title: Prolactin status in health and disease
Creators: name: Cowden, Elizabeth Anne Marie
Publisher: name: University of Glasgow
Year: 1979
Subjects: subject: Endocrinology.

description: Human prolactin was isolated in 1970 and thereafter sensitive, specific radioimmunoassays were, developed for its measurement. This has enabled progress in understanding spine of the factors which control serum prolactin concentrations in man; previously unrecognised prolactin secreting pituitary tumours may be diagnosed and the Concept of a ion-lactogenic role for human prolactin has emerged. In this thesis, Chapter 1 presents a review of selected aspects of human prolactin pathophysiology. Chapter II commences with a discussion of the several techniques available for the measurement of prolactin concentration and includes an outline of the principle of radioimmunoassay. Chapter III describes a study to assess the importance of some factors which relate to interpretation of prolactin status in health and disease. A brief historical review of the ''amenorrhoea-galactorrhoea" syndrome begins Chapter IV and there follows an account of 32 consecutive patients presenting with unexplained, symptomatic hyperprolactihaemia. Significantly elevated prolactin levels also occur in patients with renal disease and Chapter V deals with a survey of 357 patients with renal disease of variable severity and pathology. The prevalence of hyperprolactinaemia was determined and the relationship between hyperprolactinaemia and underlying pathology, creatinine concentration, duration of uraemia and drug therapy was examined. The arteriovenous concentration difference of prolactin across the normal kidney was measured, it was concluded that hyperprolactinaemia not attributable to drug therapy, occurred commonly in renal failure but not renal pathology per se. The relationship between prolactin and creatinine, reversion of prolactin levels towards normal after successful transplantation and arteriovenous concentration difference of prolactin across the normal kidney suggested that hyperprolactinaemia in uraemia may be accounted for, in part, by altered renal metabolisms. Deranged hypothalamic pituitary function in uraemia was not excluded in the survey of prolactin and renal disease. Chapter VI therefore deals with this aspect and begins, with a general review of endocrines statis in uremia Thereafter, two studies are describer (i) to determine overall basal hypothalamic pituitary status in 231 patients with progressive uraemin and after renal transplantation (ii) to define responses of several anterior pituitary hormones to stimulation and suppression in 19 maintenance haemodialysis patients and in 6 patients after successful renal transplantation. Bvidence is provided both of hypothalamic and pituitary dysfunction in uremia, not ameliorated by dialysis but reversed by successful renal transplantation. It is concluded that endocrine dysfunction, and hyperproactinaemia in particular may be sensitive indices of non urea and crentinine related urnemic toxicity. Circulating prolactin, like other peptide hormones, occurs naturally in several forms, which though immunologically indistinguishable are separable on the basis of size Chapter VII describes a study to identify in uraomic sera, compared to pregnancy or molecular heterogeneity as a result of altored renal metabolism of prolactin. Only one peak of immunorective prolactin similar to monomeric prolactin, was seen in uraemic sera with no evidence of aggregate or fragmount formation. This unexampled finding provided additional data to biological significance. The thesis concludes (chapter VIII) with an assessment of the studies described and discussed in sarlier chapter and potentially productive areas for future study are consider. (Abstract shortened by ProQuest.).