Effect of thyrotropin-releasing factor on serum thyroid-stimulating hormone

Costom, Bruce H.; Grumbach, Melvin M.; Kaplan, Selna L.

doi:10.1172/jci106717

Cited by 125 publications

(23 citation statements)

References 30 publications

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“…We have reported (11) that 13 of 13 children with growth hormone (GH) deficiency without apparent TSH deficiency, 10 of 13 children with idiopathic GH deficiency plus TSH deficiency, and 1 of 5 children with GH and TSH deficiency secondary to operative procedures for craniopharyngiomas released TSH to a comparable extent as normal children after TRH injection. The interpretation of these data by our group (11) and similar data by Costom, Grumbach, and Kaplan (12) was that at least some children with apparent TSH deficiency had idiopathic hypopituitarism because an apparently normal pituitary gland was not receiving the appropriate releasing stimulus for TSH.…”

Section: Introductionsupporting

confidence: 63%

“…Thyrotropin-releasing hormone (TRH)1 releases thyrotropin (TSH) in vivo from the pituitaries of normal adults (1-10) and children (11,12), and most patients with idiopathic hypopituitarism (11)(12). We have reported (11) that 13 of 13 children with growth hormone (GH) deficiency without apparent TSH deficiency, 10 of 13 children with idiopathic GH deficiency plus TSH deficiency, and 1 of 5 children with GH and TSH deficiency secondary to operative procedures for craniopharyngiomas released TSH to a comparable extent as normal children after TRH injection.…”

Section: Introductionmentioning

confidence: 99%

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Human prolactin and thyrotropin concentrations in the serums of normal and hypopituitary children before and after the administration of synthetic thyrotropin-releasing hormone

Foley¹,

Jacobs²,

Hoffman³

et al. 1972

J. Clin. Invest.

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A B S T R A C T Synthetic thyrotropin-releasing hormone (TRH) was administered to normal children and hypopituitary patients in a dose of 7 jg/kg i.v. over 30-60 sec. Serum thyrotropin (TSH) and prolactin (HPr) concentrations were measured by radioimmunoassay before and at 15-min intervals for 2 hr after TRH. In 20 normal children HPr rose from a mean baseline value of 7.0±1.2 (SEM) ng/ml to a mean peak value of 39.5±5 ng/ml.In 11 patients with growth hormone (GH) deficiency without TSH deficiency, HPr values rose from a mean baseline of 3.6±0.8 ng/ml to a mean peak value of 13.9+-2.8, a significantly less peak response as compared with normal children (P < 0.005). The TSH responses to TRH, however, were statistically indistinguishable from those of normal children.In 10 patients with GH and TSH deficiency both the mean baseline HPr levels (25.0+5 ng/ml) and the mean peak HPr levels after TRH (68.5+10 ng/ml) were significantly higher (P < 0.005 and < 0.025) than those of normal children. Similar comparisons were also true for the peak TSH responses (P < 0.05). Two panhypopituitary patients released no TSH and only small amounts of HPr after TRH. After thyroid replacement therapy in eight of the patients with GH and TSH deficiency, the mean HPr baseline levels (7.6+1.0 ng/ml) and peak levels (23.3+4.6 ng/ml) after the same dose of TRH were significantly less than their pretreatment levels (P<0.001 and <0.01) and were within the range for normal children.Synthetic TRH stimulates the simultaneous release of TSH and HPr in normal children and most hypopituitary patients. When the concentrations of thyroxine (T4) and triiodothyronine (T3) are low, the levels of HPr before and after TRH are elevated. After thyroid replacement therapy, HPr levels decrease to normal.T4 and/or T3 may condition the production or effects of prolactin-inhibiting factor (PIF) activity. The TSH and HPr responses after TRH in hypopituitary patients will determine whether the primary defect resides in the pituitary or hypothalamus, but cannot delineate the hypothalamic defect as a deficiency of hypothalamic hormone production or neurohumoral transmission.

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Section: Introductionsupporting

confidence: 63%

Section: Introductionmentioning

confidence: 99%

Human prolactin and thyrotropin concentrations in the serums of normal and hypopituitary children before and after the administration of synthetic thyrotropin-releasing hormone

Foley¹,

Jacobs²,

Hoffman³

et al. 1972

J. Clin. Invest.

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“…TRH deficiency appears, therefore, to have been confirmed by producing chemical euthyroidism by replacement of the presumedly missing hormone. Several other patients, however, have been described who, like L. C., and K. C., had low serum thyroid hormone and low-normal basal TSH levels and normal TSH responses to a single dose of TRH (18)(19)(20)(21)(22). The marked fall in the initially subnormal TSH response to TRH in M. J., the patient with presumed pituitary insensitivity to TRH, was accompanied by rises in serum T3 and T4, but rises so small that the final levels were still subnormal.…”

Section: Discussionmentioning

confidence: 99%

Repetitive Administration of Thyrotropin-Releasing Hormone Results in Small Elevations of Serum Thyroid Hormones and in Marked Inhibition of Thyrotropin Response

Snyder¹,

Utiger²

1973

J. Clin. Invest.

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A B S T R A C T Repetitive administration of thyrotropinreleasing hormone (TRH) to human subjects was used to produce small elevations of endogenous serum triiodothyronine (T3) and thyroxine (T4) levels and thereby to determine the effect of these small elevations on the serum thyrotropin (TSH) response to subsequent doses of TRH. Each subject received 13 consecutive doses of 25 ,Ag TRH at 4-h intervals. Serum Ta, T4, and TSH levels were measured before the 1st, 7th, and 13th doses ("basal levels") and for the 4 h after each of these doses.In 10 normal subjects, the mean TSH response fell from 14.6 AU/ml after the 1st TRH dose to 6.9 and 3.0 AU/ml after the 7th, and 13th doses. These falls in TSH response were accompanied by rises in the mean basal serum Ts levels from 81 to 115 to 114 ng/100 ml (normal range, 70-150 ng/100 ml) and rises in the mean basal serum T4 from 6.7 to 8.6 to 9.5 ,Ag/lOO ml (normal range, 5-11 Ag/lOO ml).

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“…The latter samples were obtained through the courtesy of Drs. S. Kaplan and M. Grumbach, University of California, and the serum TSH responses have been reported [5].…”

Section: Special Study Groupsmentioning

confidence: 99%

Serum Prolactin Levels in Humans from Birth to Adult Life

1973

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ExtractSerum prolactin (HPr) and serum growth hormone (HGH) were determined by double antibody radioimmunoassay methods. Markedly elevated levels of serum prolactin with considerable variation were observed in the neonatal period. No significant difference was observed in six matched arteriovenous cord blood samples. No sex difference was noted in the full term infants, whereas the mean value for 24 premature male infants in the 1st week of life (190 ± 17 ng/ml SEM) was significantly higher (P < 0.001) than mean values for 34 premature female infants (104 ± 10 ng/ml SEM). During the first year of life, the mean prolactin value for both boys and girls was approximately 10 ng ml. Mean prolactin levels for both male and female children, aged 2-12 years, were approximately 5 ng/ml. Mean levels for the adolescent female were not increased significantly over those for adolescent males. However, the mean prolactin level of all values determined for adult females (7.9 ± 0.40 ng/ml SEM) was significantly increased (P < 0.001) over the mean level for adult males (5.2 ± 0.55 ng/ml, SEM). Daily serum prolactin throughout the menstrual cycle in six normal female subjects was compared with daily serum HLH levels. Considerable fluctuation was evident, particularly in the luteal phase, where the mean prolactin level was observed to be statistically higher (P < 0.005) than the mean follicular phase level.Insulin hypoglycemia did not produce a significant increase in serum prolactin in 10 normal subjects, whereas arginine infusion produced a twofold increase in mean serum prolactin at 30 min with a return to basal values by 60 min. Glucagon administered intravenously did not produce any significant change in the already elevated levels of prolactin observed on days 1 and 3 of life. Serum prolactin was uniformly and completely suppressed by L-dopa in six subjects for 1-4 hr following a single oral dose of 250 mg. In normal children, the maximal increases in both prolactin and thyroid-stimulating hormone (TSH) were observed at 15-30 min after the intravenous injection of thyrotropin-releasing hormone (TRH) and values were still slightly elevated at 120 min after injection.These studies document the pattern of secretion of serm prolactin from birth to adulthood. The physiologic basis for the increased levels of serum prolactin in the neonate has not been clarified by our studies. Significantly increased levels of prolactin are observed at a time when maximum increases in neonatal breast hypertrophy are observed clinically. Significant mean differences are observed in the adult female population compared with adult males. L-Dopa acts at the hypothalamic level to alter pituitary secretion via alterations in releasing and inhibiting hypothalamic 534 Serum prolactin by radioimmunoassay 535 hormones, whereas TRH acts directly on the pituitary. Our studies indicate that responses to these agents in the prepubertal child are qualitatively similar to those in adults. The response of the neonatal hypothalamic pituitary axis to these agents r...

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Effect of thyrotropin-releasing factor on serum thyroid-stimulating hormone

Cited by 125 publications

References 30 publications

Human prolactin and thyrotropin concentrations in the serums of normal and hypopituitary children before and after the administration of synthetic thyrotropin-releasing hormone

Human prolactin and thyrotropin concentrations in the serums of normal and hypopituitary children before and after the administration of synthetic thyrotropin-releasing hormone

Repetitive Administration of Thyrotropin-Releasing Hormone Results in Small Elevations of Serum Thyroid Hormones and in Marked Inhibition of Thyrotropin Response

Serum Prolactin Levels in Humans from Birth to Adult Life

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