[Clinical and experimental studies of the mechanism of neuroendocrine action of cerebral phospholipids: the behavior of prolactin as a marker of such action].
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Biomedical subjects
Publications and source records attributed to R D'Urso.
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Interest in neuroendocrinoimmunology has increased greatly in the last decade. The most important evidence of neuroendocrine-immune system interactions is that spleen, thymus, bone marrow and lymph nodes are innervated by neurons of the autonomic nervous system; changes in brain functions can affect different immune responses; immune and neuroendocrine cells share receptors (e.g., lymphocytes and macrophages have receptors for a vast number of hormones and neuropeptides); hormones and neuropeptides can alter the functional activity of immune system cells; several hormones and neuropeptides can be synthesized by leukocytes; cytokines produced by leukocytes are able to modulate neuroendocrine system activity, behaviour, sleep and thermoregulation. The recent literature on neuroendocrinoimmunology has laid the physiopathological groundwork for a new clinical approach which perceives and treats the patient as a psychic and somatic whole.
OBJECTIVE: To evaluate the effects on hormonal and metabolic variables and bone density of a transdermal system delivering estrogen and progestagen. DESIGN: Twenty-one patients were included in the study and randomly assigned to the following treatments: group A was treated with transdermal 17 beta-estradiol, 50 micrograms/day (Estraderm TTS 50), from the first to the fourteenth day of the cycle and with a transdermal combination of 17 beta-estradiol (50 micrograms/day) and norethisterone acetate (NETA) 250 micrograms/day during the following 14 days; group B was treated with Estraderm TTS 50 from the first to the twenty-eighth day, adding oral medroxyprogesterone acetate (MPA), 10 mg/day, during the final 14 days. DHEAS, testosterone, SHBG, prolactin, gonadotropins, and estrogens were measured in basal conditions and after 6 months' therapy. In the same schedule, lipid patterns (total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides), phosphocalcium variables (osteocalcin, calcitonin, parathormone), and bone mineral density were also studied. RESULTS: Both treatments were efficient in reducing menopausal symptoms. An increase of DHEAS (P < .05) and a decrease of FSH and LH (P < .02, < .01, respectively) were observed in group B. No significant modifications in lipid and lipoprotein metabolism were shown in either group after 6 months. The calcium-regulating hormone osteocalcin (BCG) decreased significantly (P < .05) only in group A; calcitonin, parathormone, and bone density were unchanged after treatment. CONCLUSION: Transdermal administration of estrogen plus progestagen reduces menopausal symptoms, but does not induce changes in metabolic variables and hormonal levels (androgens and prolactin).