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Brain and Nerve No to Shinkei Volume 43, Issue 7 （July 1991）

Brain and Nerve 脳と神経 43巻7号（1991年7月発行）

Japanese English

原著

ヒト下垂体腺腫の成長ホルモンおよびプロラクチン分泌に及ぼすCa拮抗剤Nicardipineの影響について Effect of Calcium Channel Antagonist (Nicardipine) on Growth Hormone and Prolactin Secretion in Pituitary Adenomas 兜正則 ¹ , 林實 ¹ , 久保田紀彦 ¹ , 古林秀則 ¹ , 中川敬夫 ¹ , 勝村浩敏 ¹ , 細谷和生 ¹ Masanori Kabuto ¹ , Minoru Hayashi ¹ , Toshihiko Kubota ¹ , Hidenori Kobayashi ¹ , Takao Nakagawa ¹ , Hirotoshi Katsumura ¹ , Kazuo Hosotani ¹ ¹福井医科大学脳神経外科 ¹Department of Neurosurgery, Fukui Medical School キーワード： nicardipine , Ca channel antagonist , growth hormone , prolactin , pituitary adenoma Keyword: nicardipine , Ca channel antagonist , growth hormone , prolactin , pituitary adenoma pp.637-643

発行日 1991年7月1日 Published Date 1991/7/1

DOI https://doi.org/10.11477/mf.1406900219

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Abstract 文献概要
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　脳血流改善剤や降圧剤として広く用いられているCa拮抗剤Nicardipine（Nc）がヒト下垂体腺腫のGHとPRL分泌に及ぼす影響をin vivoおよびin vitroで検討した。対象は末端肥大症6例とprolactinoma2例でNc 40mg単独，bromocriptine（Br）2.5mg単独，Nc 40mgとBr 2.5mg併用の3通りの方法で内服後12時間後まで経時的に採血を行った。In vitroではNc 20ng／ml又は200ng／ml単独，Br 200ng／ml単独，Nc 200ng／mlとBr 200ng／ml併用添加の各群につき培養を行い経時的に培地中のホルモン値の変化を調べた。末端肥大症6例中基礎値の比較的高い3例にin vivoおよびin vitro共にGH分泌の抑制を認め，この疾患に対するNcの有用性が示唆された。Prolactinoma例ではin vitroでPRL分泌抑制を認めたが，invivoでは抗ドーパミン作用のためにPRL分泌を亢進させる可能性が示唆された。又BrとNcを併用した場合，BrのGHやPRLに対する分泌抑制効果が減弱される可能性も示唆された。

This study was designed to investigate the effect of calcium channel antagonist (nicardipine) on basal and bromocriptine-inhibited GH or PRL secretion in eight patients with pituitary adenomas (six GH producing adenomas and two prolactinomas) . GH or PRL was measured in blood collected at intervals for 12 hours after oral admin-istration of nicardipine (Nc) (40mg) and/or bromo-criptine (Br) (2.5mg) in each case. In vitro, pitui-tary adenoma cells were incubated in media containing Nc (200ng/ml) and/or Br (200ng/ml) over a 72-h period, and then in drugs-free media for three days. Media were collected at 24-h intervals and assayed for GH or PRL. In three of six GH producing pituitary adenomas, GH secretion was inhibited by Nc both in vivo and in vdtro. In prolactinomas, PRL secretion was inhibited by Nc in vitro, but in vivo, an increase of plasma PRL levels was observed after Nc administration in one of two cases. In two acromegalic patients and one patient with prolactinoma, Nc reduced the suppres-sion of GH or PRL secretion induced by Br.

These findings indicate that influx of extracellularcalcium plays an important part in both GH and PRL secretion in functioning pituitary adenomas, and that Nc effects on GH and PRL secretion in pituitary adenomas by blocking of influx of calcium and/or antidopaminergic action. It is consideredthat the combined administration of calcium chan-nel antagonist (Nc) and Br for acromegalic patients and administration of Nc for patients with prolactinomas should be avoided.