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Kinetics of prolactin release in rheumatoid arthritis
C Jorgensen1, H Maziad, C Bologna
1Immuno-Rheumatology Department, Centre Gui-de-Chauliac, Montpellier, France.
Objective:
To study the dynamics of pituitary prolactin secretion in RA, and its association with the HLA DR4 status in patients.
Methods:
TRH stimulation of the pituitary secretion of PRL was performed in 23 RA patients and 8 control subjects, all of whom were post-menopausal women. Hormone concentrations were assessed by radioimmunoassay.
Results:
Basal prolactin concentrations were higher in RA patients compared to controls (579 +/- 80 mu UI/ml versus 187 +/- 47, (p < 0.01). An increase in the prolactin response to TRH at 30 min (2257 +/- 218 mu UI/l versus 1074 +/- 207, p < 0.005), independent of disease activity, was observed in the RA patients. In DR4+ RA patients, we observed a higher PRL peak at 60 min. (3913 +/- 506 mu UI/ml versus 2120 +/- 443, p < 0.01), and an increased residual value at 120 min compared to DR4- RA patients. The area under the curve of the PRL response was also increased in DR4+ RA patients, suggesting higher PRL secretion compared to DR4- RA patients.
Conclusion:
In female, post-menopausal RA patients an alteration in pituitary prolactin release, not linked to disease activity, can be observed. In DR4+ RA patients, the overall prolactin secretion reflected by the AUC is increased compared to DR4- patients. These results suggest a dysregulation of the pituitary response in RA.