Effects and site of action of morphine on gonadotropin secretion in the female rhesus monkey

Role of thioridazine in unexplained infertility

A total of 452 women with unexplained infertility were selected for the present study. From them 310 women were put on thioridazine tablet (5 mg), 1 h after dinner from the 8th day of the menstrual cycle to the 18th day in each cycle. Coitus was advised about 1-2 h after the drug intake and proper posture was advised to the patients. The other 142 patients were given placebo therapy. Patients were followed up for pregnancy for 1 year which was confirmed by ultrasonographic examination. Ninety-four patients (30.2%) in the study group conceived in contrast to 22 (15.42%) in the control group (P less than 0.001). Incidence of abortions, congenital malformations and perinatal mortality and mode of delivery were not significantly different in the two groups. Thioridazine due to anxiolytic effect in low dosage appears to be promising in the treatment of unexplained infertility.

Estrogen Changes as a Critical Factor in Modulation of Central Opioid Tonus: Possible Correlations with Post-Menopausal Migraine

The effects exerted by ovarian steroids on the modulation of opioid activity were investigated in post-menopausal migraine sufferers and in healthy controls. In order to evaluate central opioid tonus, plasma LH rise after naloxone injection was measured, bearing in mind the tonic inhibition of endogenous opioid on hypothalamic LH-RH. There was no response of plasma LH to naloxone in post-menopausal women or in patients submitted to ovariectomy in fertile life. When the subjects underwent a sequencial estrogens + progestagens therapy, such a response was noted from the first month of treatment; progestagens alone were ineffective. The same phenomena were also evident in post-menopausal migraine sufferers. These data indicate that ovarian steroids modulate the activity of opiate receptors in both healthy women and migraine sufferers. Interestingly, replacement therapies through ovarian steroids restored the activity of central opioid tonus in patients affected by migraine.

Corticotrophin-releasing factor and stress-induced inhibition of the gonadotrophin-releasing hormone pulse generator in the female

It is well established that stress activates the hypothalamo-pituitary-adrenal (HPA) axis and suppresses the hypothalamo-pituitary-gonadal (HPG) axis. A large literature dealing with various stressors that regulate gonadotrophin-releasing hormone (GnRH) secretion in a variety of species (including nonhuman primates, sheep, and rats) provides evidence that stress modulates GnRH secretion by activating the corticotrophin-releasing factor (CRF) system and sympathoadrenal pathways, as well as the limbic brain. Different stressors may suppress the HPG axis by activating or inhibiting various pathways in the CNS. In addition to CRF being the principal hypophysiotropic factor driving the HPA axis, it is a potent inhibitor of the GnRH pulse generator. The suppression of the GnRH pulse generator by a variety of stressful stimuli can be blocked by CRF antagonists, suggesting a pivotal role for endogenous CRF. The differential roles for CRF receptor type 1 (CRF-R1) and CRF-R2 in stress-induced suppression of the GnRH pulse generator add to the complexity of CRF regulation of the HPG axis. Although the precise sites and mechanisms of action remain to be elucidated, noradrenergic and gamma-amino-butyric acid (GABA) neurones are implicated in the system's regulation, and opioids and kisspeptin in the medial preoptic area (mPOA) and hypothalamic arcuate nucleus (ARC) may operate downstream of the CRF neuronal system.

Three-dimensional representation of the neurotransmitter systems of the human hypothalamus: inputs of the gonadotrophin hormone-releasing hormone neuronal system

The gonadotrophin-releasing hormone (GnRH) represents the final common pathway of a neuronal network that integrates multiple external and internal factors to control fertility. Among the many inputs GnRH neurones receive, oestrogens play the most important role. In females, oestrogen, in addition to the negative feedback, also exhibits a positive feedback influence upon the activity and output of GnRH neurones to generate the preovulatory luteinising hormone surge and ovulation. Until recently, the belief has been that the GnRH neurones do not contain oestrogen receptors and that the action of oestrogen upon GnRH neurones is indirect, involving several, oestrogen-sensitive neurotransmitter and neuromodulator systems that trans-synaptically regulate the activity of the GnRH neurones. Although this concept still holds for humans, recent studies indicate that oestrogen receptor-beta is expressed in GnRH neurones of the rat. This review provides three dimensional stereoscopic images of GnRH-immunoreactive (IR) and some peptidergic (neuropeptide Y-, substance P-, beta-endorphin-, leu-enkaphalin-, corticotrophin hormone-releasing- and galanin-IR) and catecholaminergic neurones and the communication of these potential oestrogen-sensitive neuronal systems with GnRH neurones in the human hypothalamus. Because the post-mortem human tissue does not allow the electron microscopic identification of synapses on GnRH neurones, the data presented here are based on light microscopic immunocytochemical experiments using high magnification with oil immersion, semithin sections or confocal microscopy.

Caloric restriction inhibits steroid-induced gonadotropin surges in ovariectomized rhesus monkeys

We recently reported that caloric restriction inhibited ovulation in rhesus monkeys. The objective of the current study was to determine if caloric restriction affected the positive feedback response to ovarian steroids in non-human primates. Studies were conducted in four long-term ovariectomized rhesus monkeys. Animals were given an estrogen/progesterone challenge while maintained on a normal diet and on a diet that reduced body weight by approx 20%. In all cases, animals were maintained at the desired weight [based on a calculation of body mass index (BMI)] for a minimum of 4 wk before initiating the steroid challenge. Caloric restriction reduced BMI from 23.3 +/- 0.3 to 18.9 +/- 0.2 kg/m2. The estrogen/progesterone challenge elicited an LH and FSH surge in each animal maintained at a normal BMI. By contrast, gonadotropin surges were significantly compromised when monkeys were challenged at a low BMI. In addition to affecting the reproductive axis, caloric restriction stimulated cortisol release and suppressed T3 secretion. These endocrine effects of caloric restriction are consistent with our findings in ovary-intact monkeys. In summary, our previous reports in ovary-intact animals confirmed an effect of caloric restriction on tonic gonadotropin secretion leading to anovulation. Our current results suggest the effects of caloric restriction on the reproductive axis extend beyond inhibition of tonic gonadotropin secretion to include a disturbance of phasic gonadotropin secretion.

Effect of prodynorphin-derived opioid peptides on the ovulatory luteinizing hormone surge in the proestrous rat

The objective of this study was to determine whether prodynorphin-derived opioid peptides could block the spontaneous luteinizing hormone (LH) surge and ovulation, and if so, whether this inhibitory action was mediated through kappa-opioid receptors. Various doses of dynorphin peptides (dynorphin A(1-17), dynorphin A(1-8), dynorphin B, alpha- and beta-neoendorphin) were infused into the brain through third-ventricle cannulae in rats between 1330-1800 h on proestrus. Each dynorphin peptide blocked the LH surge and ovulation in a dose-dependent manner. Dynorphin A(1-17) and A(1-8) were equally effective in producing these actions, and more potent than either dynorphin B or alpha- or beta-neoendorphin. U50,488H, a specific kappa-opioid receptor agonist, also blocked the LH surge and ovulation. When a mixture of five dynorphin peptides was infused intraventricularly, each at a dose that inhibited the LH surge, both the surge and ovulation were blocked. However, when norbinaltorphimine, a specific kappa-opioid receptor antagonist, was coinfused with the mixture of dynorphin peptides, the LH surge and ovulation were fully restored. These results demonstrate that prodynorphin-derived opioid peptides, acting through kappa-opioid receptors, can block the LH surge and ovulation. Dynorphin A(1-17) and A(1-8) are the most potent in this regard.

Neurobiological mechanisms of the onset of puberty in primates

An increase in pulsatile release of LHRH is essential for the onset of puberty. However, the mechanism controlling the pubertal increase in LHRH release is still unclear. In primates the LHRH neurosecretory system is already active during the neonatal period but subsequently enters a dormant state in the juvenile/prepubertal period. Neither gonadal steroid hormones nor the absence of facilitatory neuronal inputs to LHRH neurons is responsible for the low levels of LHRH release before the onset of puberty in primates. Recent studies suggest that during the prepubertal period an inhibitory neuronal system suppresses LHRH release and that during the subsequent maturation of the hypothalamus this prepubertal inhibition is removed, allowing the adult pattern of pulsatile LHRH release. In fact, y-aminobutyric acid (GABA) appears to be an inhibitory neurotransmitter responsible for restricting LHRH release before the onset of puberty in female rhesus monkeys. In addition, it appears that the reduction in tonic GABA inhibition allows an increase in the release of glutamate as well as other neurotransmitters, which contributes to the increase in pubertal LHRH release. In this review, developmental changes in several neurotransmitter systems controlling pulsatile LHRH release are extensively reviewed.

Effect of naloxone on serum luteinizing hormone concentration in anovulatory Holstein cows during the early postpartum period

This experiment was conducted to investigate the effect of naloxone (NAL), an opioid receptor antagonist, on pituitary LH secretion in anovulatory Holstein cows during the early postpartum period when cows were expected to be in negative net energy balance. Twenty-three cows (11 primiparous) received either saline (n = 12) or 1 mg/kg BW NAL i.v. (n = 11) on Day 14 or 15 postpartum. Jugular blood samples were collected at 15-min intervals for 2 hr before and 2.5 hr after NAL or saline. All cows received 3 ug gonadotropin releasing hormone (GnRH) at 2.5 hr post-NAL or -saline and blood collection was continued for 1 hr. Mean serum progesterone concentration was 0.33 +/- 0.2 ng/ml. Mean net energy balance for all cows was -5.5 +/- 0.6 Mcal/day. Naloxone caused a transient increase (P < 0.05) in serum LH concentrations in both primi- and multiparous cows within 45 min after administration. In contrast, serum LH concentrations remained unchanged in saline-treated cows. GnRH increased (P < 0.05) LH and there was no effect of treatment. These results suggest that modulation of LH secretion, at least in part, may be mediated via endogenous opioids in dairy cows before first postpartum ovulation.

Neuropeptides, the stress response, and the hypothalamo-pituitary-gonadal axis in the female rhesus monkey

In conclusion, we have demonstrated that in the primate increased activity of the immune system and the consequent IL-1 release result in the activation of neuropeptides of the adrenal axis, mainly CRF and AVP. These neuropeptides, through a direct effect on the GnRH pulse generator or indirectly through the hypothalamic endogenous opioid peptides, inhibit the GnRH pulse generator. Some of the POMC derivatives, such as alpha-MSH, may antagonize these effects. The consequential decrease in GnRH pulse frequency results in an acute decrease in LH and FSH secretion. This decrease in gonadotropin release may explain the deleterious effects of stress on the menstrual cycle. However, an acute decrease in gonadotropins following activation of the adrenal axis is not observed in the presence of estradiol. Thus, during the menstrual cycle, a relative protection against the deleterious effects of acute stress may exist. How potent this protective mechanism is against repetitive stress is not known.

Beta-endorphin levels in women with elevated prolactin and following bromocriptine therapy

1. Plasma levels of beta-endorphin were not significantly different in women with normal plasma prolactin or women with hyperprolactinemia. 2. A bromocriptine induced decrease in plasma prolactin was not accompanied by a decrease in beta-endorphin. 3. This study suggests that no direct link exists between plasma prolactin levels and endogenous beta-endorphin.

Influence of hypothalamic-pituitary-adrenocortical hormones on reproductive hormones in gray wolves (Canis lupus)

The release of hypothalamic-pituitary-adrenocortical hormones was studied in intact and neutered gray wolves (Canis lupus) to determine how these hormones interact and affect reproductive hormones. Experiments were performed on adult wolves anesthetized with 400 mg ketamine and 50 mg promazine. Intravenous (i.v.) injections with 50 micrograms ovine corticotropin releasing factor (oCRF) significantly increased adrenocorticotropin (ACTH; P < or = 0.01), cortisol (CORT; P < or = 0.004), and progesterone (P < or = 0.036), but not beta-endorphin (P > or = 0.52). Since neutered wolves demonstrated dose-dependent elevations in response to ACTH, it was concluded that the progesterone was secreted from the adrenal gland. Basal luteinizing hormone (LH) concentrations in neutered wolves were similar before and 60 min after i.v. injection of 1, 5, or 25 IU ACTH (P > or = 0.36) or 2.2 mg/kg cortisol (P = 0.42). Neither 25 IU ACTH (P = 0.55) nor 0.22 mg/kg dexamethasone (P = 0.49) altered the LH response to injection of LH releasing hormone in neutered wolves. Chronic administration of 0.22 mg/kg/day dexamethasone for 3 d did not alter baseline LH concentrations (P = 0.75). Injection of 1.0 mg/kg naloxone (NAL), however, increased LH concentrations relative to baseline values in both intact (P = 0.032) and neutered (P = 0.0005) female wolves, but not in intact (P = 0.19) or neutered males (P = 0.07). These results indicated that in gray wolves (1) oCRF stimulated the release of pituitary and adrenal hormones in a fashion similar to that of other mammals; (2) the adrenal cortex was capable of secreting progesterone into the systemic circulation; (3) exogenous glucocorticoids did not alter LH concentrations; and (4) endogenous opioids may modulate LH secretion in female wolves.

Effects of suckling and of a long interval after ovariectomy on hypothalamo-hypophyseal responsiveness to naloxone, morphine and GnRH in beef cows

The response of serum luteinizing hormone (LH) to morphine, naloxone and gonadotropin-releasing hormone (GnRH) in ovariectomized, suckled (n=4) and nonsuckled (n=3) cows was investigated. Six months after ovariectomy and calf removal, the cows were challenged with 1mg, i.v. naloxone/kg body weight and 1 mg i.v. morphine/kg body weight in a crossover design; blood was collected at 15-minute intervals for 7 hours over a 3-day period. To evaluate LH secretion and pituitary responsiveness, 5 microg of GnRH were administered at Hour 6 on Day 1. On Days 2 and 3, naloxone or morphine was administered at Hour 3, followed by GnRH (5 microg/animal) at Hour 6. Mean preinjection LH concentrations (3.6 +/- 0.2 and 4.7 +/- 0.2 ng/ml), LH pulse frequency (0.6 +/- 0.1 and 0.8 +/- 0.1 pulses/hour) and LH pulse amplitude (2.9 +/- 0.5 and 2.9 +/- 0.6 ng/ml) were similar for suckled and nonsuckled cows, respectively. Morphine decreased (P < 0.01) mean serum LH concentrations (pretreatment 4.2 +/- 0.2 vs post-treatment 2.2 +/- 0.2 ng/ml) in both suckled and nonsuckled cows; however, mean serum LH concentrations remained unchanged after naloxone. Nonsuckled cows had a greater (P < 0.001) LH response to GnRH than did suckled cows (area of response curve: 1004 +/- 92 vs 434 +/- 75 arbitrary units). We suggest that opioid receptors are functionally linked to the GnRH secretory system in suckled and nonsuckled cows that had been ovariectomized for a long period of time. However, gonadotropin secretion appears not to be regulated by opioid mechanisms, and suckling inhibits pituitary responsiveness to GnRH in this model.

Current concepts of beta-endorphin physiology in female reproductive dysfunction

beta-Endorphin has a role in the regulation of the normal menstrual cycle and possibly in the onset of puberty. We have reviewed the evidence pointing to an alteration in this neuropeptide that may contribute to the pathogenesis of various reproductive dysfunctions. Elevated or high levels of beta-endorphin have been associated with exercise-associated amenorrhea, stress-associated amenorrhea, and polycystic ovarian syndrome. Depressed or low levels of beta-endorphin have been associated with PMS and menopause. Alterations in the levels of beta-endorphin may change the pulsatile release of GnRH via noradrenergic and/or dopaminergic pathways. We have primarily focused on beta-endorphin as representative of the endogenous opioid peptides, but other opioid peptides may also contribute to the pathogenesis of various types of reproductive dysfunction. Perhaps it will become possible to characterize and hone our understanding of the function of beta-endorphin and the other substances composing the endogenous opioid peptides. A better understanding of their role in physiological as well as pathophysiological processes may allow for the development of rational approaches to the treatment of specific disorders pertaining to reproduction. Many questions remain unanswered. Among the most relevant are: what is the precise mechanism of action by which beta-endorphin exerts its influence on pulsatile GnRH release? Is there a functional relationship between CNS and peripheral (serum) levels of beta-endorphin? Are the detected changes in beta-endorphin levels merely associated, or are they a cause of a particular disorder? Since it took almost 40 years between the time prostaglandins were first discovered and eventual realization of their clinical application, it may take some time before the beta-endorphin story is complete.

Effects of naloxone and animal temperament on serum luteinizing hormone and cortisol concentrations in seasonally anestrous Brahman heifers

The effect of endogenous opioid peptides (EOP) and individual animal temperament on serum luteinizing hormone (LH) were investigated in seasonally anestrous Brahman heifers (n = 24). Animals that had shown behavioral estrus in previous months but that had not returned to estrus for at least 30 d were selected. The heifers were ranked by temperament (tame = 1, normal = 2, wild = 3) and randomly allotted into three groups. Blood was collected from one heifer of each group per day. Blood samples were taken via jugular cannula every 15 min for 6 h and every 30 min for another 4 h. After the first hour of sampling, the heifers received intravenous saline (SAL, n = 8); naloxone (LN, 0.5 mg/kg i.v., n = 8); or naloxone (HN, 1.0 mg/kg i.v., n = 8). Three hours after naloxone treatment, each heifer was given gonadotropin releasing hormone (GnRH, 100 microg i.m.). All samples were processed to yield serum and were assayed for LH by radioimmunoassay (RIA). Hourly samples were assayed for cortisol by RIA. The area under the LH curve 60 min postnaloxone treatment was higher in LN and HN than in SAL (57.0 and 40.8 vs 6.1 units; P<0.01); and the area under the 180 min postnaloxone curve remained higher in LN than in SAL (106.2 vs 35.1 units; P<0.05). Cortisol concentrations 60 min postnaloxone administration were above prenaloxone levels(38.2 vs 26.7 ng/ml; P<0.0002). Temperament scores of heifers were positively correlated with cortisol release. The area under the cortisol curve had a negative correlation with mean LH. Serum LH concentrations appear to be suppressed by EOP in seasonally anestrous Brahman heifers, and EOP appear to reduce serum cortisol concentrations. Excitable heifers had higher concentrations of serum cortisol, which negatively affected serum LH concentrations.

Attenuation by an opioid agonist of the oestradiol-induced LH surge in anoestrous ewes and its reversal by naloxone

The effects of a potent opioid peptide agonist [D-ala2-Phe4, Met(0)ol5-enkephalin (FK 33-824) on the magnitude of the oestradiol-induced LH surge and on basal plasma LH concentrations were examined in intact and chronically-ovariectomized ewes during the late-anoestrous period. In intact ewes, treatment with FK 33-824 (0.5 mg i.v. every 3 hr) for a 24 hr period commencing at the time of oestradiol-17 beta administration (25 micrograms i.m. bolus) was associated with non-significant 65% reduction in the peak plasma LH level observed and a significant (P less than 0.05) 58% reduction in the total amount of LH released during the surge (calculated from the area under the curve). Concurrent treatment with the opioid antagonist naloxone (10 mg i.v. every 3 hr) partially reversed this suppressive effect on the magnitude of the LH-surge. In ovariectomized ewes no significant effects on the oestradiol-induced LH surge of either FK 38-824 alone or FK 33-824 in combination with naloxone were observed. Administration of FK 33-824 at a 6-fold higher dose rate (0.5 mg every 30 min) failed to modify basal plasma LH concentration in intact ewes. In ovariectomized ewes, however, a significant (P less than 0.05) 25% fall in basal plasma LH was observed, an effect which was completely reversed by combined treatment with naloxone (10 mg every 30 min). These results support the conclusion that endogenous opioid peptides may contribute to the neuroendocrine mechanism through which oestradiol promotes a preovulatory-like surge in the anoestrous ewe.

Effects of different opiates on hypothalamic monoamine turnover and on plasma LH levels in pro-oestrous rats

Opiate inhibition of luteinizing hormone (LH) appears to involve changes in hypothalamic monoaminergic activity. Agonists of mu-, kappa- and sigma-opioid receptors and an opiate antagonist were administered at the onset of the preovulatory LH surge and their effects on hypothalamic monoamine turnover, and on plasma LH levels, investigated. The opiate antagonist, naloxone, significantly increased both noradrenaline (NA) turnover and plasma LH levels. Morphine (mu-agonist), significantly decreased NA concentration and plasma LH levels, but significantly increased dopamine (DA) and serotonin (5-HT) activity. Levorphanol (another mu-agonist) significantly decreased both NA and 5-HT concentrations and had no effect on circulating LH. Cyclazocine, ketocyclazocine and tifluadom (kappa-agonists) increased NA turnover but only tifluadom increased 5-HT turnover, also reducing LH levels significantly. N-Allylnormetazocine (SKF 10,047; sigma-agonist) increased 5-HT activity but did not alter LH levels. This study has confirmed the existence of a heterogenous group of opioid receptors within the hypothalamus which modulate monoamine neurotransmitters controlling LH release.

The role of endogenous opioid peptides in the regulation of the menstrual cycle

This brief review, which is solely based on research performed in our laboratory in a non-human primate model, examines the central role which endogenous opioid peptides, principally beta-endorphin, may exert in the physiology and pathology of the menstrual cycle.

Naloxone reversal of stress-induced suppression of LH release in the common marmoset

There is considerable evidence suggesting that endogenous opioid peptides (EOP) might play a role in the defensive response to stressful stimuli. The stress associated with receipt of aggression from a female conspecific and physical restraint for collection of serial blood samples (at 10-min intervals) resulted in a significant (p less than 0.05) suppression of LH secretion in the oestradiol primed ovariectomized marmoset. Administration of the opioid receptor antagonist, Naloxone (1 mg/kg) immediately before and after receipt of aggression completely prevented the stress-induced decrease in LH release. This suggests that EOP may mediate, at least in part, this stress induced decline in LH release in the marmoset.

Opiate inhibition of growth hormone secretion in young chickens

Plasma concentrations of growth hormone (GH) were decreased following the intravenous administration of morphine sulfate. Maximum inhibition of GH secretion was observed 40 min after morphine sulfate challenge. At this time, doses of morphine sulfate (at 5 mg and 50 mg/kg) reduced the GH concentrations by 86 and 90%, respectively, in comparison with those in the vehicle-injected controls. An opiate antagonist, naloxone, had no stimulatory effect on basal GH concentrations, but attenuated the GH response to morphine. Neither morphine nor naloxone had any significant effect on circulating luteinizing hormone (LH) levels. These results indicate an inhibitory opiate pathway in the control of GH release and demonstrate effects on GH and LH secretion contrary to those observed in mammalian species.

Peptide-steroid interactions in brain regulation of pulsatile gonadotropin secretion

Reproductive function is regulated by an intricate system of peptide, steroid and amine factors interacting within the brain, pituitary and gonads. At no point is the complexity of the reproductive system better exemplified than in the exquisite interplay of factors required to produce and modulate pulsatile gonadotropin secretion. By extension, analysis of the pulsatile secretory pattern of the gonadotropins, as a means of assessing the contribution of these various factors, can reveal interactions too subtle to be detected by the conventional examination of mean gonadotropin concentration. Analysis of the pulsatile secretory patterns of both LH and FSH reveals striking differences between the two gonadotropins in their response to inhibitory, gonadal peptide and steroid factors, suggesting divergent paths of brain-pituitary regulation. Further studies to clarify this disparity in regulation have demonstrated that neutralization of endogenous LHRH completely abolishes pulsatile LH secretion without affecting pulsatile FSH secretion, suggesting the existence of another, as of yet unknown, brain factor which regulates FSH secretion. The feedback signals provided by gonadal steroids can induce both inhibition and facilitation of LHRH and LH secretion. Neurons of the central opiatergic system exert a tonic inhibitory influence on the catecholaminergic neurons regulating LHRH secretion, and are believed to mediate the inhibitory actions of the gonadal steroids on the LHRH system. Withdrawal of the gonadal steroids has been reported to cause a rapid loss of the tonic inhibitory control of the opiate system on LHRH secretion as revealed by a lack of response to naloxone. Reassessment of this system by analyzing the pulsatile pattern of LH secretion, however, reveals that the loss of naloxone effect after gonadectomy occurs very gradually and that an effect can still be obtained up to 2 weeks after the removal of gonadal steroids. These studies provide excellent examples of the complex interplay observed just between selected factors regulating pulsatile gonadotropin secretion. The use of pulsatile gonadotropin analysis is a powerful model, not only for providing greater clarity of known regulatory interactions, but also for revealing new and more subtle levels of control in the brain-pituitary-axis.

Opioid control of LH secretion in humans: menstrual cycle, menopause and aging reduce effect of naloxone but not of morphine

A number of studies have been made on the role played by endogenous opioid peptides in the secretion of LH in humans. However no previous studies have compared the effects of the most potent pharmacological agonist and antagonist, morphine and naloxone, in the same subjects. The present study examined the acute effects of injections of morphine and naloxone on plasma LH levels in 30 healthy subjects (18 women and 12 men). Fertile women were subdivided into follicular (n = 6) and luteal (n = 6) phase groups; the remaining 6 were postmenopausal women. The 12 men were sub-divided in two groups of 6 subjects according to age (24-33 years, and over 60 years). There was a two day interval between injection studies in the same subjects. Morphine significantly decreased plasma LH levels in all groups examined (P less than 0.01). On the other hand, naloxone caused a significant increase in plasma LH levels in fertile women during the luteal phase of the cycle, but not during the follicular phase or in postmenopausal subjects, and in young but not in aged men (P less than 0.01). These results indicate that in humans there is a change in the activity of the opioids regulating LH secretion during the menstrual cycle, after menopause and in aged men and that these may be studied by the use of naloxone. The inability of naloxone under certain conditions to increase LH levels reflects the decreased activity of the endogenous system, while morphine, being active in all the subjects, seems to be less discriminative, at least in physiological conditions.

The sex hormone-dependent development of opiate receptors in the rat medial preoptic area

The opiate receptor content of the sexually dimorphic medial preoptic area (MPOA) was examined in newborn and 5-day old (D6) male and female rats. A significant increase of [3H]naloxone binding was observed in and around the sexually dimorphic nucleus of the preoptic area (SDN-POA) in D6 female rats, relative to newborn females. Opiate receptor labeling did not increase over this period in males, nor was labeling different between males and females at birth. This dramatic alteration of MPOA opiate receptor content was observed to occur in either sex in the absence of testosterone postnatally; that is, neonatally-castrated males exhibited the same increase of labeling by D6 as did normal females. Conversely, daily postnatal testosterone treatment of females from birth to D6 resulted in the development of male-like MPOA opiate receptor pattern. The sex hormone-dependence of MPOA opiate receptor development is discussed in relation to the sex hormone-dependent ontogeny of SDN-POA structure. The overlap of critical periods for the development of these structural and chemical sexual dimorphisms suggests a role for endogenous opioids in modulating MPOA development.

Short-term effects of ovariectomy: the opioid control of LH secretion in fertile climacteric and postmenopausal women

The aim of this study was to evaluate the activity of opiate receptors involved in the regulation of LH secretion in relationship to ovariectomy. Menstruating fertile (n = 5) and climacteric (n = 7) patients and postmenopausal (n = 5) women who underwent therapeutical bilateral ovariectomy were studied in the first week postsurgery and LH plasma levels were evaluated after naloxone (4 mg in bolus plus 4 mg infusion/90 min), LHRH (10 micrograms + 10 micrograms iv) and saline administration. Two groups of fertile (n = 6) and postmenopausal (n = 6) subjects were studied as controls. Since the LH responsiveness to naloxone was impaired in climacteric patients after ovariectomy, the test was repeated in 5 of them after 1 and 6 months of estrogen-gestagen treatment (conjugated estradiol + noretisterone acetate), showing a significant increase in all patients in both cases. In four subjects treated with only gestagen, naloxone was still unable to significantly modify LH plasma levels. These results indicate that ovariectomy affects the activity of opiate receptors, resulting in the first week postsurgery LH rise inversely related to basal LH levels. Furthermore, these results indicate that one or six cycles of estrogen-gestagen treatment in ovariectomized patients similarly induces a restoration of the opiate receptors neuroendocrine activity.

Impairment of opioid control of luteinizing hormone secretion in menstrual disorders

With the aim of examining central opioid influences on the control of luteinizing hormone (LH) secretion, we evaluated the LH response to naloxone, an opioid receptor antagonist, in patients affected by normo-, hyper-, and hypogonadotropic amenorrhea, polycystic ovarian disease and hyperprolactinemia. The results indicate that opioid influences are altered in well-defined pathologic conditions (hyperprolactinemia, obesity), in addition to being modified by gonadal steroids.

Sexual maturation of the hypothalamus: pathophysiological aspects and clinical implications

Sexual maturation in humans begins early in fetal life and culminates in adulthood when the gonads have acquired a full capacity for reproduction. It is remarkable that during this long process, the pituitary gonadal function, hence its hypothalamic control presents an alternative of activation and inhibition periods, during which the interrelations of the 3 components of the hypothalamic-pituitary-gonadal axis change gradually and inversely. The ontogeny of the hypothalamic-pituitary system, the varying activity of the reproductive endocrine system throughout sexual maturation and the developmental changes in the interrelations of the hypothalamic-pituitary-gonadal axis are reviewed: the most striking feature of human sexual development is the long inhibition of hypothalamo-pituitary function during childhood. Much indirect evidence points to the determining role of the CNS in the maturation of hypothalamic function: the occurrence of rhythms of secretion, the amplitude of secretions and peripubertal specific sleep-related nycthemeral rhythm of secretion at the onset of puberty. Despite the reality of a negative feedback control, these changes do occur independently of gonadal secretions since they are observed (qualitatively if not strictly quantitatively) in agonadal children. It is likely that neurotransmitters (dopamine, serotonine) and opiates have an inhibitory effect on Gn-RH release. But we still don't know their evolution during sexual maturation. It does not appear that melatonine plays any determinant role in the onset of human puberty. The clinical implications of our present understanding of the physiological events occurring during sexual maturation are several. Considering the major problems related to abnormal sexual maturation we will discuss successively: (1) diagnosis of hypogonadotrophic hypogonadism in early infancy; (2) differential diagnosis between premature thelarche and true sexual precocity; (3) the usefulness of endocrine investigations in the evaluation of hypothalamic-pituitary function; and (4) the new developments in the treatment of precocious puberty, delayed puberty or hypogonadism.

Endogenous opioid peptides and the control of the menstrual cycle

This paper reviews recent experimental evidence which supports a role for endogenous opioid peptides in the control of gonadotropin function. In primates, cell bodies containing endogenous opioid peptides have been located within the hypothalamus in areas rich in gonadotropin-releasing hormone (GnRH) and dopamine. The release of beta-endorphin from these hypothalamic neurons is influenced by gonadal steroids, maximal release being observed when both estradiol and progesterone are present. beta-Endorphin has been shown to decrease LH secretion, and naloxone, an opiate antagonist, reverses this action. The LH-releasing activity of naloxone parallels variations in hypothalamic beta-endorphin secretory activity, so that maximal effects are seen during the luteal phase of the cycle. Present evidence indicates that opiates exert their effect on LH via a hypothalamic site. It is concluded that increased opioid inhibition of the GnRH-LH axis is responsible for the decline in LH pulse frequency during the luteal phase. The studies provide evidence for a chemical basis rationalizing relationships between reproductive function and stress, and have further implication on other forms of amenorrhea.

The sexually dimorphic region of the preoptic area in rats contains denser opiate receptor binding sites in females

Quantitative autoradiographic analysis of opiate receptor binding using [3H]naloxone shows higher levels in the sexually dimorphic region of the medial preoptic area in female rats than in males. Opiate receptor density varies across the estrous cycle being densest in diestrous females. The sexually dimorphic nucleus of the preoptic area lies within the opiate receptor-rich region. Endogenous opiates in the medial preoptic region acting at opiate receptors which are of differential density in males and females could influence sex-specific behavior mediated by the region.

Medical hypophysectomy: I. Dose-response using a gonadotropin-releasing hormone antagonist

The hypothalamic-pituitary-ovarian axis can be "dissected" in a nonsurgical and reversible fashion by the administration of a potent gonadotropin-releasing hormone (GnRH) antagonist. We created a transient, functional lesion at the level of the pituitary gonadotrope by using a potent GnRH antagonist ([ Ac- pClPhe1 , pClDPhe2 , DTrp3 , DArg6 , DAla10 ]-GnRH). In long-term castrate cynomolgus monkeys, doses of 0.05 to 2.0 mg/kg/day intramuscularly were administered for a total of 32 days. At doses up to 0.2 mg/kg/day, follicle-stimulating hormone (FSH) and luteinizing hormone (LH) in circulation were only moderately suppressed; these subjects responded to an estradiol challenge by manifesting an LH elevation or surge within 48 hours. At doses of 0.5 to 1.0 mg/kg/day, FSH and LH secretion was suppressed to or below the limits of assay detection within 7 days, remaining in a severely hypogonadotropic state for the remainder of the treatment interval. Using 2 mg/kg/day, estradiol-positive feedback for midcycle-like LH/FSH surges was fully inhibited. This suppression of gonadotropin secretion was rapidly reversible, in that circulating gonadotropin levels had returned to pretreatment castrate levels within 60 days after termination of GnRH antagonist treatments. These findings suggest that potent GnRH antagonists can effectively create a hypogonadotropic milieu without the initial enhancement of gonadotropin secretion that occurs during initiation of GnRH agonist therapy. "Medical hypophysectomy" through GnRH antagonist administration may permit a more direct and controlled approach to gonadal therapies such as ovulation induction.

Beta-endorphin in pregnancy

Concentrations of maternal plasma beta-endorphin (beta-EP) as measured by radioimmunoassay decline during pregnancy, reaching a nadir during the second trimester, rise during labor, remain elevated during the early postpartum period and are increased prior to elective cesarean section in the absence of labor. They decline in response to epidural anesthesia during labor and increase during induction of general but not regional anesthesia for cesarean section. Umbilical venous plasma beta-EP levels are not affected by the route or mode of delivery nor the presence or absence of labor, but rise in conjunction with fetal distress. In the presence of fetal distress, umbilical arterial plasma beta-EP levels appear to rise faster than umbilical venous beta-EP concentrations. Amniotic fluid beta-EP levels are higher during the second than third trimester. These data indicate that peripheral plasma beta-EP concentrations reflect stress in both mother and fetus. In the mother, pregnancy itself does not appear to be stressful, whereas pain associated with labor rather than uterine contractions as such increase plasma beta-EP levels. In the fetus, hypoxia and acidosis effectively raise plasma beta-EP concentrations. The origin and physiologic significance of amniotic fluid beta-EP, which appears to be unrelated to fetal maturity, remain to be established.

Axonal projections and peptide content of steroid hormone concentrating neurons

The axonal projections of cell groups containing the most dense collections of steroid hormone concentrating cells have been demonstrated with retrograde neuroanatomical tracing methods. Horseradish peroxidase revealed large numbers of neurons in ventrolateral ventromedial nucleus (VL-VM) which project to dorsal midbrain. Wheat germ agglutinin (immunocytochemical recognition method) revealed large numbers of neurons in medial basal hypothalamus (MBH) and particular subdivisions of paraventricular nucleus (PVN) that project to dorsal caudal medulla or spinal cord. Fluorescent dyes revealed that many preoptic area (POA), anterior hypothalamic (AHA), and bed nucleus of the stria terminalis (BNST) neurons project to ventral tegmental area of Tsai (VTA). Also many neurons in POA and BNST project to amygdala. A method which enabled simultaneous demonstration of the steroid binding capacity and axonal projections of neurons in the same tissue section revealed that 26-36% estradiol (E2) concentrating cells in VL-VM project to dorsal midbrain. E2 concentrating neurons in POA and BNST project to amygdala and E2 concentrating POA neurons project to VTA. These neurons, which send their axons to cell groups located in different brain regions, are probably under the genomic-regulatory influence of E2. Using a method which allows simultaneous demonstration of peptide content and steroid hormone concentrating capacity of cells, many oxytocin-neurophysin and vasopressin-neurophysin containing magnocellular neurons in the caudal PVN were found to concentrate E2. About 4% of the beta-endorphin and about 6% of the dynorphin containing neurons in the MBH concentrate E2. In contrast, virtually none (less than 0.2%) of the LHRH containing hypothalamic neurons concentrate E2.