BIOLOGICALLY-ACTIVE CORTICOTROPIN-RELEASING HORMONE IN MATERNAL AND FETAL PLASMA DURING PREGNANCY
BIOLOGICALLY-ACTIVE CORTICOTROPIN-RELEASING HORMONE IN MATERNAL AND FETAL PLASMA DURING PREGNANCY
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DOI：
10.1016/s0002-9378(88)80162-5
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发表时间：
1988-10-01
影响因子：
9.8
通讯作者：
STARK, RI
中科院分区：
文献类型：
--
作者：
GOLAND, RS;WARDLAW, SL;STARK, RI
在110名孕妇的血浆和25名早产儿和43名足月婴儿的脐带血浆中检测了促肾上腺皮质激素释放激素。直到妊娠中期，母体血浆促肾上腺皮质激素释放激素的平均值（< 41 pg/ml）才被检测到，平均值上升到204。妊娠30周24 pg/ml，至326 +-。35周时为41 pg/ml，然后在近期急剧上升，妊娠38至40周时平均为2930 pg/ml。对7名孕妇的连续测量证实，血浆促肾上腺皮质激素释放激素以一种可预测的模式上升，在怀孕的最后几周急剧上升。产妇血浆浓度的小时变异性很小。脐带血浆中也检测到促肾上腺皮质激素释放激素；平均促肾上腺皮质激素释放激素为194 +-。早产儿44例，早产儿150例。19 .足月婴儿。从母体和胎儿循环中提取的促肾上腺皮质激素释放激素在体外具有生物活性，并引起促肾上腺皮质激素和β的剂量依赖性释放。从培养的大鼠垂体前细胞中提取-内啡肽。在倍他米松给药后的早晨，母体血浆促肾上腺皮质激素释放激素与皮质醇水平之间存在显著相关性，这一发现支持母体血浆促肾上腺皮质激素释放激素的生理作用。我们得出结论，胎盘分泌大量的生物活性促肾上腺皮质激素释放激素到母体和胎儿循环在怀孕期间。我们证明，在正常足月妊娠期间，促肾上腺皮质激素释放激素以可重复的模式分泌到母体血浆中，并建议连续的促肾上腺皮质激素释放激素测量可能被证明具有临床实用性。此外，胎盘促肾上腺皮质激素释放激素可能是怀孕期间下丘脑-垂体-肾上腺轴的重要调节因子。
Corticotropin-releasing hormone was measured in the plasma of 110 pregnant women and in the umbilical cord plasma of 25 premature infants and 43 infants born at term. Mean maternal plasma corticotropin-releasing hormone was undetectable (< 41 pg/ml) until mid-second trimester, rose to a mean of 204 .+-. 24 pg/ml by 30 weeks'' gestation, to 326 .+-. 41 by 35 weeks, and then rose sharply near term, with a mean of 2930 pg/ml at 38 to 40 weeks'' gestation. Sequential measurements in seven pregnant women confirmed that plasma corticotropin-releasing hormone rose in a predictable pattern, with a dramatic increase in the final weeks of pregnancy. There was little hour-to-hour variability in maternal plasma concentrations. Corticotropin-releasing hormone was also detectable in umbilical cord plasma; mean corticotropin-releasing hormone was 194 .+-. 44 in the preterm infants and 150 .+-. 19 in the term infants. The corticotropin-releasing hormone extracted from both the maternal and fetal circulation was biologically active in vitro and caused the dose-dependent release of adrenocorticotropic hormone and .beta.-endorphin from cultured rat anterior pituitary cells. A significant correlation was found betwene maternal plasma corticotropin-releasing hormone and cortisol levels the morning after betamethasone administration, a finding that supports a physiologic role for maternal plasma corticotropin-releasing hormone. We conclude that the placenta secretes large amounts of biologically active corticotropin-releasing hormone into both the maternal and fetal circulation during pregnancy. We demonstrate that corticotropin-releasing hormone is secreted into the maternal plasma in a reproducible pattern during normal term pregnancy and suggest that sequential corticotropin-releasing homone measurements may prove to be of clinical utility. In addition, placental corticotropin-releasing hormone may be an important modulator of the hypothalamic-pituitary-adrenal axis during pregnancy.