褪黑素抑制小鼠卵母细胞的体外成熟

目的:探讨褪黑素(MT)对小鼠卵母细胞的体外成熟的影响.方法:通过卵母细胞自发、次黄嘌呤(HX)阻滞和激素诱导成熟三种体外培养模型研究了褪黑素(MT)对小鼠卵母细胞体外成熟的影响.结果:①0.1 g/L、0.02g/L、0.004 g/L及0.0008 g/L浓度的MT均能显著抑制小鼠卵丘卵母细胞复合体(CEOs)自发成熟过程中第一极体(PB1)的释放(P＜0.01);②动力曲线分析表明,MT对自发成熟的CEOs的GVBD和PB1有显著的推后作用,与对照组相比,处理组的GVBD和PB1分别被推后8～10 h和3～4 h;③0.1 g/L和0.02 g/L两有效浓度的MT还能显著抑制促性腺激素(FSH)诱导的HX阻滞的CEOsGVBD的发生(P＜0.05),对PB1的排出虽有一定的抑制作用,但没有统计学意义;④MT和次黄嘌呤(HX)对CEOs的自发成熟有协同抑制作用(P＜0.01),但在裸卵(DO)自发成熟的阻滞中没有协同效应.结论:MT是调节哺乳动物卵母细胞成熟的重要激素之一,其作用机制可能是通过卵丘细胞实现的.     

体外培养条件下促性腺激素对昆明白小鼠卵母细胞成熟及卵丘扩展的影响

研究促卵泡激素（FSH）,人绒毛膜促性腺激素（hCG)对昆明白小鼠卵母细胞成熟和卵丘扩展的影响,以及体外培养时卵丘扩展与卵母细胞成熟之间的关系,FSH可以明显促进次黄嘌吟（HX）抑制条件下的卵丘－卵母细胞复合体CEO卵母细胞成熟及卵丘扩展,其最佳作用剂量为100IU／L,且FSH作用30分钟即可以使CEO获得恢复减数分裂的信息,在HX存在的条件下,FSH处理后10hr,CEO卵丘明显扩展,而生发泡破裂（GVBD）则在16－20hr明显增加,所有卵丘未扩展的CEO中卵母细胞均未发生GVBD,低剂量hCG单独或与FSH共同存在,对CEO卵母细胞成熟及卵丘扩展均无明显影响;高剂量hCG可以部分抑制FSH对卵母细胞成熟的促进作用,结果表明：FSH明显促进CEO卵母细胞成熟及卵丘扩展,而hCG却不具有此作用,体外培养条件下（含次黄嘌呤）,卵丘扩展是卵母细胞成熟的前提条件,但卵母细胞成熟并不需要卵丘完全扩展。     

FSH诱导卵丘细胞分泌一种促减数分裂物质

本实验利用卵母细胞的体外培养模型,将小鼠卵丘－卵母细胞复合体（CEO）和去卵丘卵母细胞（DO）在体外培养,系统研究了促性腺激素（FSH、hCG）诱导小鼠卵母细胞减数分裂的机制。结果显示,FSH能剂量依赖性地诱导CEO恢复减数分裂（Fig.1),但对DO无影响;hCG对CEO、DO皆无效果（Fig.2);用FSH预处理CEO时间达到1小时后,就能显著诱导卵母细胞成熟,2小时后作用达到最大,不再增强（Fig.3);用FSH处理CEO2小时及24小时的培养液,能诱导DO恢复减数分裂,但预处理卵丘细胞24小时的培养液,并不能诱导DO恢复减数分裂（Fig.4A);这种培养液在70℃下30分钟后,仍能刺激DO成熟（Fig.4B);甾醇类物质合成抑制剂酮康唑,可剂量依赖性地抑制FSH的促减数分裂恢复作用（Fig.5)。这些结果说明,FSH可能诱导卵丘－卵母细胞复合体中的卵丘细胞分泌一种促减数分裂恢复物质;该物质用于卵母细胞,诱导其恢复减数分裂而成熟;这种物质可能是一种甾醇类物质。     

小鼠年龄及卵丘—卵母细胞间联接的解离对卵母细胞体外成熟的影响

实验研究了小鼠卵母细胞体外过程中卵丘－卵母细胞间的相互作用。实验小鼠为雌性Ｂ６Ｄ２杂交一代。激素处理４８小时后分离出卵后天和卵母细胞复合体,并培养在含有次黄嘌呤的培养液中。２４小时后检查卵母细胞核成熟情况。     

一氧化氮供体硝普纳对小鼠卵母细胞体外自发成熟的影响

目的　探讨一氧化氮供体—硝普纳 (SodiumNitroprusside ,SNP)对昆明小鼠卵母细胞体外自发成熟的影响。方法　利用体外培养方法 ,在培养的不同时间观察卵母细胞的成熟情况 ,研究SNP对卵母细胞自发成熟的动力学影响。结果　 (1) 1mmol LSNP能够明显延迟卵丘卵母细胞复合体 (CEOs)的自发成熟 ,与对照组相比 ,CEOs的生发泡破裂 (GVBD)和第一极体 (PB1)释放分别延迟了 8h和 10h。但在培养结束 (2 4h)时 ,CEOs处理组的PB1释放率与对照组相比有明显的降低 ,而处理组的生发泡破裂 (GVBD)百分率和对照组相比没有明显变化 ;1mmol LSNP能够明显延迟裸卵母细胞 (DOs)的自发成熟 ,与对照组相比 ,DOs处理组的GVBD和PB1释放分别延迟了 6h和 12h。且在培养 2 4h后 ,DOs处理组的GVBD和PB1释放率与对照组相比有显著的降低。 (2 ) 1mmol LSNP能够明显促进CEOs中卵丘细胞的离散 ,造成CEOs互相粘连在一起。 (3) 1mmol LSNP能够明显影响体外培养的DOs的形态 ,但对CEOs的卵母细胞却没有影响。而 1μmol LSNP对CEOs和DOs的自发成熟都没有影响。 结论高浓度的SNP对小鼠卵母细胞体外自发成熟有抑制作用     

抗真菌药物影响生殖细胞发育机理的研究

目的：探讨抗真菌药物对促性腺激素诱导的卵母细胞成熟的机理。方法：用小鼠卵母细胞体外培养模型,将小鼠卵母细胞培养在含有次黄嘌呤（ＨＸ,卵母细胞成熟抑制物）的培养注中,观察促卵泡生成素（ＦＳＨ）、两性毒素Ｂ、酮康唑对卵母细胞减数分裂恢复的影响。结果：①ＦＳＨ（１０￣２００ＩＵ／Ｌ）显著刺激卵丘－卵母细胞复合体（ＣＥＯ）克服ＨＸ的抑制而恢复减数分裂,该作用具有剂量依赖性（Ｐ〈０．０５）;②两性霉素Ｂ（０     

小鼠卵母细胞体外成熟、体外受精的效果观察

目的　研究不同培养条件对小鼠卵母细胞体外成熟及体外受精率的影响。方法　小鼠卵母细胞分别在含有FSH、BSA和胰岛素的培养液中体外成熟,在Whitten 氏液中体外受精,比较体外成熟率、体外受精率。结果　1- 裸卵(DO) 的体外成熟率、体外受精率(81-4% ,31-0 % ) 均高于卵丘卵母细胞复合体(COC)(48-6 % ,27-1% ) 。2- 在培养液中添加FSH、胰岛素和BSA,卵母细胞的体外成熟率为77-9 % ,82-3% 、60-7% ;体外受精率为77-2 % 、72-6 % 、26-7% ;2 - 细胞率为49-2 % 、34-2 % 、10-0% 。胰岛素组的卵母细胞IVM 率最高,但IVF率、2 - 细胞率低于FSH 组。3- 添加BSA的两组的体外受精率只有26-7 % 、25-8 % ,显著低于其他组,其体外成熟率也较添加FSH 和胰岛素的组成。4- 排出第一极体(PbI) 的卵母细胞的体外受精率和2 - 细胞率(85-9 % ,22-4% ) 均高于GV期卵母细胞(71-1 % ,12-9 % ) 。结论　1- 卵丘卵母细胞(COC) 较裸卵(DO) 的体外成熟率、体外受精率都低,差异显著(P成熟< 0-01;P受精< 0-05) 。2-FSH 和胰岛素均能提高小鼠卵母细胞的体外成熟率、体外受精率。3-BSA可以降低小鼠卵母细胞体外受精率,差异极显著。4-GV 期卵母细胞的体外受精率显著低于体外培养的排出第一极体的卵母细胞(P2 - cell < 0-05,P受精<0-05)     

腺嘌呤对体外小鼠卵母细胞减数分裂的抑制

本文研究了嘌呤类物质对小鼠卵母细胞减数分裂的影响。于卵母细胞的生发泡内显微注射腺嘌呤和腺嘌呤的类似物苄基腺嘌呤可显著抑制卵母细胞的分裂的重新启动。同时发现在腺嘌呤的作用过程中,腺苷酸环化酶的激活剂氟化钠可增强其对卵母细胞的抑制作用,表明cAMP途径在小鼠卵母细胞减数分裂成熟过程中起重要作用。腺嘌呤在不同培养液中的抑制效果不一,次黄嘌呤在DMEM和EMEM中对小鼠的卵丘细胞-卵母细胞复合体(COC)和无卵丘细胞的裸卵(DO)均具有明显的抑制效应。但腺嘌呤在DMEM比在EMEM中对COC的抑制效果更强,而且腺嘌呤在DMEM中与次黄嘌呤具有协同效应,这些差别可能是由于两种培养液中不同成分如谷氨酰胺造成卵母细胞对腺嘌呤吸收差异而引起的。     

绵羊卵母细胞体外核成熟抑制及其对胚胎发育潜力的影响

本研究旨在探讨次黄嘌呤 +dbcAMP或IBMX +dbcAMP对绵羊卵母细胞体外成熟的可逆性抑制作用 ,以及这种抑制作用对卵母细胞胚胎发育潜力的影响。自绵羊卵巢分离卵丘 -卵母细胞复合物进行体外培养 ,培养基中分别加入或不加入上述抑制剂。培养 6h后各组取部分卵母细胞固定染色检查卵母细胞核成熟情况 ;将其余的卵母细胞分别移入无抑制剂的成熟培养基中继续培养 18h后 ,再次检查各组卵母细胞核成熟情况 ,并进行体外受精和胚胎培养。结果表明 :次黄嘌呤 +dbcAMP或IBMX +dbcAM都分别能使 6 0 %以上的绵羊卵母细胞抑制在GV期。这种抑制是可逆性的 ,去除抑制剂后卵母细胞能恢复减数分裂 ,并加快由GVBD到MⅡ的成熟过程。各处理组受精率、卵裂率和囊胚发育率与对照组相比无显著性差异 ,表明卵母细胞的胚胎发育潜力没有受损。上述物质对卵母细胞成熟的可逆性抑制可用于研究卵母细胞成熟及其胚胎发育潜力的调节机制。     

绵羊卵母细胞体外核成熟和抑制及其对胚胎发育潜力的影响

本研究旨在探讨次黄嘌呤＋dbcAMP或IBMX＋dbcAMP对绵羊卵母细胞体外成熟的可逆性抑制作用,以及这种抑制作用对卵母细胞胚胎发育潜力的影响。自绵羊卵巢分离卵丘－卵母细胞复合物进行体外培养,培养基中分别加入或不加入上述抑制剂。培养6h后各组取部分卵母细胞固定染色检查卵母细胞核成熟情况;将其余的卵母细胞分别移入无抑制剂的成熟培养基中继续培养18h后,再次检查各组卵母细胞核成熟情况,并进行体外受精和胚胎培养。结果表明,次黄嘌呤＋dbcAMP或IBMS＋dbcAM都分别能使60％以上的绵羊卵母细胞抑制在GV期。这种抑制是可行性的,去除抑制剂后卵母细胞能恢复减数分裂,并加快由GVBD到MⅡ的成熟过程。各处理组肥精率,卵裂率和囊胚发育率与对照组相比无显著性差异,表明卵母细胞的胚胎发育潜力没有受损。上述物质对卵母细胞成熟的可逆性抑制可用于研究卵母细胞成熟及其胚胎发育潜力的调节机制。     

Atrial natriuretic peptide negatively regulates follicle-stimulating hormone-induced porcine oocyte maturation and cumulus expansion via cGMP-dependent protein kinase pathway

This study examined the effect of atrial natriuretic peptide (ANP) on porcine cumulus-enclosed oocyte (CEO) maturation and cumulus expansion. ANP negatively regulated follicle-stimulating hormone (FSH)-stimulated germinal vesicle breakdown (GVBD; 90.1, 81.2 and 68.2% for FSH, FSH+10nM ANP and FSH+1 microM ANP, respectively), first polar body emission (PB1; 86.1, 75.3 and 53.3% for FSH, FSH+1 nM ANP and FSH+1 microM ANP, respectively) and cumulus expansion (CEI; 3.47, 3.16 and 2.43 for FSH, FSH+1 nM ANP and FSH+1 microM ANP, respectively) in a dose-dependent manner when CEOs were cultured in the maturation medium containing porcine follicular fluid (pFF). This negative effect showed a time-dependent manner after preincubation with 100 nM ANP for 5h (78.4% PB1), 10h (81.7% GVBD and 74.1% PB1), 20 h (78.5% GVBD and 68.9% PB1), and 44 h (75.3% GVBD and 60.5% PB1), respectively. ANP also significantly inhibited FSH-induced porcine oocyte GVBD (47.6% versus 83.8%) and PB1 emission (22.4% versus 45.2%) when CEOs were cultured in pFF-free maturation medium. cGMP analog 8-Br-cGMP (10 microM to 1mM) mimicked the effects of ANP on GVBD, PB1, and CEI. The negative effect of ANP was completely reversed by KT5823 (a specific inhibitor of cGMP-dependent protein kinase), while C-ANP-(4-23) (an analogue of ANP and specific binder for natriuretic peptide receptors-C) was ineffective in oocyte maturation. Neither ANP nor C-ANP-(4-23) had an effect on spontaneous porcine oocyte maturation and cumulus expansion. These results suggested that ANP negatively regulates FSH-activated porcine oocyte meiotic resumption, meiotic maturation and cumulus expansion. The function of ANP on porcine oocyte maturation is via the cGMP dependent protein kinase (PKG) pathway.     

Energy substrate metabolism of mouse cumulus-oocyte complexes: response to follicle-stimulating hormone is mediated by the phosphatidylinositol 3-kinase pathway and is associated with oocyte maturation

Successful in vitro maturation (IVM) of oocytes obtained from medium-sized antral follicles could avoid the need for superovulation for in vitro fertilization. The wide range of doses of FSH used in IVM prompted us to study the effect of varying concentrations of FSH on the dynamics of nutrient uptake and production by individual maturing mouse cumulus-oocyte complexes (COCs). COCs isolated from the antral follicles of unprimed, prepubertal B6CBF(1) mice were cultured individually in increasing concentrations of FSH (0-2000 ng/ml). Following culture, pyruvate, glucose, and lactate uptake or production by individual complexes were noninvasively assessed and compared with the stage of nuclear maturation of the enclosed oocyte. FSH significantly increased oocyte maturation and produced a two- to threefold increase in glucose uptake and lactate production by COCs in which the enclosed oocyte completed maturation. In these COCs, pyruvate was taken up under control conditions but was produced in progressively higher quantities in increasing concentrations of FSH. In COCs where the oocyte failed to complete maturation, pyruvate was taken up (rather than produced) and glucose uptake and lactate production were lower and unaffected by the presence or absence of FSH. This suggests that there is dialogue between cumulus cells and the maturing oocyte that influences FSH responsiveness and substrate metabolism of the whole COC. Finally, inhibition of FSH-stimulated glucose uptake by the PI3-kinase inhibitor LY294002 and the finding of GLUT4 protein in granulosa cells suggest that FSH increases glucose uptake by PI3-kinase-mediated translocation of GLUT4 to the granulosa cell membrane.     

Effect of glucocorticoids on spontaneous and follicle-stimulating hormone induced oocyte maturation in mouse oocytes during culture

Several studies have indicated that glucocorticoids are involved in maturation of mammalian oocytes. Recently, maturation of porcine oocytes in culture was shown to be inhibited by glucocorticoids in a time- and dose-dependent manner. In addition, levels of cortisol available for biological action in fluid of preovulatory follicles are higher than that present in circulation. The present study evaluates the effect of cortisol and dexamethasone on mouse cumulus enclosed oocytes (CEO) undergoing spontaneous- and FSH-induced maturation during a 24 h culture period using breakdown of the germinal vesicle (GVBD) as end-point. FSH-induced oocyte maturation was studied using media containing 4.5 mM hypoxanthine to maintain levels of cAMP elevated, whereas spontaneous oocyte maturation was studied in a medium without hypoxanthine. In the presence of FSH (25 IU/l) the rate of GVBD was significantly elevated compared to the control. Dexamethasone (1–20 μg/ml) in combination with FSH resulted in a rate of GVBD similar to FSH alone. Cortisol (0.1–10 μg/ml) resulted in a significant higher rate of GVBD in combination with a physiological concentration of FSH (10 IU/l) as compared to the control but similar to that caused by FSH alone. Nearly all CEO that matured spontaneously resumed meiosis irrespective of whether or not cortisol was present. In conclusion, these results indicate that glucocorticoids have little or no influence on the regulation of oocyte maturation in the mouse. Species differences between mouse and pig oocytes may exist.     

Induction of maturation in cumulus cell-enclosed mouse oocytes by follicle-stimulating hormone and epidermal growth factor: evidence for a positive stimulus of somatic cell origin

The efficacy of follicle-stimulating hormone (FSH), epidermal growth factor (EGF), and dibutyryl cGMP (dbcGMP) as inducers of germinal vesicle breakdown (GVBD) in cumulus cell-enclosed mouse oocytes was examined when meiotic arrest was maintained in vitro with purines, dibutyryl cAMP (dbcAMP), or the phosphodiesterase inhibitor, 3-isobutyl-1-methylxanthine (IBMX). When FSH was added to hypoxanthine (HX)-containing medium, the effect on oocyte maturation was at first inhibitory and later stimulatory. EGF stimulated GVBD at all time points tested. FSH and EGF also induced GVBD when oocytes were arrested with dbcAMP, IBMX, or guanosine. Dibutyryl cGMP stimulated GVBD when meiotic arrest was maintained with HX, but not when oocytes were meiotically arrested with guanosine, and was inhibitory in dbcAMP-supplemented medium. FSH and dbcGMP produced a transient delay of oocyte maturation in control medium, but the FSH effect was much more pronounced. EGF had no effect on maturation kinetics. The actions of FSH and EGF required the presence of cumulus cells. Both agents significantly stimulated cAMP production in oocyte-cumulus cell complexes. A brief exposure of complexes to a high concentration of dbcAMP induced GVBD, suggesting that FSH and EGF may act via a cAMP-dependent process. The frequency of FSH- and EGF-induced GVBD in cumulus cell-enclosed oocytes was significantly higher than the frequency of GVBD when oocytes were cultured while denuded of cumulus cells. of maturation is apparently not mediated solely by oocyte-cumulus cell uncoupling and termination of the transfer of an inhibitory meiotic signal from cumulus cells to the oocyte. The data suggest the generation of a positive signal within cumulus cells in response to hormone treatment that acts upon the oocyte to stimulate GVBD in the continued presence of inhibitory factors.     

Involvement of MEK-mitogen-activated protein kinase pathway in follicle-stimulating hormone-induced but not spontaneous meiotic resumption of mouse oocytes

Mitogen-activated protein (MAP) kinase has been reported to be activated during oocyte meiotic maturation in a variety of mammalian species. However, the mechanism(s) responsible for MAP kinase activation and the consequence of its premature activation during gonadotropin-induced oocyte meiotic resumption have not been examined. The present experiments were conducted to investigate the possible role of MAP kinase in FSH-induced and spontaneous oocyte meiotic resumption in the mouse. MAP kinase kinase (MAPKK, MEK) inhibitor, PD98059 or U0126, produced a dose-dependent inhibitory effect on both FSH-induced oocyte meiotic resumption and MAP kinase activation in the oocytes. However, the same inhibitor did not block spontaneous meiotic resumption of either denuded or cumulus cell-enclosed mouse oocytes, despite the activity of MAP kinase being totally inhibited. Immunoblotting the oocytes and the cumulus cells with the anti-active MAP kinase antibody showed that MAP kinase activity in the oocytes was detected at 8 h of FSH treatment, prior to germinal vesicle breakdown and increased as maturation progressed in the following culture period. In the cumulus cells, MAP kinase was activated even faster, its activity was detected at 1 h of FSH stimulation and increased gradually until 8 h of FSH treatment, then decreased and diminished after 12 h of FSH action. These data demonstrated that the MEK-MAP kinase pathway is implicated in FSH-induced but not spontaneous oocyte meiotic resumption.     

Oocyte maturation is inhibited by adenosine in the presence of follicle-stimulating hormone

Considerable evidence implicates cyclic 3', 5' adenosine monophosphate (AMP) in the maintenance of meiotic arrest of mammalian oocytes. Since this laboratory previously found that adenosine augmented follicle-stimulating hormone (FSH)-stimulated accumulation of cyclic AMP in oocyte-cumulus-complexes (OCC), in the present studies we investigated the possibility that adenosine inhibits maturation of oocytes. In rat OCC cultured in the presence of FSH, adenosine markedly inhibited oocyte maturation in a dose-dependent and biphasic manner. Maximum inhibition of oocyte maturation was seen with 1-30 microM adenosine in the presence of FSH, and half-maximal inhibition occurred with less than 0.3 microM adenosine. High levels of adenosine (100 microM) did not inhibit oocyte maturation in the presence of FSH. In the absence of FSH, adenosine showed little effect on oocyte maturation in the present studies, but increased the maximum inhibition of oocyte maturation produced by FSH approximately twofold. Like adenosine, adenosine triphosphate (ATP), adenosine diphosphate (ADP), and adenosine 5'-monophosphate (AMP) also inhibited oocyte maturation; whereas adenine, guanosine, inosine, and hypoxanthine were inactive at equivalent levels. The metabolism-resistant adenosine analog (2-chloroadenosine) was as active an inhibitor as adenosine. Inhibition produced by the adenine nucleotides may have been direct or due to conversion to adenosine by extracellular nucleotidases. The concentration dependence and purine specificity for inhibition of oocyte maturation are characteristic of an adenosine receptor-mediated process, but direct evidence for such a mechanism was not shown. The effective concentration of adenosine for inhibition of oocyte maturation is within the range of reported levels of adenosine in biological tissues and fluids.(ABSTRACT TRUNCATED AT 250 WORDS)     

A follicular fluid component prevents gonadotropin reversal of cyclic adenosine monophosphate-dependent meiotic arrest in murine oocytes

The effects of the putative maturation inhibitor in porcine follicular fluid on gonadotropinstimulated reversal of cyclic adenosine monophosphate (cAMP)-maintained meiotic arrest in mouse oocytes in vitro were assessed in this study. When cumulus cell-enclosed oocytes were cultured in a suboptimal inhibitory concentration of dibutyryl cAMP (dbcAMP), the effect of follicle-stimulating hormone (FSH) on oocyte maturation was initially inhibitory at 3 hr, but stimulatory at 6 hr. Supplementation of the medium with an ultrafiltrate of porcine follicuiar fluid (PM10-filtrate) completely suppressed FSH-promoted reversal of inhibition at 6 hr. Charcoal extraction eliminated this effect of the PM10-filtrate. FSH reversed the inhibition of maturation of cumulus cell-enclosed oocytes maintained by a high concentration of dbcAMP and suboptimal concentrations of the phosphodiesterase inhibitor, 3-isobutyl-1-methyl xanthine (IBMX), during a 21–22-hr culture period. However, the effect of a completely inhibitory concentration of IBMX was not reversed by gonadotropin. A component of serum was also found to inhibit FSH reversal of dbcAMP-maintained meiotic arrest, and this activity was removed by charcoal extraction. In addition, when oocytes were cultured in medium containing a suboptimal concentration of dbcAMP plus a low molecular weight fraction (< 1,000) of porcine follicular fluid, porcine serum, or fetal bovine serum, a synergistic inhibition of maturation was observed. Experiments with highly purified gonadotropins revealed that reversal of dbcAMP-maintained meiotic arrest occurred only in response to FSH; neither highly purified luteinizing hormone nor human chorionic gonadotropin could mimic this action of FSH. Also, this effect was mediated by the cumulus cells, since FSH could not reverse dbcAMP-maintained meiotic arrest in denuded oocytes. Furthermore, elevating cAMP levels in denuded oocytes augmented, rather than reversed, the inhibitory action of dbcAMP on oocyte maturation. These data therefore suggest that dbcAMP- or IBMX-maintained meiotic arrest in vitro is reversed by an FSH-stimulated, cAMP-dependent process mediated by the cumulus cells and demonstrate that a factor present both in follicular fluid and serum prevents this action of the gonadotropin.