EFFECT OF PROGESTERONE ON HUMAN UTERUS
EFFECT OF PROGESTERONE ON HUMAN UTERUS
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DOI：
10.1073/pnas.54.4.1069
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发表时间：
1965-01-01
影响因子：
11.1
通讯作者：
PINTODAN.CA
中科院分区：
文献类型：
--
作者：
CSAPO, AI;PINTODAN.CA
华盛顿大学圣路易斯医学院和巴西巴伊亚大学妇产科系。科纳，1965年8月18日在科纳和艾伦发现孕酮和这种类固醇对维持兔子怀孕的独特作用后不久，这就产生了一个问题，即这种激素是否在哺乳动物和人类子宫肌层功能的调节中具有普遍的作用。2最近有观点认为孕酮对人类子宫肌层没有作用，而且在不同物种之间存在着深刻的差异在维持和终止妊娠中调节子宫功能。这一概念阻碍了对不同物种共有的基本调节机制的研究。它还鼓励这样一种想法，即不同动物和人类中这种基本机制的叠加修饰代表了控制子宫活动的替代机制。然而，由于孕酮阻滞的发现，以及“两个极端物种，人类和兔子，在子宫调节的基本机制上没有区别，但在局部胎盘和全身卵巢孕酮效应对子宫肌层阻滞的相对贡献方面，”的提议，这场争论一直没有解决。这一观点没有得到普遍接受。内分泌学家坚持认为，”孕酮理论”4-6是由外周血中孕酮的排出与分娩开始之间的巧合证明的。临床医生，包括我们自己，要求证明黄体酮治疗能抑制子宫活动和对催产素的反应，从而阻止怀孕。这些要求并不完全合理，因为在孕酮理论中，仅预测子宫肌层孕酮浓度、阻断效应、子宫活动的性质和程度以及临床状况之间存在相关性。此外，胎盘孕酮”局部”效应的理论7明确指出，人体子宫的内分泌和功能不对称可能不容易通过全身孕酮治疗来改变，也不能通过外周血孕酮水平来反映。
DEPARTMENTS OF OBSTETRICS AND GYNECOLOGY, WASHINGTON UNIVERSITY SCHOOL OF MEDICINE, ST. LOUIS, AND THE UNIVERSITY OF BAHIA, BRAZIL Communicated by George W. Corner, August 18, 1965 Soon after Corner and Allen's discovery'of progesterone and the unique effect of this steroid on the maintenance of pregnancy in the rabbit, the question arose whether this hormone has a general role in regulating myometrial function in mammals and man. Recently the opinion2 has been expressed that progesterone has no effect on the human myometrium and that profound differences exist among various species in the regulation of uterine function in the maintenance and termination of pregnancy. This concept discouraged the search for a basic regulatory mechanism common to different species. It also encouraged the thought that superimposed modifications of this basic mechanism in different animals and man represent alternative mechanisms for the control of uterine activity. The debate was kept open, however, by the discovery of the progesterone block3 and by the proposal'that two extreme species, humans and rabbits, do not differ in their basic mechanism of uterine regulation, but in the relative contributions to the myometrial block of a local placental and a systemic ovarian progesterone effect. This view was not generally accepted. Endocrinologists insisted that the" progesterone theory" 4-6 is proved by the demonstration of a coincidence between progesterone withdrawal in the peripheral blood and the onset of labor. Clinicians, ourselves included, demanded proof that progesterone therapy extinguishes uterine activity and response to oxytocin and thus prolongs pregnancy. These demands were notfully justified, for in the progesterone theory a correlation was only predicted between myometrial progesterone concentration, the blocking effect, the character and magnitude of uterine activity, and clinical conditions. Furthermore, the theory7 of the" local" effect of placental progesterone stated explicitly that the endocrine and functional asymmetry of the human uterus may not be readily modified by systemic progesterone treatment, nor reflected by peripheral blood progesterone levels.