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Laboratoire de Neuroendocrinologie Experimentale (N.B., V.G., C.F., N.S., C.O., A.D.), INSERM U297, Institut Fédératif Jean Roche, 13916 Marseille Cedex 20 France; Service dEndocrinologie, Maladies Métaboliques et de la Nutrition (V.G., C.F., C.O., A.D), Hôpital Nord, Chemin des Bourrely 13915 Marseille Cedex 20 France; Departamentes de Phisiologia Anatomia y Produccìon Animal (M.R-G.), Facultad Veterinaria, Campus Universitario, 27002 Lugo Spain
Address all correspondence and requests for reprints to: C. Oliver, Laboratoire de Neuroendocrinologie Expérimentale, INSERM U297, Institut Fédératif Jean Roche, Bvd P. Dramard, 13916 Marseille Cedex 20, France.
| Abstract |
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Endotoxin induced a sustained increase of GH (x6.2 ± 1.3) in intact rams. This stimulation was delayed and less marked when compared with the hypothalamic-pituitary-adrenal axis. Surprisingly, the GH increase was associated with an important rise of jugular (x10.6 ± 2.4) and portal (x7.9 ± 3) SRIH levels, without a significant GHRH increase. To determine if the portal SRIH increase was a consequence of an increased short feedback of GH, we studied GH response to endotoxin after a previous GHRH injection to deplete the pituitary pools of GH. In that case, despite the absence of increase of GH after endotoxin treatment, SRIH levels was markedly increased. For the first time we have observed an experimental situation in sheep with a simultaneous and closed amplitude increase in jugular and portal SRIH. The source of jugular SRIH is likely the gastrointestinal tract and the increased jugular SRIH release in systemic circulation might be in part responsible for the increase of hypophysial portal SRIH.
Ultimately our results show that endotoxin induced a complex reaction at multiple levels with a specific increase in both portal and peripheral SRIH levels. The surprising association of a lack of change in GHRH release and an increased secretion of SRIH with the increase of GH suggests that the effect of endotoxin on GH axis is mainly a pituitary one. The selective blockade of somatostatin should be useful for a better knowledge of the role of SRIH stimulation in the physiopathology of septic shock.
| Introduction |
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(TNF
), interleukin 1
(IL-1), and interleukin 6 (IL-6). In turn, endotoxin together with
circulating cytokines stimulates prostaglandin E2 (PGE-2) and
interleukin production by various tissues including the hypothalamus
and the pituitary gland; its action is mediated, at least in part, via
CD14, an endotoxin receptor, which has been identified in monocytes,
serum (as a soluble form) as well as in brain and in pituitary (2, 3).
Changes in the secretion of several hormones have also been observed
(4). Several teams have observed that hormonal changes induced by LPS
are important and occur at multiple levels. Indeed, LPS increases
activity of the hypothalamic-pituitary-adrenal (HPA) axis (5, 6, 7) and
decreases TSH (8) and LH (9, 10, 11) secretion. The activation of the
pituitary adrenal axis after endotoxin injection is associated with an
increased release of both corticotropin releasing hormone (CRH) and
arginine vasopressin (AVP) secretion into hypophysial portal blood (7).
The gonadal effect of endotoxin and interleukins occurs also at
multiple levels (hypothalamic, pituitary and gonadal), the dramatic
decrease of LH being associated with a decrease of GnRH gene expression
(12, 13). Communications between the immune and endocrine systems are
bi-directional and the hormonal changes induced by endotoxin or
cytokines can act on the immune system.
The somatotropic axis is also involved in the reaction to
endotoxin or cytokines administration. Indeed, GH and insulin-like
growth factor I (IGF-1) have been identified in immune competent cells
with immunomodulatory properties (14). The administration of endotoxin
induces species-dependent effects on GH secretion: indeed, it increases
GH secretion in humans (15, 16) and in sheep (17) but decreases it in
rats (18) and cattle (19). The mechanisms of action of endotoxin are
not clearly understood. The action of endotoxin may be exerted directly
at the level of the pituitary gland or indirectly at the level of one
or both hypothalamic neurohormones GH-releasing hormone (GHRH) and
somatostatin (SRIH), which act respectively as stimulator or inhibitor
of GH secretion. In vitro, endotoxin increases basal GH
release from dispersed sheep anterior pituitary cells in a time- and
dose-dependent manner (17, 20). Moreover, TNF
in sheep (21) and IL-6
in rats (22) have been shown to act on GH secretion directly at the
pituitary level. However, the direct effect of IL-1 on GH secretion
from the pituitary gland is unclear with contradictory reports
(23, 24, 25). The action of IL-1 at the level of the hypothalamus has been
tested in rats. IL-1 stimulates GHRH and SRIH release from hypothalamic
explants (26). Furthermore in rats, the increase of GH induced by the
intracerebroventricular inject 10 ng of IL-1 is abolished by the
immunoneutralisation of GHRH (27).
There are experimental limitations in rodent models and growing interest in a clinical relevant animal model, such as the sheep, for GH regulation (28). In this animal, it is possible to collect hypophysial portal blood (HPB) and quantify the secretion of neurohormones into HPB under physiological conditions. The purpose of this study was to determine the effects of an acute iv administration of endotoxin on jugular GH, portal GHRH, and jugular and portal SRIH plasma levels in intact rams chronically implanted with perihypophysial cannulae.
| Materials and Methods |
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Experimental procedures
Three sets of experiments were carried out successively. For
each experiment, endotoxin (Escherichia coli 055: B5: Sigma,
St. Louis, MO) was reconstituted in PBS with 0.1% BSA to a stock
concentration of 0.1 µg/µl. Body temperature was recorded
regularly.
Exp 1. The aim of this experiment was to study the effect of endotoxin on plasma GH levels in intact rams and to compare the chronology of GH changes with those of several components of the hypothalamic-pituitary adrenal (HPA) axis. The animals (n = 6) were housed in individual pens placed immediately adjacent to each other. They were free to sit or to stand, exposed to natural lighting conditions and allowed free access to food and water. An indwelling catheter was inserted into the external jugular vein. On the following day, endotoxin was administered by an iv bolus injection (400 ng/kg) in 2 ml of saline through the jugular cannula, followed by 5 ml of saline as previously described (16). Jugular blood was collected every 15 min during the 2-h period preceding endotoxin injection and during the subsequent 7 h. Blood samples were immediately centrifuged at 4 C for 10 min and the resulting plasma was stored at -20 C until assayed for GH, ACTH, cortisol, and AVP.
Exp 2. The aim of this experiment was to determine the effects of an acute iv endotoxin administration on jugular GH, portal GHRH, and jugular and portal SRIH plasma levels in intact rams chronically implanted with perihypophysial cannulae. Fifteen days before the experiment, four rams were anesthetized and prepared for portal blood sampling under general anesthesia, as previously described (29, 30). A twin cannula was implanted through the transnasal route in front of the long portal vessels, above the anterior pituitary gland. After 14 days, two catheters were inserted in each jugular vein, one catheter for injection of heparin and endotoxin, the other one for collection of peripheral blood. Two animals were placed side to side in two small pens. One day later, heparin (an initial dose of 25,000 IU followed by 5,000 IU every 30 min) was injected and at 0600 h, a needle was inserted into the upper cannula to create a lesion of the hypophysial portal vessels. The resulting portal blood was collected through the lower cannula.
Animals were injected with endotoxin (200 ng/kg) as described above. Portal and jugular blood was collected every 15 min during the 2-h period preceding endotoxin injection and during the subsequent 9 h. Samples were handled as described in Exp 1 until assayed for GH, SRIH, and GHRH.
Exp 3. The aim of this experiment was to determine if the increase of SRIH after endotoxin was due to an increased short feedback of GH on the hypothalamus. Four rams were prepared for portal blood sampling as described above. Two hours after the beginning of the experiment hGHRH(144)NH2 (1 µg/kg bw) (Sanofi, Toulouse, France) was administered by iv bolus injection to deplete the intracellular pool of GH and block the GH response to endotoxin. Three hours after hGHRH injection, endotoxin (200 ng/kg) was administered iv as a bolus. Jugular and portal blood were collected every 15 min for 7 h. Samples were handled as described in Exp 1 until assayed for peripheral GH and peripheral and portal SRIH.
Hormone assays
The GH RIA was performed in duplicate using reagents provided by
NIADDK, Hormone Distribution Program (Bethesda, MD). oGH-14 was used
as standard and the least detectable concentration of GH was 0.5 ng/ml
plasma: the intra and interassay coefficients of variation (CV) were 7
and 11%, respectively.
Before GHRH and SRIH RIA, peptides were extracted from plasma with 2 vol acetone/20 mM HCl. The SRIH RIA was performed in duplicate in portal and jugular plasma extracts using [125I]-Tyr-somatostatin as radioligand. The antiserum (no. 2044) was a gift from Dr. C. Rougeot (INSERM U207, Paris, France). The intra and interassay CV were 8 and 10%, respectively, and the least detectable concentration was 5 pg/ml plasma. The GHRH RIA was performed in duplicate in portal plasma extracts. oGHRH (Peninsula, St. Helens, Meseyside, UK), labeled with I125 using the lactoperoxydase method, served as radioligand. Antiserum was raised in our laboratory by immunization of rabbits against oGHRH coupled to BSA with glutaraldehyde. Intra and interassay CV were 9 and 11%, respectively, and the least detectable concentration of oGHRH was 10 pg/ml plasma. Both assays have been previously described (31).
Cortisol, ACTH, and AVP levels were measured in extracted plasma according to RIA methods previously described (32). The intraassay coefficients of variations within the measurement range of each assay were: cortisol 4.7%, ACTH 5%, AVP 5.5%. The limits of detection of the assays were 0.5 ng/ml plasma for cortisol, 10 pg/ml plasma for ACTH, 5 pg/ml plasma for AVP.
Statistical analysis
All data are reported as the mean ± SEM. In
Exp 2, mean plasma GH, GHRH, and SRIH values were calculated during
each 60-min period. In Exp 3, the mean plasma hormone concentrations
were calculated for the period of basal secretion (2 h) the period
following GHRH iv injection (2 h) the period of return to GH basal
secretion (1 h), and the period following endotoxin administration (2
h). All statistical analysis were performed using one-way ANOVA for
repeated measures followed by Fishers test (with computer program:
Statview 512, Brain Power, Inc., Calabasas, CA). P <
0.05 was considered significant.
| Results |
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Exp 1: effect of endotoxin administration on jugular plasma levels
of GH, ACTH, AVP, and cortisol
Endotoxin increased plasma GH concentration significantly
(x5.9 ± 2.3) (P < 0.01) (Fig. 1
). This sustained rise in GH
concentration peaked 60 min after endotoxin administration. The
hypothalamic-pituitary-adrenal axis was also rapidly and significantly
activated (Fig. 1
). This activation occurred earlier and was much more
marked than that of GH. Mean plasma ACTH and cortisol levels increased
30 min after endotoxin administration with a maximum during the second
hour (x21.4 ± 6.8 for ACTH and x8 ± 1.9 for cortisol).
They remained high during the first 5 (ACTH) and 6 (cortisol) h.
Jugular AVP levels increased 30 min and peaked 45 min after endotoxin
administration (x10.6 ± 3.1); this increase was rapid and
transient, lasting for only 2 h.
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| Discussion |
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Surprisingly, in our experiment, the increase of GH was associated with an important rise of SRIH without a significant increase of GHRH. Our results concerning GHRH are different from the results obtained in rats. No study on GHRH secretion in portal blood has been performed in rats, but the in vitro results have shown an increase of GHRH release from hypothalamic explants (26) induced by IL-1ß. Furthermore, LPS induced an increase in GHRH release from mediobasal hypothalamus that was abolished by CRH antagonist and an interleukin receptor antagonist protein (IRAP) (34). The difference between rats and sheep may be due to the difference of approach, studies in vitro in rats and in vivo in sheep, or to the species difference.
For the first time, we report that endotoxin induces marked and significant rise in both hypophysial portal and peripheral SRIH levels. This increase in portal SRIH is in agreement with a series of in vitro results obtained in rats (26, 34, 35). For instance, IL-1 stimulates SRIH release from acute hypothalamic explants and from diencephalic fetal cells in vitro (26, 34). On the other hand, the effect of IL-1 on SRIH release from mediobasal hypothalamic (MBH) explants is controversial (34, 35) But, in rats, the increase of SRIH has been correlated with a decrease of GH, the suppression of GH secretion by endotoxin being reversed by a pretreatment with an antiserum antisomatostatin (18). In sheep, no results are available on SRIH and GHRH regulation by endotoxin. It has just been shown that endotoxin induced IL-1 gene expression in choroid plexus (36).
The origin of portal SRIH remained to be determined. LPS could, directly or through the stimulation of cytokines synthesis, stimulate SRIH secretion by neurons of the periventricular nucleus (PeV) as shown in rats (26, 35). This effect might be subsequent to or only amplified by the activation of neurons synthesizing CRH. CRH has been shown to stimulate the release of SRIH in vitro (37, 38) and in vivo (39) (increasing SRIH secretion into hypophysial portal blood). To determine if the portal SRIH increase is a consequence of an increased short feedback of GH, we studied the GH response to endotoxin animal whose GH pituitary pool has been depleted by a previous GHRH injection. Under that condition, despite the absence of increase of GH, SRIH levels were markedly increased after endotoxin treatment. Alternately, the increased levels of SRIH in HPB may simply reflect the contribution of peripheral SRIH to the level of SRIH in the hypothalamic-pituitary vasculature. So far, the rate of transfer of SRIH from peripheral circulation to long hypophysial portal has not been investigated.
For the first time, we have observed an experimental situation in sheep
with a simultaneous and closed amplitude increase in jugular and portal
SRIH levels. During another stressful conditions (a 5-min isolation
contention), we have also observed an increase in portal SRIH levels,
but no change in jugular SRIH was evidenced (40). An important
peripheral SRIH increase has also been demonstrated in rats after
endotoxin treatment (41) and in human during septic shock (Chayvialle,
personal communication). In pigs, it has been shown that the increase
of somatostatin was much higher in the abdominal portal vein than in
the aorta or the internal jugular vein throughout the endotoxin
infusion period (42). Peripheral SRIH probably arises mainly from the
gastrointestinal tract as Taborsky and Ensinck (43) have shown that, in
dogs, the pancreas is a minor source of circulating SRIH even when the
D pancreatic cells are stimulated. Moreover, in dogs, TNF
has been
shown to regulate somatostatin release from cultured fundic D cells
(44). It has been hypothesized that peripheral somatostatin plays in
rats an important role in the regulation of glucose levels during
endotoxicosis (41). It is well known that somatostatin induces a
decrease in intestinal blood flow, capillary surface area, and
intestinal consumption. Acting on smooth muscle of both arterioles and
precapillary sphincters, it induces a potent vasoconstriction in the
intestinal microcirculation (45, 46). During septic shock, severe
evolution is associated with metabolic abnormalities, cardiovascular
dysfunction, and multiple organ failure mainly related to ischaemia in
part due to alterations in regional microcirculatory blood flow (47, 48). The gastrointestinal somatostatin rise could be a worsening factor
in the evolution of multiple organ failure during septic shock.
The surprising association of a lack of change in GHRH release and an increased secretion of SRIH with the increase of GH suggests that the effect of endotoxin on GH axis is mainly a pituitary one. In rats, a discordant effect of endotoxin at hypothalamic and pituitary levels has also be found: endotoxin induces an increase of GHRH secretion from hypothalamic explants (results obtained in vitro) contrasting with the in vivo decrease of GH. The important effect at the pituitary level has previously been shown in vitro. Indeed, Coleman et al. (17, 20) have shown that endotoxin stimulates GH release directly from ovine pituitary cultured cells. This increase of GH secretion is associated with an increased GH mRNA content and this effect is mediated through the lipooxygenase pathway.
The administration of LPS induces complex and multiple-step changes in
the organism including a stimulation of cytokines release from
peripheral macrophages, particularly a rapid increase of TNF
, IL-1,
and IL-6. LPS and peripheral cytokines stimulate PGE-2 production by
the central vasculature and regulate hypothalamic neurons (49). LPS as
well as circulating cytokines stimulate both synthesis and secretion of
pituitary IL-6 as well as they increase the expression of pituitary
IL-1ß and binding sites for cytokines. The effect of cytokines on
pituitary cells has been extensively studied. In ovine pituitary cells,
Nash et al. (21) have shown that TNF
increase both IL-6
and GH mRNA level, suggesting a paracrine/autocrine role for IL-6 in GH
regulation. In rats, IL-6 stimulates GH release together with PRL and
LH release from anterior pituitary cells (22). Furthermore, Il-1
receptors have been identified in rat pituitary and mainly on
somatotrophs (50, 51). Moreover, endotoxin can have a physiological
effect on pituitary cells since Abraham et al. (3) have
established the presence of CD14 in cultured pig anterior pituitary
cells.
In addition, LPS may increase the number of receptors for GHRH (GHRH-R) at the pituitary level. This effect may be secondary to the increased stimulation of the HPA axis. Indeed, glucocorticoids act directly at the pituitary level as potent stimulators of GHRH-R gene expression inducing a 5.6 ± 0.7-fold increase in GHRH-R mRNA levels (52). Finally, LPS could act on an unknown hypothalamic factor acting as a GH secretagogue. This factor might bind to the new GH-RP receptor that has been recently identified in hypothalamus and pituitary (53). It could explain the effect of endotoxin on GH without increase in GHRH secretion.
To better understand the mechanism of the prolonged effect of endotoxin
on GH in sheep, it would be of interest to study its effect on GH
receptor (GH-R) as well as on IGF-1 and insulin-like growth
factor-binding protein (IGF-BP) levels. Indeed, a decrease of IGF-1
could explain the sustained effect of endotoxin on GH. In addition in
rats, IL-1ß and TNF
to a lesser extent blunt the IGF-1 mRNA
response to GH in hepatocyte primary culture. IL-1ß decreases GH-R
and GH-binding protein (GH-BP) mRNA levels (54, 55). Similarly, in
steers, a reduction in plasma IGF-1 and IGF-BP2 within the first
24 h after endotoxin administration was found (56).
Ultimately, our results show that endotoxin induces a complex reaction at multiple levels with a specific increase in both portal and peripheral SRIH levels. The selective blockade of somatostatin should be useful for a better knowledge of the role of SRIH in the physiopathology of septic shock.
| Acknowledgments |
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| Footnotes |
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Received December 1, 1997.
| References |
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on growth hormone and interleukin 6 mRNA in ovine
pituitary cells. Mol Cel Endocrinol 84:3137
and
interleukin-8 on somatostatin release from canine fundic D cells.
Gastroenterology 112:136143[CrossRef][Medline]
of the insulin-like
growth factor I messenger ribonucleic acid response to growth hormone
in rat hepatocyte primary culture. Endocrinology 138:10781084
inhibit growth hormone stimulation of insulin-like growth factor I
synthesis and growth hormone receptor mRNA levels in cultured rat liver
cells. Eur J Endocrinol 135:729737This article has been cited by other articles:
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