indeed involved in human parturition. The onset of labour is associated with only a slight to moderate increase in the levels of oxytocin in the blood but as labour progresses there is a further increase, probably related to distension of the genital tract (Ferguson reflex). Even the reports that patients with diabetes insipidus and no detectable circulating oxytocin can proceed to normal labour can be reconciled with the Oxytocin has the distinction of being the first peptide hormone to be sequenced and synthesized (Du Vigneaud et al., 1954). The synthesis of arginine vasopressin was achieved closely afterwards, culminating in Du Vigneaud being awarded the Nobel prize for chemistry. These nonapeptides of the neurohypophysis differ only in two amino acids but while vasopressin has been intensively studied, and has now been shown to have a multiplicity of actions, oxytocin has received much less attention. Its actions have traditionally been confined to those affecting the uterus and breast, and the major purpose of this review is to consider the evidence for other functions, emphasizing wherever possible results from human studies.
Classical functions of oxytocinIn the course of its classical functions oxytocin is synthesized in the magnocellular neurones of hypothalamic nuclei as a precursor molecule and is transported axonally in association with its neurophysin to the neurohypophysis from whence it is released into the circulation. It is clear from immunohistochemical studies that the oxytocin-secreting neurones are different from those which produce vasopressin (Dierickx & Vandesande, 1977) and the regulatory mechanisms are also quite separate.
Actions on the uterusThe stimulatory effect of posterior pituitary extracts on the contractions of the uterus was first described by Dale (1906) and the therapeutic use of such extracts in labour was demonstrated soon afterwards (Blair Bell, 1909). However, in spite of these reports, which appeared over 80 years ago, there has been some controversy as to the physiological role of oxytocin in human parturition. Fuchs and Fuchs (1984) have reviewed the topic in some detail and from their own work, and that of many others, they conclude that oxytocin is