Parathyroid hormone-related peptide might stimulate calcium secretion into the milk of goats.

Parathyroid hormone-related peptide (PTHrP) has been shown to stimulate the placental calcium pump in pregnant ewes. Recent studies also suggest a physiological role for this peptide during lactation. In the present work, we have studied the possible role of synthetic human PTHrP(1-34), (1-86) and (140-173) fragments on calcium, inorganic phosphorus and magnesium secretion into milk of four adult goats in early lactation. This was done by measuring differences in calcium, inorganic phosphorus and magnesium concentrations in the carotid artery and superficial epigastric vein, the concentration of these minerals in milk and milk production. Both PTHrP(1-34) and (1-86) fragments stimulated calcium, inorganic phosphorus and magnesium uptake by the mammary gland and secretion into milk, without any significant effect on milk production. Therefore PTHrP might have important physiological roles in the pregnant and/or lactating female, by regulating calcium transport through the placenta and mammary gland.     

Production of parathyroid hormone-related protein by the mammary gland of the goat.

Parathyroid hormone-related protein (PTHRP) has been quantified by sensitive specific immunoassays in mammary venous blood and milk from 7 days before to 7 days after parturition in the goat. A significant venous-arterial concentration gradient in plasma PTHRP 1-86 concentrations was demonstrated across the mammary gland, indicating that PTHRP enters the maternal circulation and may have a role in calcium homoeostasis during lactation. Significant and sustained increases in mammary venous and milk PTHRP 1-86 concentrations were found from 1 day before parturition to 7 days afterwards, with peak concentrations of 1.57 +/- 0.58 pmol/l (plasma) and 8.69 +/- 2.95 nmol/l (milk) (mean +/- S.E.M.) occurring on day -1 and the day of parturition respectively. Estimates of the mammary output of PTHRP into plasma in four goats averaged 9% (range 1-25%) of that secreted into milk. Suppression of maternal prolactin concentrations by bromocriptine significantly reduced milk yield and the mammary venous PTHRP concentration, without affecting the concentration of PTHRP in milk. In conclusion, parturition in the goat is associated with a sustained increase in secretion of PTHRP into both plasma and milk; the former may be involved in maternal calcium homoeostasis, whereas the latter may have a role in the neonate.     

The role of parathyroid hormone-related protein in intra-tracheal fluid

Parathyroid hormone-related protein (PTHrP), a multi-functional protein, is produced by many tissues in fetus. PTHrP concentration in amniotic fluid is reported to be significantly higher than in either fetal or maternal plasma. Other investigators have reported that PTHrP in amniotic fluid is derived mainly from amnion. The aim of this study was to investigate the contribution of fetus to PTHrP in amniotic fluid and the role of PTHrP in human fetal lung tissue. Samples of amniotic fluid, neonatal intra-tracheal fluid, gastric fluid, and the first urine of neonates were obtained at the time of elective cesarean section (n=11), and the concentrations of PTHrP were measured. The PTHrP level in intra-tracheal fluid (41.0+/-19.6 pmol/l, mean+/-SD) was significantly higher than the levels in amniotic fluid (22.1+/-0.8), neonatal gastric fluid (13.5+/-2.5), first urine (0.95+/-0.6), umbilical cord venous and arterial plasma (1.35+/-0.2, 1.63+/-0.3) and maternal plasma (1.05+/-0.1). PTHrP and PTH/PTHrP receptor mRNA were detected in human lung tissue obtained from a fetus stillborn at 36 weeks of gestation. The effects of PTHrP on fetal lung maturation were studied in H441 cells from a human lung epithelial cell line. PTHrP (10(-7)M) significantly suppressed cell proliferation (p<0.05) to approximately 80% of the control level, while administration of PTHrP significantly increased surfactant protein A production (p<0.01). We first demonstrated the high concentration of PTHrP in intra-tracheal fluid that may suggest the positive production of this protein from the fetal lung. The results obtained by in vitro study using a human lung epithelial cell line suggest that PTHrP derived from the fetal lung might modulate its own maturation.     

Changes in epidermal growth factor concentrations of submandibular gland, plasma and urine of normal and sialoadenectomized female mice during various reproductive stages

The concentrations of epidermal growth factor (EGF) were measured by radioimmunoassay in the submandibular gland, plasma and urine of adult female C3H/HeN mice whilst virgin and during pregnancy, lactation and after lactation. During gestation there was a significant increase in the submandibular EGF concentration which was five to seven times higher than that found in virgin mice. The level of EGF in the gland remained high during the period of lactation and even several weeks after lactation. Plasma EGF levels were also increased during the periods of pregnancy, lactation and after lactation when compared with those of virgin mice. These increases were, however, apparent only between 24.00 and 08.00 h, because of circadian variations in circulating EGF. The level of plasma EGF was significantly (P less than 0.05) higher during the 24.00-08.00 h period than during the 12.00-20.00 h period in all stages examined. Concentrations of EGF in the urine of virgin, pregnant, lactating and primiparous mice remained relatively constant, and the levels were much higher than those in the plasma. Similar studies using sialoadenectomized pregnant and lactating mice indicated that the plasma levels of EGF were below the level of sensitivity of the assay (less than 16.5 pmol/l (less than 0.1 ng/ml] even during the 24.00-08.00 h period, whereas urinary EGF remained at high levels which were similar to those of normal pregnant and lactating mice. These results suggest that submandibular EGF contributes to the increase in plasma EGF which occurs after gestation, but is not the major source of the urinary EGF.     

Parathyroid hormone-related protein(1-34) in gestational fluids and release from human gestational tissues

Parathyroid hormone-related protein (PTHrP) is present in fetal and gestational tissues, in which its proposed roles include stimulation of epithelial growth and differentiation, vasodilatation of the uteroplacental vasculature, relaxation of uterine muscle and stimulation of placental calcium transport. The aim of this study was to determine whether the release of PTHrP from gestational tissue explants was tissue specific. In addition, PTHrP concentrations were measured in maternal plasma, umbilical artery and vein plasma, and amniotic fluid from term, uncomplicated pregnancies before the onset of labour. PTHrP was detected in low concentrations in the mother, fetus and placental tissue. Amniotic fluid had ten times the PTHrP concentration compared with that in the maternal or fetal circulations. Using late pregnant human gestational tissues in an in vitro explant system, we found that amnion over placenta, choriodecidua, reflected amnion, and placenta released PTHrP into culture medium in progressively greater amounts over 24 h (P<0.05). This release was not associated with a loss of cell membrane integrity, as indicated by measurement of the intracellular enzyme, lactate dehydrogenase, in the incubation media. After 24 h incubation, the fetal membranes released significantly (P<0.05) greater amounts of PTHrP than did the placenta (placenta 3. 7+/-0.5 pmol PTHrP/g protein). Amnion over placenta released significantly more PTHrP (139.3+/- 43.1 pmol PTHrP/g protein) than did reflected amnion (29.0+/-8.3 pmol PTHrP/g protein) (P<0.05). This study unequivocally demonstrated that human gestational tissues release PTHrP and it was concluded that the main contributors to PTHrP in amniotic fluid were the human fetal membranes, particularly amnion over placenta. Fetal membrane-derived and amniotic fluid PTHrP are proposed to have stimulatory effects on epithelial growth and differentiation in fetal lung, gut, skin and hair follicles and paracrine effects on placental vascular tone and calcium transport.     

Concentrations of parathyroid hormone-related protein in rat milk change with duration of lactation and interval from previous suckling, but not with milk calcium.

PTH-related protein (PTHrP) is found in high concentrations in the milk of various mammals. However, little is known about the regulation of PTHrP production or the physiological role(s) of PTHrP in the mammary glands. To address these questions, we examined in lactating rats 1) the longitudinal changes in PTHrP concentrations in milk and PTHrP mRNA levels in the mammary glands throughout lactation, 2) the effects of the nonsuckling interval on milk PTHrP concentration, and 3) the correlation between PTHrP and calcium concentrations in milk. PTHrP concentrations in milk, measured by RIA and in vitro bioassay, increased with the duration of lactation. The maximal concentrations of PTHrP (observed between days 19-21 of lactation in rats milked serially) were 4.8- to 8.0-fold higher than the concentrations on day 7. PTHrP mRNA levels in the mammary glands also increased during the late stages of lactation. The longitudinal changes in calcium concentrations in milk were small and did not parallel the changes in PTHrP. When pups were removed from the mother for 4-24 h, milk PTHrP decreased while calcium increased in a time-dependent manner. As a whole, calcium concentrations in milk did not correlate with PTHrP throughout lactation. These data suggest that the production and secretion of PTHrP into milk are regulated independently of the other major milk proteins by a factor(s) that changes with progression of lactation and in relation to suckling status.     

Hypercalcemia during pregnancy, puerperium, and lactation: review and a case report of hypercalcemic crisis after delivery due to excessive production of PTH-related protein (PTHrP) without malignancy (humoral hypercalcemia of pregnancy)

Hypercalcemia during pregnancy or after delivery is uncommon, and mostly associated with primary hyperparathyroidism (PHPT). If unrecognized, it may increase maternal and fetal morbidity. In a very few patients with PHPT, hypercalcemic crisis develops during pregnancy and particularly after delivery, since calcium transport from the mother to the fetus is abruptly disrupted. Hypercalcemia may also develop in pregnant women due to PTH-related protein (PTHrP)-producing malignant tumors (humoral hypercalcemia of malignancy). Since PTHrP is produced physiologically in fetal and maternal tissues, hypercalcemia may occasionally develop during pregnancy, puerperium, and lactation due to excessive production of PTHrP in the placenta and/or mammary glands. PTHrP may also be involved in milk-alkali syndrome that develops during pregnancy. Although non-malignant hypercalcemia is usually mild, we report a 28-years-old pregnant woman who developed hypercalcemic crisis after normal delivery of an infant. On the first postpartum day, the corrected serum calcium concentration increased to 19.4 mg/dl with a markedly increased serum level of PTHrP (28.4 pmol/L) (normal <1.1 pmol/L). After administration of saline and pamidronate, the serum levels of calcium and PTHrP rapidly normalized. Extensive examination revealed no malignant lesion, suggesting that the placenta may have been producing an excessive amount of PTHrP (humoral hypercalcemia of pregnancy). We review case reports of non-malignant hypercalcemic crisis associated with pregnancy indexed in PubMed in which serum levels of intact PTH and/or PTHrP were described, and stress that rapid control of hypercalcemia is mandatory to save the life of the mother and the infant.     

Impaired mammary function and parathyroid hormone-related protein during lactation in growth-restricted spontaneously hypertensive rats

Evidence implicates pivotal roles for parathyroid hormone-related protein (PTHrP) during lactation, including stimulation of mammary and pup growth. As spontaneously hypertensive rat (SHR) pups are growth restricted compared with the control Wistar Kyoto (WKY), we examined the relative roles of pup suckling and maternal lactational environment on pup growth, mammary PTHrP, and milk PTHrP and calcium concentrations. SHR pups were lighter compared with the control from 6 days. SHR mammary PTHrP content and milk PTHrP were lower but maternal plasma PTHrP was raised compared with WKY. SHR mammary morphological development was also impaired compared with control. Cross fostering growth-restricted pups onto WKY mothers increased pup weight in association with normal mammary function and higher milk PTHrP and calcium. Control pups suckling on an SHR mother had reduced body weight. Both cross fostering groups were associated with increased maternal and milk PTHrP concentrations, indicating the importance of suckling, together with a functional mammary gland. The results suggested that impaired SHR mammary function and milk PTHrP are associated with a reduced SHR postnatal growth. Our data also indicated that milk and mammary PTHrP are regulated by different mechanisms but that they are influenced by the maternal lactational environment and the suckling pup.     

Naloxone stimulates sexual behaviour in lactating rats

During lactation the display of sexual receptivity in response to treatment with oestradiol benzoate (OB; 2 or 10 micrograms) and progesterone (0.5 mg) was inhibited, but the behaviour could be activated by i.p. (5 mg) or intracerebroventricular (i.c.v.; 100 micrograms) but not intrathecal (i.t.; 100 or 500 micrograms) injections of the opioid peptide receptor antagonist naloxone. The behaviour was also inhibited in ovariectomized rats in which serum progesterone and prolactin levels had been raised by treatment with progesterone implants and the dopamine receptor antagonist domperidone, and the uterine cervix had been stimulated. Intraperitoneal injections of naloxone (1 mg) reactivated the behaviour of cervically stimulated rats. The concentration of beta-endorphin-like immunoreactivity in the serum of lactating rats (42.8 +/- 9.2 pmol/l) was not raised above that of ovariectomized rats (35.8 +/- 8.4 pmol/l) nor was the concentration of beta-endorphin-like immunoreactivity altered in the pituitary gland (22.5 +/- 2.5 pmol/l), midbrain central grey (6.3 +/- 2.2 pmol/l) or hypothalamus (5.6 +/- 2.6 pmol/l) of lactating rats in comparison with ovariectomized rats (24.8 +/- 4.4, 4.0 +/- 2.0 and 4.7 +/- 1.4 pmol/l respectively). Adrenalectomy facilitated the display of sexual behaviour in lactating rats treated with OB plus progesterone and caused a slight increase in serum beta-endorphin-like immunoreactivity (30.5 +/- 2.7 pmol/l) compared with that in non-adrenalectomized lactating rats (26.1 +/- 2.1 pmol/l). It is suggested that an opioid peptide, but probably not beta-endorphin, inhibits sexual behaviour during lactation and after cervical stimulation.     

Role of PTHrP in Mammary Gland Development and Breast Cancer

Parathyroid hormone-related protein (PTHrP) signaling has been shown to affect the development of many tissues including bone, cartilage, and mammary gland. In this review, we focus on the role of PTHrP in the normal mammary gland and its contributions to breast pathogenesis. During embryonic mammary development, PTHrP drives mammary mesenchyme specification, which is responsible for maintaining mammary cell fate, promoting the outgrowth of ducts, and directing the formation of the nipple. During lactation, PTHrP mobilizes maternal calcium to ensure a supply of calcium into milk and may play a role in regulating neonatal bone and mineral metabolism. PTHrP is expressed in primary breast cancer and breast cancer metastases, and contributes to the formation of osteolytic bone lesions as well as the growth and progression of primary tumors.     

HYPERPROLACTINAEMIA DURING PROLONGED LACTATION: EVIDENCE FOR ANOVULATORY CYCLES AND INADEQUATE CORPUS LUTEUM

Serum progesterone and prolactin were measured in single blood samples collected from 176 mothers during a lactation period of 2 years and from fifty-six non-lactating, non-pregnant and regularly menstruating women from the Kivu region (Zaire). On the basis of serum progesterone levels, evidence of corpus luteum activity was obtained in 61% of non-lactating women; but only 20% of non-amenorrhoeic lactating mothers. This suggests an increased incidence of anovulatory cycles and/or cycles with short luteal phases among nursing mothers. The incidence of corpus luteum activity was 8% in amenorrhoeic lactating mothers. In this 8% recurrence of ovulation preceded return of menstruation. Mean serum progesterone was significantly higher and serum prolactin significantly lower in the non-lactating women than in the nursing mothers. This suggests that although ovulation occurs, corpus luteum activity is inadequate in hyperprolactinaemic nursing mothers.     

Atrial natriuretic peptide in pregnant and lactating goats

Plasma concentrations of atrial natriuretic peptide (ANP) were measured in 6 goats during pregnancy, lactation and a nonpregnant, nonlactating (= control) period before and during a rapid iv load of 0.9% NaCl. The volume of the load was 20% of blood volume. The infusions increased central venous pressure by 7 +/- 1 mmHg during pregnancy and 8 +/- 1 mmHg during lactation. Before infusions plasma ANP concentrations were 5.7 +/- 0.7 pmol/l (control period), 10.8 +/- 1.8 pmol/l (pregnancy; P less than 0.05), and 6.5 +/- 1.5 pmol/l (lactation; NS). ANP increased significantly in all periods. Maximal values were 12.5 +/- 1.5 (control period), 25.5 +/- 2.3 (pregnancy; P less than 0.01 vs control period, P less than 0.05 vs lactation), and 13.0 +/- 1.6 (lactation; NS). Renal Na excretion increased similarly during pregnancy and control period, but slightly more during lactation. In 4 of the goats iv infusions of ANP (1 microgram/min, 60 min) were given. The infusions caused natriuresis during the control period, but not during pregnancy and lactation, despite more than 10-fold increases of plasma ANP levels. In conclusion, our results indicate that although plasma ANP concentration rose to high levels during acute NaCl loading in pregnant goats, this effect was not important for the natriuresis. Instead, the natriuretic response to ANP appears attenuated during pregnancy, and also during lactation.     

The Role of PTHrP in Regulating Mineral Metabolism During Pregnancy,Lactation, and Fetal/Neonatal Development

Parathyroid hormone-related protein (PTHrP) was originally identified as the cause of humoral hypercalcemia of malignancy (HHM), a condition that resembles primary hyperparathyroidism and the effects of excess parathyroid hormone (PTH). But HHM is an unusual situation because PTHrP is normally undetectable in the circulation of the child or adult. Instead, most of PTHrP’s actions are now understood to be paracrine or autocrine, and not humoral. However, PTHrP is present in the circulation at measurable levels during fetal development, pregnancy, and lactation. During these time periods, PTHrP has humoral actions that regulate mineral and bone homeostasis independently of PTH. In fact, the existence of PTHrP was also predicted by the characteristic pattern of serum chemistries and PTH in cord blood of normal newborns, and by the normalization of calcium metabolism that temporarily occurs in hypoparathyroid women who breast-feed. This article reviews our present understanding about PTHrP’s role to control mineral and bone metabolism during pregnancy, lactation, and fetal development. Excess PTHrP can also be produced by the placenta or the breasts during pregnancy, or by the breasts during lactation, and in both situations it can lead to hypercalcemia and other clinical features that are indistinguishable from HHM. The highest concentrations of PTHrP are found in milk, and recent evidence indicates that milk-based PTHrP may reduce mineral accretion by the newborn skeleton, but whether it does this through local actions in the neonatal gut or after absorption into the neonatal circulation is unknown.     

Elevation of circulating plasma cytokines in cancer patients with high plasma parathyroid hormone-related protein levels

Parathyroid hormone (PTH) and PTH-related protein/peptide (PTHrP) bind to the same PTH/PTHrP receptor and stimulate osteoblasts to secrete pro-inflammatory cytokines like interleukin (IL)-6. In patients with primary hyperparathyroidism, elevation of plasma levels of tumor necrosis factor (TNF)-alpha and IL-6 was also described. We, therefore, postulated that PTHrP secreted from cancer cells stimulates the secretion of cytokines and causes increases in their blood levels. Blood concentrations of several cytokines (TNF-alpha, IL-1beta, IL-5, IL-6, IL-8, IL-11 and IL-12) in cancer-bearing patients with or without elevation of blood PTHrP were measured by ELISA. The patients with high plasma PTHrP levels (n=29, intact PTHrP: 8.5 +/- 1.4 pmol/l, normal: <1.1) had higher serum type 1 collagen C-telopeptide (ICTP). Twenty of the patients were hypercalcemic. Plasma concentrations of TNF-alpha, IL-6 and IL-8 were significantly increased in patients with high PTHrP, in either the presence or absence of hypercalcemia. The concentrations of TNF-alpha and IL-6 were also significantly correlated with those of PTHrP. Our observations indicate that high plasma levels of PTHrP in cancer-bearing patients contribute not only to the development of hypercalcemia, but also to the development of the syndrome caused by an excess of pro-inflammatory cytokines.     

Degradation of 125I-labelled prolactin in the rabbit: effect of nephrectomy and prolactin infusion

The concentrations of progesterone and oestradiol-17 beta in the maternal plasma of Bennett's wallaby, Macropus rufogriseus rufogriseus, were measured daily throughout gestation after reactivation of the diapausing corpus luteum by removal of the suckling pouch young (RPY). Progesterone increased from mean concentrations of 382-424 pmol/l (120-133 pg/ml) during lactation to reach peak concentrations of 908 +/- 172 (S.E.M.) pmol/l (285 +/- 54 pg/ml) (n = 8) 4 days after RPY and 971 +/- 220 and 971 +/- 229 pmol/l (305 +/- 69 and 305 +/- 72 pg/ml) (n = 7) 24 and 25 days after RPY respectively. The mean gestation length (RPY to birth) was 26.8 +/- 0.6 (S.D.) days (n = 6, range 25.75-27.50 days). Immediately after birth the plasma progesterone concentration declined to 299 +/- 51 (S.E.M.) pmol/l (94 +/- 16 pg/ml) (n = 6). Oestradiol-17 beta increased from mean concentrations of 291-553 pmol/l (80-152 pg/ml) during lactation to reach a peak concentration of 967 +/- 331 pmol/l (266 +/- 91 pg/ml) (n = 9) 1 day after RPY. The concentration declined from 7 days after RPY and fluctuated between mean concentrations of 273 and 480 pmol/l before reaching a minimum of 207 +/- 69 pmol/l (57 +/- 19 pg/ml) (n = 6) 19 days after RPY. A transient increase to 542 +/- 207 pmol/l (n = 7) occurred at 22 days after RPY. Plasma concentrations declined to a low of 156 +/- 55 pmol/l (43 +/- 15 pg/ml) (n = 6) 5 days after parturition. The mean concentration of plasma 13,14-dihydro-15-oxo-prostaglandin F2 alpha was less than 2.8 nmol/l (1 ng/ml) for all samples from 13 days after RPY until 4 days after parturition. The results suggest that oestradiol-17 beta may be important in the early stages of blastocyst reactivation to synergize with progesterone in stimulating uterine secretions. 13,14-Dihydro-15-oxo-prostaglandin F2 alpha is unlikely to be involved in the birth process and any luteolytic effect is likely to be from a local production of PGF2 alpha.     

Maternal and foetal resistin and adiponectin concentrations in normal and complicated pregnancies

OBJECTIVE: The aim of this study was to evaluate how resistin and adiponectin (ApN) are involved in maternal energy metabolism and foetal growth. DESIGN: A cross-sectional study. PATIENTS AND MEASUREMENTS: Resistin and ApN were measured in 30 healthy nonpregnant women, 73 pregnant women [10-41 weeks of gestation; 18 with gestational diabetes mellitus (GDM), five with pregnancy-induce hypertension (PIH), nine with pre-eclampsia (PE), eight with chronic hypertension (CH) and 33 normal] and 40 foetal samples (20-41 weeks of gestation; 18 from GDM mothers and 22 from normal mothers). RESULTS: Resistin levels were significantly higher in normal pregnant women than in nonpregnant controls (13.7 +/- 2.1 vs. 6.3 +/- 1.6 ng/ml; P < 0.005) and showed a negative correlation with gestational age (P < 0.0001, r = -0.7). Only women with PE presented resistin levels significantly lower than normotensive women of the same gestational age (8.2 +/- 1.2 vs. 17.9 +/- 4.3 ng/ml; P < 0.005). ApN levels, although similar in normal pregnant women to those in nonpregnant controls, were significantly lower in women with GDM (37-41 weeks; 5.2 +/- 0.5 vs. 8.2 +/- 0.8 mg/l; P < 0.0001) and PE (20-37 weeks; 5.0 +/- 0.7 vs. 9.5 +/- 0.7 mg/l; P = 0.008) than those found in normal women matched for gestational age. Resistin was detected in the umbilical venous blood in foetuses from 20 to 41 weeks of gestation. In all newborns, both resistin and ApN levels were significantly higher than those recorded in adult life and did not correlate with maternal levels (P = ns, r = 0.03 for resistin and P = ns, r = -0.3 for ApN). Foetuses from diabetic mothers had ApN significantly lower than normal foetuses (26.8 +/- 2.6 vs. 37.5 +/- 3.5 mg/l; P = 0.02), while resistin levels were similar (17.3 +/- 3.7 vs. 18.2 +/- 1.5 ng/ml; P = ns). CONCLUSION: The secretion pattern of ApN in normal and complicated pregnancies strongly suggests an involvement of ApN in insulin resistance during gestation, while resistin seems to have a minor role. Moreover, the detection of high levels of resistin and ApN in cord blood during gestation is consistent with a regulatory action of these adipokines on tissue differentiation and foetal growth.     

The corticotrophin releasing hormone test in late pregnancy: lack of adrenocorticotrophin and cortisol response

Biologically active corticotrophin-releasing-hormone (CRH) is produced by the placenta in large amounts and can be measured in the maternal circulation during third trimester of pregnancy. Its physiological significance is unknown. To further investigate the action of CRH in pregnancy, we performed a standard CRH-test (1 micrograms/kg synthetic human CRH) in seven pregnant women 1 week prior to their calculated delivery data and 4-5 weeks post-partum. No response of plasma ACTH to CRH administration could be measured in any of the third trimester pregnant women. Post-partum, basal ACTH levels were significantly lower (1.6 +/- 0.3 vs 5.3 +/- 0.2 pmol/l) and reacted promptly to CRH administration (1.6 +/- 0.3-4.2 +/- 0.5 pmol/l; P less than 0.05). Concentration of cortisol in plasma and salivary cortisol paralleled the ACTH response to administration of CRH. However, one pregnant woman experienced physical and emotional stress during the CRH-test and reacted with a sharp rise in cortisol secretion. The lack of the ACTH and cortisol response in this study to exogenously administered CRH in third trimester pregnancy may be due to high circulating glucocorticoid concentrations, desensitization of the pituitary corticotroph and/or in part due to circulating specific CRH-carrier protein.     

Maternal pinealectomy abolishes the diurnal rhythm in plasma melatonin concentrations in the fetal sheep and pregnant ewe during late gestation

We have investigated the effect of pinealectomy of ewes in pregnancy on the presence of the diurnal rhythm in fetal and maternal plasma concentrations of melatonin. Six ewes were pinealectomized between 104 and 118 days of gestation. Fetal and maternal blood samples were collected during 24-h periods between 125 and 140 days of gestation in the pinealectomized ewes and in an intact control (n = 4). There was a significant diurnal rhythm in both fetal and maternal plasma concentrations of melatonin in the control group. In this group, the fetal and maternal plasma melatonin concentrations were significantly higher in the dark (128.4 +/- 6.2 and 192.2 +/- 10.7 pmol/l respectively) than in the light (46.2 +/- 4.2 and 25.8 +/- 2.1 pmol/l respectively). However there was no diurnal rhythm in either the fetal or maternal plasma melatonin concentrations in the pinealectomized group between 125 and 140 days of gestation. In contrast to the control animals, there was also no light-dark difference in the fetal or maternal plasma melatonin concentrations in four pinealectomized animals sampled frequently in the 3-7 days preceding delivery (mean length of gestation 146.5 days). However, in the pinealectomized sheep there was a gradual increase in the combined light-dark fetal plasma melatonin concentrations during late gestation from 27.9 +/- 2.8 pmol/l (at 15-20 days before delivery) to 95.2 +/- 14.1 pmol/l on the day of delivery. We have therefore demonstrated that the maternal pineal is the major source of the diurnal rhythm in maternal and fetal plasma melatonin concentrations.(ABSTRACT TRUNCATED AT 250 WORDS)     

Changing osteocalcin concentrations during pregnancy and lactation: implications for maternal mineral metabolism

We measured serum osteocalcin concentrations in 82 pregnant and 21 nonpregnant women. Osteocalcin values declined in the second trimester, but returned to nonpregnant levels late in the third trimester. The mean serum osteocalcin concentration in 36 women during pregnancy (mean gestation, 26 weeks) of 2.8 ng/mL was significantly lower than that in nonpregnant women (6.4 ng/mL; P less than 0.001) or term pregnant women at delivery (6.1 ng/mL; n = 46). Serum immunoreactive PTH (iPTH) levels were significantly higher during pregnancy than in nonpregnant women [97 +/- 5 vs. 56 +/- 4 ng/L (mean +/- SE); P less than 0.001]. No significant correlations were found between maternal osteocalcin concentrations and serum phosphorus, alkaline phosphatase, or iPTH, but significant negative correlations were found between osteocalcin and total calcium or total protein. Osteocalcin concentrations in midtrimester amniotic fluid were very low (mean, 0.3 +/- 0.1 ng/mL; n = 11). In 29 lactating mothers, the mean serum osteocalcin level was 9.5 +/- 1.5 ng/mL, significantly higher than in any of the other groups (P less than 0.05), but their serum calcium and iPTH levels were normal. There was no correlation between serum osteocalcin and calcium or iPTH concentrations in lactating women. These changes are compatible with a sequence in which bone turnover is reduced during early pregnancy, rebounds in the third trimester, and increases in postpartum lactating women.