IntroductionHuman lactotroph adenomas (prolactinomas) are the most frequent functioning pituitary tumors (1), but their pathogenesis remains elusive. The primary regulation of prolactin (PRL) secretion is mediated by the inhibitory effects of dopamine released from the median eminence of the hypothalamus and acting at the dopamine D2 receptor subtype (D2R) (2). Mice deficient in the D2R receptor (Drd2 -/-mice) have previously been shown to develop hyperprolactinemia, lactotroph hyperplasia, and prolactinomas (3, 4), confirming a critical role of hypothalamic dopamine and dopamine receptor activation in the physiologic regulation of lactotroph proliferation and PRL secretion. However, the involvement of a number of other regulatory factors has been postulated, including PRL itself (5). PRL increases hypothalamic-pituitary dopamine tone, i.e., constitutive inhibitory signaling by the D2R, and decreases PRL secretion (6-8) by altering the expression (9) and activity (7) of tyrosine hydroxylase (TH), the rate-limiting enzyme in dopamine synthesis.In addition to its indirect effects, mediated by changes in hypothalamic dopamine, we hypothesize that PRL might have direct effects on the pituitary gland. PRL receptors (PRLRs) have been demonstrated in the anterior pituitary in several species, including mouse (10, 11), and have been found specifically on lactotrophs in rats (12) and humans (13). Its effects on proliferation of other cell types are varied, but are predominantly stimulatory (14-25) except in the ovary (26, 27), adrenal gland (28), and vascular endothelium (29). Although it has been postulated that PRL may play an autocrine or paracrine role in lactotroph proliferation (11), there is limited empirical evidence supporting this theory. Experiments to evaluate a direct pituitary effect of PRL in vivo are difficult because of its concurrent effects on hypothalamic dopamine. By Hypothalamic dopamine inhibits pituitary prolactin secretion and proliferation of prolactin-producing lactotroph cells by activating lactotroph dopamine D2 receptors (D2Rs). Conversely, prolactin (PRL) stimulates hypothalamic dopamine neurons via PRL receptors (PRLRs) in a short-loop feedback circuit. We used Drd2 -/-and Prlr -/-mutant mice to bypass this feedback and investigate possible dopamine-independent effects of PRL on lactotroph function. The absence of either receptor induced hyperprolactinemia and large prolactinomas in females. Small macroadenomas developed in aged Prlr -/-males, but only microscopic adenomas were found in Drd2 -/-male mice. Pharmacologic studies in Prlr -/-mice with D2R agonists and antagonists demonstrated a significant loss of endogenous dopamine tone, i.e., constitutive inhibitory signaling by the D2R, in the pituitary. However, Prlr -/-mice exhibited more profound hyperprolactinemia and larger tumors than did age-matched Drd2 -/-mice, and there were additive effects in compound homozygous mutant male mice. In vitro, PRL treatment markedly inhibited the proliferation of wild-type female and male Drd2 -/-l...