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Biomedical subjects

A L Hulting

Publications and source records attributed to A L Hulting.

At least 19 recordsLinked to original sources
PubMed2000

Prolactin-secreting pituitary adenoma in neuroleptic treated patients with psychotic disorder.

Three patients with psychoses and concomitant prolactin-secreting pituitary tumours are described. Patients A and B had bipolar and schizoaffective disorders, respectively. They had both been treated with neuroleptics for 20 years before the prolactinomas were revealed. Patient C developed a paranoid psychosis after two years of continuous bromocriptine treatment for a pituitary tumour. In patient A the prolactin level was successfully normalized and a good antipsychotic effect was maintained by combined therapy with haloperidol and quinagolide but not bromocriptine. In patient B the prolactinoma was removed by surgery, in view of the serious nature of the psychotic disorder, to avoid psychotic relapse by treatment with a dopamine agonist. In patient C a good result was obtained with the combination of clozapine and bromocriptine. These case reports support the view that neuroleptics being dopamine antagonists and dopamine agonistic agents which are the primary treatment of prolactinomas can cancel out each other's effects. The combination of clozapine and quinagolide is recommended as the treatment of choice for most patients.

Adult↗
PubMed1999

Oxytocin causes a sustained decrease in plasma levels of corticosterone in rats.

The aim of this study was to investigate how oxytocin (OXT) influences plasma levels of ACTH and corticosterone in rats. A single injection of OXT (1 mg/kg s.c.) caused a transient increase in ACTH and corticosterone. In contrast, 1 mg/kg OXT (but not 10-100 microg/kg) decreased corticosterone, but not ACTH levels, 6 h after the injection. OXT (1 mg/kg s.c.) administered once a day for 5 days, decreased cortiocosterone for 10 days after the last injection. An acute challenge with ACTH increased corticosterone to the same level in rats pretreated with OXT and controls. Dexamethasone decreased corticosterone to equal levels in both groups. Thus, OXT seems to be able to stimulate as well as to inhibit the activity within the HPA-axis within a short- and a long-term perspective, respectively.

Adrenocorticotropic Hormone↗
PubMed1999

Paradoxical GH response to TRH during status epilepticus in man.

Information on GH in relation to epilepsy is sparse, and to our knowledge there is no information on GH levels during status epilepticus in man. We studied GH in serum in six patients during status epilepticus, and in a control group of six seizure-free patients with epilepsy, before and after injection of TRH. The baseline GH values before TRH administration were within the normal range in all patients. After injection of TRH all patients with status epilepticus showed a paradoxical peak-shaped increase of GH to at least twice their baseline levels within 45 min after the injection (median basal GH value 1.5 mU/l and median peak GH value 6. 5 mU/l, mean increase 330%). No uniform reaction to TRH was observed in the control group (median basal GH value 2.7 U/l and median of the highest value within 45 min 5.2mU/l). A paradoxical peak reaction of GH to TRH was significantly more frequent in the status epilepticus group compared with the control group (P=0.008, Fisher exact probability test). TRH is not considered a GH-releasing hormone in humans during normal conditions, but a paradoxical response of GH to TRH, similar to that observed during status epilepticus, has been reported in various other pathological conditions, such as acromegaly, liver cirrhosis, mental depression and hypothyroidism. Our results of GH release after TRH administration in patients with status epilepticus suggest an altered regulation of GH as a result of the long-standing epileptic activity.

Adult↗
PubMed1999

Different influences of classical antipsychotics and clozapine on glucose-insulin homeostasis in patients with schizophrenia or related psychoses.

BACKGROUND: The aim of this study was to investigate the influence of classical antipsychotics and the atypical antipsychotic agent clozapine on glucose-insulin homeostasis to explain possible mechanisms behind weight gain associated with antipsychotic treatment. METHOD: Twenty-eight patients on therapy with classical antipsychotics and 13 patients treated with clozapine (all meeting DSM-III-R criteria for schizophrenia or related psychoses) were studied. Fasting blood samples for glucose and insulin, as well as for 2 markers of the glucose-insulin homeostasis, i.e., the growth hormone (GH)-dependent insulin-like growth factor I (IGF-I) and the insulin-dependent insulin-like growth factor binding protein-1, were analyzed. Body mass index (BMI) was calculated and serum concentrations of the different antipsychotic drugs were measured. In addition, the relationship between the endocrine parameters and drug serum concentrations was examined. RESULTS: The insulin levels were positively correlated to the serum concentration of clozapine, whereas no correlations were found between insulin and the serum concentrations of perphenazine (N = 12) or zuclopenthixol (N = 9). Insulin elevation was seen in the patients receiving clozapine more frequently than in the patients receiving classical antipsychotics. In addition, the median level of IGF-I was significantly lower in the patients receiving clozapine than in the patients receiving classical antipsychotics. No significant difference in BMI was found between the 2 patient groups, and all patients but 1 were normoglycemic. CONCLUSION: The correlation between insulin and the clozapine concentration indicates a probable influence of clozapine on insulin secretion. The normal blood glucose levels in the clozapine group support the theory that clozapine induces concentration-dependent insulin resistance with secondary increased insulin secretion. In addition, lower median level of IGF-I in patients receiving clozapine compared with patients receiving classical antipsychotics points to a lower GH secretion in the clozapine group. This impaired GH secretion together with the clozapine-induced insulin resistance might be mechanisms behind weight gain during clozapine therapy.

Adult↗
PubMed1998

Pituitary autoantibodies in patients with hypopituitarism and their relatives.

Autoantibodies to human pituitary cytosol proteins were determined by immunoblotting in sera from patients with hypopituitarism and their relatives. Reactivity to an M(r) 49,000 protein was significantly more frequent in patients (6/21 (28%) P < 0.05) as well as in relatives (10/35 (28%) P < 0.02) compared with controls (3/44 (6.8%)). Autoantibodies to this particular protein have previously been detected in sera from 70% of patients with biopsy-proven lymphocytic hypophysitis. Unlike patients with biopsy-proven lymphocytic hypophysitis, none of the patients in this study presented with a suspected pituitary adenoma or showed an enlarged sella turcica. Cisternal herniation was seen in 6/21 patients and this may very well represent the end stage of lymphocytic hypophysitis. Since organ specific autoantibodies are frequent in patients with autoimmune endocrine disease as well as in their unaffected relatives, autoantibodies to this M(r) 49,000 pituitary cytosolic protein may represent markers for an immunological process affecting the pituitary gland.

Aged↗
PubMed1997

Botulinum neurotoxin F, a VAMP-specific endopeptidase, inhibits Ca(2+)-stimulated GH secretion from rat pituitary cells.

Botulinum neurotoxin F (BoNTx F) is a zinc-dependent endopeptidase that causes proteolytic cleavage of the vesicle protein VAMP (vesicle-associated membrane protein). VAMP is an important component of the molecular machinery regulating docking and fusion of secretory vesicles with the target membrane. We have investigated presence of VAMP protein in cultured rat anterior pituitary cells. Confocal laser microscopy revealed presence of VAMP-like immunoreactivity in secretory granules of GH-containing cultured rat anterior pituitary cells. Using BoNTx F, we have investigated whether VAMP is involved in growth hormone (GH) secretion. Treatment of streptolysin-O permeabilized GH-secreting cells with BoNTx F (2.0 and 20 nM) significantly inhibited Ca(2+)-induced GH release. The results show that the secretory granules of rat anterior pituitary cell contain VAMP protein and suggest that VAMP is of importance in regulating Ca(2+)-mediated GH secretion.

Animals↗
PubMed1997

Evidence for a dual function of oxytocin in the control of growth hormone secretion in rats.

The aim of the present study was to investigate the role of oxytocin (Oxy) in the control of growth hormone (GH) release. Oxy was administered subcutaneously (s.c.) or intracerebroventricularly (i.c.v.) to male rats. The animals were decapitated and trunk blood was collected at 30 and 120 min after Oxy administration. GH levels were analyzed by radioimmunoassay. Oxy (100 microg, s.c) increased plasma levels of GH significantly 30 min after administration. Oxy (2 ng, i.c.v.) caused a significant rise of GH after 120 min. This effect was completely abolished by previous administration of the Oxy antagonist 1-deamino-2-D-Tyr-(OEt)-4-Thr-8-Orn-oxytocin. When 5 microg of Oxy were given i.c.v. or 1 mg s.c., an inhibition of GH secretion was seen after 120 min. This effect was also abolished by the Oxy antagonist. Thus Oxy may influence GH in opposite directions depending on the doses given.

Animals↗
PubMed1997

High-molecular weight IGF-2 expression in a haemangiopericytoma associated with hypoglycaemia.

Spontaneous hypoglycaemia is usually caused by an insulin-producing islet-cell tumour of the pancreas. Rarely, it can be caused by non-islet cell tumours. Most of the tumours are of mesenchymal type, large, and slowly growing. One representative is haemangiopericytoma (HAP). The present report describes a case of a large recurrent retroperitoneal HAP associated with severe hypoglycaemia. Blood serum insulin and proinsulin concentrations were low. By means of acid-gel chromatography and dot-blot techniques, an increased amount of a high-molecular-weight IGF-2 peptide was found. By using antigen retrieval procedures, IGF-2-immunoreactive tumour cells were found in specimens of the recent tumour recurrence-but not in the original. When the in situ hybridization technique was used it could be shown that IGF-2 mRNA labelling had already occurred in the original tumour specimen, 11 years before the onset of hypoglycaemic symptoms. These observations confirm the hypothesized hypoglycaemic effects of high-molecular-weight (HMW) IGF-2, but also point to the presence of a prolonged compensation of this effect. A literature review, based on 17 similar cases of haemangiopericytoma with hypoglycaemia, is presented. Our observation and findings in the literature review support the idea that non-islet-cell tumour hypoglycaemia is caused by an overproduction of a HMW IGF-2 peptide. The insulin-like effect is mediated via non-specific binding to the insulin receptors. To anticipate patients at risk of developing this kind of hypoglycaemia, the histopathological investigation should include not only immunohistochemical analyses of the presence of IGF-2 peptide, but also in situ hybridization of the IGF-2 mRNA expression.

Aged↗
PubMed1997

Nitric oxide synthase and cGMP in the anterior pituitary gland: effect of a GnRH antagonist and nitric oxide donors.

Using immunohistochemistry and in situ hybridization, it has been previously shown that gonadotropes and folliculo-stellate cells in the rat anterior pituitary gland express nitric oxide (NO) synthase (NOS), and that NOS expression is increased by gonadectomy. Using the indirect immunofluorescence technique in conjunction with antibodies raised to conjugated cGMP, we have attempted to establish the target cells for NO in the anterior pituitary and to define the mediator of NO regulation. After incubation of pituitary slices with several NO donors, numerous endocrine cells, but no folliculo-stellate cells, expressed cGMP. Most of these cells stained for LH, that is they were gonadotropes. However, there were apparently cGMP-positive, LH-negative and LH-positive, cGMP-negative endocrine cells. The increase in cGMP could be virtually completely blocked by a guanylyl cyclase inhibitor. cGMP was not expressed in corticotropes, but cGMP-positive cells often contained NOS-like immunostaining. Incubation with GnRH did not result in detectable levels of cGMP. However, when castrated rats were pretreated with a potent longlasting GnRH antagonist, antide, the castration-induced increase in NOS was completely blocked. This suggests that GnRH is involved in the in vivo upregulation of NOS after castration, but that GnRH cannot induce cGMP accumulation in normal pituitary slices in vitro. Taken together, the present results give further evidence for a role of NO in the control of, in particular, LH secretion from the anterior pituitary gland in the rat.

Animals↗
PubMed1996

Effect of oxytocin on growth hormone release in vitro.

The effect of oxytocin (OT) on growth hormone (GH) secretion was investigated using dispersed rat anterior pituitary cells. OT dose-dependently inhibited GH secretion as well as GHRH-stimulated GH release. The inhibitory actions of OT on GH release were totally abolished by pretreatment with the OT-antagonist VAP 259. The peptides galanin and cholecystokinin did not affect the OT-induced inhibition on basal or GHRH-stimulated GH release. Several possible mechanisms by which OT may influence GH release are discussed.

Animals↗
PubMed1996

Expression of leptin receptor mRNA in the hypothalamic arcuate nucleus--relationship with NPY neurones.

The obese phentotype of ob/ob mice is linked to a mutation in the ob gene that results in expression of a truncated inactive protein. The ob gene product, leptin, is synthesized in adipose tissue and is a circulating factor that regulates body weight. Leptin receptors were recently cloned and a mutation in the leptin receptor gene in obese db/db mice was identified. Leptin receptor mRNA has been detected in brain, including hypothalamus, but the cellular localization has so far not been clarified. Here we report on the cellular localization of leptin receptor mRNA in the mouse brain using in situ hybridization. Strong hybridization was observed in the choroid plexus and hypothalamic arcuate nucleus. Weaker hybridization was detected in the hippocampal formation and in the cerebral cortex. Within the arcuate nucleus, cell bodies expressing leptin receptor mRNA were distributed in its ventromedial subdivision. Hybridization of semiadjacent sections with a probe to neuropeptide Y (NPY) showed a co-distribution of labelled cell bodies, suggesting the presence of leptin receptors on NPY-containing neurones.

Animals↗
PubMed1995

High diagnostic accuracy for idiopathic Addison's disease with a sensitive radiobinding assay for autoantibodies against recombinant human 21-hydroxylase.

Autoantibodies against 21-hydroxylase (P450c21) are common in idiopathic autoimmune Addison's disease. In the present work, we have developed a sensitive radiobinding assay using in vitro translated recombinant human 35S-P450c21. Levels of P450c21 antibodies (P450c21-Ab) were expressed as a relative index (P450c21 index) using a P450c21-Ab positive Addisonian serum and two antibody-negative healthy sera as positive and negative standards in healthy individuals. The upper level of normal was the mean + 3 SD. Positivity for P450c21-Ab was confirmed by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) analysis of immunoprecipitated 35S-P450c21. In 38 Addisonian patients, P450c21-Ab were found in 24/28 (86%) idiopathic, 0/5 post-tuberculosis, 0/3 adrenoleukodystrophy, and 0/2 post-adrenalectomy sera. Among healthy individuals, 1/70 (1.4%) were positive. The P450c21 index, as an estimate of P450c21-Ab levels, correlated inversely with the duration of idiopathic Addison's disease (r = -0.527; P = 0.007): 16/16 (100%) positive in patients with less than 20 yr and 8/12 (67%) positive in patients with more than 20 yr disease duration. The availability of this simple and sensitive radiobinding assay to evaluate levels of P450c21-Ab will permit large clinical studies as well as screening subjects at risk. In addition, the general population can now be screened to evaluate the predictive value of P450c21-Ab for Addison's disease.

Acute Disease↗
PubMed1994

Haemorrhagic pituitary tumours.

In a group of 69 patients with pituitary tumours, 12 were found to have evidence of intratumoral haemorrhage on MRI, characterized by high signal intensity on short TR/TE sequences. This was verified in all but 1 patient. The majority of the bleedings occurred in macroadenomas. Five (42%) were prolactinomas and 4 (33%) were non-functioning adenomas. There were 2 GH- and 1 ACTH-secreting tumours. All 5 patients with prolactinomas were on bromocriptine medication. Two of the patients had a clinical picture of pituitary apoplexy. The haemorrhage was not large enough to prompt surgery in any of the patients. However, surgical verification of the diagnosis was obtained in 5 cases, while 6 patients were examined with follow-up MRI.

Adenoma↗
PubMed1994

Plasticity of NO synthase expression in the nervous and endocrine systems.

Using immunohistochemistry and in situ hybridization the effect of nerve injury and of hormones was analysed in sensory and hypothalamic systems and in the pituitary gland. After peripheral axotomy a marked increase in NOS protein and mRNA levels was observed in dorsal root ganglia, the trigeminal ganglion and a less dramatic effect in the nodose ganglia. This effect lasted in the dorsal root ganglion neurons for at least 10 weeks. In the hypothalamic magnocellular neurons a transient increase was observed in the paraventricular and supraoptic nuclei. A similar effect was also seen after salt loading. In the anterior pituitary gland NOS was expressed in gonadotrophs and folliculo-stellate cells. Castration markedly increased NOS levels in the anterior lobe, and this could be counteracted by steroid hormone replacement. Thus, the present results show that the constitutive, neuronal NOS can be dramatically regulated in response to various manipulations, suggesting an important involvement of NO in these situations.

Amino Acid Oxidoreductases↗
PubMed1993

Nitric oxide synthase in the rat anterior pituitary gland and the role of nitric oxide in regulation of luteinizing hormone secretion.

By using immunohistochemistry and in situ hybridization, we have demonstrated that the nitric oxide (NO)-synthesizing enzyme NO synthase is present in gonadotrophs and in folliculo-stellate cells of the anterior pituitary gland of male and female rats. A marked increase in levels of NO synthase protein and mRNA was observed after gonadectomy. In vitro studies on dispersed anterior pituitary cells suggest that NO inhibits gonadotropin-releasing-hormone-stimulated luteinizing hormone release. An inhibitory effect of NO has also been shown on growth-hormone-releasing-hormone-stimulated release of growth hormone [Kato, M. (1992) Endocrinology 131, 2133-2138]. Thus these findings support a dual mechanism for NO in the control of anterior pituitary hormone secretion, an autocrine mediation of luteinizing hormone release on gonadotrophs, and a paracrine effect on growth hormone secretion involving folliculo-stellate cells closely related to somatotrophs. We speculate that NO may participate in producing the pulsatile secretion patterns of these two pituitary hormones.

Amino Acid Oxidoreductases↗
PubMed1993

Galanin receptors from human pituitary tumors assayed with human galanin as ligand.

Galanin (i.v.) elevates circulating growth hormone levels in humans, and human growth hormone producing tumors show galanin-like immunoreactivity. We have therefore investigated the presence of galanin receptors in sixteen human pituitary tumors. Specific binding of [125I]monoiodo-[Tyr26]-porcine galanin was found in membranes from four clinically inactive and three growth hormone producing tumors. The affinity of human, rat and porcine galanin to these receptor sites was identical (Kd = 0.9 nM). The rank order of potency of galanin receptor ligands was the same in the human pituitary tissue as in the rat and porcine pituitary, hypothalamus, pancreas and hippocampus. GTP (1 mM) or GMPP(NH)P (0.5 mM) lowered the apparent specific binding of [125I]galanin (0.2 nM), suggesting that the human pituitary galanin receptor is coupled via a G-protein similarly to galanin receptors in mouse, rat and pig. The possible significance of galanin receptors in pituitary tumors is discussed.

Adult↗
PubMed1993

Effect of galanin on plasma levels of oxytocin and cholecystokinin.

Galanin, oxytocin and cholecystokinin (CCK) are peptides that influence feeding behaviour. Galanin has been found to stimulate food intake and oxytocin and CCK have been suggested to be satiety agents. The present study was performed in order to investigate if galanin influences the secretion of oxytocin and CCK as a possible indication of a functional relationship between these peptides with respect to their influence on feeding behaviour. Galanin (0.1 and 1 micrograms) was administered intracerebroventricularly (i.c.v.) and intraperitoneally (i.p.) to anaesthetized rats and blood samples were collected 20 and 60 min after administration. Plasma levels of oxytocin and CCK were measured with radioimmunoassay. Galanin, 0.1 and 1 microgram, caused a significant decrease in oxytocin levels after 60 min, both when administered i.c.v. and i.p. In contrast, CCK levels increased following i.c.v. and also i.p. galanin. The possible mechanisms by which galanin causes a decrease in oxytocin and an increase in CCK levels are discussed.

Animals↗