LHRH superanalogue点鼻投与の内因性LHRH, ゴナドトロピンに及ぼす影響

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概要

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• Plasma LH, FSH and endogenous LHRH were determined by radioimmunoassay (RIA) when 100 μg of LHRH superanalogue, des-Gly<SUP>10</SUP> [D-Leu<SUP>6</SUP>]-LHRH ethylamide (leuprolide) was intranasally administered to both 7 healthy subjects aged 22 to 63 years and 6 patients with various hypogonadism aged 22 to 43 years [2 with anorexia nervosa, 3 with hypophysial hypogonadism and 1 with isolated gonadotropin (Gn) deficiency].<BR>The response of plasma LH after the intranasal administration of leuprolide was observed to be 814±236 (mean±SE) % in the healthy subjects at 2 to 10 hours, and 528±183% in the patients with hypogonadism at 2 to 4 hours. These elevations were observed until 24 hours after administration in both groups. The response of plasma FSH was observed to be 449±99% in the healthy subjects at 3 to 8 hours, and 593±238% in the patients with hypogonadism at 2 to 6 hours. These elevations were observed until 24 hours in the healthy subjects and until 12 hours in the patients with hypogonadism. Furthermore, these responses tended to be higher than those after 100μg intravenous administration of LHRH; LH responded up to 386±50% in the healthy subjects and up to 390±91% in the patients with hypogonadism, and FSH up to 282±38%, 343±90%, respectively.<BR>The elevation of plasma immunoreactive LHRH which was determined using RIA having no immunocrossreactivity with leuprolide (less than 0.01%) was observed at 6 hours after the administration of leuprolide in the healthy subjects (789±497%). On the other hand, the retardation of the plasma LHRH elevation was observed in the patients with anorexia nervosa, and the failure of that elevation was observed in the patients with hypophysial hypogonadism or isolated Gn deficiency.<BR>These results suggest 1) that the intranasal administration of leuprolide may be able to be substituted for the former LHRH test as the stimulation test of gonadotropins, and 2) that the possible role of the delayed elevation of endogenous LHRH after administration of leuprolide in the healthy subjects may be interpreted as a rebound phenomenon after the first suppression by the negative feedback or caused by the prolonged possession of LHRH receptor in gonadotrophs, but further examination is needed to clarify its mechanism.

• 一般社団法人 日本内分泌学会の論文

著者

• 松原 三八夫

  市立小樽病院内科

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• LHRH superanalogue点鼻投与の内因性LHRH, ゴナドトロピンに及ぼす影響

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