L’LH endogeno è in grado, in presenza di FSH, di elicitare una biosintesi androgenica massimale, anche se legato soltanto ad una quantità inferiore all’ 1% dei propri recettori espressi dalle cellule della teca (spare receptor hypothesis) (Chappel e Howles, 1991). Le concentrazioni endogene di LH in corso di ciclo spontaneo e finanche i livelli circolanti di ormoni residui alla soppressione dell’asse ipotalamo-ipofisi-ovaio con analoghi del Gn-RH sembrerebbero essere sufficienti, nella maggior parte dei casi, ad occupare tale quota recettoriale e, quindi, a sostenere l’attività dell’FSH esogeno. Ciononostante, in una quota di pazienti oscillanti tra il 10 e il 30% , la COH (Iperstimolazione ovarica controllata) non esita in una risposta ovarica soddisfacente. È possibile ipotizzare che in queste pazienti ci sia un grado eccessivo di soppressione dell’asse ipotalamo-ipofisario a causa dell’uso di analoghi o antagonisti del Gn-RH e, quindi, ad una insufficiente attività LH residua (2). Tali pazienti potrebbero beneficiare dell’uso di preparazioni (Luveris fl 75 UI) contenenti LH (2-4), la cui somministrazione, LH-added, dovrebbe essere calibrata al fine di non produrre concentrazioni circolanti eccessivamente alte e potenzialmente dannose (5). E’ stato recentemente suggerito che la necessità di somministrare LH esogeno coincida con il riscontro di concentrazioni sieriche circolanti dell’ormone <1.2 UI/l. Ma anche questo dato è soggetto a numerose revisioni critiche sulla reale efficacia ed opportunità dell’LH-added anche nelle pazienti con bassi livelli di LH circolante (4,6).
Azione dell’LH sul corpo luteo: La secrezione steroidea luteale gode di un certo grado di autonomia; infatti, Rossmanith e coll. nel 1990 hanno riscontrato nella donna che un certo numero di picchi secretori di estradiolo e progesterone non erano preceduti da picchi di LH. Inoltre, la ghiandola luteale se espiantata e studiata in vitro continua a secernere progesterone in modo pulsatile. Tuttavia, l’importanza dell’azione di stimolo esercitata dall’LH a livello luteale sulla secrezione di progesterone è ampiamente provata. Infatti l’immunoneutralizzazione dell’LH nella scimmia induce un calo repentino dei livelli plasmatici di progesterone provocando rapida luteolisi. Allo stesso modo la somministrazione di antagonisti del GnRH nella fase luteale determina calo della produzione di progesterone, mentre la contemporanea somministrazione di HCG o HMG, consente il mantenimento della funzione luteale pure in assenza di gonadotropine endogene. Inoltre nel 1988 Veldhuis e coll. hanno dimostrato nella donna l’esistenza di una stretta correlazione tra picchi di LH e progesterone: un picco di LH precede di 10 minuti quello di progesterone.
- Bioactivity of gonadotropins. Endocrinol Metab Clin North Am 1991 Mar;20(1):85-120.
- Differential regulation of two forms of gonadotropin-releasing hormone messenger ribonucleic acid by gonadotropins in human immortalized ovarian surface epithelium and ovarian cancer cells.
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Hillier, S. Gonadotropic control of ovarian follicular growth and development. Mol. Cell. Endocrinol. 179, 39–46 (2001).
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Edwards, H. V., Christian, F. & Baillie, G. S. cAMP: Novel concepts in compartmentalised signalling. Semin. Cell Dev. Biol. 23, 181–190 (2012).
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Ezcurra, D. et al. A review of luteinising hormone and human chorionic gonadotropin when used in assisted reproductive technology. Reprod. Biol. Endocrinol. 12, 95 (2014).
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Smitz, J., Wolfenson, C., Chappel, S. & Ruman, J. Follicle-Stimulating Hormone: A Review of Form and Function in the Treatment of Infertility. Reprod. Sci. 23, 706–716 (2016).
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Mazina, O., Luik, T., Kopanchuk, S., Salumets, A. & Rinken, A. Characterization of the Biological Activities of Human Luteinizing Hormone and Chorionic Gonadotropin by a Förster Resonance Energy Transfer-Based Biosensor Assay. Anal. Lett. 48, 2799–2809 (2015).
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Havelock, J. C., Rainey, W. E. & Carr, B. R. Ovarian granulosa cell lines. Mol. Cell. Endocrinol. 228, 67–78 (2004).
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Jiang, X. et al. Structural predictions for the ligand-binding region of glycoprotein hormone receptors and the nature of hormone–receptor interactions. Structure 3, 1341–1353 (1995).
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Montaner A.D. Mongiat L. Lux-Lantos V.A.R. Park M.K. Fischer W.H. Craig A.G. Rivier J.E. Lescheid D. Lovejoy D. Libertun C. Sherwood N.M. Somoza G.M.: Structure and Biological Activity of Gonadotropin-Releasing Hormone Isoforms Isolated from Rat and Hamster Brains. Neuroendocrinology 2001;74:202–212
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Fink G: Gonadotropin secretion and its control; in Knobil E, Neill J (eds): The Physiology of Reproduction. New York, Raven Press, 1998, pp 1349–1377.
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Muske LE: Ontogeny, phylogeny and neuroanatomical organization of multiple molecular forms of GnRH; in Parhar IS, Sakuma Y (eds): GnRH Neurons. Gene to Behavior. Tokyo, Brain Shupan, 1997, pp 145–180.
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Was ich selbst für Ernährungsumstellungen liebe, sind
frostige Wannen!
Ich kenne nur wenige Tipps, welche einen so starken Effekt auf die Geschwindigkeit des Stoffwechsels haben. Das Alles fühlt
sich so an, als ob man erneut geboren wird. Mich brachte dies dauernd in Trainingseifer.
Das ist noch nicht alles, zufolge jüngster Studien, fördert man durch kühle Bäder eine Umwandlung von hellem in braunes Fettzellengewebe!
Dieses Gewebe hat Mitochondrien, das wieder impliziert, dass von selbst schon Kcal.
verbrannt werden. Stichwort Thermogenese. Ein schöner Folgeeffekt, nicht wahr?
🙂
Beste Grüße
Erik