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Owens LA, Abbara A, Lerner A, O'floinn S, Christopoulos G, Khanjani S, Islam R, Hardy K, Hanyaloglu AC, Lavery SA, Dhillo WS, Franks S. The direct and indirect effects of kisspeptin-54 on granulosa lutein cell function. Hum Reprod 2019; 33:292-302. [PMID: 29206944 DOI: 10.1093/humrep/dex357] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 11/13/2017] [Indexed: 11/12/2022] Open
Abstract
STUDY QUESTION What are the in vivo and in vitro actions of kisspeptin-54 on the expression of genes involved in ovarian reproductive function, steroidogenesis and ovarian hyperstimulation syndrome (OHSS) in granulosa lutein (GL) cells when compared with traditional triggers of oocyte maturation? SUMMARY ANSWER The use of kisspeptin-54 as an oocyte maturation trigger augmented expression of genes involved in ovarian steroidogenesis in human GL cells including, FSH receptor (FSHR), LH/hCG receptor (LHCGR), steroid acute regulatory protein (STAR), aromatase, estrogen receptors alpha and beta (ESR1, ESR2), 3-beta-hydroxysteroid dehydrogenase type 2 (3BHSD2) and inhibin A (INHBA), when compared to traditional maturation triggers, but did not alter markers of OHSS. WHAT IS KNOWN ALREADY hCG is the most widely used trigger of oocyte maturation, but is associated with an increased risk of OHSS. The use of GnRH agonists to trigger oocyte maturation is a safer alternative to hCG. More recently, kisspeptin-54 has emerged as a novel therapeutic option that safely triggers oocyte maturation even in women at high risk of OHSS. Kisspeptin indirectly stimulates gonadotropin secretion by acting on hypothalamic GnRH neurons. Kisspeptin and its receptor are also expressed in the human ovary, but there is limited data on the direct action of kisspeptin on the ovary. STUDY DESIGN SIZE, DURATION Forty-eight women undergoing IVF treatment for infertility consented to kisspeptin-54 triggering and/or granulosa cell collection and were included in the study. Twelve women received hCG, 12 received GnRH agonist and 24 received kisspeptin-54 to trigger oocyte maturation. In the kisspeptin-54 group, 12 received one injection of kisseptin-54 (9.6 nmol/kg) and 12 received two injections of kisspeptin-54 at a 10 h interval (9.6 nmol/kg × 2). PARTICIPANTS/MATERIALS, SETTING, METHODS Follicular fluid was aspirated and pooled from follicles during the retrieval of oocytes for IVF/ICSI. GL cells were isolated and either RNA extracted immediately or cultured in vitro ± kisspeptin or hCG. MAIN RESULTS AND THE ROLE OF CHANCE GL cells from women who had received kisspeptin-54 had a 14-fold and 8-fold higher gene expression of FSHR and a 2-fold (ns) and 2.5-fold (P < 0.05) higher expression of LHCGR than GL cells from women who had received hCG or GnRH agonist, respectively. CYP19A1 expression was 3.6-fold (P < 0.05) and 4.5-fold (P < 0.05) higher, STAR expression was 3.4-fold (P < 0.01) and 1.8-fold (P < 0.05) higher, HSD3B2 expression was 7.5- (P < 0.01) and 2.5-fold higher (P < 0.05), INHBA was 2.5-fold (P < 0.01) and 2.5-fold (P < 0.01) higher in GL cells from women who had received kisspeptin-54 than hCG or GnRHa, respectively. ESR1 (P < 0.05) and ESR2 (P < 0.05) both showed 3-fold higher expression in cells from kisspeptin treated than GnRHa treated women. Markers of vascular permeability and oocyte growth factors were unchanged (VEGFA, SERPINF1, CDH5, amphiregulin, epiregulin). Gene expression of kisspeptin receptor was unchanged. Whereas treating GL cells in vitro with hCG induced steroidogenic gene expression, kisspeptin-54 had no significant direct effects on either OHSS genes or steroidogenic genes. LIMITATIONS REASONS FOR CAUTION Most women in the study had PCOS, which may limit applicability to other patient groups. For the analysis of the in vitro effects of kisspeptin-54, it is important to note that GL cells had already been exposed in vivo to an alternate maturation trigger. WIDER IMPLICATIONS OF THE FINDINGS The profile of serum gonadotropins seen with kisspeptin administration compared to other triggers more closely resemble that of the natural cycle as compared with hCG. Thus, kisspeptin could potentially permit an ovarian environment augmented for steroidogenesis, in particular progesterone synthesis, which is required for embryo implantation. STUDY FUNDING/COMPETING INTEREST(S) Dr Owens is supported by an Imperial College London PhD Scholarship. Dr Abbara is supported by an National Institute of Health Research Academic Clinical Lectureship. The authors do not have any conflict of interest to declare. TRIAL REGISTRATION NUMBER ClinicalTrials.gov NCT01667406.
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Affiliation(s)
- L A Owens
- Institute of Reproductive and Developmental Biology, Hammersmith Hospital, Imperial College, Du Cane Road, London W12 0NN, UK
| | - A Abbara
- Department of Investigative Medicine, Imperial College London, Hammersmith Hospital, Du Cane Road, London W12 0NN, UK
| | - A Lerner
- Institute of Reproductive and Developmental Biology, Hammersmith Hospital, Imperial College, Du Cane Road, London W12 0NN, UK
| | - S O'floinn
- Institute of Reproductive and Developmental Biology, Hammersmith Hospital, Imperial College, Du Cane Road, London W12 0NN, UK
| | - G Christopoulos
- Department of Reproductive Medicine, Hammersmith Hospital, Imperial College Healthcare NHS Trust, Du Cane Road, London W12 0NN, UK
| | - S Khanjani
- Department of Reproductive Medicine, Hammersmith Hospital, Imperial College Healthcare NHS Trust, Du Cane Road, London W12 0NN, UK
| | - R Islam
- Department of Reproductive Medicine, Hammersmith Hospital, Imperial College Healthcare NHS Trust, Du Cane Road, London W12 0NN, UK
| | - K Hardy
- Institute of Reproductive and Developmental Biology, Hammersmith Hospital, Imperial College, Du Cane Road, London W12 0NN, UK
| | - A C Hanyaloglu
- Institute of Reproductive and Developmental Biology, Hammersmith Hospital, Imperial College, Du Cane Road, London W12 0NN, UK
| | - S A Lavery
- Department of Reproductive Medicine, Hammersmith Hospital, Imperial College Healthcare NHS Trust, Du Cane Road, London W12 0NN, UK
| | - W S Dhillo
- Department of Investigative Medicine, Imperial College London, Hammersmith Hospital, Du Cane Road, London W12 0NN, UK
| | - S Franks
- Institute of Reproductive and Developmental Biology, Hammersmith Hospital, Imperial College, Du Cane Road, London W12 0NN, UK
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Algeffari M, Jayasena CN, MacKeith P, Thapar A, Dhillo WS, Oliver N. Testosterone therapy for sexual dysfunction in men with Type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials. Diabet Med 2018; 35:195-202. [PMID: 29171080 DOI: 10.1111/dme.13553] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/20/2017] [Indexed: 12/19/2022]
Abstract
AIM To evaluate the effectiveness of testosterone therapy on a range of sexual function domains in men with Type 2 diabetes. METHOD Electronic databases were searched for studies investigating the effect of testosterone therapy on sexual function in men with Type 2 diabetes. All randomized controlled trials were considered for inclusion if they compared the efficacy of testosterone therapy with that of placebo and reported sexual function outcomes. Statistical analysis was performed using a random-effects model, and heterogeneity was expressed using the I2 statistic. RESULTS A total of 611 articles were screened. Six randomized control trials, in a total of 587 men with Type 2 diabetes, were eligible for inclusion. The pooled data suggested that testosterone therapy improves sexual desire (random-effects pooled effect size 0.314; 95% CI 0.082-0.546) and erectile function (random-effects pooled effect size 0.203; 95% CI 0.007-0.399) when compared with control groups. Testosterone therapy had no significant effect on constitutional symptoms or other sexual domains compared with control groups. No studies have investigated the incidence of prostate cancer, fertility and cardiovascular disease after testosterone therapy in men with Type 2 diabetes. CONCLUSION Testosterone therapy may moderately improve sexual desire and erectile function in men with Type 2 diabetes; however, available data are limited, and the long-term risks of testosterone therapy are not known in this specific patient group. We conclude that testosterone therapy is a potential treatment for men with Type 2 diabetes non-responsive to phosphodiesterase-5 inhibitors. Testosterone therapy could be considered for men with Type 2 diabetes when potential risks and benefits of therapy are carefully considered and other therapeutic options are unsuitable.
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Affiliation(s)
- M Algeffari
- Department of Investigative Medicine, Imperial College London, London, UK
- Department of Family Medicine, College of Medicine, Qassim University, Saudi Arabia
| | - C N Jayasena
- Department of Investigative Medicine, Imperial College London, London, UK
- Department of Andrology, Hammersmith Hospital, London, UK
| | - P MacKeith
- Department of Public Health, University of East Anglia, Norwich, UK
| | - A Thapar
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - W S Dhillo
- Department of Investigative Medicine, Imperial College London, London, UK
| | - N Oliver
- Department of Investigative Medicine, Imperial College London, London, UK
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Affiliation(s)
- J. K. Prague
- Department of Investigative Medicine, Imperial College London, London, UK
| | - W. S. Dhillo
- Department of Investigative Medicine, Imperial College London, London, UK
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Vimalesvaran S, Narayanaswamy S, Yang L, Prague JK, Buckley A, Miras AD, Franks S, Meeran K, Dhillo WS. Using kisspeptin to assess GnRH function in an unusual case of primary amenorrhoea. Endocrinol Diabetes Metab Case Rep 2017; 2017:EDM160117. [PMID: 28458903 PMCID: PMC5404476 DOI: 10.1530/edm-16-0117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 02/10/2017] [Indexed: 11/14/2022] Open
Abstract
Summary Primary amenorrhoea is defined as the failure to commence menstruation by the age of 15 years, in the presence of normal secondary sexual development. The potential causes of primary amenorrhoea extend from structural to chromosomal abnormalities. Polycystic ovarian syndrome (PCOS) is a common cause of secondary amenorrhoea but an uncommon cause of primary amenorrhoea. An early and prompt diagnosis of PCOS is important, as up to 30% of these women are predisposed to glucose intolerance and obesity, with the subgroup of women presenting with primary amenorrhoea and PCOS displaying a higher incidence of metabolic dysfunction. We describe a case of an 18-year-old female presenting with primary amenorrhoea of unknown aetiology. Although initial investigations did not demonstrate clinical or biochemical hyperandrogenism or any radiological evidence of polycystic ovaries, a raised luteinising hormone (LH) suggested a diagnosis of PCOS. If PCOS was the correct diagnosis, then one would expect intact hypothalamic GnRH and pituitary gonadotropin release. We used the novel hormone kisspeptin to confirm intact hypothalamic GnRH release and a GnRH stimulation test to confirm intact pituitary gonadotroph function. This case highlights that kisspeptin is a potential unique tool to test GnRH function in patients presenting with reproductive disorders. Learning points:
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Affiliation(s)
- S Vimalesvaran
- 1Department of Endocrinology & Metabolism, Imperial College London UK
| | - S Narayanaswamy
- 1Department of Endocrinology & Metabolism, Imperial College London UK
| | - L Yang
- 1Department of Endocrinology & Metabolism, Imperial College London UK
| | - J K Prague
- 1Department of Endocrinology & Metabolism, Imperial College London UK
| | - A Buckley
- 1Department of Endocrinology & Metabolism, Imperial College London UK
| | - A D Miras
- 2Department of Diabetes & Endocrinology, Imperial Healthcare NHS Trust, London UK
| | - S Franks
- 2Department of Diabetes & Endocrinology, Imperial Healthcare NHS Trust, London UK
| | - K Meeran
- 2Department of Diabetes & Endocrinology, Imperial Healthcare NHS Trust, London UK
| | - W S Dhillo
- 1Department of Endocrinology & Metabolism, Imperial College London UK
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Polyviou T, MacDougall K, Chambers ES, Viardot A, Psichas A, Jawaid S, Harris HC, Edwards CA, Simpson L, Murphy KG, Zac‐Varghese SEK, Blundell JE, Dhillo WS, Bloom SR, Frost GS, Preston T, Tedford MC, Morrison DJ. Randomised clinical study: inulin short-chain fatty acid esters for targeted delivery of short-chain fatty acids to the human colon. Aliment Pharmacol Ther 2016; 44:662-72. [PMID: 27464984 PMCID: PMC5026196 DOI: 10.1111/apt.13749] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 01/04/2016] [Accepted: 07/10/2016] [Indexed: 12/16/2022]
Abstract
BACKGROUND Short-chain fatty acids (SCFA) produced through fermentation of nondigestible carbohydrates by the gut microbiota are associated with positive metabolic effects. However, well-controlled trials are limited in humans. AIMS To develop a methodology to deliver SCFA directly to the colon, and to optimise colonic propionate delivery in humans, to determine its role in appetite regulation and food intake. METHODS Inulin SCFA esters were developed and tested as site-specific delivery vehicles for SCFA to the proximal colon. Inulin propionate esters containing 0-61 wt% (IPE-0-IPE-61) propionate were assessed in vitro using batch faecal fermentations. In a randomised, controlled, crossover study, with inulin as control, ad libitum food intake (kcal) was compared after 7 days on IPE-27 or IPE-54 (10 g/day all treatments). Propionate release was determined using (13) C-labelled IPE variants. RESULTS In vitro, IPE-27-IPE-54 wt% propionate resulted in a sevenfold increase in propionate production compared with inulin (P < 0.05). In vivo, IPE-27 led to greater (13) C recovery in breath CO2 than IPE-54 (64.9 vs. 24.9%, P = 0.001). IPE-27 also led to a reduction in energy intake during the ad libitum test meal compared with both inulin (439.5 vs. 703.9 kcal, P = 0.025) and IPE-54 (439.5 vs. 659.3 kcal, P = 0.025), whereas IPE-54 was not significantly different from inulin control. CONCLUSIONS IPE-27 significantly reduced food intake suggesting colonic propionate plays a role in appetite regulation. Inulin short-chain fatty acid esters provide a novel tool for probing the diet-gut microbiome-host metabolism axis in humans.
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Affiliation(s)
- T. Polyviou
- Stable Isotope Biochemistry LaboratoryScottish Universities Environmental Research Centre (SUERC)East KilbrideUK
| | - K. MacDougall
- School of ScienceUniversity of the West of ScotlandHamiltonUK
| | - E. S. Chambers
- Nutrition and Dietetic Research GroupHammersmith CampusFaculty of MedicineImperial College LondonLondonUK
| | - A. Viardot
- Nutrition and Dietetic Research GroupHammersmith CampusFaculty of MedicineImperial College LondonLondonUK
| | - A. Psichas
- Nutrition and Dietetic Research GroupHammersmith CampusFaculty of MedicineImperial College LondonLondonUK
| | - S. Jawaid
- School of ScienceUniversity of the West of ScotlandHamiltonUK
| | - H. C. Harris
- School of MedicineCollege of Medical Veterinary and Life ScienceUniversity of GlasgowGlasgowUK
| | - C. A. Edwards
- School of MedicineCollege of Medical Veterinary and Life ScienceUniversity of GlasgowGlasgowUK
| | - L. Simpson
- Stable Isotope Biochemistry LaboratoryScottish Universities Environmental Research Centre (SUERC)East KilbrideUK,School of ScienceUniversity of the West of ScotlandHamiltonUK
| | - K. G. Murphy
- Section of Endocrinology and Investigative MedicineHammersmith CampusFaculty of MedicineImperial College LondonLondonUK
| | - S. E. K. Zac‐Varghese
- Nutrition and Dietetic Research GroupHammersmith CampusFaculty of MedicineImperial College LondonLondonUK
| | - J. E. Blundell
- Institute of Psychological SciencesUniversity of LeedsLeedsUK
| | - W. S. Dhillo
- Section of Endocrinology and Investigative MedicineHammersmith CampusFaculty of MedicineImperial College LondonLondonUK
| | - S. R. Bloom
- Section of Endocrinology and Investigative MedicineHammersmith CampusFaculty of MedicineImperial College LondonLondonUK
| | - G. S. Frost
- Nutrition and Dietetic Research GroupHammersmith CampusFaculty of MedicineImperial College LondonLondonUK
| | - T. Preston
- Stable Isotope Biochemistry LaboratoryScottish Universities Environmental Research Centre (SUERC)East KilbrideUK
| | - M. C. Tedford
- School of ScienceUniversity of the West of ScotlandHamiltonUK
| | - D. J. Morrison
- Stable Isotope Biochemistry LaboratoryScottish Universities Environmental Research Centre (SUERC)East KilbrideUK
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Salem V, Izzi‐Engbeaya C, Coello C, Thomas DB, Chambers ES, Comninos AN, Buckley A, Win Z, Al‐Nahhas A, Rabiner EA, Gunn RN, Budge H, Symonds ME, Bloom SR, Tan TM, Dhillo WS. Glucagon increases energy expenditure independently of brown adipose tissue activation in humans. Diabetes Obes Metab 2016; 18:72-81. [PMID: 26434748 PMCID: PMC4710848 DOI: 10.1111/dom.12585] [Citation(s) in RCA: 113] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 08/01/2015] [Accepted: 09/29/2015] [Indexed: 02/06/2023]
Abstract
AIMS To investigate, for a given energy expenditure (EE) rise, the differential effects of glucagon infusion and cold exposure on brown adipose tissue (BAT) activation in humans. METHODS Indirect calorimetry and supraclavicular thermography was performed in 11 healthy male volunteers before and after: cold exposure; glucagon infusion (at 23 °C); and vehicle infusion (at 23 °C). All volunteers underwent (18)F-fluorodeoxyglucose ((18)F-FDG) positron emission tomography (PET)/CT scanning with cold exposure. Subjects with cold-induced BAT activation on (18)F-FDG PET/CT (n = 8) underwent a randomly allocated second (18)F-FDG PET/CT scan (at 23 °C), either with glucagon infusion (n = 4) or vehicle infusion (n = 4). RESULTS We observed that EE increased by 14% after cold exposure and by 15% after glucagon infusion (50 ng/kg/min; p < 0.05 vs control for both). Cold exposure produced an increase in neck temperature (+0.44 °C; p < 0.001 vs control), but glucagon infusion did not alter neck temperature. In subjects with a cold-induced increase in the metabolic activity of supraclavicular BAT on (18)F-FDG PET/CT, a significant rise in the metabolic activity of BAT after glucagon infusion was not detected. Cold exposure increased sympathetic activation, as measured by circulating norepinephrine levels, but glucagon infusion did not. CONCLUSIONS Glucagon increases EE by a similar magnitude compared with cold activation, but independently of BAT thermogenesis. This finding is of importance for the development of safe treatments for obesity through upregulation of EE.
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Affiliation(s)
- V. Salem
- Section of Investigative MedicineHammersmith Hospital, Imperial College LondonLondonUK
| | - C. Izzi‐Engbeaya
- Section of Investigative MedicineHammersmith Hospital, Imperial College LondonLondonUK
| | - C. Coello
- Imanova Centre for Imaging Sciences, Hammersmith HospitalLondonUK
| | - D. B. Thomas
- Department of ComputingImperial College LondonLondonUK
| | - E. S. Chambers
- Section of Investigative MedicineHammersmith Hospital, Imperial College LondonLondonUK
| | - A. N. Comninos
- Section of Investigative MedicineHammersmith Hospital, Imperial College LondonLondonUK
| | - A. Buckley
- Section of Investigative MedicineHammersmith Hospital, Imperial College LondonLondonUK
| | - Z. Win
- Department of RadiologyImperial College NHS Healthcare TrustLondonUK
| | - A. Al‐Nahhas
- Department of RadiologyImperial College NHS Healthcare TrustLondonUK
| | - E. A. Rabiner
- Imanova Centre for Imaging Sciences, Hammersmith HospitalLondonUK
- Centre for Neuroimaging SciencesKing's CollegeLondonUK
| | - R. N. Gunn
- Imanova Centre for Imaging Sciences, Hammersmith HospitalLondonUK
- Division of Brain SciencesImperial College LondonLondonUK
| | - H. Budge
- Early Life Research Group, Academic Division of Child Health, Obsterics and Gynaecology, School of Medicine, Queen's Medical Centre, University HospitalThe University of NottinghamNottinghamUK
| | - M. E. Symonds
- Early Life Research Group, Academic Division of Child Health, Obsterics and Gynaecology, School of Medicine, Queen's Medical Centre, University HospitalThe University of NottinghamNottinghamUK
| | - S. R. Bloom
- Section of Investigative MedicineHammersmith Hospital, Imperial College LondonLondonUK
| | - T. M. Tan
- Section of Investigative MedicineHammersmith Hospital, Imperial College LondonLondonUK
| | - W. S. Dhillo
- Section of Investigative MedicineHammersmith Hospital, Imperial College LondonLondonUK
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Jayasena CN, Abbara A, Narayanaswamy S, Comninos AN, Ratnasabapathy R, Bassett P, Mogford JT, Malik Z, Calley J, Ghatei MA, Bloom SR, Dhillo WS. Direct comparison of the effects of intravenous kisspeptin-10, kisspeptin-54 and GnRH on gonadotrophin secretion in healthy men. Hum Reprod 2015; 30:1934-41. [PMID: 26089302 PMCID: PMC4507333 DOI: 10.1093/humrep/dev143] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 05/22/2015] [Indexed: 12/16/2022] Open
Abstract
STUDY QUESTION How potently does the novel hypothalamic stimulator of reproduction, kisspeptin, increase gonadotrophin secretion when compared with GnRH in healthy men? SUMMARY ANSWER At the doses tested, intravenous administration of either of two major kisspeptin isoforms, kisspeptin-10 and -54, was associated with similar levels of gonadotrophin secretion in healthy men; however, GnRH was more potent when compared with either kisspeptin isoform. WHAT IS KNOWN ALREADY Kisspeptin-10 and -54 are naturally occurring hormones in the kisspeptin peptide family which potently stimulates endogenous GnRH secretion from the hypothalamus, so have the potential to treat patients with reproductive disorders. Rodent studies suggest that kisspeptin-54 is more potent when compared with kisspepitn-10; however, their effects have not previously been directly compared in humans, or compared with direct pituitary stimulation of gonadotrophin secretion using GnRH. STUDY DESIGN, SIZE AND DURATION A single-blinded placebo controlled physiological study was performed from January to December 2013. Local ethical approval was granted, and five participants were recruited to each dosing group. PARTICIPANTS/MATERIALS, SETTING, METHODS Healthy men were administered vehicle, kisspeptin-10, kisspeptin-54 and GnRH intravenously for 3 h on different study days. Each hormone was administered at 0.1, 0.3 and 1.0 nmol/kg/h doses (n = 5 subjects per group). Regular blood sampling was conducted throughout the study to measure LH and FSH. Study visits were conducted at least a week apart. MAIN RESULTS AND THE ROLE OF CHANCE Serum LH and FSH levels were ∼3-fold higher during GnRH infusion when compared with kisspeptin-10 and ∼2-fold higher when compared with kisspeptin-54 [mean area under the curve serum LH during infusion (in hours times international units per litre, h.IU/l): 10.81 ± 1.73, 1.0 nmol/kg/h kisspeptin-10; 14.43 ± 1.27, 1.0 nmol/kg/h kisspeptin-54; 34.06 ± 5.18, 1.0 nmol/kg/h GnRH, P < 0.001 versus kisspeptin-10, P < 0.01 versus kisspeptin-54]. LIMITATIONS, REASONS FOR CAUTION This study had a small sample size. WIDER IMPLICATIONS OF THE FINDINGS Kisspeptin offers a novel means of stimulating the reproductive axis. Our data suggest that kisspeptin stimulates gonadotrophin secretion less potently when compared with GnRH; however, kisspeptin may stimulate gonadotrophins in a more physiological manner when compared with current therapies. Kisspeptin is emerging as a future therapeutic agent, so it is important to establish which kisspeptin hormones could be used to treat patients with infertility. Results of this study suggest that either isoform has similar effects on reproductive hormone secretion in healthy men when administered intravenously. STUDY FUNDING/COMPETING INTERESTS This work is funded by grants from the MRC and NIHR and is supported by the NIHR Imperial Biomedical Research Centre Funding Scheme. C.N.J. is supported by an NIHR Clinical Lectureship. A.A. is supported by Wellcome Trust Research Training Fellowships. A.N.C. is supported by Wellcome Trust Translational Medicine Training Fellowship. W.S.D. is supported by an NIHR Career Development Fellowship.
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Affiliation(s)
- C N Jayasena
- Department of Investigative Medicine, Imperial College London, Hammersmith Hospital, 6th Floor, Commonwealth Building, London W12 0NN, UK
| | - A Abbara
- Department of Investigative Medicine, Imperial College London, Hammersmith Hospital, 6th Floor, Commonwealth Building, London W12 0NN, UK
| | - S Narayanaswamy
- Department of Investigative Medicine, Imperial College London, Hammersmith Hospital, 6th Floor, Commonwealth Building, London W12 0NN, UK
| | - A N Comninos
- Department of Investigative Medicine, Imperial College London, Hammersmith Hospital, 6th Floor, Commonwealth Building, London W12 0NN, UK
| | - R Ratnasabapathy
- Department of Investigative Medicine, Imperial College London, Hammersmith Hospital, 6th Floor, Commonwealth Building, London W12 0NN, UK
| | - P Bassett
- Statsconsultancy Ltd, 40 Longwood Lane, Amersham, Bucks HP7 9EN, UK
| | - J T Mogford
- Department of Investigative Medicine, Imperial College London, Hammersmith Hospital, 6th Floor, Commonwealth Building, London W12 0NN, UK
| | - Z Malik
- Department of Investigative Medicine, Imperial College London, Hammersmith Hospital, 6th Floor, Commonwealth Building, London W12 0NN, UK
| | - J Calley
- Department of Investigative Medicine, Imperial College London, Hammersmith Hospital, 6th Floor, Commonwealth Building, London W12 0NN, UK
| | - M A Ghatei
- Department of Investigative Medicine, Imperial College London, Hammersmith Hospital, 6th Floor, Commonwealth Building, London W12 0NN, UK
| | - S R Bloom
- Department of Investigative Medicine, Imperial College London, Hammersmith Hospital, 6th Floor, Commonwealth Building, London W12 0NN, UK
| | - W S Dhillo
- Department of Investigative Medicine, Imperial College London, Hammersmith Hospital, 6th Floor, Commonwealth Building, London W12 0NN, UK
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Ramachandran R, Bech P, Murphy KG, Caplin ME, Patel M, Vohra S, Khan MS, Dhillo WS, Sharma R, Palazzo FF, Win Z, Tan T, Khoo B, Meeran K, Frilling A, Ghatei MA, Bloom SR, Martin NM. Comparison of the utility of Cocaine- and Amphetamine-Regulated Transcript (CART), chromogranin A, and chromogranin B in neuroendocrine tumor diagnosis and assessment of disease progression. J Clin Endocrinol Metab 2015; 100:1520-8. [PMID: 25664601 DOI: 10.1210/jc.2014-3640] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
CONTEXT Prognosis in patients with neuroendocrine tumors (NETs) is often poor, frequently reflecting delayed diagnosis. Hence, accurate and practical NET markers are needed. Cocaine- and amphetamine-regulated transcript (CART) peptide is a potential novel NET marker. DESIGN AND PARTICIPANTS Circulating levels of CART peptide and the established NET markers chromogranin A (CgA) and chromogranin B (CgB) were measured using RIA in 353 patients with NET (normal renal function) and in controls. Clinical data were collected retrospectively. MAIN OUTCOME MEASURE(S) The comparative and combined utility of CART, CgA, and CgB for diagnosis and assessment of disease progression was measured in different NET subtypes. RESULTS CgA and CgB in combination improved diagnostic accuracy in patients with gut NETs, nongastroenteropancreatic NETs, and NETs with an unknown primary origin compared with each biomarker alone. Measuring CART did not further improve diagnosis in these NET subtypes. For pancreatic NETs, CgB was superior to CgA and CART in detecting stable disease (P < .007), whereas CgA and CART in combination were most effective in identifying progressive disease. In phaeochromocytomas/paragangliomas (PCC/PGL), CART was the most useful biomarker for identifying stable (P < .001) and progressive (P = .001) disease. Consistent with this, plasma CART decreased following PCC/PGL tumor resection, remaining low in all patients in remission, but increasing in those with progressive disease. CONCLUSIONS CART is a useful marker for identifying progressive pancreatic NETs. CART is superior to CgA and CgB in detecting stable and progressive PCC/PGLs, and may have a role as a surveillance marker for PCC/PGL patients.
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Affiliation(s)
- R Ramachandran
- European Neuroendocrine Tumor Society (ENETS) Centre of Excellence (R.R., P.B., K.G.M., M.P., S.V., W.S.D., R.S., F.F.P., Z.W., T.T., K.M., A.F., M.A.G., S.R.B., N.M.M.), Division of Diabetes, Endocrinology and Metabolism, Section of Investigative Medicine (R.R., P.B., K.G.M., M.P., S.V., W.S.D., T.T., K.M., M.A.G., S.R.B., N.M.M.), Imperial College London, London, W12 0HS United Kingdom; ENETS Centre of Excellence Neuroendocrine Tumor Unit (M.E.C., M.S.K., B.K.), Royal Free London NHS Foundation Trust Hospital, London, NW3 2QG. United Kingdom; Department of Gastroenterology (M.S.K.), University Hospital of Wales, Cardiff, CF14 4XW United Kingdom; Division of Experimental Medicine (R.S.), Departments of Surgery and Cancer (F.F.P.), and Radiology (Z.W.), Imperial College Healthcare NHS Trust, London, London W12 0HS, United Kingdom
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9
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Jayasena CN, Abbara A, Izzi-Engbeaya C, Comninos AN, Harvey RA, Gonzalez Maffe J, Sarang Z, Ganiyu-Dada Z, Padilha AI, Dhanjal M, Williamson C, Regan L, Ghatei MA, Bloom SR, Dhillo WS. Reduced levels of plasma kisspeptin during the antenatal booking visit are associated with increased risk of miscarriage. J Clin Endocrinol Metab 2014; 99:E2652-60. [PMID: 25127195 PMCID: PMC4255122 DOI: 10.1210/jc.2014-1953] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Kisspeptin is a recently identified hormone encoded by the KISS1 gene, playing a critical role in human reproduction. Plasma kisspeptin levels rise dramatically during normal pregnancy due to placental synthesis, which implicates it as a potential tool for assessing risks of pregnancy complications. No previous prospective study has investigated the association between plasma kisspeptin and risk of miscarriage. OBJECTIVE The objective of the study was to determine whether a single plasma kisspeptin or serum human chorionic gonadotropin (hCG) measurement in asymptomatic women attending their booking antenatal visit is associated with miscarriage. DESIGN This was a prospective cohort study. SETTING The study was conducted at a tertiary obstetric center. PARTICIPANTS A total of 993 asymptomatic pregnant women with a gestation of 6 weeks or longer attending routine antenatal booking visit were recruited between January 2010 and December 2012. MAIN OUTCOME MEASURES Plasma kisspeptin and serum hCG were measured during the antenatal booking visit. Pregnancy outcome was recorded prospectively. RESULTS Plasma kisspeptin correlated with gestation (r(2) = 0.57; P < .0001). Gestational age-corrected (multiples of median) plasma kisspeptin was 60.4% lower (P < .001), and multiples of median-hCG was 36.1% lower (P < .001) in women later diagnosed with miscarriage compared with women without miscarriage. Increased plasma kisspeptin was associated with reduced miscarriage risk, even after adjusting for age, body mass index, gestational age, smoking, and blood pressure [odds ratio 0.13 (95% confidence interval 0.08-0.22), P = .0001]. Kisspeptin had a higher diagnostic performance for miscarriage than hCG (receiver-operator characteristic-area under the curve 0.899 ± 0.025 plasma kisspeptin; 0.775 ± 0.040, serum hCG, P < .01 vs plasma kisspeptin). CONCLUSION Our data suggest for the first time that a single plasma kisspeptin measurement taken during the antenatal booking visit provides a potential novel marker for identifying asymptomatic pregnant women at a gestation of 6 weeks or greater at increased risk of miscarriage.
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Affiliation(s)
- C N Jayasena
- Section of Investigative Medicine (C.N.J., A.A., A.I.-E., A.N.C., Z.S., Z.G.-D., M.A.G., S.R.B., W.S.D.) and Imperial Clinical Trials Unit (H.G.M.), Imperial College London, London W12 ONN, United Kingdom; Medical Oncology Laboratory (R.A.H., A.I.P.), Charing Cross Hospital Campus, Imperial College National Health Service Healthcare Trust, London W6 8RF, United Kingdom; Department of Obstetrics and Gynaecology (M.D.), Queen Charlotte's Hospital, Imperial College National Health Service Healthcare Trust, London W12 0HS, United Kingdom; Department Obstetrics and Gynaecology (C.W.), King's College London, London SE5 9PJ, United Kingdom; and Department of Obstetrics and Gynaecology (L.R.), St Mary's Hospital, Imperial College National Health Service Healthcare Trust, London W2 1NY, United Kingdom
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10
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McGowan BM, Minnion JS, Murphy KG, Roy D, Stanley SA, Dhillo WS, Gardiner JV, Ghatei MA, Bloom SR. Relaxin-3 stimulates the neuro-endocrine stress axis via corticotrophin-releasing hormone. J Endocrinol 2014; 221:337-46. [PMID: 24578294 DOI: 10.1530/joe-13-0603] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Relaxin-3 is a member of the insulin superfamily. It is expressed in the nucleus incertus of the brainstem, which has projections to the hypothalamus. Relaxin-3 binds with high affinity to RXFP1 and RXFP3. RXFP3 is expressed within the hypothalamic paraventricular nucleus (PVN), an area central to the stress response. The physiological function of relaxin-3 is unknown but previous work suggests a role in appetite control, stimulation of the hypothalamic-pituitary-gonadal axis and stress. Central administration of relaxin-3 induces c-fos expression in the PVN and increases plasma ACTH levels in rats. The aim of this study was to investigate the effect of central administration of human relaxin-3 (H3) on the hypothalamic-pituitary-adrenal (HPA) axis in male rodents in vivo and in vitro. Intracerebroventricular (i.c.v) administration of H3 (5 nmol) significantly increased plasma corticosterone at 30 min following injection compared with vehicle. Intra-PVN administration of H3 (1.8-1620 pmol) significantly increased plasma ACTH at 1620 pmol H3 and corticosterone at 180-1620 pmol H3 at 30 min following injection compared with vehicle. The stress hormone prolactin was also significantly raised at 15 min post-injection compared with vehicle. Treatment of hypothalamic explants with H3 (10-1000 nM) stimulated the release of corticotrophin-releasing hormone (CRH) and arginine vasopressin (AVP), but H3 had no effect on the release of ACTH from in vitro pituitary fragments. These results suggest that relaxin-3 may regulate the HPA axis, via hypothalamic CRH and AVP neurons. Relaxin-3 may act as a central signal linking nutritional status, reproductive function and stress.
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Affiliation(s)
- B M McGowan
- Department of Diabetes and Endocrinology, Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London SE1 7EH, London Section of Investigative Medicine, Department of Medicine, Imperial College London, 6th Floor Commonwealth Building, Hammersmith Campus, Du Cane Road, London W12 ONN, UK Molecular Genetics, Rockefeller University, New York, NY 10065, USA
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11
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Beale KE, Kinsey-Jones JS, Gardiner JV, Harrison EK, Thompson EL, Hu MH, Sleeth ML, Sam AH, Greenwood HC, McGavigan AK, Dhillo WS, Mora JM, Li XF, Franks S, Bloom SR, O'Byrne KT, Murphy KG. The physiological role of arcuate kisspeptin neurons in the control of reproductive function in female rats. Endocrinology 2014; 155:1091-8. [PMID: 24424033 PMCID: PMC3929743 DOI: 10.1210/en.2013-1544] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Kisspeptin plays a pivotal role in pubertal onset and reproductive function. In rodents, kisspeptin perikarya are located in 2 major populations: the anteroventral periventricular nucleus and the hypothalamic arcuate nucleus (ARC). These nuclei are believed to play functionally distinct roles in the control of reproduction. The anteroventral periventricular nucleus population is thought to be critical in the generation of the LH surge. However, the physiological role played by the ARC kisspeptin neurons remains to be fully elucidated. We used bilateral stereotactic injection of recombinant adeno-associated virus encoding kisspeptin antisense into the ARC of adult female rats to investigate the physiological role of kisspeptin neurons in this nucleus. Female rats with kisspeptin knockdown in the ARC displayed a significantly reduced number of both regular and complete oestrous cycles and significantly longer cycles over the 100-day period of the study. Further, kisspeptin knockdown in the ARC resulted in a decrease in LH pulse frequency. These data suggest that maintenance of ARC-kisspeptin levels is essential for normal pulsatile LH release and oestrous cyclicity.
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Affiliation(s)
- K E Beale
- Section of Investigative Medicine (K.E.B., J.S.K.-J., J.V.G., E.K.H., E.L.T., M.L.S., A.H.S., H.C.G., A.K.M., W.S.D., S.R.B., K.G.M.) and Institute of Reproductive and Developmental Biology (J.M.M., S.F.), Imperial College London, London W12 0NN, United Kingdom; and Division of Women's Health (M.H.H., X.F.L., K.T.O.), School of Medicine, King's College London, London SE1 1UL, United Kingdom
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12
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Jayasena CN, Comninos AN, Nijher GMK, Abbara A, De Silva A, Veldhuis JD, Ratnasabapathy R, Izzi-Engbeaya C, Lim A, Patel DA, Ghatei MA, Bloom SR, Dhillo WS. Twice-daily subcutaneous injection of kisspeptin-54 does not abolish menstrual cyclicity in healthy female volunteers. J Clin Endocrinol Metab 2013; 98:4464-74. [PMID: 24030945 PMCID: PMC4111853 DOI: 10.1210/jc.2013-1069] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Kisspeptin is a critical hypothalamic regulator of reproductive function. Chronic kisspeptin administration causes profound tachyphylaxis in male monkeys and in women with functional hypothalamic amenorrhea. The pharmacological effects of chronic kisspeptin exposure in healthy women with normal menstrual cycles have not been studied previously. AIM Our aim was to determine the effects of follicular-phase kisspeptin-54 treatment on menstrual cyclicity in healthy women. METHODS We performed a prospective, single-blinded, 1-way crossover study. Healthy women received twice-daily sc injections of kisspeptin (6.4 nmol/kg) or 0.9% saline during menstrual days 7-14 (n = 5 per treatment arm). Serial assessments of basal reproductive hormones, ultrasound parameters, LH pulsatility, and acute sensitivity to GnRH and kisspeptin-54 injection were performed. RESULTS Menstrual cyclicity persisted in all women after follicular-phase kisspeptin-54 treatment. Chronic exposure to kisspeptin-54 did not abolish acute stimulation of LH after injection of kisspeptin-54 or GnRH. In addition, kisspeptin-54 treatment was associated with a shorter mean length of the menstrual cycle (mean length of menstrual cycle was 28.6 ± 1.4 days with saline vs 26.8 ± 3.1 days with kisspeptin, P < .01), earlier onset of highest recorded serum LH (mean menstrual day of highest LH was 15.2 ± 1.3 with saline vs 13.0 ± 1.9 with kisspeptin, P < .05), and earlier onset of the luteal phase (mean menstrual day of progesterone increase was 18.0 ± 2.1 with saline vs 15.8 ± 0.9 with kisspeptin, P < .05). CONCLUSION Our data suggest that 1 week of exogenous kisspeptin-54 does not abolish menstrual cyclicity in healthy women. Further work is needed to determine whether kisspeptin could be used to treat certain anovulatory disorders.
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Affiliation(s)
- C N Jayasena
- Department of Investigative Medicine, Imperial College London, Sixth Floor, Commonwealth Building, Hammersmith Hospital, Du Cane Road, London W12 ONN, United Kingdom.
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13
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Izzi-Engbeaya C, Zac-Varghese S, Palazzo F, Sanderson F, Meeran K, Dhillo WS. A young fit man presenting to the emergency department with a painful neck due to a thyroid abscess. QJM 2013; 106:1041-2. [PMID: 23824940 DOI: 10.1093/qjmed/hct144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- C Izzi-Engbeaya
- Section of Investigative Medicine, Imperial College London, 6th Floor, Commonwealth Building, Hammersmith Hospital, Du Cane Road, London W12 ONN, UK.
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14
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Jayasena CN, Comninos AN, Veldhuis JD, Misra S, Abbara A, Izzi-Engbeaya C, Donaldson M, Ghatei MA, Bloom SR, Dhillo WS. A single injection of kisspeptin-54 temporarily increases luteinizing hormone pulsatility in healthy women. Clin Endocrinol (Oxf) 2013; 79:558-63. [PMID: 23452073 DOI: 10.1111/cen.12179] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Revised: 11/08/2012] [Accepted: 02/19/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Kisspeptin is a novel hypothalamic peptide which stimulates endogenous gonadotrophin releasing hormone (GnRH) secretion. A single subcutaneous bolus injection of kisspeptin-54 increases circulating luteinizing hormone (LH) levels in women, but its acute effects on LH pulsatility are not known. AIMS To investigate the effects of a single subcutaneous (sc) injection of kisspeptin-54 administration on LH pulsatility in healthy female volunteers. METHODS Six healthy female adult volunteers underwent 10-minute blood sampling for serum LH measurement for 8 h during the follicular phase of menstrual cycle. Sc bolus injection of saline or kisspeptin-54 (0·15, 0·30 or 0·60 nmol/kg) was administered 4 h after commencing the study. A previously described, blinded deconvolution method was used to detect LH pulses. RESULTS Mean number of LH pulses was increased significantly following 0·30 and 0·60 nmol/kg kisspeptin-54 when compared with saline (mean increase in number of LH pulses per 4 h, following injection: -0·17 ± 0·54, saline; +2·33 ± 0·56, 0·30 nmol/kg kisspeptin-54, P < 0·05 vs saline; +2·33 ± 0·80, 0·60 nmol/kg kisspeptin-54, P < 0·05 vs saline). LH pulse secretory mass increased following injection of 0·60 nmol/kg in five of six subjects, but the mean change in all subjects was non-significant when compared with saline (mean increase in pulse secretory mass in IU/l following injection: +0·35 ± 0·40, saline; +2·61 ± 1·17, 0·60 nmol/kg kisspeptin-54, P = 0·10 vs saline). CONCLUSIONS A single injection of kisspeptin-54 temporarily stimulates the number of LH pulses in healthy women. Further studies are required to investigate the therapeutic potential of kisspeptin-54 injection to restore LH pulsatility in patients with reproductive disorders caused by impaired GnRH secretion.
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Affiliation(s)
- C N Jayasena
- Section of Investigative Medicine, Imperial College London, Hammersmith Hospital, Du Cane Road, London, UK
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15
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Beale K, Gardiner JV, Bewick GA, Hostomska K, Patel NA, Hussain SS, Jayasena CN, Ebling FJP, Jethwa PH, Prosser HM, Lattanzi R, Negri L, Ghatei MA, Bloom SR, Dhillo WS. Peripheral administration of prokineticin 2 potently reduces food intake and body weight in mice via the brainstem. Br J Pharmacol 2013; 168:403-10. [PMID: 22935107 DOI: 10.1111/j.1476-5381.2012.02191.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2012] [Revised: 08/02/2012] [Accepted: 08/06/2012] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND AND PURPOSE Prokineticin 2 (PK2) has recently been shown to acutely reduce food intake in rodents. We aimed to determine the CNS sites and receptors that mediate the anorectic effects of peripherally administered PK2 and its chronic effects on glucose and energy homeostasis. EXPERIMENTAL APPROACH We investigated neuronal activation following i.p. administration of PK2 using c-Fos-like immunoreactivity (CFL-IR). The anorectic effect of PK2 was examined in mice with targeted deletion of either prokineticin receptor 1 (PKR1) or prokineticin receptor 2 (PKR2), and in wild-type mice following administration of the PKR1 antagonist, PC1. The effect of IP PK2 administration on glucose homeostasis was investigated. Finally, the effect of long-term administration of PK2 on glucose and energy homeostasis in diet-induced obese (DIO) mice was determined. KEY RESULTS I.p. PK2 administration significantly increased CFL-IR in the dorsal motor vagal nucleus of the brainstem. The anorectic effect of PK2 was maintained in mice lacking the PKR2 but abolished in mice lacking PKR1 and in wild-type mice pre-treated with PC1. DIO mice treated chronically with PK2 had no changes in glucose levels but significantly reduced food intake and body weight compared to controls. CONCLUSIONS AND IMPLICATIONS Together, our data suggest that the anorectic effects of peripherally administered PK2 are mediated via the brainstem and this effect requires PKR1 but not PKR2 signalling. Chronic administration of PK2 reduces food intake and body weight in a mouse model of human obesity, suggesting that PKR1-selective agonists have potential to be novel therapeutics for the treatment of obesity.
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Affiliation(s)
- Kel Beale
- Section of Investigative Medicine, Imperial College London, London, UK
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Nazzaro A, Salerno A, Di Iorio L, Landino G, Marino S, Pastore E, Fabregues F, Iraola A, Casals G, Creus M, Peralta S, Penarrubia J, Manau D, Civico S, Balasch J, Lindgren I, Giwercman YL, Celik E, Turkcuoglu I, Ata B, Karaer A, Kirici P, Berker B, Park J, Kim J, Rhee J, Krishnan M, Rustamov O, Russel R, Fitzgerald C, Roberts S, Hapuarachi S, Tan BK, Mathur RS, van de Vijver A, Blockeel C, Camus M, Polyzos N, Van Landuyt L, Tournaye H, Turhan NO, Hizli D, Kamalak Z, Kosus A, Kosus N, Kafali H, Lukaszuk A, Kunicki M, Liss J, Bednarowska A, Jakiel G, Lukaszuk K, Lukaszuk M, Olszak-Sokolowska B, Lukaszuk K, Kunicki M, Liss J, Jakiel G, Bednarowska A, Wasniewski T, Neuberg M, Lukaszuk M, Cavalcanti V, Peluso C, Lechado BL, Cordts EB, Christofolini DM, Barbosa CP, Bianco B, Venetis CA, Kolibianakis EM, Bosdou J, Tarlatzis BC, Onal M, Gungor DN, Acet M, Kahraman S, Kuijper E, Twisk J, Caanen M, Korsen T, Hompes P, Kushnir M, Rockwood A, Meikle W, Lambalk CB, Hizli D, Kamalak Z, Kosus A, Kosus N, Turhan NO, Kafali H, Yan X, Dai X, Wang J, Zhao N, Cui Y, Liu J, Yarde F, Maas AHEM, Franx A, Eijkemans MJC, Drost JT, van Rijn BB, van Eyck J, van der Schouw YT, Broekmans FJM, Martyn F, Anglim B, Wingfield M, Fang T, Yan GJ, Sun HX, Hu YL, Chrudimska J, Krenkova P, Macek M, Macek M, Teixeira da Silva J, Cunha M, Silva J, Viana P, Goncalves A, Barros N, Oliveira C, Sousa M, Barros A, Nelson SM, Lloyd SM, McConnachie A, Khader A, Fleming R, Lawlor DA, Thuesen L, Andersen AN, Loft A, Smitz J, Abdel-Rahman M, Ismail S, Silk J, Abdellah M, Abdellah AH, Ruiz F, Cruz M, Piro M, Collado D, Garcia-Velasco JA, Requena A, Kollmann Z, Bersinger NA, McKinnon B, Schneider S, Mueller MD, von Wolff M, Vaucher A, Kollmann Z, Bersinger NA, Weiss B, Stute P, Marti U, von Wolff M, Chai J, Yeung WYT, Lee CYV, Li WHR, Ho PC, Ng HYE, Kim SM, Kim SH, Jee BC, Ku S, Suh CS, Choi YM, Kim JG, Moon SY, Lee JH, Kim SG, Kim YY, Kim HJ, Lee KH, Park IH, Sun HG, Hwang YI, Sung NY, Choi MH, Cha SH, Park CW, Kim JY, Yang KM, Song IO, Koong MK, Kang IS, Kim HO, Haines C, Wong WY, Kong WS, Cheung LP, Choy TK, Leung PC, Fadini R, Coticchio G, Renzini MM, Guglielmo MC, Brambillasca F, Hourvitz A, Albertini DF, Novara P, Merola M, Dal Canto M, Iza JAA, DePablo JL, Anarte C, Domingo A, Abanto E, Barrenetxea G, Kato R, Kawachiya S, Bodri D, Kondo M, Matsumoto T, Maldonado LGL, Setti AS, Braga DPAF, Iaconelli A, Borges E, Iaconelli C, Setti AS, Braga DPAF, Figueira RCS, Iaconelli A, Borges E, Kitaya K, Taguchi S, Funabiki M, Tada Y, Hayashi T, Nakamura Y, Snajderova M, Zemkova D, Lanska V, Teslik L, Calonge RN, Ortega L, Garcia A, Cortes S, Guijarro A, Peregrin PC, Bellavia M, Pesant MH, Wirthner D, Portman L, de Ziegler D, Wunder D, Chen X, Chen SHL, Liu YD, Tao T, Xu LJ, Tian XL, Ye DSH, He YX, Carby A, Barsoum E, El-Shawarby S, Trew G, Lavery S, Mishieva N, Barkalina N, Korneeva I, Ivanets T, Abubakirov A, Chavoshinejad R, Hartshorne GM, Marei W, Fouladi-nashta AA, Kyrkou G, Trakakis E, Chrelias CH, Alexiou E, Lykeridou K, Mastorakos G, Bersinger N, Kollmann Z, Mueller MD, Vaucher A, von Wolff M, Ferrero H, Gomez R, Garcia-Pascual CM, Simon C, Pellicer A, Turienzo A, Lledo B, Guerrero J, Ortiz JA, Morales R, Ten J, Llacer J, Bernabeu R, De Leo V, Focarelli R, Capaldo A, Stendardi A, Gambera L, Marca AL, Piomboni P, Kim JJ, Choi YM, Kang JH, Hwang KR, Chae SJ, Kim SM, Yoon SH, Ku SY, Kim SH, Kim JG, Moon SY, Iliodromiti S, Kelsey TW, Anderson RA, Nelson SM, Lee HJ, Weghofer A, Kushnir VA, Shohat-Tal A, Lazzaroni E, Lee HJ, Barad DH, Gleicher NN, Shavit T, Shalom-Paz E, Fainaru O, Michaeli M, Kartchovsky E, Ellenbogen A, Gerris J, Vandekerckhove F, Delvigne A, Dhont N, Madoc B, Neyskens J, Buyle M, Vansteenkiste E, De Schepper E, Pil L, Van Keirsbilck N, Verpoest W, Debacquer D, Annemans L, De Sutter P, Von Wolff M, Kollmann Z, Vaucher A, Weiss B, Bersinger NA, Verit FF, Keskin S, Sargin AK, Karahuseyinoglu S, Yucel O, Yalcinkaya S, Comninos AN, Jayasena CN, Nijher GMK, Abbara A, De Silva A, Veldhuis JD, Ratnasabapathy R, Izzi-Engbeaya C, Lim A, Patel DA, Ghatei MA, Bloom SR, Dhillo WS, Colodron M, Guillen JJ, Garcia D, Coll O, Vassena R, Vernaeve V, Pazoki H, Bolouri G, Farokhi F, Azarbayjani MA, Alebic MS, Stojanovic N, Abali R, Yuksel A, Aktas C, Celik C, Guzel S, Erfan G, Sahin O, Zhongying H, Shangwei L, Qianhong M, Wei F, Lei L, Zhun X, Yan W, Vandekerckhove F, De Baerdemaeker A, Gerris J, Tilleman K, Vansteelandt S, De Sutter P, Oliveira JBA, Baruffi RLR, Petersen CG, Mauri AL, Nascimento AM, Vagnini L, Ricci J, Cavagna M, Massaro FC, Pontes A, Franco JG, El-khayat W, Elsadek M, Foroozanfard F, Saberi H, Moravvegi A, Kazemi M, Gidoni YS, Raziel A, Friedler S, Strassburger D, Hadari D, Kasterstein E, Ben-Ami I, Komarovsky D, Maslansky B, Bern O, Ron-El R, Izquierdo MP, Ten J, Guerrero J, Araico F, Llacer J, Bernabeu R, Somova O, Feskov O, Feskova I, Bezpechnaya I, Zhylkova I, Tishchenko O, Oguic SK, Baldani DP, Skrgatic L, Simunic V, Vrcic H, Rogic D, Juras J, Goldstein MS, Garcia De Miguel L, Campo MC, Gurria A, Alonso J, Serrano A, Marban E, Peregrin PC, Hourvitz A, Shalev L, Yung Y, Yerushalmi G, Giovanni C, Dal Canto M, Fadini R, Has J, Maman E, Monterde M, Gomez R, Marzal A, Vega O, Rubio JM, Diaz-Garcia C, Pellicer A, Eapen A, Datta A, Kurinchi-selvan A, Birch H, Lockwood GM, Ornek MC, Ates U, Usta T, Goksedef CP, Bruszczynska A, Glowacka J, Kunicki M, Jakiel G, Wasniewski T, Jaguszewska K, Liss J, Lukaszuk K, Oehninger S, Nelson S, Verweij P, Stegmann B, Ando H, Takayanagi T, Minamoto H, Suzuki N, Maman E, Rubinshtein N, Yung Y, Shalev L, Yerushalmi G, Hourvitz A, Saltek S, Demir B, Dilbaz B, Demirtas C, Kutteh W, Shapiro B, Witjes H, Gordon K, Lauritsen MP, Loft A, Pinborg A, Freiesleben NL, Mikkelsen AL, Bjerge MR, Andersen AN, Chakraborty P, Goswami SK, Chakravarty BN, Mittal M, Bajoria R, Narvekar N, Chatterjee R, Bentzen JG, Johannsen TH, Scheike T, Andersen AN, Friis-Hansen L, Sunkara S, Coomarasamy A, Faris R, Braude P, Khalaf Y, Makedos A, Kolibianakis EM, Venetis CA, Masouridou S, Chatzimeletiou K, Zepiridis L, Mitsoli A, Lainas G, Sfontouris I, Tzamtzoglou A, Kyrou D, Lainas T, Tarlatzis BC, Fermin A, Crisol L, Exposito A, Prieto B, Mendoza R, Matorras R, Louwers Y, Lao O, Kayser M, Palumbo A, Sanabria V, Rouleau JP, Puopolo M, Hernandez MJ, Diaz-Garcia C, Monterde M, Marzal A, Vega O, Rubio JM, Gomez R, Pellicer A, Ozturk S, Sozen B, Yaba-Ucar A, Mutlu D, Demir N, Olsson H, Sandstrom R, Grundemar L, Papaleo E, Corti L, Rabellotti E, Vanni VS, Potenza M, Molgora M, Vigano P, Candiani M, Andersen AN, Fernandez-Sanchez M, Bosch E, Visnova H, Barri P, Garcia-Velasco JA, De Sutter P, Fauser BJCM, Arce JC, Sandstrom R, Olsson H, Grundemar L, Peluso P, Trevisan CM, Cordts EB, Cavalcanti V, Christofolini DM, Fonseca FA, Barbosa CP, Bianco B, Bakas P, Vlahos N, Hassiakos D, Tzanakaki D, Gregoriou O, Liapis A, Creatsas G, Adda-Herzog E, Steffann J, Sebag-Peyrelevade S, Poulain M, Benachi A, Fanchin R, Gordon K, Zhang D, Andersen AN, Aybar F, Temel S, Kahraman S, Hamdine O, Macklon NS, Eijkemans MJC, Laven JS, Cohlen BJ, Verhoeff A, van Dop PA, Bernardus RE, Lambalk CB, Oosterhuis GJE, Holleboom CAG, van den Dool-Maasland GC, Verburg HJ, van der Heijden PFM, Blankhart A, Fauser BCJM, Broekmans FJ, Bhattacharya J, Mitra A, Dutta GB, Kundu A, Bhattacharya M, Kundu S, Pigny P, Dassonneville A, Catteau-Jonard S, Decanter C, Dewailly D, Pouly J, Olivennes F, Massin N, Celle M, Caizergues N, Fleming R, Gaudoin M, Messow M, McConnachie A, Nelson SM, Dewailly D, Vanhove L, Peigne M, Thomas P, Robin G, Catteau-Jonard S. Reproductive endocrinology. Hum Reprod 2013. [DOI: 10.1093/humrep/det221] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Jayasena CN, Abbara A, Comninos AN, Ratnasabapathy R, Veldhuis JD, Nijher GMK, Ganiyu-Dada Z, Mehta A, Todd C, Ghatei MA, Bloom SR, Dhillo WS, Grynberg M, Frydman N, Frydman R, Peltoketo H, Bouchard P, Fanchin R, Freriks K, Verhaak CM, Sas TCJ, Menke LA, Otten BJ, Keizer-Schrama SMPFDM, Wit JM, Netea-Maier RT, Hermus ARMM, Kessels RPC, Timmers HJLM, Busnelli A, Benaglia L, Leonardi M, Faulisi S, Ragni G, Somigliana E, Roesner S, Toth B, Weigert J, Strowitzki T, Montag M. Session 69: Clinical endocrinology. Hum Reprod 2013. [DOI: 10.1093/humrep/det203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Bodri D, Kawachiya S, Kondo M, Kato R, Matsumoto T, Verpoest W, Vloeberghs V, Staessen C, Devos A, De Rycke M, Bonduelle M, Tournaye H, Blockeel C, Abbara A, Jayasena CN, Nijher GM, Comninos AN, Christopoulos G, Ashby D, Ghatei MA, Bloom SR, Carby A, Trew G, Dhillo WS, Imthurn B, Rettenbacher M, Group EBS, Weiss NS, Braam S, Konig TE, Hendriks ML, Hamilton CJ, Koks C, Kaaijk EM, van Wely M, Hompes PGA, Lambalk CB, Mol BW, Groeneveld E, Krul IM, Spaan M, van den Belt-Dusebout AW, Mooij TM, Lambers MJ, Twisk JWR, Hauptmann M, Burger CW, Hompes PGA, van Leeuwen FE, Lambalk CB. Session 29: Ovarian stimulation. Hum Reprod 2013. [DOI: 10.1093/humrep/det157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Dhillo WS, Dewailly D. SESSION 12: INTERACTIONS BETWEEN NUTRITION AND REPRODUCTION. Hum Reprod 2012. [DOI: 10.1093/humrep/27.s2.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Jayasena CN, Comninos AN, Clarke H, Donaldson M, Meeran K, Dhillo WS. The effects of long-term growth hormone and insulin-like growth factor-1 exposure on the development of cardiovascular, cerebrovascular and metabolic co-morbidities in treated patients with acromegaly. Clin Endocrinol (Oxf) 2011; 75:220-5. [PMID: 21521288 DOI: 10.1111/j.1365-2265.2011.04019.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Acromegaly is characterized by the hypersecretion of growth hormone (GH) and insulin-like growth factor-1 (IGF-1). This leads to an increased cardiovascular, cerebrovascular and metabolic morbidity resulting in excess mortality. There is controversy over which biomarker, GH or IGF-1, better predicts this increased morbidity and mortality. The relationship between the cumulative exposure to GH and IGF-1 with co-morbidities in acromegaly has not previously been reported. OBJECTIVE To investigate the relationship between the cumulative exposure to GH and IGF-1 with cardiovascular, cerebrovascular and metabolic co-morbidities. METHODS Records of 116 acromegalic patients were retrospectively examined. Cardiovascular and cerebrovascular histories, serum GH and IGF-1, fasting glucose and oral glucose tolerance test results, were reviewed for the duration of follow-up. IGF-1 index was calculated by dividing each serum IGF-1 value by the upper limit of reference range for IGF-1. GH and IGF-1 burdens were calculated for each patient by multiplying known disease duration (in years) by mean level of basal GH or IGF-1 index recorded during the patients' entire follow-up. RESULTS Patients with abnormal glucose tolerance had a significantly higher mean GH burden compared with euglycaemic patients (P = 0·005). Ischaemic heart disease was also associated with a higher GH burden (P = 0·009) whereas cerebrovascular disease and cardiomyopathy were associated with a significantly higher mean IGF-1 burden (P = 0·018, P = 0·011 respectively). CONCLUSION This study identifies associations of raised GH and IGF-1 burden with cardiovascular, cerebrovascular and metabolic complications of acromegaly. Results from this study therefore suggest that consideration of the overall level of GH and IGF-1 exposure may provide important information for the management and surveillance of patients with treated acromegaly.
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Affiliation(s)
- C N Jayasena
- Department of Endocrinology, Imperial College London, Faculty of Medicine, Hammersmith Hospital, London, UK
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Abstract
BACKGROUND Temporary hypocalcaemia occurs in up to 40% of patients following a total thyroidectomy. Serum calcium and parathyroid hormone (PTH) measurements are currently used to predict post-thyroidectomy hypocalcaemia. However, immediate access to PTH measurement is expensive and not widely available. Serum phosphate responds rapidly to changes in circulating PTH levels, and its measurement is readily available in all hospitals. We evaluated the use of serum phosphate to predict temporary hypocalcaemia post-thyroidectomy. METHODS We retrospectively assessed 111 consecutive patients who had total or completion thyroidectomy. Patients had serum calcium and phosphate measured preoperatively, on the evening of surgery (day 0), on the morning of day 1 and over the following week as clinically indicated. Serum PTH was measured on the morning of day 1. Vitamin D levels were measured preoperatively. RESULTS Seventy-six patients did not develop treatment-demanding hypocalcaemia. In these patients, the mean serum phosphate concentration was lower on the morning of day 1 compared to that on the evening of surgery. Seventeen patients with a vitamin D>25 nmol/l developed hypocalcaemia requiring treatment from day 1 onwards. All had an overnight rise in serum phosphate to >1.44 mmol/l (100% sensitivity and specificity for predicting hypocalcaemia). Twelve patients who had a vitamin D<25 nmol/l also developed hypocalcaemia but had an attenuated rise in serum phosphate. CONCLUSION Serum phosphate is a reliable biochemical predictor of post-thyroidectomy hypocalcaemia in patients without vitamin D deficiency. The use of serum phosphate may facilitate safe day 1 discharge of patients undergoing thyroidectomy.
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Affiliation(s)
- Amir H Sam
- Division of Diabetes, Endocrinology and Metabolism, Hammersmith Hospital, Imperial College London, London, UK
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McGowan BMC, Minnion JS, Murphy KG, White NE, Roy D, Stanley SA, Dhillo WS, Gardiner JV, Ghatei MA, Bloom SR. Central and peripheral administration of human relaxin-2 to adult male rats inhibits food intake. Diabetes Obes Metab 2010; 12:1090-6. [PMID: 20977581 DOI: 10.1111/j.1463-1326.2010.01302.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM Relaxin is a polypeptide hormone involved in pregnancy and lactation. It is mainly secreted by the corpus luteum and placenta, but is expressed in a number of other tissues, including heart and brain. Within the brain, relaxin is expressed in the olfactory and limbic systems, the cortex and the hypothalamic arcuate nucleus (ARC). Its cognate receptor, relaxin family peptide receptor 1 (RXFP1), is also widely expressed in the brain, including the hypothalamic ARC and paraventricular nucleus (PVN), areas important in appetite regulation. The aim of this study was to investigate whether relaxin influences food intake through central hypothalamic circuits. METHODS The human form of relaxin, human relaxin-2 (H2) was administered centrally and peripherally to male Wistar rats and food intake measured. Behaviour was also assessed. RESULTS Intracerebroventricular (ICV) administration of H2 significantly decreased 1-h food intake in the early dark phase [2.95 ± 0.45 g (saline) vs. 0.95 ± 0.18 g (180 pmol H2), p < 0.001]. ICV administration of H2 decreased feeding behaviour and increased grooming and headdown behaviour. Intraparaventricular injections of H2 significantly decreased 1-h food intake in the early dark phase [3.13 ± 0.35 g (saline) vs. 1.35 ± 0.33 g (18 pmol H2), p < 0.01, 1.61 ± 0.31 g (180 pmol H2), p < 0.05 and 1.23 ± 0.32 g (540 pmol H2), p < 0.001]. Intraperitoneal (IP) administration of H2 significantly decreased 1-h food intake in the early dark phase [4.63 ± 0.46 g (vehicle) vs. 3.08 ± 0.15 g (66 nmol H2), p < 0.01, 3.00 ± 0.17 g (200 nmol H2), p < 0.01 and 2.26 ± 0.36 g (660 nmol H2), p < 0.001]. CONCLUSIONS Central and peripheral administration of H2 reduces the food intake in rats. This effect may be mediated via the PVN and/or other brain regions.
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Affiliation(s)
- B M C McGowan
- Department of Diabetes and Endocrinology, Guy's & St Thomas' NHS Foundation Trust, London, UK
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Jayasena CN, Nijher GMK, Abbara A, Murphy KG, Lim A, Patel D, Mehta A, Todd C, Donaldson M, Trew GH, Ghatei MA, Bloom SR, Dhillo WS. Twice-Weekly Administration of Kisspeptin-54 for 8 Weeks Stimulates Release of Reproductive Hormones in Women With Hypothalamic Amenorrhea. Clin Pharmacol Ther 2010; 88:840-7. [DOI: 10.1038/clpt.2010.204] [Citation(s) in RCA: 93] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Gardiner JV, Beale KE, Roy D, Boughton CK, Bataveljic A, Campbell DC, Bewick GA, Patel NA, Patterson M, Leavy EM, Ghatei MA, Bloom SR, Dhillo WS. Cerebellin1 is a novel orexigenic peptide. Diabetes Obes Metab 2010; 12:883-90. [PMID: 20920041 DOI: 10.1111/j.1463-1326.2010.01247.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM Cerebellin1 (Cbln1) is highly expressed in the hypothalamus, a region of the brain involved in appetite regulation. However, the effects of Cbn1 on food intake are not known. The present study aimed to investigate the effect of Cbln1 on appetite regulation in rats. METHODS We determined the effect of (i) intracerebroventricular (ICV) injection of Cbln1 on food intake, behaviour and plasma pituitary hormone levels in male Wistar rats; (ii) Cbln1 on the release of hypothalamic neuropeptides known to modulate food intake from hypothalamic explants and (iii) fasting on hypothalamic Cbln1 mRNA expression. RESULTS (i) ICV administration of Cbln1 significantly increased food intake in rats and caused no adverse behaviours. ICV administration of Cbln1 significantly reduced plasma thyroid stimulating hormone (TSH) levels 10 min postinjection in rats. (ii) Cbln1 significantly increased the release of neuropeptide Y (NPY) from hypothalamic explants. (iii) Cbln1 mRNA expression levels were increased in the ventromedial nucleus of the hypothalamus in fasted rats. CONCLUSIONS These data suggest that Cbln1 is a novel orexigenic peptide, which may mediate its effects via hypothalamic NPY.
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Affiliation(s)
- J V Gardiner
- Department of Investigative Medicine, Hammersmith Hospital, Imperial College London, London, UK
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Hrabovszky E, Ciofi P, Vida B, Horvath MC, Keller E, Caraty A, Bloom SR, Ghatei MA, Dhillo WS, Liposits Z, Kallo I. The kisspeptin system of the human hypothalamus: sexual dimorphism and relationship with gonadotropin-releasing hormone and neurokinin B neurons. Eur J Neurosci 2010; 31:1984-98. [PMID: 20529119 DOI: 10.1111/j.1460-9568.2010.07239.x] [Citation(s) in RCA: 197] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Kisspeptin signaling via the kisspeptin receptor G-protein-coupled receptor-54 plays a fundamental role in the onset of puberty and the regulation of mammalian reproduction. In this immunocytochemical study we addressed the (i) topography, (ii) sexual dimorphism, (iii) relationship to gonadotropin-releasing hormone (GnRH) neurons and (iv) neurokinin B content of kisspeptin-immunoreactive hypothalamic neurons in human autopsy samples. In females, kisspeptin-immunoreactive axons formed a dense periventricular plexus and profusely innervated capillary vessels in the infundibular stalk. Most immunolabeled somata occurred in the infundibular nucleus. Many cells were also embedded in the periventricular fiber plexus. Rostrally, they formed a prominent periventricular cell mass (magnocellular paraventricular nucleus). Robust sex differences were noticed in that fibers and somata were significantly less numerous in male individuals. In dual-immunolabeled specimens, fine kisspeptin-immunoreactive axon varicosities formed axo-somatic, axo-dendritic and axo-axonal contacts with GnRH neurons. Dual-immunofluorescent studies established that 77% of kisspeptin-immunoreactive cells in the infundibular nucleus synthesize the tachykinin peptide neurokinin B, which is known to play crucial role in human fertility; 56 and 17% of kisspeptin fibers in the infundibular and periventricular nuclei, respectively, contained neurokinin B immunoreactivity. Site-specific co-localization patterns implied that kisspeptin neurons in the infundibular nucleus and elsewhere contributed differentially to these plexuses. This study describes the distribution and robust sexual dimorphism of kisspeptin-immunoreactive elements in human hypothalami, reveals neuronal contacts between kisspeptin-immunoreactive fibers and GnRH cells, and demonstrates co-synthesis of kisspeptins and neurokinin B in the infundibular nucleus. The neuroanatomical information will contribute to our understanding of central mechanisms whereby kisspeptins regulate human fertility.
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Affiliation(s)
- E Hrabovszky
- Laboratory of Endocrine Neurobiology, Institute of Experimental Medicine, Hungarian Academy of Sciences, Budapest, 1083 Hungary.
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Corander MP, Challis BG, Thompson EL, Jovanovic Z, Loraine Tung YC, Rimmington D, Huhtaniemi IT, Murphy KG, Topaloglu AK, Yeo GSH, O'Rahilly S, Dhillo WS, Semple RK, Coll AP. The effects of neurokinin B upon gonadotrophin release in male rodents. J Neuroendocrinol 2010; 22:181-7. [PMID: 20041982 DOI: 10.1111/j.1365-2826.2009.01951.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Growing evidence suggests the tachykinin neurokinin B (NKB) may modulate gonadotrophin secretion and play a role in sex-steroid feedback within the reproductive axis. NKB signalling has recently been identified as being necessary for normal human reproductive function, although the precise mechanisms underpinning this role remain to be established. We have used rodents to explore further the role of NKB within the reproductive axis. In particular, we have studied its interactions with kisspeptin, a neuropeptide essential for reproductive function in rodent and human with close anatomical links to NKB within the hypothalamus. Intraperitoneal administration of NKB (50 nmol) to male mice had no effect on circulating luteinsing hormone (LH) levels and, although i.p. kisspeptin (15 nmol) increased LH five-fold, co-administration of NKB and kisspeptin was indistinguishable from kisspeptin alone. Intracerebroventricular administration of NKB (10 nmol) to male mice also had no effect on LH levels, with 1 nmol kisspeptin i.c.v. significantly increasing LH compared to control (0.37 +/- 0.18 versus 5.11 +/- 0.28 ng/ml, respectively). Interestingly, i.c.v. co-administration of NKB and kisspeptin caused a significant increase in LH concentrations compared to kisspeptin alone (8.96 +/- 1.82 versus 5.11 +/- 0.28 ng/ml respectively). We used hypothalamic explants from rats to assess the effect of NKB on gonadotrpohin-releasing hormone (GnRH) secretion ex vivo. Doses of NKB up to 1000 nm failed to stimulate GnRH secretion, whereas 100 nm kisspeptin robustly increased GnRH secretion. Of note, co-administration of NKB with kisspeptin abrogated the effect of kisspeptin, producing no GnRH release above basal state. Finally, we analysed the expression of Tac2/Tacr3 (genes encoding NKB and NK3R, respectively) within the arcuate nucleus in different nutritional states. After a 48-h fast, the expression of both Tac2 and Tacr3 showed a significant increase, in contrast to levels of Kiss1 and Kiss1r mRNA, which remained unchanged. In male rodent models, NKB and kisspeptin have different effects upon gonadotrophin release and appear to interact in a complex manner.
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Affiliation(s)
- M P Corander
- University of Cambridge Metabolic Research Laboratories, Institute of Metabolic Science, Addenbrooke's Treatment Centre, Addenbrooke's Hospital, Cambridge, UK
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Thompson EL, Amber V, Stamp GWH, Patterson M, Curtis AE, Cooke JH, Appleby GF, Dhillo WS, Ghatei MA, Bloom SR, Murphy KG. Kisspeptin-54 at high doses acutely induces testicular degeneration in adult male rats via central mechanisms. Br J Pharmacol 2009; 156:609-25. [PMID: 19226253 DOI: 10.1111/j.1476-5381.2008.00061.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND AND PURPOSE The kisspeptins are critical regulators of reproduction and a therapeutic target for reproductive disease. Intracerebroventricular (i.c.v.) or peripheral injection of kisspeptin potently stimulates the hypothalamic-pituitary gonadal (HPG) axis via gonadotrophin-releasing hormone (GnRH). However, little is known regarding the effects of kisspeptin administration on testicular function. We investigated the mechanism(s) of kisspeptin-induced testicular degeneration in the rat. EXPERIMENTAL APPROACH Kisspeptin-54 (50 nmol.day(-1)) was continuously administered subcutaneously (6 h to 3 days) to male Wistar rats and reproductive hormones and testicular histology analysed. We also investigated the effects of a single subcutaneous injection of 0.5, 5 or 50 nmol kisspeptin-54. In order to determine whether the testicular degeneration observed is peripherally or centrally mediated, we investigated effects of i.c.v. injections of 5 nmol kisspeptin-54 and pre-administered a GnRH-receptor antagonist (cetrorelix) to rats peripherally treated with kisspeptin-54. KEY RESULTS Continuous subcutaneous administration of kisspeptin-54 caused testicular degeneration after only 12 h, when gonadotrophins were still markedly raised, suggesting that the degeneration is independent of the desensitization of the HPG axis to kisspeptin-54. Furthermore, a single subcutaneous injection of kisspeptin-54 caused dose-dependent testicular degeneration. Continuous kisspeptin-54 administration is thus not required to cause testicular degeneration. Pretreatment with cetrorelix blocked kisspeptin-induced testicular degeneration, and a single i.c.v. injection of kisspeptin-54 caused testicular degeneration, suggesting it is GnRH-mediated. CONCLUSIONS AND IMPLICATIONS Kisspeptin-induced testicular degeneration appears to be centrally mediated, and result from acute hyper-stimulation of the HPG axis. Doses must be carefully considered if kisspeptin is to be used therapeutically.
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Affiliation(s)
- E L Thompson
- Department of Investigative Medicine, Hammersmith Hospital, Imperial College London, London, UK
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Dhillo WS, Bewick GA, White NE, Gardiner JV, Thompson EL, Bataveljic A, Murphy KG, Roy D, Patel NA, Scutt JN, Armstrong A, Ghatei MA, Bloom SR. The thyroid hormone derivative 3-iodothyronamine increases food intake in rodents. Diabetes Obes Metab 2009; 11:251-60. [PMID: 18671794 DOI: 10.1111/j.1463-1326.2008.00935.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The thyroid hormone derivative 3-iodothyronamine (T(1)AM), an endogenous biogenic amine, is a potent agonist of the G protein-coupled trace amine-associated receptor 1 (TAAR1). T(1)AM is present in rat brain, and TAAR1 is expressed in hypothalamic nuclei associated with the regulation of energy homeostasis. AIM The aim of this study was to determine the effects of T(1)AM on food intake in rodents. METHODS We determined the effect of (i) intraperitoneal (i.p.) administration of T(1)AM on food intake, oxygen consumption (VO(2)) and locomotor activity in mice; (ii) intracerebroventricular (ICV) injection of T(1)AM on food intake in male rats; (iii) c-fos expression following ventricular administration of T(1)AM in male rats; and (iv) direct injection of T(1)AM into the arcuate nucleus (ARC) of male rats on food intake. RESULTS (i) T(1)AM (4 nmol/kg) significantly increased food intake following i.p. injection in mice but had no effect on VO(2) or locomotor activity. (ii) ICV administration of T(1)AM (1.2 nmol/kg) significantly increased food intake in male rats. (iii) Intraventricular administration of T(1)AM significantly increased c-fos expression in the ARC of male rats. (iv) Direct administration of T(1)AM (0.12, 0.4 and 1.2 nmol/kg) into the ARC of male rats significantly increased food intake. CONCLUSION These data suggest that T(1)AM is an orexigenic factor that may act through the ARC to increase food intake in rodents.
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Affiliation(s)
- W S Dhillo
- Department of Investigative Medicine, Faculty of Medicine, Imperial College London, Hammersmith Hospital, London, UK
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Abstract
The kisspeptin hormones are a family of peptides encoded by the KiSS-1 gene, which bind to the G-protein coupled receptor-54 (GPR54). Interactions between kisspeptin and GPR54 are thought to play a critical role in reproduction. In agreement with animal data, kisspeptin-54 administration acutely stimulates the release of gonadotrophins in both male and female healthy subjects, with no observed adverse effects. Furthermore, its potency is comparable to those of other gonadotrophin secretagogues studied. The kisspeptin-GPR54 system thus offers a novel means of therapeutically manipulating the hypothalamo-pituitary-gonadal (HPG) axis in humans. This article aims to provide a focused review of the experimental data which inform us how kisspeptin influences the HPG axis in humans.
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Affiliation(s)
- C N Jayasena
- Department of Investigative Medicine, Imperial College London, Hammersmith Hospital, 6th Floor, Commonwealth Building, Du Cane Road, W12 0NN, London, UK
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Abstract
The gastrointestinal tract is the largest endocrine organ in the body. It secretes more than 20 different peptide hormones, which serve both a local regulatory function and provide a means by which the gut can regulate appetite and satiety. As the worldwide prevalence of obesity reaches epidemic proportions, the importance of delineating the mechanisms which regulate food intake becomes even more urgent. There is now a substantial body of work in both rodent and human models demonstrating the effects of these peptides on appetite and work is underway to therapeutically manipulate the gut-brain axis for the treatment of obesity. In addition, it may also be possible to use our understanding of the entero-endocrine system to treat calorie-deficient states.
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Affiliation(s)
- S Hameed
- Department of Investigative Medicine, Faculty of Medicine, Imperial College London, Hammersmith Hospital, London, UK
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32
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Abstract
The UK and international neuroendocrine community was deeply shocked and saddened the unbelievably premature death of Michael Harbuz in Bristol in 2006. Mick was a superb friend and colleague, and played a huge part in the development and activities of the British Neuroendocrine Group/British Society for Neuroendocrinology (BSN), serving as both Membership Secretary and Treasurer between 1999 and 2004. Mick was a leader in the field of neuroendocrine-immune interactions, and brought a great deal of charisma, humour and ability to meetings and conferences. He was also a passionate and committed supporter of the progress of young researchers and of their participation in neuroendocrine events. He recognised that today's postgraduate students and postdoctoral research fellows are tomorrow's neuroendocrine researchers, be it in academia, the health services or industry. To recognise Mick's great commitment to and enthusiasm for postgraduate education both in the University of Bristol and in the BSN, we decided to honour and remember him by instituting the 'Michael Harbuz Young Investigator Prize Lecture' to be delivered annually. Dr Waljit Dhillo from Imperial College London was the inaugural recipient of this award, and presented his lecture at the Annual Meeting of the BSN in Nottingham in September 2007, upon which this review is based. Recent evidence demonstrates that the neuropeptide kisspeptin and its receptor, GPR54, have a fundamental role in initiating the onset of puberty and are important in regulating reproductive function. This review discusses the evidence available from animals and humans demonstrating that kisspeptin potently stimulates the release of gonadotrophins by stimulating the release of gonadotrophin-releasing hormone and that a lack of kisspeptin or GPR54 results in reproductive failure.
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Affiliation(s)
- W S Dhillo
- Department of Investigative Medicine, Faculty of Medicine, Hammersmith Hospital, Imperial College London, London, UK.
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White NE, Dhillo WS, Liu YL, Small CJ, Kennett GA, Gardiner JV, Ghatei MA, Bloom SR. Co-administration of SR141716 with peptide YY3-36 or oxyntomodulin has additive effects on food intake in mice. Diabetes Obes Metab 2008; 10:167-70. [PMID: 17941865 DOI: 10.1111/j.1463-1326.2007.00807.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND SR141716 has been shown to significantly inhibit food intake and reduce body weight by antagonizing CB(1) receptors. The gut hormones peptide YY(3-36) (PYY(3-36)) and oxyntomodulin (OXM) inhibit food intake through Y(2) and Glucagon-Like-Peptide (GLP)-1 receptors respectively. OBJECTIVE To determine the effects of co-administration of SR141716 with either PYY(3-36) or OXM in mice on food intake. METHODS Mice (n = 14 per group) were fasted for 16 h prior to study days and given two intraperitoneal injections: study 1, vehicle-saline, SR141716-saline, vehicle-PYY3-36 or SR141716-PYY3-36; study 2: vehicle-saline, SR141716-saline, vehicle-OXM or SR141716-OXM. Food was returned and measured following injections. RESULTS Co-administration of SR141716-PYY(3-36) or SR141716-OXM showed greater inhibition in food intake when compared with administration of SR141716, PYY(3-36) or OXM alone. CONCLUSION Our data show that SR141716 in combination with PYY(3-36) or OXM reduces food intake additively in mice.
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Affiliation(s)
- N E White
- Department of Metabolic Medicine, Faculty of Medicine, Imperial College London, Hammersmith Hospital, London, UK
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Martin NM, Dhillo WS, Meeran K. The dexamethasone-suppressed corticotropin-releasing hormone stimulation test and the desmopressin test to distinguish Cushing's syndrome from pseudo-Cushing's states. Clin Endocrinol (Oxf) 2007; 67:476. [PMID: 17581261 DOI: 10.1111/j.1365-2265.2007.02926.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Martin NM, Small CJ, Lee JL, Ellis S, Dhillo WS, Smith KL, Kong WM, Frost GS, Bloom SR. Low-dose oral tri-iodothyronine does not directly increase food intake in man. Diabetes Obes Metab 2007; 9:435-7. [PMID: 17391172 DOI: 10.1111/j.1463-1326.2006.00613.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Previously, we have shown that low-dose tri-iodothyronine (T3) increases food intake in rodents. This randomised, double-blind, placebo-controlled study aimed to investigate the effects of low-dose T3 on food intake in normal body weight individuals. However, despite an elevation in fT3 comparable to our earlier studies, administration of low-dose T3 in the fasted state did not stimulate food intake in man.
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Affiliation(s)
- N M Martin
- Department of Metabolic Medicine, Hammersmith Hospital, Imperial College London, London, UK
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Martin NM, Dhillo WS, Banerjee A, Abdulali A, Jayasena CN, Donaldson M, Todd JF, Meeran K. Comparison of the dexamethasone-suppressed corticotropin-releasing hormone test and low-dose dexamethasone suppression test in the diagnosis of Cushing's syndrome. J Clin Endocrinol Metab 2006; 91:2582-6. [PMID: 16670165 DOI: 10.1210/jc.2005-2143] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT The low-dose dexamethasone suppression test (LDDST) is widely used in confirming a diagnosis of Cushing's syndrome. CRH administration at the end of an LDDST has been reported to improve the diagnostic accuracy of this test. OBJECTIVE Our objective was to assess whether CRH administration after a standard LDDST (LDDST-CRH test) improves diagnostic accuracy in Cushing's syndrome. DESIGN, SETTING, AND PARTICIPANTS Thirty-six individuals with a clinical suspicion of Cushing's syndrome each completed a standard LDDST and an LDDST-CRH test at Hammersmith Hospitals NHS Trust, London. The LDDST involved administration of 0.5 mg oral dexamethasone given 6-hourly for 48 h. Serum cortisol was measured 6 h after the last dose of dexamethasone, with a value of 50 nmol/liter or below excluding Cushing's syndrome. Immediately after this, the LDDST-CRH test commenced with administration of a ninth dose of 0.5 mg dexamethasone. Exactly 2 h later, 100 mug human-sequence CRH was administered. Serum cortisol was measured 15 min after the CRH injection, with a value of less than 38 nmol/liter also excluding Cushing's syndrome. MAIN OUTCOME MEASURE Diagnosis or exclusion of Cushing's syndrome was the main outcome measure. RESULTS Twelve subjects were diagnosed with Cushing's syndrome (eight Cushing's disease and four primary adrenal). The sensitivity of the LDDST in diagnosing Cushing's syndrome was 100%, with a specificity of 88%. In contrast, although the sensitivity of the LDDST-CRH test was also 100%, specificity was reduced at 67%. These results give a positive predictive value of 80% for the LDDST and 60% for the LDDST-CRH test. CONCLUSION This small study suggests that the addition of CRH to the LDDST does not improve the diagnostic accuracy of the standard LDDST in Cushing's syndrome.
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Affiliation(s)
- N M Martin
- Department of Endocrinology, Imperial College, Faculty of Medicine, Hammersmith Hospital, London W12 0NN, United Kingdom
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Dhillo WS, Jayasena CN, Lewis CJ, Martin NM, Tang KCN, Meeran K, Todd JF. Plasma gastrin measurement cannot be used to diagnose a gastrinoma in patients on either proton pump inhibitors or histamine type-2 receptor antagonists. Ann Clin Biochem 2006; 43:153-5. [PMID: 16536918 DOI: 10.1258/000456306776021607] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Patients with a gastrinoma are treated with proton pump inhibitors (PPI) and histamine type-2 receptor antagonists (H2). In order to diagnose a gastrinoma these drugs must be discontinued, but this increases the risk of gastrointestinal perforation. We aimed to determine if a gastrinoma could be diagnosed without cessation of PPI/H2 therapy. METHODS In all, 90 patients (controls and patients diagnosed with a gastrinoma both on and off PPI/H2 therapy) were recruited, and plasma gastrin measured. RESULTS Patients with a gastrinoma on PPI/H2 medication had a significantly higher fasting plasma gastrin concentration than control patients on PPI/H2 medication (298+/-33 versus 204+/-30 pmol/L, P = 0.01). However, there was substantial overlap between gastrin levels in these two groups. CONCLUSION This study confirms that a gastrinoma cannot be diagnosed on the basis of a fasting plasma gastrin assay while patients remain on PPI/H2 therapy.
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Affiliation(s)
- W S Dhillo
- Department of Endocrinology, Imperial College Faculty of Medicine, Hammersmith Hospital, London W12 ONN, UK
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Dhillo WS, Gardiner JV, Castle L, Bewick GA, Smith KL, Meeran K, Todd JF, Ghatei MA, Bloom SR. Agouti Related Protein (AgRP) is Upregulated in Cushing's Syndrome. Exp Clin Endocrinol Diabetes 2005; 113:602-6. [PMID: 16320160 DOI: 10.1055/s-2005-872895] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Alpha melanocyte-stimulating hormone (alpha-MSH) is an agonist at the melanocortin 3 (MC3-R) and melanocortin 4 (MC4-R) receptors. Alpha-MSH stimulates corticosterone release from rat and human adrenal cells. Patients with Cushing's syndrome have elevated levels of serum alpha-MSH. Agouti related protein (AgRP) is an endogenous antagonist at the MC3-R and MC4-R and is expressed in the rat adrenal cortex. AgRP antagonises alpha-MSH-induced corticosterone release from rat and bovine adrenal cells. This suggests that AgRP may have an inhibitory paracrine role in the adrenal gland. We measured adrenal AgRP mRNA expression and circulating AgRP in 2 patients with Cushing's syndrome and controls. Adrenal AgRP mRNA expression and plasma AgRP were higher in the patients with Cushing's syndrome compared to controls. Plasma AgRP in the patients with Cushing's syndrome following bilateral adrenalectomy and hydrocortisone replacement were similar to the levels seen in controls. Our results suggest that AgRP may have a novel inhibitory paracrine role in the human adrenal gland.
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Affiliation(s)
- W S Dhillo
- Department of Metabolic Medicine, Faculty of Medicine, Imperial College, 6th Floor Commonwealth Building, Hammersmith Hospital, Du Cane Road, London W12 0NN, UK
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Shariff M, Dhillo WS, Seal LJ, Todd JF, Meeran K. A case of excess growth hormone levels. Int J Clin Pract 2005:34-6. [PMID: 15875616 DOI: 10.1111/j.1742-1241.2005.00309.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Patients with anorexia nervosa are known to have elevated basal growth hormone levels, which fail to suppress normally during glucose tolerance testing. We describe a case of probable anorexia nervosa initially diagnosed as acromegaly despite a low insulin-like growth factor-1 level and treated with transsphenoidal surgery based on a pituitary microadenoma on magnetic resonance imaging and a lack of suppression of growth hormone levels during glucose tolerance testing. This case highlights, firstly, that pituitary magnetic resonance imaging will suggest a pituitary adenoma in up to 10% of normal individuals. Secondly, that a diagnosis of acromegaly should be made on clinical features as well as growth hormone measurements.
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Affiliation(s)
- M Shariff
- Department of Endocrinology, Imperial College Faculty of Medicine, Charing Cross Hospital, London W6 6RF, UK
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Gardiner JV, Kong WM, Ward H, Murphy KG, Dhillo WS, Bloom SR. AAV mediated expression of anti-sense neuropeptide Y cRNA in the arcuate nucleus of rats results in decreased weight gain and food intake. Biochem Biophys Res Commun 2005; 327:1088-93. [PMID: 15652508 DOI: 10.1016/j.bbrc.2004.12.113] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2004] [Indexed: 10/26/2022]
Abstract
Neuropeptide Y (NPY) is the most potent stimulant of feeding when administered by intracerebroventricular injection. Despite this, there is conflicting evidence as to its importance in the regulation of daily food intake and energy balance. It has been suggested that whilst it is important in the response to starvation it has little role in the regulation of daily food intake. To investigate the role of NPY in the regulation of food intake, anti-sense cRNA to NPY was expressed in the arcuate nucleus of adult male rats. The anti-sense NPY (AS-NPY) construct was initially tested in vitro and there was a decrease of approximately 50% in NPY release from anti-sense treated cells compared to controls (16.3 +/- 2.0 fmol/L [AS-NPY] vs 37.3 +/- 7.7 fmol/L [control], mean +/- SEM p < 0.05). NPY release from hypothalamic explants from anti-sense injected animals was decreased by over 50% compared to those from controls at both 15 and 20 days after AAV injection (15 days 42% +/- 6.5% [AS-NPY] vs 100% +/- 36% [control], 20 days 41% +/- 6% [AS-NPY] vs 100% +/- 27% [control] mean+/-SEM, p < 0.05). In a study lasting for 50 days, weight gain was significantly lower in anti-sense injected animals from day 16 (day 16: 6.25 +/- 1.10 g [AS-NPY] vs 9.42 +/- 0.65 g [control] mean +/- SEM, p < 0.05) and remained so until the end of the study when they had gained approximately 40% less weight than controls (day 50: 52.0 +/- 9.6 g [AS-NPY] vs 82.0 +/- 6.3 g [control] mean +/- SEM, p < 0.01). Cumulative food intake was significantly lower in the anti-sense injected animals from day 23 (day 23: 225.8 +/- 1.9 g [AS-NPY] vs 250.6 +/- 8.7 g [control], mean +/- SEM, p < 0.05) and remained so until the end of the study (day 50: 834.5 +/- 14.8 g [AS-NPY] vs 926.0 +/- 31.7 g [control], mean +/- SEM, p < 0.05). Similarly mean daily food intake was also reduced in the anti-sense injected animals (days 7-14: 24.9 +/- 0.4 g/day [AS-NPY] vs 27.2 +/- 0.4 g/day [control], mean +/- SEM, p < 0.01). These data are supportive of a role for NPY in the regulation of daily food intake as well as in response to starvation.
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Affiliation(s)
- J V Gardiner
- Metabolic Medicine, Hammersmith Campus, Imperial College London, London W12 0NN, UK
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41
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Abstract
Obesity has been described as the greatest current threat to human health. In order to design drugs to target obesity, it is essential to understand its physiology and pathophysiology. Several peptides synthesised in the gastrointestinal tract which affect food intake have been identified including ghrelin, cholecystokinin (CCK), glucagon-like peptide-1 (7-36) amide (GLP-1), oxyntomodulin, peptide YY (PYY) and pancreatic polypeptide (PP). These peptides represent potential targets for the design of anti-obesity drugs. In this article we review recent advances in our understanding of food intake by these gastrointestinal hormones.
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Affiliation(s)
- W S Dhillo
- Department of Metabolic Medicine, Imperial College Faculty of Medicine, Hammersmith Hospital, London W12 ONN, UK
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Thompson EL, Patterson M, Murphy KG, Smith KL, Dhillo WS, Todd JF, Ghatei MA, Bloom SR. Central and peripheral administration of kisspeptin-10 stimulates the hypothalamic-pituitary-gonadal axis. J Neuroendocrinol 2004; 16:850-8. [PMID: 15500545 DOI: 10.1111/j.1365-2826.2004.01240.x] [Citation(s) in RCA: 356] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Kisspeptin is the peptide product of the KiSS-1 gene and the endogenous agonist for the GPR54 receptor. Recent evidence suggests the kisspeptin/GPR54 system is a key regulator of the reproductive system. We examined the effect of intracerebroventricular (i.c.v.) and peripheral administration of the active kisspeptin fragment, kisspeptin-10, on circulating gonadotrophins and total testosterone levels in adult male rats. The effect of kisspeptin-10 in vitro on the release of hypothalamic peptides from hypothalamic explants and gonadotrophins from anterior pituitary fragments was also determined. The i.c.v. administration of kisspeptin-10 dose-dependently increased plasma luteinizing hormone (LH) and increased plasma follicle stimulating hormone (FSH) and total testosterone at 60 min postinjection. In a separate study investigating the time course of this response, i.c.v. administered kisspeptin-10 (3 nmol) significantly increased plasma LH at 10, 20 and 60 min, FSH at 60 min and total testosterone at 20 and 60 min postinjection. Kisspeptin-10 stimulated the release of luteinizing hormone-releasing hormone (LHRH) from in vitro hypothalamic explants. Peripheral administration of kisspeptin-10 increased plasma LH, FSH and total testosterone. However, doses of 100-1000 nM kisspeptin-10 did not influence LH or FSH release from pituitary fragments in vitro. Kisspeptin therefore potently stimulates the hypothalamic-pituitary-gonadal axis. These effects are likely to be mediated via the hypothalamic LHRH system.
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Affiliation(s)
- E L Thompson
- Department of Metabolic Medicine, Imperial College Faculty of Medicine, Hammersmith Campus, Du Cane Road, London W12 0NN, UK
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le Roux CW, Chapman GA, Kong WM, Dhillo WS, Jones J, Alaghband-Zadeh J. Free cortisol index is better than serum total cortisol in determining hypothalamic-pituitary-adrenal status in patients undergoing surgery. J Clin Endocrinol Metab 2003; 88:2045-8. [PMID: 12727952 DOI: 10.1210/jc.2002-021532] [Citation(s) in RCA: 101] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Serum total cortisol has traditionally been used for the interpretation of tests of the hypothalamic-pituitary-adrenal axis. Approximately 80% of total cortisol is bound to cortisol-binding globulin (CBG), and variation in CBG significantly affects serum total cortisol levels. Reliable assessment of hypothalamic-pituitary-adrenal axis reserve is difficult in severely ill patients, because CBG falls substantially during the acute phase response. The free cortisol index (FCI), defined as the ratio of total cortisol/CBG, correlates well with serum free cortisol. We evaluated the FCI in the context of severe stress and the acute phase response by measuring total cortisol and CBG pre- and postoperatively in 31 patients undergoing major elective surgery. Serum total cortisol increased by 55% from 453 +/- 35.2 (mean +/- SEM) nmol/liter (range, 88-882) to 700 +/- 47.2 (range, 294-1631) nmol/liter. Serum CBG decreased by 30% from 45 +/- 1.7 (range, 26.6-64.1) to 31.4 +/- 1.62 (range, 16.1-51.9) mg/liter, but FCI increased by 130% from 10 +/- 0.8 (range, 2-18) to 23 +/- 1.7 (range, 13-58) nmol/mg. In seven patients (23%), postoperative serum total cortisol was less than 500 nmol/liter, but their postoperative CBG levels were significantly lower than levels in the rest of the group (P < 0.01). However, there was no difference in the FCI between this subgroup and the rest of the group. This study demonstrates the importance of CBG measurement and the calculation of FCI for the interpretation of serum total cortisol in situations where CBG changes significantly.
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Affiliation(s)
- C W le Roux
- Department of Metabolic Medicine, Hammersmith Hospitals Trust, London, United Kingdom W12 0NN.
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Kennedy AR, Todd JF, Dhillo WS, Seal LJ, Ghatei MA, O'Toole CP, Jones M, Witty D, Winborne K, Riley G, Hervieu G, Wilson S, Bloom SR. Effect of direct injection of melanin-concentrating hormone into the paraventricular nucleus: further evidence for a stimulatory role in the adrenal axis via SLC-1. J Neuroendocrinol 2003; 15:268-72. [PMID: 12588515 DOI: 10.1046/j.1365-2826.2003.00997.x] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Melanin-concentrating hormone (MCH) is implicated in the control of a number of hormonal axes including the hypothalamic-pituitary adrenal (HPA) axis. Previous studies have shown that there is evidence for both a stimulatory and an inhibitory action on the HPA axis; therefore, we attempted to further characterize the effects of MCH on this axis. Intracerebroventricular injection of MCH increased circulating adrenocorticotropic hormone (ACTH) at 10 min post injection. Injection of MCH directly into the paraventricular nucleus (PVN) was found to increase both circulating ACTH and corticosterone 10 min after injection. Additionally, MCH was found to increase corticotropin-releasing factor (CRF) release from hypothalamic explants, and this effect was abolished by the specific SLC-1 antagonist SB-568849. Neuropeptide EI, a peptide from the same precursor as MCH was also found to increase CRF release from explants. These results suggest that MCH has a stimulatory role in the HPA axis via SLC-1, and that MCH exerts its effects predominantly through the PVN CRF neuronal populations
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Affiliation(s)
- A R Kennedy
- Imperial Centre for Obesity Research, Faculty of Medicine, Imperial College, London, UK
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Frost GS, Brynes AE, Dhillo WS, Bloom SR, McBurney MI. The effects of fiber enrichment of pasta and fat content on gastric emptying, GLP-1, glucose, and insulin responses to a meal. Eur J Clin Nutr 2003; 57:293-8. [PMID: 12571662 DOI: 10.1038/sj.ejcn.1601520] [Citation(s) in RCA: 98] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2002] [Revised: 04/09/2002] [Accepted: 04/19/2002] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To assess whether the addition of viscous fiber at an amount recommended by the US FDA to allow a 'low saturated fat, cholesterol, soluble fiber and coronary heart disease', health claim label on a food package (1.7 g psyllium) and/or fat (30 g sunflower oil and 3 g sodium propionate) to a pasta meal would affect gastric emptying, postprandial glucose, insulin and GLP-1 concentrations. DESIGN Ten subjects participated in a two-by-two single blind randomized crossover study. Four meals containing 50 g of available carbohydrate were consumed: pasta with or without psyllium enrichment served with a tomato sauce with (520 kcal per meal) and without (240 kcal per meal) fat. Blood samples were taken for 240 min following the meal and all subjects consumed a buffet meal at the end of the study. Gastric emptying was measured using the paracetamol absorption test. Blood was analysed for glucose, insulin, GLP-1. Visual analog scales were used to record feelings of hunger, pleasantness and nausea. RESULTS The psyllium-enriched pasta had no significant effect on gastric emptying or the incremental area under the curve (IAUC) for GLP-1, insulin or glucose compared with the control pasta. The addition of polyunsaturated fat and sodium propionate significantly increased the IAUC for GLP-1 (P<0.001), delaying gastric emptying (P<0.002), and decreasing glucose (P<0.002). CONCLUSIONS A dose of 1.7 g psyllium did not evoke measurable effects on gastric emptying, postprandial GLP-1, insulin or glucose metabolism. However the addition of 30 g of oil and 3 g of sodium propionate to the pasta did reduce gastric emptying, increase GLP-1 and reduce glucose and insulin concentrations. While this short-term study may have implications in terms of reducing the risk of diabetes and improving coronary risk factor profiles the long term effects of these nutrients need to be studied.
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Affiliation(s)
- G S Frost
- Nutrition and Dietetic Research Group, Hammersmith Hospital, London, UK.
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Dhillo WS, Small CJ, Gardiner JV, Bewick GA, Whitworth EJ, Jethwa PH, Seal LJ, Ghatei MA, Hinson JP, Bloom SR. Agouti-related protein has an inhibitory paracrine role in the rat adrenal gland. Biochem Biophys Res Commun 2003; 301:102-7. [PMID: 12535647 DOI: 10.1016/s0006-291x(02)02991-1] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
alpha-Melanocyte-stimulating-hormone (alpha-MSH) is an agonist at the melanocortin 3 receptor (MC3-R) and melanocortin 4 receptor (MC4-R). alpha-MSH stimulates corticosterone release from rat adrenal glomerulosa cells in vitro. Agouti-related protein (AgRP) an endogenous antagonist at the MC3-R and MC4-R, is expressed in the adrenal gland. We investigated the expression of the MC3-R and MC4-R and the role of AgRP in the adrenal gland. MC3-R and MC4-R expression was detected in rat adrenal gland using RT-PCR. The effect of AgRP on alpha-MSH-induced corticosterone release was investigated using dispersed rat adrenal glomerulosa cells. AgRP administered alone did not affect corticosterone release, but co-administration of AgRP and alpha-MSH attenuated alpha-MSH-induced corticosterone release. To investigate glucocorticoid feedback, adrenal AgRP expression was compared in rats treated with dexamethasone to controls. AgRP mRNA was increased in rats treated with dexamethasone treatment compared to controls. Our findings demonstrate that adrenal AgRP mRNA is regulated by glucocorticoids. AgRP acting via the MC3-R or MC4-R may have an inhibitory paracrine role, blocking alpha-MSH-induced corticosterone secretion.
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Affiliation(s)
- W S Dhillo
- Endocrine Unit, Faculty of Medicine, Imperial College, 6th Floor Commonwealth Building, Hammersmith Hospital, Du Cane Road, London W12 ONN, UK
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Dhillo WS, Small CJ, Stanley SA, Jethwa PH, Seal LJ, Murphy KG, Ghatei MA, Bloom SR. Hypothalamic interactions between neuropeptide Y, agouti-related protein, cocaine- and amphetamine-regulated transcript and alpha-melanocyte-stimulating hormone in vitro in male rats. J Neuroendocrinol 2002; 14:725-30. [PMID: 12213133 DOI: 10.1046/j.1365-2826.2002.00832.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A number of neuropeptides implicated in the hypothalamic regulation of appetite are synthesized in the arcuate nucleus (Arc). Neuropeptide Y (NPY) and agouti-related protein (Agrp) are orexigenic. The pro-opiomelanocortin (POMC) product alpha-melanocyte-stimulating hormone (alpha-MSH) is anorectic. Intracerebroventricular administration of cocaine- and amphetamine-regulated transcript (CART) decreases food intake. However, recent results show that CART is orexigenic when injected into discrete hypothalamic nuclei. There is almost complete coexpression of NPY and Agrp mRNA in Arc neurones, and the majority of CART-containing neurones in the Arc also contain POMC mRNA. We investigated possible interactions between these neuropeptides in vitro using a rat hypothalamic explant system. Administration of 1, 10 and 100 nm of NPY to hypothalamic explants significantly increased release of Agrp(83-132)-immunoreactivity (IR). NPY (10 and 100 nm) significantly increased the release of CART(55-102)-IR and alpha-MSH-IR from hypothalamic explants. Agrp(83-132) (10 nm) administered to hypothalamic explants significantly increased the release of NPY-IR. Agrp(83-132) (10 and 100 nm) significantly decreased the release of CART(55-102)-IR from hypothalamic explants. Administration of 1, 10 and 100 nm CART(55-102) to hypothalamic explants resulted in a significant increase in NPY-IR release. Administration of 10 nm CART(55-102) to hypothalamic explants significantly increased the release of Agrp(83-132)-IR. NDP-MSH (10 nm) administered to hypothalamic explants significantly increased the release of NPY-IR. NDP-MSH (10 and 100 nm) significantly increased the release of Agrp(83-132)-IR from hypothalamic explants. These data suggest that orexigenic neuropeptides in the arcuate nucleus stimulate the release of each other, perhaps reinforcing orexigenic behaviour via a positive-feedback loop. Our results are also in keeping with the possibility that the melanocortin-3 receptor in the arcuate nucleus may influence the release of arcuate neuropeptides.
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Affiliation(s)
- W S Dhillo
- Department of Metabolic Medicine, Imperial College Faculty of Medicine, Hammersmith Hospital, London, UK
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48
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Dhillo WS, Kong WM, Le Roux CW, Alaghband-Zadeh J, Jones J, Carter G, Mendoza N, Meeran K, O'Shea D. Cortisol-binding globulin is important in the interpretation of dynamic tests of the hypothalamic--pituitary--adrenal axis. Eur J Endocrinol 2002; 146:231-5. [PMID: 11834433 DOI: 10.1530/eje.0.1460231] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Assessment of the hypothalamic--pituitary--adrenal (HPA) axis relies on the interpretation of serum (total) cortisol in response to dynamic tests of the HPA axis. Most cortisol is bound to cortisol-binding globulin (CBG) and serum total cortisol levels are significantly affected by variation in CBG. We hypothesised that CBG variation significantly affects interpretation of dynamic tests of the HPA axis. DESIGN We investigated the effect of CBG variation on the outcome of the 250 microg short Synacthen test (SST) in 30 healthy adults. METHODS Blood was sampled at time -30, 0 (at which point Synacthen was given) and +30 min. CBG and total cortisol were measured at each time-point. Integrity of the HPA axis was confirmed by measurement of urine cortisol. RESULTS We found that CBG varied significantly within individuals, falling from 51+/-3.4 to 43 +/-3.2 microg/ml (P<0.0001) on changing from standing to lying. Total cortisol levels strongly correlated with CBG (r=0.88, P<0.0001). Thirteen subjects had a +30 min total cortisol <550 nmol/l. In these subjects, the CBG levels at each time-point were significantly lower compared with subjects who had a +30 min total cortisol of >550 nmol/l (P<0.05). To correct for variation in CBG we calculated the total cortisol:CBG ratio and found no significant difference in the +30 min ratio between these two groups. CONCLUSION CBG varies significantly within and between individuals. This is accompanied by changes in serum total cortisol large enough to affect the outcome of an SST and, by implication, other tests of the HPA axis.
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Affiliation(s)
- W S Dhillo
- Department of Endocrinology, Imperial College School of Medicine, Charing Cross and Hammersmith Hospital Sites, London W6 8RF, UK.
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Wren AM, Seal LJ, Cohen MA, Brynes AE, Frost GS, Murphy KG, Dhillo WS, Ghatei MA, Bloom SR. Ghrelin enhances appetite and increases food intake in humans. J Clin Endocrinol Metab 2001. [PMID: 11739476 DOI: 10.1210/jc.86.12.5992] [Citation(s) in RCA: 474] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Ghrelin is a recently identified endogenous ligand for the growth hormone secretagogue receptor. It is synthesized predominantly in the stomach and found in the circulation of healthy humans. Ghrelin has been shown to promote increased food intake, weight gain and adiposity in rodents. The effect of ghrelin on appetite and food intake in man has not been determined. We investigated the effects of intravenous ghrelin (5.0 pmol/kg/min) or saline infusion on appetite and food intake in a randomised double-blind cross-over study in nine healthy volunteers. There was a clear-cut increase in energy consumed by every individual from a free-choice buffet (mean increase 28 +/- 3.9%, p<0.001) during ghrelin compared with saline infusion. Visual analogue scores for appetite were greater during ghrelin compared to saline infusion. Ghrelin had no effect on gastric emptying as assessed by the paracetamol absorption test. Ghrelin is the first circulating hormone demonstrated to stimulate food intake in man. Endogenous ghrelin is a potentially important new regulator of the complex systems controlling food intake and body weight.
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Affiliation(s)
- A M Wren
- Endocrine Unit, Imperial College School of Medicine, Hammersmith Hospital, London W12 ONN, United Kingdom
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Wren AM, Seal LJ, Cohen MA, Brynes AE, Frost GS, Murphy KG, Dhillo WS, Ghatei MA, Bloom SR. Ghrelin enhances appetite and increases food intake in humans. J Clin Endocrinol Metab 2001. [PMID: 11739476 DOI: 10.1210/jc.86.12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Ghrelin is a recently identified endogenous ligand for the growth hormone secretagogue receptor. It is synthesized predominantly in the stomach and found in the circulation of healthy humans. Ghrelin has been shown to promote increased food intake, weight gain and adiposity in rodents. The effect of ghrelin on appetite and food intake in man has not been determined. We investigated the effects of intravenous ghrelin (5.0 pmol/kg/min) or saline infusion on appetite and food intake in a randomised double-blind cross-over study in nine healthy volunteers. There was a clear-cut increase in energy consumed by every individual from a free-choice buffet (mean increase 28 +/- 3.9%, p<0.001) during ghrelin compared with saline infusion. Visual analogue scores for appetite were greater during ghrelin compared to saline infusion. Ghrelin had no effect on gastric emptying as assessed by the paracetamol absorption test. Ghrelin is the first circulating hormone demonstrated to stimulate food intake in man. Endogenous ghrelin is a potentially important new regulator of the complex systems controlling food intake and body weight.
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Affiliation(s)
- A M Wren
- Endocrine Unit, Imperial College School of Medicine, Hammersmith Hospital, London W12 ONN, United Kingdom
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