Nihon Naibunpi Gakkai zasshi最新文献

Bone is known to be a target organ of not only estrogens, but also androgens. The mechanism by which these steroids exert their action on bone cells is still poorly understood. In the present study, the effect of 17 beta-estradiol (E2) on 5 alpha-reductase activity, converting testosterone (T) to a more potent biological androgen, dihydrotestosterone (DHT), was assessed in an osteoblast-like cell line of rat origin (UMR106-01). Cells were incubated under standardized conditions with varying concentrations of E2 (10(-12)-10(-6) M) for 48 hours. Incubation medium was replaced when the cells were preconfluent and thereafter at 24 hour intervals. Then the cells were harvested. Each cell homogenate was incubated with [4-14C]-T. DHT was detected as a single metabolite on silicagel thin layer chromatography. 5 alpha-reductase activity was determined by measuring the amount of labeled DHT from T. The radiochemical purity of DHT recovered after incubation was confirmed by recrystallization to constant specific activity. Under the conditions used, no estrogen was detected. Production of insulin-like growth factor-I and alkaline phosphatase in UMR106-01 was increased when E2 was added into the culture medium, however, 5 alpha-reductase activity was significantly decreased by the addition of 10(-12) M to 10(-6) M of E2. Maximum inhibition was noticed at 10(-10) M. Our results demonstrate that UMR106-01 cells have a capacity to transform T into the biologically more potent androgen, DHT. The result, that the enzyme activity was influenced by E2, suggests the regulatory mechanism of both sex steroids on the steroid metabolism in osteoblasts.

TZP-4238 suppresses plasma testosterone in humans, but its action on the androgen biosynthesis pathway has not been established. Therefore, we researched the testicular testosterone level and the testosterone biosynthesis pathway in vitro in rats before and after receiving a single or continuous oral dose of TZP-4238. The total testosterone fell to 60% of the basal level within 3-8 hr (p < 0.05) and then returned to the control concentration by 24 hr after a single administration of 32 mg/kg. The alteration of the plasma testosterone level correlated well with that of the intratesticular level, which was decreased to 50% at 3-8 hr and recovered to the control level by 24 hr. However, the decrement of the plasma LH level at 3-8 hr after a single oral administration was slight and it then returned to the original level at 12 hr. During the 8 weeks of daily administration of 0.5 mg/kg of TZP-4238 or chlormadinone acetate to dogs, the plasma testosterone levels were slightly lower than the basal extent. In vitro experiments were conducted on the rat testis using the exogenous precursor steroids 20 alpha-hydroxycholesterol, pregnenolone and progesterone, in various steps leading to the biosynthesis of testosterone. Trilostane acted at 3 beta-hydroxysteroid dehydrogenase (50% inhibition concentration, IC50 was 1 microM), ketoconazole inhibited the 17 alpha-hydroxylase, and C20, 22- and C17, 20-lyase activities, with an IC50 of 1-50 microM. Cyproterone acetate inhibited both the 3 beta-hydroxysteroid dehydrogenase (IC50;50 microM) and C17, 20-lyase. On the other hand, TZP-4238 exhibited a weaker inhibition of 3 beta-hydroxysteroid dehydrogenase (IC50; 100 microM) than cyproterone acetate, but not of hydroxylase and lyase. Though TZP-4238 did not inhibit the increased testosterone level induced by hCG, trilostane markedly inhibited the effect induced by hCG.(ABSTRACT TRUNCATED AT 250 WORDS)

We present a 66-year-old man with morning fasting hypoglycemia from an unknown cause associated with markedly suppressed levels of insulin. In this patient we examined the diurnal changes of plasma corticotropin-releasing hormone (CRH). ACTH, cortisol, glucose, insulin and body temperature, and the correlations among them. We also discussed an implication of plasma CRH in glucose metabolism by taking these findings together with results from previous studies on plasma CRH in diabetic or hypoglycemic animals and human beings. In this case, the stress induced by severe spontaneous hypoglycemia in the morning fasting state increased CRH in plasma compared to the euglycemia state and simultaneously activated the hypothalamic-pituitary-adrenal system as well as the sympathetic nervous system remarkably. The daily intravenous infusion of glucose brought the fasting hypoglycemia to normal and hypothermia to normothermia in the morning, and improved no or blunt responsiveness of insulin to glucose. On the 50th day of therapy, the i.v. infusion of glucose quickly produced moderate hyperglycemia and an increase in plasma insulin, and inhibited secretions of CRH, ACTH and cortisol. The source of plasma CRH remains obscure. However, the positive correlations of plasma CRH with both plasma ACTH and cortisol and several lines of evidence indicate that CRH in peripheral plasma is derived from both the hypothalamus and extrahypothalamic peripheral tissue and that during stressed conditions, in particular, the CRH increase in plasma is derived mainly from the paraventricular nucleus of the hypothalamus. The role of CRH not only in the systemic circulation but also in the endocrine pancreases for glucose metabolism remains to be clarified.

Development and fluctuation of thyroid hormone autoantibody (THAA) titers were observed during long-term treatment of thyroid diseases in three patients. The presence of THAA was noticed by spuriously high serum free thyroid hormone levels measured with an analog tracer RIA (Amerlex-M FT3, FT4) in all three patients. Amerlex-M FT3 or FT4 levels gradually decreased to appropriate values for the clinical status according to the decreasing titers of THAA. Free thyroid hormone levels with radiolabeled antibody radioassay (Amerlex-MAB FT3, FT4) were not affected by the THAA and always reflected actual thyroid function. Case 1 was a 46-year-old man with untreated primary hypothyroidism. Auti-T4 autoantibody was detected in his serum. The 125I-T4 analog binding to the autoantibody (125I-T4 analog binding ratio) gradually declined after L-T4 therapy and finally almost disappeared two years and four months later. Amerlex-MAB FT4 level rose to the normal range two months after T4 therapy, but TSH level remained slightly elevated (5.4-13 microU/ml) for five months during T4 therapy. The 125I-T4 analog binding ratio and anti-Tg autoantibody (TgAb) titer were inversely correlated. Case 2 was a 72-year-old woman had received desiccated thyroid for a long time. Sequential changes of 125I-T4 analog binding ratio were very similar to those of TgAb titer. Case 3 was a 74-year-old woman with Graves' disease. She had been treated with methimazole (MMI) and desiccated thyroid for three years and five months. Ten months after stopping both drugs, anti-T3 autoantibody was detected. The 125I-T3 analog binding ratio was transiently elevated and gradually declined to reference range for four years during L-T4 therapy. 125I-T3 analog binding ratio and TgAb titer changed in a similar way. These results suggest that desiccated thyroid hormone therapy and TgAb formation are related to the development of THAA and that L-T4 therapy reduces the THAA titer.

To elucidate the effects of growth hormone (GH), prolactin (PRL), and human placental lactogen (hPL) on the regulation of insulin-like growth factor (IGF-1), we compared plasma IGF-1 levels, the pattern of circulating IGF-1-IGF-binding protein complexes (IGF-1 complexes), and unsaturated binding protein (USBP) levels among 1) naturally growing Wistar rats at several developmental stages, 2) rats subcutaneously administered GH, and 3) hypophysectomized rats treated with each of the three hormones. We further evaluated the in vitro secretion of IGF-1 by primary cultured rat hepatocytes, following exposure to the hormones singly or in combination. Plasma IGF-1 and USBP levels were determined by radioimmunoassay and competitive radioassay, respectively. IGF-1 complexes were separated from plasma and culture medium by Sephadex G150 and HPLC gel-chromatography, respectively. The results were as follows. 1) In naturally growing rats, plasma IGF levels were low during fetal life and after birth until 28 days of age, and thereafter increased rapidly to reach an adult level by 35 days. At 35 days, the molecular distribution of IGF-1 switched from an infantile pattern (only 40Kd IGF-1 complex) to an adult form (IGF-1 complexes with both 40Kd and 150Kd proteins). In addition, 150Kd USBP became detectable after 28 days. 2) Administration of GH for 3 days to 13-day-old rats induced 150Kd USBP 9 days earlier than in controls, while plasma IGF-1 levels remained comparable throughout the period examined. 3) In the hypophysectomized rats, plasma IGF-1 levels decreased to approximately one fifth of those in untreated rats, accompanied by the disappearance of 150Kd USBP and 150Kd IGF-1 complex. However, when GH (but not PRL or hPL) was continuously administered for 72 hrs, plasma IGF-1 levels and the circulating profile of IGF-1 complexes were nearly restored to those in control rats. 4) Addition of GH (but not PRL) to the culture medium caused hepatocytes to secrete IGF-1, consisting of only the 40Kd IGF-1 complex. This effect was blocked by the simultaneous addition of hPL with GH. These findings indicate that, of the hormones analyzed, GH is the most important regulator of the plasma IGF-1 concentration and circulating complex forms during the developmental periods in rats, as is also thought to be the case in humans.

ATP-sensitive potassium channels (KATP) are the ion channels which are closely associated with cellular metabolism. A number of chemical compounds which block KATP facilitate the release of hormones or neuropeptides. For example, KATP-blocking agents such as antidiabetic sulfonylureas and imidazolines stimulate insulin secretion from pancreatic beta-cells by decreasing KATP activity. On the other hand, so-called potassium channel openers, KATP-activating drugs which constitute a chemically diverse group of compounds, inhibit growth hormone secretion from anterior pituitary cells and release of gamma-aminobutylic acid from substantia nigra. Several endogenous substances also modulate release of hormone or neuropeptide by affecting KATP activity. Acetylcholine and histamine stimulate the release of endothelium-derived hyperpolarizing factor, which activates KATP in the plasma membrane of vascular smooth muscle cells. Both galanin and somatostatin inhibit insulin release from pancreatic beta-cells by opening KATP through the activation of G-protein. Glucagon-like peptide-1[7-36], which stimulates insulin secretion by indirectly blocking KATP in beta-cells, shows antidiabetic effects in patients with non-insulin-dependent diabetes mellitus. Endosulphine, an endogenous inhibitor of KATP, stimulates insulin secretion from pancreatic beta-cells. Accumulating knowledge of the modulation and function of KATP would help our understanding of the regulation and physiological role of hormones and neuropeptides.

The purpose of this study is to clarify the pathological and endocrinological variations of male idiopathic hypogonadotropic hypogonadism (IHH) from the viewpoint of testicular maturation. Twenty-five patients with IHH were classified into 3 groups according to the degree of germ cell maturation. The most mature germ cells in patients with severe IHH, moderate IHH and mild IHH were spermatogonia, primary spermatocytes and postmeiotic germ cells, respectively. All patients were treated with hCG alone or a combination of hMG-hCG for 1 year or more. The therapeutic efficacy of gonadotropin therapy was evaluated by findings of semen analysis, spermatogenesis and sexual maturation. The total GCI, which was expressed as the number of germ cells per Sertoli cell, diameter of the seminiferous tubules and testicular volume in mild IHH were the largest among the 3 IHH groups, and those in severe IHH were the smallest. Even in mild IHH, spermatogonial proliferation and meiotic activity were quantitatively smaller than those of normal pubertal boys. All patients showed extremely low basal testosterone levels. Response of serum testosterone to hCG administration correlated to the maturity of germ cells. Basal serum gonadotropin levels and responses to GnRH administration varied widely among the 3 groups. In particular, the response of serum gonadotropin to GnRH correlated to the maturity of the germ cells. Spermatogenesis could be initiated by hCG alone in IHH patients without cryptorchidism. Normal sperm density was obtained by hCG alone in the case of mild IHH; however, in moderate and severe IHH groups, hMG-hCG therapy was required for sufficient spermiogenesis. Sexual maturation was completely obtained by gonadotropin therapy within 1 year in moderate and mild IHH. However, in severe IHH, satisfactory sexual maturation could not be obtained within 1 year. The therapeutic prognosis for sexual maturation could be made based on the response to the hCG test at 6 months of gonadotropin therapy. In conclusion, the maturity of germ cells before treatment, which varies widely among patients with IHH, is a sensitive parameter for hypothalamo-pituitary-testicular function and the efficacy of gonadotropin therapy for testicular function. In severe IHH groups, to obtain satisfactory sexual maturation, the administration of testosterone should be considered in addition to gonadotropin replacement.

This study examined the effect of acute hypoxia or hypocapnia on renal phosphate excretion in thyroparathyroidectomized rats. Hypoxia is usually accompanied by a secondary hypocapnia due to hypoxic hyperventilation. Respiratory alkalosis has been described as blunting the phosphaturic effect of parathyroid hormone (PTH). In the present study, to know the effect of hypoxia on renal phosphate excretion in the absence of hypocapnia, the rats were ventilated mechanically, and arterial PCO2 levels were controlled. The rats were divided into three groups depending on the arterial PO2 and PCO2 levels: 1) hypoxic normocapnic group; 2) normoxic normocapnic group; 3) normoxic hypocapnic group. Hypoxia was achieved by ventilating with 10% oxygen, and hypocapnia by hyperventilating with 25-30% oxygen. PTH infusion significantly increased fractional excretion of phosphate (FEPi) from 4.1 +/- 0.9 (mean +/- SE) to 37.7 +/- 2.6% in the hypoxic group (n = 7), from 1.4 +/- 0.3 to 27.4 +/- 2.5% in the normoxic group (n = 8), and from 1.5 +/- 0.4 to 19.5 +/- 1.2% in the hypocapnic group (n = 10). The change of FEPi (delta FEPi) after PTH infusion during hypoxia was significantly greater (33.6 +/- 2.1%) than that during normoxia (26.1 +/- 2.4%, p < 0.05). In contrast to this, hypocapnia blunted the phosphaturic response to PTH (18.0 +/- 1.1% delta FEPi, p < 0.05). Urinary adenosine 3', 5'-cyclic monophosphate (cAMP) increased similarly after PTH infusion in all three groups. To test whether the enhanced phosphaturic effect of PTH during hypoxia and the blunted phosphaturic effect of PTH during hypocapnia are due to steps beyond the production of cAMP, cAMP was administered to the three groups. Cyclic AMP infusion displayed greater phosphaturia in the hypoxic group (n = 6, 30.0 +/- 1.4%) and less phosphaturia in the hypocapnic group (n = 7, 11.3 +/- 1.8%) as compared the the normoxic group (n = 6, 24.1 +/- 1.0%). In conclusion, acute hypoxia enhances the phosphaturic effect of PTH, whereas acute hypocapnia attenuates the phosphaturic effect of PTH.

To elucidate the pathophysiological significance and the regulation of natriuretic peptide receptors (NP-R) in hypertension, we investigated the changes of NP-R in the lung, renal cortex and medulla using radioreceptor assay. We also examined the concentrations of atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) in the atria and ventricles and plasma ANP concentration by specific radioimmunoassays. Elevated plasma ANP level, decreased atrial ANP concentration and increased ventricular ANP and BNP contents were observed in the DOCA-salt group when compared with the control group (p < 0.01). The ratio of BNP/ANP in the ventricle of the DOCA-salt rats was 50% of the control rats. The elevated plasma ANP secreted from the heart seems to reflect a defensive compensatory mechanism to counteract hypertension, and that ANP is the major natriuretic peptide secreted from the cardiac ventricle in DOCA-salt hypertensive rats. Scatchard plot analysis revealed that the maximal binding capacities (Bmax) of NP-R of the lung and renal cortex in DOCA-salt rats were significantly decreased from 71.0 +/- 10.4 to 38.4 +/- 5.9 (p < 0.05) and from 32.7 +/- 1.8 to 21.7 +/- 0.4 (fmol/mg. protein) (p < 0.01) compared with those in the control rats. The values of Bmax of the renal medulla between the two groups were not different. There was no significant change in the apparent dissociation constant (Kd) in the lung, renal cortex and medulla between the two groups. A competitive binding study using 125I- alpha-rANP1-28 and C-ANF4-23, a biologically silent clearance receptor (C-receptor) specific ligand, revealed that C-receptors are abundantly present in the renal cortex, while a relatively small quantity of C-receptor was detected in the renal medulla. In the lung, a substantial amount of C-receptor was detected. In the DOCA-salt treated rats, C-receptors were decreased in the lung and renal cortex compared with the control rats. These results indicate that the down-regulation of NP-R, especially C-receptor, was induced in the lung and renal cortex when plasma ANP levels were elevated in DOCA-salt hypertensive rats. In conclusion, our results suggest that down-regulation of C-receptor in the lung and kidney contributes to maintaining higher plasma ANP levels and maybe responsible for the counter-regulatory role of endogenous ANP in DOCA-salt rats. Our results show that the down-regulation of NP-R in the lung was larger than that in the kidney, suggesting that the lung may play a dominant role in the regulation of the clearance of ANP through C-receptors in vivo.