[en] It is now well established that during the second half of normal pregnancy, the human placenta secretes its specific GH variant (placental GH) in increasing amounts up to delivery. During the same period, pituitary GH secretion is progressively suppressed. The present study was aimed at clarifying the physiology of GH secretion in pregnant acromegalic women. Two young women remained acromegalic despite transphenoidal removal of their pituitary adenoma. Increased basal levels of GH and insulin-like growth factor-I (IGF-I) as well as paradoxical GH release after TRH injection were noted. Both women became pregnant and delivered term babies without any complication. In both patients, pituitary GH remained elevated during the entire pregnancy, contrary to the situation in normal women. Paradoxical GH release after TRH treatment was also present, whereas no response was observed in five normal control subjects. GH pulsatility studies revealed a highly pulsatile secretory pattern of pituitary GH, in contrast to that in normal woman, whose placental GH is secreted tonically. Tissue placental GH concentrations were within the range of levels in normal placentas. An increase in serum IGF-I in late pregnancy was also similar to that observed in normal pregnancy. These findings confirm that increased IGF-I levels are not pituitary GH dependent in late pregnancy. They add new evidence that adenomatous somatotrophs lack an IGF-I-dependent feedback regulation present in normal somatotrophs.
Disciplines :
Endocrinology, metabolism & nutrition
Author, co-author :
Beckers, Albert ; Université de Liège - ULiège > Département des sciences cliniques > Endocrinologie
Stevenaert, Achille ; Centre Hospitalier Universitaire de Liège - CHU > Neurochirurgie
Foidart, Jean-Michel ; Université de Liège - ULiège > Département des sciences cliniques > Gynécologie - Obstétrique - Labo de biologie des tumeurs et du développement
Hennen, Georges ; Centre Hospitalier Universitaire de Liège - CHU > Endocrinologie clinique
Frankenne, Francis ; Université de Liège - ULiège > Département des sciences cliniques > Département des sciences cliniques
Language :
English
Title :
Placental and Pituitary Growth Hormone Secretion During Pregnancy in Acromegalic Women
Publication date :
1990
Journal title :
Journal of Clinical Endocrinology and Metabolism
ISSN :
0021-972X
eISSN :
1945-7197
Publisher :
Endocrine Society, Chevy Chase, United States - Maryland
Hennen G, Frankenne F, Pirens G, et al. New chorionic GH-like antigen revealed by monoclonal antibody radioimmunoassay. Lancet. 1985;1:399.
Frankenne F, Scippo ML. Circulating forms and partial glycosy-lation of human placental growth hormone (hPGH) [Abstract 1129]. Proc of the 70th Annual Meet of The Endocrine Soc. 1938;303.
Scippo ML, Frankenne F, Van Beeuman J, Igout A, Hennen G. Human placental growth hormone: proof of identity with the GH-V gene product by N-terminal microsequence analysis. Arch Int Physiol Biochim. 1989;97:B59.
Frankenne F, Rentier-Delrue F, Scippo ML, Martial J, Hennen G. Expression of the growth hormone variant gene in human placenta. J Clin Endocrinol Metab. 1987;64:635-7.
Igout A, Scippo ML, Frankenne F, Hennen G. Cloning and nucleotide sequence of placental hGH-V cDNA. Arch Int Physiol Biochim. 1988;96:63-7.
Frankenne F, Closset J, Gomez F, Scippo ML, Smal J, Hennen G. The physiology of growth hormones (GHs) in pregnant women and partial characterization of the placental GH variant. J Clin Endocrinol Metab. 1988;66:1171-80.
Eriksson L, Frankenne F, Eden S, Hennen G, von Schoultz B. Growth hormone 24-hour serum profides during pregnancy-lack of pulsatility for the secretion of the placental variant. Br J Obstet Gynaecol. 1989;96:949-53.
Spellacy WN, Buhi WC. Pituitary GH and PL levels measured in normal term pregnancy and at the early and late postpartum period. Am J Obstet Gynecol. 1969;105:888-96.
Artenisio AC, Volpe A, Rayonese F, Maccarone G, Forte F, Consol F. Behaviour of hPL and GH plasmatic rate in pregnant women at different times of their pregnancy during dynamic tests. Horm Metab Res. 1980; 12:205.
Spellacy WN, Buhi WC, Birk SA. Human growth hormone and placental lactogen levels in midpregnancy and late postpartum. Obstet Gynecol. 1970;36:238-73.
Grumbach MM, Kaplan SL, Sciarra JJ, Burr IM. Chorionic growth hormone-prolactin (CGP): secretion, disposition, biologic activity in man, and postulated function as the “growth hormone” of the second half of pregnancy. Ann NY Acad Sci. 1968;148:501-31.
Tyson JE, Friesen HG. Factors influencing the secretion of human prolactin and growth hormone in menstrual and gestational women. Am J Obstet Gynecol. 1973;116:377-87.
Yen SSC, Vela P, Tsai CC. Impairment of growth hormone secretion in response to hypoglycemia during early and late pregnancy. J Clin Endocrinol Metab. 1970;31:29-32.
Yamashita S, Weiss M, Melmed S. Insulin-like growth factor I regulates growth hormone secretion and messenger ribonucleic acid levels in human pituitary tumor cells. J Clin Endocrinol Metab. 1986;63:730-5.
Blanchard MM, Goodyear CG, Charrier J, Dulor JP, Barenton B. Effects of hypothalamic hormones (GRF, TRH, somatostatin) and insulin-like growth factor I on growth hormone secretion from prepubertal male lamb pituitary cultures. Reprod Nut Dev. 1987;27:471-80.
Cundy T, Grundy EN, Melville H, Scheldon J. Bromocriptine treatment of acromegaly following spontaneous conception. Fertil Steril. 1984;42:134-6.
Stevenaert A. Contribution de la microchirurgie transsphénoïdale à l’étude étiopathogénique des adénomes hypophysaires prolactin-otropes et somatotropes. PhD thesis. Liege: University of Liege; 1985.
Merriam G, Wacther K. Algorhythms for the study of episodic hormone secretion. Am J Physiol. 1982 43:310.
Knott G, Reece D. MLAB: a civilized curve fitting system. In: Proceedings of the Online ‘72 International Conference. Control of the menstrual cycle. London: Brunei University; 1972;1:497.
Gomez F, Pirens G, Schaus C, Closset J, Hennen G. A highly sensitive radioimmunoassay for human growth hormone using a monoclonal antibody. J Immunoassay. 1984;5:145-57.
Wilson DM, Bennett A, Adamson GD, et al. Somatomedins in pregnancy: a cross-sectional study of insulin-like growth factors I and II and somatomedin peptide content in normal human pregnancies. J Clin Endocrinol Metab. 1982;55:858-69.
Merimee TJ, Zapf J, Froesch ER. Insulin-like growth factor in pregnancy: studies in a growth hormone-deficient Dwarf. J Clin Endocrinol Metab. 1982;54:1101-3.
Caufriez A, Frankenne F, Englert Y, Golstein J, Cantraine, F, Hennen G, Copinschi G. Placental growth hormone as a potential regulator of maternal IGF-I during human pregnancy. Am J Physiol. In press.
Goodyear CG, Marcovitz S, Hardy J, Lefebvre Y, Guyda HJ, Posner BI. Effect of insulin-like growth factors on human foetal, adult normal and tumour pituitary function in tissue culture. Acta Endocrinol (Copenh). 1986;112:49.