Serum thyrotropin response to thyrotropin-releasing hormone and free thyroid hormone indices in patients with familial thyroxine-binding globulin deficiency.

The response in serum thyrotropin (TSH) to synthetic thyrotropin-releasing hormone (TRH) as well as serum free thyroxine index (FT4I) and free triiodothyronine index (FT3I) was investigated in six patients with familial thyroxine-binding-globulin (TBG) deficiency. The total serum thyroxine (T4) and triiodothyronine (T3) concentrations were significantly decreased, compared with those of normal subjects (3.4 +/- 0.9 microgram/dl, mean +/- SD. vs. 9.0 +/- 1.5 microgram/dl, p less than 0.01 and 87 +/- 27 ng/dl vs. 153 +/- 37 ng/dl, p less than 0.01, respectively). FT4I was lower than the normal range in all but one (5.3 +/- 1.5 vs. 8.9 +/- 1.6, p less than 0.01), whereas FT3I was all in the normal range and of no significant difference from the normal control (132 +/- 22 vs. 148 +/- 25). Serum TSH concentrations in TBG deficiency were all in the normal range (1.0-4.2 muU/ml) and the maximum TSH increments following TRH 500 microgram iv were 8.9 +/- 2.0 muU/ml and of no significant difference from the normal control (10.2 +/- 4.5 muU/ml). These results indicate that the euthyroid state in familial TBG deficiency is more clearly defined by TRH-test and the normal response to TRH in familial TBG deficiency is presumably under the control of the serum free T3 level rather than the serum free T4 level.     

Growth hormone response to thyrotropin releasing hormone in a pellagrin

An abnormal hyperresponse of GH to intravenous injection of TRH in a 66-year-old female pellagra patient with typical 3'D's was reported. Diagnosis of pellagra was mainly based on her clinical course and manifestations, although serum levels of nicotinic acid and serotonin were within the normal range. Serum vitamin A and B2 levels were low. However, these findings did not exclude the diagnosis. The abnormal GH response to TRH observed in this patient was decreased at 2 months and thoroughly disappeared at 10 months after admission. GH response to arginine showed an exaggerated and sustained response on admission, decreased at 2 months and showed an almost normal pattern at 10 months after admission. TSH and prolactin response to TRH were normal throughout the clinical course. LH and FSH response to LH-RH were exaggerated, suggesting post-menopausal hypogonadism. Cortisol response to ACTH showed slightly sustained reactions at both times of the provocation. Oral glucose tolerance test revealed a slight impairment in this patient. These results suggest that pellagra is one of the disorders which exhibit an abnormal hyperresponse of GH to intravenous administration of TRH.     

Growth hormone and prolactin response to thyrotropin releasing hormone and growth hormone releasing factor in the immature turkey

Synthetic thyrotropin releasing hormone (TRH) and human pancreatic growth hormone releasing factor (hpGRF) stimulated growth hormone (GH) secretion in 6- to 9-week-old turkeys in a dose-related manner. TRH and hpGRF (1 and 10 micrograms/kg, respectively) each produced a sixfold increase in circulating GH levels 10 min after iv injection. Neither TRH nor hpGRF caused a substantial change in prolactin (PRL) secretion in unrestrained turkeys sampled through intraatrial cannulas. However, some significant increases in PRL levels, possibly related to stress, were noted.     

Increased growth hormone responses to growth hormone releasing hormone and thyrotropin releasing hormone in patients with metastatic testicular cancer

In 16 patients with metastatic testicular cancer and 10 age matched male control subjects growth hormone (GH) responses to growth hormone releasing hormone (GHRH; 1 microgram/kg body weight iv.) and thyrotropin releasing hormone (TRH; 200 micrograms iv.) were measured. Basal GH levels and GH levels following stimulation with GHRH or TRH were significantly increased in cancer patients compared to control subjects. 9 patients with testicular cancer were studied both in the stage of metastatic disease and after they had reached a complete remission. In complete remission GH responses to GHRH tended to decrease but the differences did not reach statistical significance. Our data suggest an alteration of hypothalamic and/or pituitary regulation of GH secretion in patients with metastatic testicular cancer.     

Variations in the response of enzyme-dissociated rat pituitary cells to thyrotropin releasing hormone.

While exploring the interaction between thyrotropin releasing hormone (TRH) and normal rat anterior pituitary cells in monolayer culture we observed that cells dissociated with the use of trypsin did not respond to TRH with an increase in either TSH or prolactin (PRL) release. The dissociated cells were cultured for 3 days, then washed to remove serum proteins and exposed to 10^?6M TRH for 3 hours. TSH and PRL secretion from stimulated and unstimulated cultures was determined by radio-immunoassay and normalized using cell protein. When such trypsin-dissociated cells were exposed to 0.5 mM dibutyryl cyclic AMP the release of both TSH and PRL doubled indicating that the intracellular secretory machinery was functional and that the block to TRH was proximal to the formation of cyclic AMP and presumably at the level of a TRH surface receptor. Previous studies have shown that such trypsin-dissociated cells respond to LHRH and a crude hypothalamic extract with a dose dependent increase in LH, FSH and ACTH release. This rules out a non-specific effect of trypsin. When pituitary cells were dissociated with a non-trypsin technique, the unstimulated release of both TSH and PRL was comparable to that found with the trypsin-dissociated cultures. However, these cultures did respond to TRH with an increase in TSH release although again no effect was seen with PRL. The susceptibility of the cells to trypsin suggests the possibility that a protein moiety may be closely associated with the function of the receptor.     

Dissociation of thyrotropin and prolactin responsiveness to thyrotropin releasing hormone stimulation in L-dopa treated parkinsonian patients

The hPRL, hTSH and T3 response to thyrotropin releasing hormone (TRH) stimulation (200 microgram i.v.) were studied in 8 parkinsonian patients under chronic L-dopa-carbidopa therapy. In 6 out of the 8 patients studied, treatment was stopped for a period of 2 weeks and the TRH stimulation test was repeated under similar experimental conditions. In the L-dopa-carbidopa treated patients basal hTSH levels and the hTSH response to TRH were significantly suppressed. By contrast, in the 6 patients 2 weeks after cessation of treatment, although basal hTSH levels were still suppressed, a normal hTSH response to TRH was observed. Neither the basal T3 and T4 concentrations, nor the T3 response to TRH were affected by the L-dopa-carbidopa treatment. In addition, basal hPRL levels as well as the hPRL: response to TRH were within the normal range in the two groups of patients studied. Our study provides further support for a dopaminergic inhibitory action on the hypothalamo-hypophyseal-thyroidal axis (HHTA). The inhibition of basal hTSH secretion and th hTSH response to TRH by L-dopa, suggest that the blocking action of dopamine is exerted at the hypothalamic as well as at the pituitary level. In our hands, chronic administration of L-dopa did not affect either tonic hPRL secretion of the hPRL response to TRH. The dissociation or response to TRH under the same inhibitory action of dopaminergic stimulation can be interpreted as demonstrating a greater sensitivity of the pituitary thyrotrophs, than the prolactin secreting cells, to the blocking effect of dopamine.     

Thyroid hormone response to thyrotropin releasing hormone after cold treatment during pre- and postnatal development in the domestic fowl

The purpose of the present study was to compare the effect of periodic cooling during the establishment of a functional pituitary-thyroid axis at days 11-14 of incubation and at other developmental stages, on the subsequent thyroid hormone response to thyrotropin releasing hormone (TRH). In the first and second experiment chick embryos were cooled for 6 hr/day to 30 degrees C from day 11 till 14 and from day 15 till 18 respectively, whereas control groups were incubated throughout at 37.8 degrees C. In both experiments the thyroxine (T4) response upon TRH in 19 day-old embryos was higher in the previously cold treated embryos, according to the percentages of increase. However, the higher T4 response in the cold treated animals disappeared in 1 or 7 day-old chicks hatched from the 2nd experiment, but remained present in chicks of the same ages in the 1st experiment. In a third experiment the T4 response to TRH injection immediately and 3 and 8 days after a temperature treatment (25 degrees C or 12 degrees C) for one week on four weeks old broiler chickens was found to be similar in both temperature groups. In all experiments there was a concomitant triiodothyronine (T3) increase after TRH injection, but differences between experimental groups were observed at days 15 and 19 of incubation and immediately after the postnatal temperature treatment. As an overall conclusion the results indicate that cold treatment only during the establishment of the hypothalamo-hypophysial control of thyroid function can have a long lasting effect by enhancing the T4 response to TRH injection.     

Radioimmunologic determination of the thyrotropin releasing hormone]

We describe the preliminary steps for a radio-immunoassay of Thyrotropin Releasing Hormone (TRH). Rabbit antiserum at dilution 1 : 10 000 is used with radioiodinated TRH (125I). We are able to assay from 5 to 1 000 pg unlabeled TRH with an intraassay reporducibility varying from 7 to 4 % and the lowest detectable amount in this system is 10 pg TRH. TRH mean and standard deviation in normal subjects are 136,9 and 25,3 pg/ml.     

Diagnostic value of thyrotropin releasing hormone test in 129 patients with suspected tumoral hyperprolactinemia

In 129 hyperprolactinemic (PRL > or = 100 ng/mL) and 100 normoprolactinemic patients (PRL 0-25 ng/mL), delta max. PRL (the difference between maximal prolactin (PRL) after thyrotropin releasing hormone (TRH) injection and basal value) was compared with basal PRL and computed tomography (CT) of the sellar region. In 122 hyperprolactinemic patients delta max. PRL was < 100%, while tumor was found in 106 of them. In the remainder seven hyperprolactinemic patients delta max. PRL was > or = 100% and CT showed no tumor. A significant difference in delta max. PRL between hyperprolactinemic patients without and those with verified adenoma was found and showed a significant negative correlation with basal PRL. Between 122 hyperprolactinemic patients with delta max. PRL < 100%, mean basal PRL and duration of clinical symptoms were significantly lower in 16 patients with normal CT compared to 106 patients with tumor. All normoprolactinemic patients showed delta max. PRL > or = 100% and no tumor on CT. PRL stimulation disturbance precedes tumor visualization and represents a decisive diagnostic parameter in hyperprolactinemic patients with no tumor signs.     

Release of thyroid stimulating hormone from chick anterior pituitary glands by thyrotropin releasing hormone (TRH)

Chicks two and ten days-of-age respond to a wide range of thyrotropin releasing hormone (TRH) dosages as measured by thyroid uptake of ³²P. The duration of hormone and ³²P action is important. Excellent responses were obtained with the injection of 1.0 μCi³²P at one hour and TRH either at one or four hours before autopsy in both two-day and ten-day-old birds. The ³²P uptake in the thyroid glands was increased by doses of hormone which ranged from 40 nanograms to 125,000 nanograms and was bimodal. Analysis of the data when calculated using log¹⁰ of dose was best accomplished by the use of 5th-degree polynomial equations. It is suggested that the bimodal response is a result of a dual action of TRH. First, TRH initiates the release of stored TSH from the anterior pituitary; and second, TRH stimulates the secretion of newly synthesized TSH by the anterior pituitary.     

Pituitary responsiveness to thyrotropin releasing hormone in insulin-dependent diabetes mellitus.

The pituitary responses to the intravenous administration of 200 mg of Thyrotropin Releasing Hormone were investigated in 14 poorly controlled insulin dependent diabetic males and in nine matched controls. The mean TSH and prolactin responses in the two groups were similar although both tended to be lower in the diabetics. There was a small FSH rise in 11 of the 23 subjects.