GnRH激动剂主动免疫母羊对生殖激素分泌的作用

目的:探讨GnRH激动剂(GnRHa)主动免疫对绵羊生殖激素合成与分泌的作用,并深入研究GnRH-A免疫调节动物生殖功能的机理。方法:42只5～6月龄母绵羊(Ovis aries)随机分为6组(n=7),EG-Ⅰ、EG-Ⅱ和EG-Ⅲ分别于0和14天皮下注射阿拉瑞林抗原200、300和400μg;EG-Ⅳ和EG-Ⅴ分别皮下注射阿拉瑞林抗原200、300、0、7、14和21天各一次,共4次;对照组在0和14天皮下注射抗原溶媒(除不用阿拉瑞林外,其余成分和制备方法与阿拉瑞林抗原相同)2.0 ml。无菌采集不同时段的血液,分离血清。以ELISA测定血清GnRH抗体浓度,用激素检测试剂盒(ELISA)分别测定血清GnRH、FSH、LH和E2浓度。结果:①阿拉瑞林首次免疫7天后,各实验组的抗体浓度逐渐升高,EG-Ⅰ、EG-Ⅱ和EG-Ⅲ分别在28、28和35天达到峰值(P<0.05),EG-IV和EG-V则在在45天达到峰值(P<0.01),至60天时仍明显高于对照组(P<0.05)。14～60天间EG-IV和EG-V抗体浓度均高于EG-Ⅰ、EG-Ⅱ和EG-Ⅲ(P<0.05)。②EG-Ⅰ、EG-Ⅱ的GnRH在21和28天抵谷值(P<0.05),EG-Ⅲ、EG-Ⅳ和EG-Ⅴ则在45天抵谷值(P<0.01),且以EG-Ⅴ为最低。谷值之后逐渐上升趋势,70天时达到免疫注射前水平。③实验组血清FSH浓度始终高于对照组(P<0.05)。EG-Ⅰ、EG-Ⅱ和EG-Ⅲ于28、28和35天达到峰值(P<0.05),而EG-IV和EG-V在60天达到高峰值(P<0.01)。④实验组绵羊血清LH呈下降趋势,EG-Ⅰ、EG-Ⅱ和EG-Ⅲ分别在21、21和28天达到谷值(P<0.01),EG-Ⅳ和EG-Ⅴ在35天达到谷值(P<0.01)。35天时EG-Ⅳ和EG-Ⅴ低于EG-Ⅰ、EG-Ⅱ和EG-Ⅲ。⑤各组的血清E2含量无显著差异。结论:GnRH激动剂(阿拉瑞林)抗原主动免疫可促进GnRH抗体的生成,抑制母羊GnRH和LH的合成与分泌,增强FSH的合成与分泌,且随着注射剂量和注射次数的增加,这种作用更加明显,而对血清E2无明显影响。     

GnRH及其受体在兔卵巢和子宫的分布

目的探讨GnRH与其受体(GnRHR)在卵巢和子宫组织中的分布,研究GnRH-A(激动剂Alarelin)主动免疫对GnRH和GnRHR分布的影响。方法 24只日本大耳白雌兔(Oryctolagus cuniculus)随机分为4组(n=6),实验组和对照组。其中实验1组(EG-1)、实验2组(EG-2)和实验3组(EG-3)分别在兔颈背侧皮下注射1.0m(l100μg/ml、100μg/ml和50μg/ml)GnRH-A抗原,EG-2和EG-3于20d以原剂量加强注射1次,102d无菌采集垂体、卵巢和子宫。用SP法染色,图像分析技术进行定位与分析。结果卵巢和子宫均有GnRH和GnRHR阳性细胞分布,主要见于卵母细胞、卵泡细胞、子宫内膜上皮细胞和腺上皮细胞;GnRH-A的剂量不同,GnRH和GnRH阳性细胞的染色强度也不同,即GnRHR和GnRH的表达量不同。GnRH-A能增加GnRH和GnRH的分布与表达,EG-2的作用更为明显。结论卵巢和子宫中均有GnRH和GnRHR细胞分布,GnRH-A免疫能增强GnRH和GnRHR的表达。     

GnRHa主动免疫对幼鼠子宫发育的作用

目的探讨促性腺激素释放激素激动剂(GnRHa)主动免疫对幼鼠子宫发育的作用。方法 60只昆明雌鼠随机均分为四组,分别颈部皮下注射不同剂量阿拉瑞林抗原,各组均连续注射7 d。在0 d、7 d、14 d和21 d测定体重,于21 d处理小鼠,显微镜观察子宫的组织结构变化,并用Motic imagles软件测定分析图像数据。结果阿拉瑞林能明显抑制子宫的发育,且剂量越大作用越明显。EG-Ⅲ的UWT明显缩小(P<0.05);实验组EET均小于对照组(P<0.05)。EG-Ⅰ子宫腔轻度缩小;EG-Ⅱ子宫腔和腺体管腔缩小,子宫管壁明显变薄;内膜皱襞减少,上皮变薄;EG-Ⅲ子宫壁变薄,子宫腺减少,内膜细胞胞核变小,上皮变薄,胞质明显减少。结论阿拉瑞林主动免疫能显著抑制幼鼠的子宫发育,且连续重复免疫对小鼠具有毒性作用,剂量越大,作用越明显。     

GnRH拮抗剂与GnRH激动剂短方案IVF-ET结局的比较

目的比较GnRH antagonist与GnR Hagonist短方案的IVF-ET结局。方法2006年8月至2007年8月GnR Hantagonist治疗组54人和GnR Hagonist短方案对照组132人,记录促性腺激素的用量及其用药天数、hCG日子宫内膜厚度和激素水平、获卵数、受精率、卵裂率、优胚率、妊娠率和OHSS发生率等指标。结果两组促性腺激素的用量及其用药天数、获卵数、受精率、卵裂率、着床率和妊娠率相比较均无显著差异（P〉0.05）。GnR Hantagonist组在hCG日激素水平低,与对照组比较其差异有统计学意义。结论行GnR Hantagonist方案IVF-ET助孕治疗与传统的GnR Hagonist短方案比较,其hCG日雌激素水平下降可能是OHSS发生率显著下降的主要因素;但卵泡的发育、卵母细胞的受精率、卵裂率及妊娠率和着床率均不受影响。GnR Hantagonist的使用为IVF-ET助孕药物提供了一种新的选择。     

GnRH-A主动免疫公兔对垂体GnRHR、FSH-β和LH-β基因表达的影响

目的探讨GnRH-A激动剂(阿拉瑞林)主动免疫对公兔的去势效果和垂体GnRHR、FSH-β和LH-βmRNA表达的影响。方法 30只日本大耳白兔(Oryctolagus cuniculus)随机分为三组(n=10),在实验1组(EG-Ⅰ)和实验2组(EG-Ⅱ)颈部皮下注射1.0mL(100μg/mL)阿拉瑞林抗原乳剂EG-Ⅱ于20d以相同剂量重复注射1次,用荧光定量PCR分析垂体中GnRHR、FSH-β和LH-β mRNA的表达,并测定GnRHR的核苷酸序列。结果 EG-Ⅰ和EG-ⅡGnRH抗体水平高于对照组(P0.05),EG-Ⅱ在49d达到峰值,显著高于EG-Ⅰ(P0.05)和对照组(P0.01),而后开始逐渐下降。28d以后,EG-Ⅱ和EG-Ⅰ血清睾酮浓度低于对照组(P0.05),且EG-Ⅱ低于EG-Ⅰ(P0.01);公兔GnRHR的核苷酸为1179bp,同源性达96%。结论阿拉瑞林免疫可以明显提高血清GnRH抗体水平,降低垂体GnRHR、FSH-β和LH-β基因表达,减少睾酮的合成与分泌,从而导致性器官发育受阻,具有明显的作用,加强免疫效果更佳。     

妊娠与非妊娠大鼠子宫内膜促性腺激素释放激素及其受体的免疫组织化学研究

目的：研究促性腺激素释放激素（GnRH)及其受体在妊娠与非妊娠大鼠子宫内膜中的分布及相对含量,为了解促性腺激素释放激素对子宫内膜的可能功能提供依据。方法：免疫组织化学ABC法及图像分析技术。结果：非妊娠大鼠子宫内促性腺激素释放激素及促性腺激素释放激素受体阳性反应发生在内膜上皮、腺上皮及基质细胞。妊娠大鼠子宫内这二者阳性反应主要发生在内膜上皮及基蜕膜的蜕膜细胞,妊娠大鼠子宫上皮细胞中的促性腺激素释放激素及其受体的相对含量明显高于非妊娠大鼠子宫内膜。结论：妊娠与非妊娠大鼠子宫内膜均能表达促性腺激素释放激素及其受体。     

促性腺激素释放激素激动剂改善子宫内膜异位症患者生育力的作用机制及应用

促性腺激素释放激素激动剂（GnRHa）为治疗子宫内膜异位症（EM）的常用药物之一。EM可多方面对女性生育力产生不利影响,而GnRHa可通过改善EM患者腹腔及卵泡微环境、提高子宫内膜容受性及改善输卵管功能等作用提高EM相关不孕患者生育力,并在联合腹腔镜手术及辅助生殖技术（ART）治疗改善EM不孕患者妊娠结局中具有一定价值。     

GnRH拮抗剂在体外受精-胚胎移植中的应用

目的探讨促性腺激素释放激素（GnRH）拮抗剂方案在体外受精-胚胎移植（IVF—ET）促超排卵中的应用效果。方法回顾性比较分析本中心2006年8月～2007年8月接受ⅣF—ET助孕治疗的患者中采用GnRH拮抗剂方案的54例患者和采用GnRH激动剂长方案的135例患者，观察其临床效果。结果两组Gn用量、HCG日内膜厚度、受精率、卵裂率之间比较无显著性差异；两组患者Gn使用天数、HCG日E2值、获卵数、冷冻率、种植率、妊娠率、OHSS发生率之间比较有显著性差异。结论GnRH拮抗剂联合促性腺激素促超排卵方案缩短用药时间，减少费用，并可显著降低OHSS的发生率，但冷冻率、妊娠率较GnRH激动剂长方案偏低。     

促性腺激素释放激素激动剂治疗子宫内膜异位症的进展

促性腺激素释放激素激动剂（gonadotropin releasing hormone agonists,GnRH-a）有效的治疗子宫内膜异位症已得到普遍的认可及应用。随着对GnRH-a的作用机制及临床应用方面的不断认识,GnRH-a治疗子宫内膜异位症有了新的进展,随之产生的反加疗法及时减轻了GnRH-a治疗子宫内膜异位症的不良反应,即血管运动综合症及骨质疏松等。     

人甲状腺促性腺激素释放激素及其受体的表达

目的　探讨人甲状腺中是否存在促性腺激素释放激素 (GnRH)及促性腺激素释放激素受体 (GnRH R)并细胞定位 ,试图从转录及翻译水平讨论人甲状腺可否合成GnRH及GnRH R ,为探讨GnRH可能影响甲状腺的功能提供形态学依据。　方法　采用免疫组织化学法和原位杂交技术。　结果　所测人正常甲状腺组织均呈较强的GnRH和GnRH R免疫反应阳性 ,甲状腺滤泡上皮细胞、滤泡旁细胞均为阳性细胞。免疫反应阳性物质主要分布在阳性细胞胞质内 ,胞核呈阴性。原位杂交结果同免疫组织化学染色基本一致 :甲状腺滤泡上皮细胞胞质和滤泡旁细胞胞质可检测到较强的GnRHmRNA及GnRH RmRNA阳性杂交信号。胞核均呈阴性 ,未检测到杂交信号。　结论　人甲状腺不仅表达GnRH和GnRH R ,而且可以自身合成GnRH和GnRH R。GnRH可能以自分泌的方式影响甲状腺的生理功能     

Depot versus daily administration of GnRH agonist protocols for pituitary desensitization in assisted reproduction cycles: a Cochrane Review

This paper is based on a Cochrane review published in The Cochrane Library, issue 4, 2002 (see www.CochraneLibrary.net for information) with permission from The Cochrane Collaboration. Cochrane reviews are regularly updated as new evidence emerges and in response to comments and criticisms, and The Cochrane Library should be consulted for the most recent version of the review. BACKGROUND: GnRH agonists have been widely used in cycles of IVF. There are two types of GnRH agonist administration that can be used to lead to hypophysis desensitization in IVF cycles in the long protocol: one consisting of daily low doses of GnRH agonist and the other the administration of analogues in higher, long-acting doses (depot). The objective of this study is to compare the use of a single long-acting depot dose with that of daily GnRH agonist doses in IVF cycles. METHODS: Relevant randomized controlled trials were identified by electronic search of the following databases: MEDLINE, EMBASE, LILACS (Latin American and Caribbean Center on Health Sciences Information) and the Cochrane Controlled Trials Register. Six studies, with a total of 552 women, were included and analysed. RESULTS: The studies do not indicate that there is a statistically significant difference between the use of depot GnRH agonist and of daily GnRH agonist in the primary outcome, clinical pregnancy rates per woman [odds ratio (OR) 0.94, 95% confidence interval (CI) 0.65-1.37]. However, there was sufficient evidence showing that the use of depot GnRH agonist for pituitary desensitization in IVF cycles increased the number of gonadotrophin ampoules [weighted mean difference (WMD) 3.30, 95% CI 1.27-5.34] and the duration of the ovarian stimulation (WMD 0.56, 95% CI 0.31-0.81), as compared with the use of daily GnRH agonist. CONCLUSIONS: Although we recognize that the clinical pregnancy rates per woman are not the ideal primary outcome, we found no evidence of differences between the long protocols using depot or daily GnRH agonist for IVF cycles. However, the use of depot GnRH agonist is associated with increased requirements for gonadotrophins and a longer time needed for ovarian stimulation. If these differences could be shown to translate into economic benefit, depot GnRH agonist would increase the overall costs of IVF treatment.     

Comparison of the GnRH agonist and antagonist protocol on the same patients in assisted reproduction during controlled ovarian stimulation cycles

Despite the fact that both gonadotropin-releasing hormone (GnRH) agonist and antagonist protocol are effective in suppressing the incidence of premature luteinizing hormone (LH) surges through reversibly blocking the secretion of pituitary gonadotropins, the exact impact of these two distinctive protocols on the clinical setting of patients for in vitro fertilization and embryo transfer (IVF-ET) treatment, however, remained controversial. We thus in the present report conducted a retrospective study to compare the impact of GnRH agonist and antagonist protocol on the same patients during controlled ovarian stimulation cycles. A total of 81 patients undergoing 105 agonist and 88 antagonist protocol were analyzed. We failed to detect a significant difference between two protocols for the difference in duration of ovarian stimulation, number of recombinant FSH (Gonal-F) ampoules used, number of oocytes retrieved, serum levels for estradiol (E2) and progestone (P), thickness of endometrium, and the zygote- and blastocyst-development rate. It is seemly that high quality embryo rate was higher in the antagonist protocol, but the data did not reach a statistical significance. Nevertheless, Implantation rate and clinical pregnancy rate were significantly higher in the antagonist protocol (10.64% and 30.26%, respectively) than that of the agonist protocol (5.26% and 15.82%, respectively). Our data also suggest that the GnRH antagonist protocol is likely to have the advantage for improving the outcome of pregnancy in those patients with a history of multiple failures for the IVF-ET treatment.     

Effect of active and passive immunization of male and female rats with a recombinantly expressed bonnet monkey pituitary GnRH receptor fragment

Gonadotropin releasing hormone (GnRH) exerts its action by binding to the specific receptor which belongs to the family of G-protein coupled receptors that are characterized by the presence of seven transmembrane domains linked together by extracellular and intracellular loops. A fragment of the pituitary receptor of the bonnet monkey (Macaca radiata) corresponding to amino acids 164-266 was cloned and expressed in Escherichia coli. This was used to raise antibodies to the receptor in rabbits. Active and passive immunization studies in both male and female rats were carried out using, both the 'overexpressed' fragment, as well as antibodies raised to the receptor fragment. Both active, as well as passive immunization in the male rats brought about an agonistic effect in terms of increase in serum LH level, as well as increase in serum and testicular testosterone levels. However, in the female rats, active immunization with the receptor fragment did not have any effect on the gonadal steroid levels but had a selective effect on the uterine morphology.     

Detection of gonadotropin-releasing hormone receptor in normal human pituitary cells and pituitary adenomas using immunohistochemistry

Gonadotropin-releasing hormone (GnRH), which is a well-known regulator of gonadotroph function, has recently been considered to be a paracrine factor involved in the control of somatotroph, lactotroph, and corticotroph cells. GnRH action is initiated by binding to a specific cell surface receptor, the gonadotropin-releasing hormone receptor (GnRHR), which is expressed by follicle-stimulating hormone/luteinizing hormone (FSH/LH) cells. Using in situ hybridization techniques, GnRHR messenger ribonucleic acid (mRNA) has recently been detected in normal human anterior pituitary gland and in various pituitary adenomas, including FSH/LH-cell, growth hormone (GH)-cell, adrenocorticotropic hormone (ACTH)-cell, and null-cell adenomas. However, immunohistochemical studies indicating the specific cell distribution of GnRHR in normal pituitary cells have never been reported. The aim of the present investigation was to evaluate the immunohistochemical expression of GnRHR in different types of normal pituitary cells and related tumors. Using double-label immunohistochemical techniques on formalin-fixed and paraffin-embedded tissues and specific antibodies directed against pituitary hormones and GnRHR, we found GnRHR immunoreactivity not only in FSH/LH cells, but also in GH- and thyroid-stimulating hormone (TSH) cells. GnRHR was detected in FSH/LH-cell, GH-cell, mixed GH- and prolactin (PRL)-cell, and α-subunit (α-SU)/null-cell adenomas. The findings of this study suggest that the interaction between GnRH and GnRHR may play a role in paracrine/autocrine regulation of different types of normal pituitary cells and pituitary adenomas. Received: 24 January 2000 / Accepted: 12 April 2000     

Lipid, glucose and homocysteine metabolism in women treated with a GnRH agonist with or without raloxifene

BACKGROUND: Although GnRH analogues are widely used to treat a variety of sex hormone-related diseases, little is known about their effect on metabolism. Therefore, we have evaluated the effect of a GnRH analogue, administered with or without raloxifene, on serum levels of lipoproteins, glucose, insulin and homocysteine (Hcy). METHODS: One hundred premenopausal women with symptomatic uterine leiomyomas were initially enrolled and randomized to receive 3.75 mg/28 days leuprolide acetate depot associated with 60 mg/day raloxifene hydrochloride (group A) or 1 placebo tablet/day (group B) for six cycles of 28 days. At entry and at cycle 6, subjects underwent anthropometric measurements, including body mass index and waist-to-hip ratio measurements, and blood chemistry assays for serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), glucose, insulin, Hcy, vitamin B(12) and folate concentrations. Insulin resistance was evaluated with the homeostasis model assessment (HOMA) score. RESULTS: Baseline parameters were similar in the two groups. At cycle 6, TC, HDL-C, LDL-C and TG levels were significantly increased (P < 0.05) in group B. In group A, LDL-C levels were unchanged, and TC, HDL-C and TG levels were increased (P < 0.05). Serum TC and LDL-C levels differed (P < 0.05) between the groups. Glucose levels were unchanged between and within groups, whereas insulin levels and HOMA scores increased (P < 0.05) versus baseline in group B. Post-treatment Hcy levels were higher (P < 0.05) versus baseline in group B; they were unchanged in group A. Serum vitamin B(12) and folate concentrations were unchanged in both groups. CONCLUSIONS: GnRH analogues alter serum lipoprotein and Hcy levels and increase insulin resistance. These acute metabolic changes may be prevented or reduced by raloxifene.