally), or bromocriptine (2.5 mg, orally), the mean plasma GH decrease was greatest after DA [maximum decrement, 71.9 +/- 3.8% (+/- SEM); n = 21] compared to L-dopa (44.1 +/- 5.6%; n = 23; p less than 0.001) or bromocriptine (58.9 +/- 5.0%; n = 20; p less than 0.02). Eleven of these patients received a single infusion of domperidone (0.22 mg/min, iv, for 180 min) or a combination of domperidone and L-dopa. Mean plasma GH levels did not change during domperidone alone. However, plasma GH levels in these patients increased significantly when L-dopa was administered 30 min after the start of domperidone infusion (vs. control study: at 90 min, 137.3 +/- 10.8% vs. 100.2 +/- 3.9%, p less than 0.01; at 120 min, 138.8 +/- 19.7% vs. 106.5 +/- 3.1%, p less than 0.05). In contrast, one patient who had a distinct plasma GH increase in response to the domperidone-L-dopa test had no increase in plasma GH when given L-dopa 30 min after the start of a sulpiride infusion (DA D2 receptor blocker which crosses the BBB; 1.1 mg/min, iv, for 180 min). Unlike GH, plasma PRL responses to domperidone infusion were not modified by the additional administration of L-dopa. These results suggest that in acromegaly, DA has not only direct suppressive effects on the pituitary tumor somatotrophs, but also indirect stimulatory effects via the hypothalamus; therefore, the hypothalamic GH-releasing system is not entirely suppressed by excessive tumor GH secretion.

No abstract