Metabolic effects of prolactin and the role of dopamine agonists: A review

Kirsch, Polly; Kunadia, Jessica; Shah, Shruti; Agrawal, Nidhi

doi:10.3389/fendo.2022.1002320

Cited by 30 publications

(20 citation statements)

References 114 publications

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“…According to the Endocrine society guidelines, the treatment response of a prolactinoma is defined as the normalization of prolactin levels on maximally tolerated doses of dopamine agonists and a reduction of 50% in the size of the prolactinoma [ 3 ]. However, when there is a lack of response, it could be due to cabergoline-resistant tumors resulting from a decreased number of dopamine [ 2 ] receptors, a CSF leak, or intolerance to or poor compliance with cabergoline. In addition, it is suggested that some patients with cabergoline resistance have higher prolactin levels at diagnosis, and require longer periods for normalization [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

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The Role of Aromatase Inhibitors in Male Prolactinoma

Akirov

Rudman

2023

JCM

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Background: dopamine agonists are the recommended treatment for male prolactinomas, but some patients may develop dopamine-agonist-resistant hyperprolactinemia, leading to persistent hypogonadism that requires treatment with testosterone. However, testosterone replacement therapy may be associated with a decrease in the efficacy of dopamine agonists due to the aromatization of testosterone to estradiol, which can stimulate the proliferation and hyperplasia of lactotroph cells in the pituitary, inducing resistance to dopamine agonists. Objective: this paper systematically reviewed the role of aromatase inhibitors for men with prolactinoma and dopamine-agonist-resistant or persistent hypogonadism following treatment. Method: we performed a systematic review of all studies (according to PRISMA guidelines), assessing the role of aromatase inhibitors, including anastrozole and letrozole, for male prolactinoma. An English-language search for relevant studies was conducted on PubMed from its inception to 1 December 2022. The reference lists of the relevant studies were also reviewed. Results: our systematic review identified six articles (nine patients), including five case reports and a single case series, on the use of aromatase inhibitors for male prolactinomas. Reducing estrogen levels with an aromatase inhibitor improved sensitivity to dopamine agonists, as the addition of anastrozole or letrozole improves the control of prolactin levels and may lead to the shrinkage of tumors. Conclusion: aromatase inhibitors are of potential value to patients with dopamine-agonist-resistant prolactinoma, or when hypogonadism persists while using high-dose dopamine agonists.

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Section: Discussionmentioning

confidence: 99%

“…Prolactinoma is the most common type of hormone-secreting pituitary tumor and accounts for about 40% of all pituitary adenomas. The prevalence of clinically apparent prolactinomas ranges from 6–10 per 100,000 to 50 per 100,000, according to different studies [ 1 , 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

The Role of Aromatase Inhibitors in Male Prolactinoma

Akirov

Rudman

2023

JCM

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“…DA levels in this key area for hormonal regulation could regulate the observed differences between males and females on consumption of sweets. For example, DA modulates prolactin (PRL) synthesis and secretion (Fernandez-Ruiz et al 1989 ; Mena et al 1989 ; Kochman et al 1993 ), and DA receptor agonists, via PRL, can regulate blood glucose content (Kirsch et al 2022 ; Chien et al 2023 ).…”

Section: Discussionmentioning

confidence: 99%

Sex and age differences in mice models of effort-based decision-making and anergia in depression: the role of dopamine, and cerebral-dopamine-neurotrophic-factor

Matas-Navarro,

Carratalá-Ros,

Olivares-García

et al. 2023

Psychopharmacology

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Mesolimbic dopamine (DA) regulates vigor in motivated behavior. While previous results have mainly been performed in male rodents, the present studies compared CD1 male and female mice in effort-based decision-making tests of motivation. These tests offered choices between several reinforcers that require different levels of effort (progressive ratio/choice task and 3-choice-T-maze task). Sweet reinforcers were used in both tasks. In the operant tasks, females worked harder as the task required more effort to access a 10% sucrose solution. Although males and females did not differ in preference for 10% vs 3% solutions under free concurrent presentation, females consumed more of the 10% solution when tested alone. The operant task requires a long period of training and changes in the DA system due to age can be mediating long-term changes in effort. Thus, age and sex factors were evaluated in the T-maze task, which requires only a short training period. Both sexes and ages were equally active when habituated to the running wheel (RW), but females consumed more sweet pellets than males, especially at an older age. Both sexes had a strong preference for the RW compared to more sedentary reinforcers in the 3-choice-T-maze test, but older animals spent less time running and ate more than the young ones. The DA-depleting agent tetrabenazine reduced time running in older mice but not in adolescents. Cerebral-dopamine-neurotrophic-factor was reduced in older mice of both sexes compared to adolescent mice. These results emphasize the importance of taking into account differences in sex and age when evaluating willingness to exert effort for specific reinforcers.

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“…Один из них расположен проксимально и отвечает за направление специфичной для гипофиза экспрессии, другой -дистально и отвечает за внегипофизарную экспрессию пролактина [1]. Пролактин обеспечивает аутокринную и паракринную обратную связь на лактотрофные клетки гипофиза [3,4]. К факторам, стимулирующим выработку пролактина, относят тиреотропин-рилизинг гормон, эстрогены (при беременности) и антагонисты дофамина (нейролептики).…”

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“…Примечание. Статистически значимые отличия от: 1 -уровня до лечения в пределах одной группы, 2 -от уровня соответствующего показателя в группе с прогрессированием процесса, 3 -от уровня соответствующего показателя в группе со стабилизацией процесса, 4 -от уровня соответствующего показателя в группе с частичным ответом, 5…”

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Prolactin Indices in Blood of Patients With Malignant Brain Gliomas Receiving Combination Radiation Treatment

Kaplieva¹,

Vlasov²,

M.A.³

et al. 2023

СПНО (MPSE)

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У пациентов с глиомами головного мозга (G3-G4), возрастом 62,5±0,8 года до и после проведения адаптивной стереотаксической лучевой терапии (АСЛТ) в крови методом иммуноферментного анализа изучали содержание пролактина (ПРЛ). АСЛТ проводили в режиме стандартного фракционирования на линейном ускорителе «Novalis Tx», Varian: РОД=2 Гр, СОД=60 Гр, 30 фракций, с использованием трехслойной стереотаксической маски. У 26 женщин и 30 мужчин АСЛТ сочетали с бевацизумабом: в/в, 5 мг/кг, 1 раз в 2 недели (АСЛТ+Б); у 22 женщин и 30 мужчин АСЛТ сочетали с дексаметазоном: в/м, 4 мг, 2 раза в день, 43-45 дней (АСЛТ+Д). При прогрессировании заболевания после АСЛТ+Д уровень ПРЛ увеличивался в 1,6 раза (р<0,01) у мужчин и снижался в 1,6 раза (р<0,01) у женщин относительно фона. При стабилизации процесса после АСЛТ+Д у мужчин ПРЛ вырастал в 2,0 раза, превысив референсные значения, у женщин не изменялся; после АСЛТ+Б у мужчин ПРЛ увеличивался в 1,5 раза (р<0,01), у женщин -в 2,5 раза относительно фона. При частичном ответе ПРЛ увеличивался в 2,5 раза у всех пациентов с АСЛТ+Д и не изменялся при АСЛТ+Б. Полный ответ был получен только у мужчин с АСЛТ+Б, исходный уровень ПРЛ у них был в 1,5 раза (р<0,01) больше, чем у мужчин с частичным ответом, после лечения -не изменялся. Таким образом, динамика ПРЛ в крови у пациентов с глиомами головного мозга на фоне АСЛТ зависит от пола пациента и варианта терапии. У женщин с прогрессированием заболевания редукция ПРЛ после проведения АСЛТ+Д свидетельствует о выраженных метаболических нарушениях. Исходно низкий уровень ПРЛ у мужчин с АСЛТ+Б не дает достичь полного ответа на лечение. Ключевые слова: глиома, лучевая терапия, дексаметазон, бевацизумаб, пролактин, сыворотка крови.

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Metabolic effects of prolactin and the role of dopamine agonists: A review

Cited by 30 publications

References 114 publications

The Role of Aromatase Inhibitors in Male Prolactinoma

The Role of Aromatase Inhibitors in Male Prolactinoma

Sex and age differences in mice models of effort-based decision-making and anergia in depression: the role of dopamine, and cerebral-dopamine-neurotrophic-factor

Prolactin Indices in Blood of Patients With Malignant Brain Gliomas Receiving Combination Radiation Treatment

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