[Gonadotropins, prolactin and TSH (basal values and pituitary responses) in male sterility].
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Biomedical subjects
Publications and source records attributed to A Banchini.
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The possible interactions of PGF2 alpha on the hypothalamus-pituitary-thyroid axis are the object of this study. Firstly a significant direct effect of PGF2 alpha infusion (mg2,5/270 min) on TSH,PRL,LH,FSH and GH pituitary secretion was excluded. Thereafter the possible PGF2 alpha on PRL and TSH pituitary response to TRH was considered: in only two cases PGF2 alpha was able to increase the TSH response. Finally the Authors studied T3 response to endogenous TSH rise induced by TRH: if they consider the mean peak responses of T3 the increase is significant only when PGF2 alpha infusion is performed.
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In a group of 30 obese male patients (160.2% of ideal body weight), an impaired function of the pituitary-gonadal axis has been demonstrated. Decreased testosterone and increased estradiol basal levels, increased LH and FHS responsiveness to gonadotropin-releasing hormone, and increased basal prolactin (PRL) levels are the most significant findings. The overweight factor seems to account for the documented decreased testosterone and increased estrogen levels through a modulation of peripheral steroid metabolism. These peripheral steroid patterns might affect gonadotropin and PRL secretions as well; nevertheless an interference with the metabolism of cerebral neurotransmitters, perhaps related to a nutritional component (impaired glucose tolerance), cannot be completely excluded.
Seventy patients with hypothalamus-pituitary diseases were studied. 13 of them were studied before surgical treatment and then 15-20 days and 6 months later. A comparison was made with 59 controls. In all these subjects PRL and TSH were studied under basal conditions and after TRH stimulation. As for TSH the highest percentage of abnormal responses was found in the group of patients with chromophobe adenoma and parasellar dysplasias. This area of the pituitary appears relatively undamaged in acromegalic patients. In clinically hypothyroid patients, normal or high TSH responses to TRH were often found. As for PRL, a hyperprolactinaemia was mostly found in the group of patients with chromophobe adenoma, parasellar dysplasias and craniopharyngioma, although there was a different pattern in the TSH responses. No correlation was found between the basal PRL levels and the TSH responses to TRH. There was no significant difference in the TSH responses of the patients with PRL secreting and non-secreting chromophobe adenomas. The hypothesis of two autonomous systems is supported by the finding of differences in the functional recovery of the two pituitary areas studied at different times after surgical treatment.
Fourteen patients with advanced prostatic carcinoma have been considered. Some were treated with goserelin depot and some with goserelin depot plus flutamide; basal and stimulated PRL were studied in the two groups before and after two months treatment in order to verify a possible interference with prolactin secretion which seems to have a trophic and stimulating effect on neoplastic tissue growth. Basal PRL levels and levels after TRH infusion haven't shown significant variations between the two groups of patients. Even if relative to a short time, our results exclude PRL increase, which might be suspected with these drugs, and at last confirm the effectiveness of this treatment (LHRH analogs plus flutamide) in prostatic carcinoma.
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The authors have studied LH and FSH behaviour under basal conditions and after stimulation with GnRH in groups of subjects associated by the common denominator of more or less marked compromission of gonadal activity (subjects of both sexes in old age, affected by Sertoli cells only, Klinefelter's and Turner's syndromes ans subjects with congenital anorchia or with rudimentary testes) and have compared such behaviour with that shown by control groups. Special importance was given to the behaviour of LH/FSH ratio, which is significantly reduced in almost all the situations studied. To conclude, from the results obtained, the authors have evidence new elements to better single out the mechanism of homeostatic regulation of gonadotropic incretory system, with special consideration for what happens to FSH, and also useful indications to emphasize the semeiological use of LH/FSH ratio relevant to basal values and chiefly to incretory areas.