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Endocrinology Vol. 142, No. 5 1915-1922
Copyright © 2001 by The Endocrine Society


ARTICLES

Endotoxin Inhibits Pituitary Responsiveness to Gonadotropin-Releasing Hormone1

Candace Y. Williams, Thomas G. Harris, Deborah F. Battaglia, Catherine Viguié2 and Fred J. Karsch

Reproductive Sciences Program and Department of Physiology, University of Michigan, Ann Arbor, Michigan 48109

Address all correspondence and requests for reprints to: Dr. F. J. Karsch, Reproductive Science Program, University of Michigan, 300 North Ingalls Building, Room 1101 SW, Ann Arbor, Michigan 48109-0404. E-mail: fjkarsch{at}umich.edu


    Abstract
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Immune/inflammatory challenges powerfully suppress reproductive neuroendocrine activity. This inhibition is generally considered to be centrally mediated via mechanisms that regulate GnRH secretion. The present study provides two lines of evidence that bacterial endotoxin, a commonly used model of immune/inflammatory challenge, also acts to inhibit pituitary responsiveness to GnRH. In the first experiment, pulsatile secretion of GnRH into pituitary portal blood and LH into peripheral blood were monitored in ovariectomized ewes treated with a low dose of endotoxin. Although this treatment only marginally suppressed GnRH pulsatile secretion, it markedly disrupted LH pulsatility. In extreme cases, the low dose of endotoxin blocked LH pulses without inhibiting endogenous GnRH pulses, thereby uncoupling GnRH and LH pulsatile suppression. In the second experiment, we tested the hypothesis that endotoxin inhibits pituitary responsiveness to exogenous GnRH pulses. Hourly pulses of GnRH were delivered to ovariectomized ewes in which endogenous GnRH secretion was blocked. Endotoxin suppressed the amplitude of GnRH-induced LH pulses. Together, these observations support the conclusion that endotoxin inhibits pituitary responsiveness to GnRH.


    Introduction
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
AN IMMUNE/INFLAMMATORY challenge, such as that associated with bacterial infection, impairs reproductive neuroendocrine function and disrupts ovarian cyclicity (1, 2, 3, 4, 5, 6). Endotoxin or lipopolysaccharide (LPS) is a commonly used model of immune/inflammatory challenge that consists of the toxic component of Gram-negative bacteria. When administered peripherally, endotoxin activates a cascade of cytokines and prostaglandins (PGs), as well as other mediators that induce a host of pathophysiological responses. Such responses include the induction of fever, activation of the neuroendocrine stress axis, and inhibition of the neuroendocrine reproductive axis (1, 2, 3, 4, 5, 6, 7, 8, 9).

An immune/inflammatory challenge could suppress reproductive neuroendocrine activity either by inhibiting GnRH release from the hypothalamus and/or by inhibiting pituitary responsiveness to the GnRH stimulus. Most prior work has focused on the hypothalamus as the site of reproductive neuroendocrine inhibition. Observations in a wide variety of species indicate that endotoxin or various intermediary cytokines such as interleukin-1 (IL-1) or tumor necrosis factor-{alpha} (TNF{alpha}), can inhibit both the pulsatile and surge modes of GnRH secretion (2, 3, 6, 10, 11, 12, 13, 14, 15). For example, systemic endotoxin suppresses pulsatile GnRH secretion into pituitary portal blood of ovariectomized ewes (2), and central delivery of IL-1 inhibits GnRH release and Fos expression in GnRH neurons at the time of the preovulatory LH surge of rats (15).

Surprisingly little research has focused on an effect of immune/inflammatory challenge at the level of the pituitary despite knowledge that various inhibitors of reproductive neuroendocrine function can act at this level (gonadal steroids, stress hormones, etc.). An initial study in the rat suggests that central administration of IL-1 may not impair pituitary responsiveness to GnRH (16). More recent work, however, has shown that systemic endotoxin does inhibit the expression of GnRH receptor messenger RNA in the anterior pituitary gland of the rat (17). The latter observation encourages further work to assess the impact of immune/inflammatory challenge on pituitary responsiveness to GnRH.

During the course of examining the suppressive effects of endotoxin on GnRH secretion into pituitary portal blood of the ewe, we observed an unexpected uncoupling between GnRH and LH pulses after endotoxin treatment. In extreme cases, LH pulses were eliminated, whereas GnRH pulses showed either slight or no inhibition. This provided circumstantial evidence that endotoxin may inhibit pituitary responsiveness to GnRH. In this report we first describe this uncoupling of GnRH and LH pulse suppression. Next, we present follow-up experiments performed to test the hypothesis that endotoxin inhibits pituitary responsiveness to GnRH.


    Materials and Methods
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Experiments were conducted on adult Suffolk ewes maintained outdoors at the Sheep Research Facility near Ann Arbor, MI. Ewes were fed hay and grass pellets and had free access to water and mineral licks. During the experiment, animals were housed indoors in a calm environment. To ensure that the observed alterations in GnRH and/or LH pulse patterns did not result from changes in ovarian steroid secretion, all ewes were ovariectomized. Endotoxin (Escherichia coli LPS 05:B55, Sigma, St. Louis, MO) was administered by iv bolus. Peripheral blood was obtained via an indwelling jugular catheter installed 1 day before sampling. Surgeries were performed aseptically under general anesthesia. All procedures were approved by the Committee for the Use and Care of Animals at the University of Michigan.

Exp 1: effect of endotoxin on endogenous GnRH and LH pulsatility
This experiment was conducted during the mid to late breeding season (November 1997 to January 1998) on 16 ewes ovariectomized 5–7 months previously. Ewes were surgically fitted with an apparatus for hypophyseal portal blood collection 2–4 weeks before sampling. The surgical preparation and procedure for remote automated sampling of hypophyseal portal blood have been described by Caraty (18). This procedure enables sampling of portal blood from conscious, physiologically noncompromised ewes. Portal blood for assay of GnRH was drawn continuously from 4 h before to 10 h after endotoxin and dispensed as 10-min fractions into 0.5 ml ice-cold bacitracin (3 x 10-3 M). Samples of jugular blood were obtained continuously and separated into 5- or 10-min fractions for assay of LH and cortisol. Endotoxin was injected at a dose of 40 ng/kg. This dose is 10-fold less than that which we use routinely to demonstrate profound suppression of GnRH and LH pulsatility (2, 19); it is close to the threshold for suppressing pulsatile LH secretion in ovariectomized ewes (Armstrong, S., and F. J. Karsch, unpublished observations). For injection, endotoxin was dissolved as 10 µg/ml in sterile saline on the day of the experiment, vortexed vigorously, and diluted 1:10 to provide the 40 ng/kg dose. After sample collection, ewes were killed with a barbiturate overdose (Beuthanasia, Schering Plough Animal Health Corp., Kenilworth, NJ), and the pituitary was inspected to confirm appropriate placement of the cut for sampling portal blood.

Exp 2: effect of endotoxin on pituitary responsiveness to exogenous GnRH
In this experiment we used a model in which endogenous GnRH pulses were blocked in ovariectomized ewes. Blockade of GnRH pulses was achieved by delivery of ovarian steroids to produce a midluteal phase serum level of either progesterone (Run 1) or estradiol (Run 2) during the anestrous season. These treatments were previously found to eliminate endogenous GnRH pulsatility (20, 21, 22). For the purpose of this study, this steroid-block model was preferable to one involving surgical ablation of GnRH secretion (e.g. hypothalamo-pituitary disconnection or hypothalamic lesion). The latter approach would compromise other hypothalamic functions, such as stress axis activation, which might directly or indirectly influence gonadotropin secretion after endotoxin treatment. The experiment was conducted in two runs during the anestrous season (May–July of 1998 and 1999). Both runs were conducted as a cross-over design in which each ewe acted as her own control. The design of both runs is illustrated in Fig. 1Go.



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Figure 1. Design of Exp 2, Run 1 (top) and Run 2 (bottom). Small arrowheads depict exogenous GnRH pulses delivered hourly by iv injection (Run 1) or infusion (Run 2). Large arrowheads designate treatment with endotoxin or saline and, in Run 2, with flurbiprofen (Fb) or its vehicle (V). Shaded boxes in bottom panel indicate when jugular blood samples were taken to measure plasma GnRH concentration. See Materials and Methods for further details.

 
Run 1 (Fig. 1Go, top). Seven anestrous ewes were ovariectomized and immediately treated sc with a 5-mm SILASTIC brand (Dow Corning Corp., Midland, MI) estradiol implant (22, 23) to maintain responsiveness to progesterone (24, 25). After 9 days, the estradiol implant was removed, and each ewe was treated with progesterone intravaginally (Controlled Internal Drug Release Device, InterAg, Hamilton, NZ; two devices per ewe). This treatment restored a midluteal phase concentration of serum progesterone (4–6 ng/ml) (26). After 4 days of progesterone, hourly boluses of GnRH (5 ng/kg, iv) were initiated. For delivery, a 250 ng/ml solution of GnRH (Sigma) was prepared by diluting a stock solution (100 µg/ml) with sterile saline containing 0.1% BSA. Prior studies indicate the 5 ng/kg GnRH dose creates artificial GnRH pulses that have amplitudes within the range of endogenous GnRH pulses in ovariectomized ewes (21). After a 12-h priming period to stabilize pituitary response to the hourly GnRH pulses, jugular blood was sampled at 10-min intervals for 15 h to assess LH release (Fig. 1Go, open bar). After a 5-h control period, endotoxin (400 ng/kg dissolved as 10 µg/ml in sterile saline) or vehicle was injected iv. This is the dose of endotoxin we routinely use for reliable suppression of both GnRH and LH pulses in ovariectomized ewes (2, 19). It causes pathophysiological symptoms such as fever, lethargy, occasional diarrhea, and shivering. The efficacy of the endotoxin challenge was confirmed by serum cortisol and rectal temperature responses monitored at 30- and 60-min intervals, respectively. After completion of sampling, the progesterone-releasing devices were removed, and the estradiol implant was reinserted sc for 9 days to maintain responsiveness to progesterone negative feedback. Two weeks later, the second part of this cross-over experiment was conducted with the endotoxin and saline treatments reversed, such that all seven ewes received both endotoxin and vehicle.

Run 2 (Fig. 1Go, bottom). Run 1 suggested that endotoxin inhibits pituitary responsiveness to GnRH. The results, however, were not definitive because the progesterone treatment failed to produce the expected complete blockade of endogenous GnRH/LH pulsatility in some ewes. Further, in some ewes receiving saline instead of endotoxin, responses to the hourly GnRH injections tended to increase gradually during the 15-h observation period. This suggested the 12-h priming period might have been insufficient to stabilize pituitary responsiveness to the exogenous GnRH pulses. The second run of the experiment was thus modified in two ways: the priming period was extended to 4 days, and estradiol, rather than progesterone, was used to block endogenous GnRH pulses. Estradiol is an extremely potent inhibitor of pulsatile GnRH secretion in the anestrous ewe (22). In addition, the goal of Run 2 was expanded to determine whether endotoxin inhibits pituitary responsiveness to GnRH via a PG-dependent mechanism. This was prompted by recent evidence that PGs mediate the suppressive effects of endotoxin on pulsatile GnRH and LH secretion in the ewe (19).

Run 2 was conducted on eight ewes ovariectomized 12 months previously. Before the study, each ewe received a 3-cm estradiol implant that maintains a luteal phase concentration of circulating estradiol (~2 pg/ml) (25). A cannula was inserted into each jugular vein, one for GnRH delivery and one for blood collection. GnRH (5 ng/kg, 3-ml injection volume, fresh solution prepared daily) was administered hourly as 6-min pulses using an infusion pump (MiniPuls 2, Gilson, Middletown, WI) controlled by an electronic timer (model 622–7, Fisher Scientific, Pittsburgh, PA). After a 4-day priming period, endotoxin or saline vehicle was delivered as an iv bolus (400 ng/kg, 0 h in Fig. 1Go). In addition, each ewe received flurbiprofen (2 mg/kg, iv; ~1.0-ml injection volume; Sigma) or its vehicle (95% ethanol) 30 min before endotoxin (or saline) and again 5 h later. Flurbiprofen inhibits the cyclooxygenase-1 and -2 enzymes required for PG synthesis (27). The dose selected was previously found to reverse the inhibition of pulsatile GnRH and LH secretion in ovariectomized ewes and to block endotoxin-induced fever (19), which is a PG-dependent response (28, 29).

Run 2 was conducted as a cross-over experiment in which each ewe received three treatments: 1) vehicle for both endotoxin and flurbiprofen (control), 2) endotoxin plus vehicle for flurbiprofen, 3) endotoxin plus flurbiprofen. [Note, flurbiprofen alone was not given as this treatment does not affect LH pulses in ovariectomized ewes (19).] Blood was sampled at 10-min intervals from 6 h before endotoxin or vehicle until 12.5 h after endotoxin to monitor pituitary responsiveness to GnRH. To quantify the experimentally produced GnRH concentrations, aliquots of the jugular samples surrounding six GnRH pulses (2–4 h before and 4–6 h after endotoxin/vehicle, shaded boxes in Fig. 1Go) during one run of the cross-over experiment were dispensed into bacitracin and frozen for subsequent GnRH assay. Rectal temperature was taken hourly to assess efficacy of the endotoxin challenge and to confirm that flurbiprofen blocked fever.

Assays
LH was measured in duplicate aliquots of plasma (10–200 µl) using a modification (30) of a previously described RIA (31, 32). Mean intra- and interassay coefficients of variation (33 assays) were 6.5% and 6.9%, respectively, and assay sensitivity for 200 µl averaged 0.8 ng/ml NIH LH-12. For GnRH assay, samples were centrifuged within 1 h of collection to remove cells, and plasma was stored at -80 C until assay. A 750-µl aliquot of sample (~600 µl plasma and 150 µl bacitracin) was extracted in 2 ml methanol. Duplicate aliquots of extract (~240 µl portal plasma) were assayed for GnRH using a previously described RIA (33, 34). In Exp 1, all GnRH values for a given ewe were determined in a single assay; in Exp 2, all GnRH values were determined in one assay. Intraassay variation, assessed as median variance ratio of assay replicates (35), averaged 6.8%, and assay sensitivity was 0.2 pg/tube. Plasma cortisol concentrations were determined in duplicate 50-µl aliquots of unextracted plasma using the Coat-A-Count cortisol assay kit (Diagnostic Products, Los Angeles, CA), validated for use in sheep (2). Modifications of the kit protocol included adding a low point on the standard curve and increasing the incubation time with radioactive tracer to 1 h at 37 C. Mean intra- and interassay coefficients of variation (nine assays) were 5.9% and 6.4%, respectively. Sensitivity averaged 0.8 ng/ml.

Data analysis
In Exp 1, GnRH in pituitary portal blood was assessed as a collection rate (picograms per min) rather than a concentration. This minimizes error due to contamination of portal samples with peripheral blood or cerebrospinal fluid or due to changes in pituitary blood flow. Formal pulse analysis and statistical comparisons were not performed because this was an observational study conducted for another purpose, and controls treated with vehicle instead of endotoxin were not included.

In Exp 2, all exogenous GnRH pulses induced an increase in circulating LH. In Run 1, amplitudes of these LH responses (peak minus preceding nadir) were averaged across three 5-h periods: one preendotoxin/vehicle (-5 to 0 h) and two postendotoxin/vehicle (0–5 and 5–10 h). The percent change in mean amplitude of the LH response between pre- and posttreatment periods was calculated in each ewe for both the endotoxin and vehicle runs of the cross-over study. [The 0–5 h period was removed from the analysis due to a technical problem with the animal model (see Results).] To determine if endotoxin or vehicle altered pituitary responsiveness to GnRH pulses, the percent change in LH pulse amplitude within each ewe (pretreatment value vs. value 5–10 h after endotoxin/vehicle) was compared by paired t test. In Run 2, LH pulse amplitudes during the 18-h experiment were averaged across six 3-h periods: two periods during preendotoxin/vehicle treatment and four periods posttreatment. Next, the percent change across the observational period was calculated by determining the ratio of the mean LH pulse amplitude in the first pretreatment period to that in each subsequent period. These ratios were log transformed and analyzed by repeated measures ANOVA in which both treatment and time were repeated measures. To identify where significant interactions existed among treatments, each treatment was deleted in turn, and the analysis was repeated in a pairwise manner. This determined which treatments differed across time.


    Results
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Exp 1: dissociation of GnRH and LH pulsatile secretion
In 10 of 16 ewes treated with the 40 ng/kg dose of endotoxin, pulsatile GnRH and LH secretion became dissociated to varying degrees after treatment (representative examples in Fig. 2Go). Specifically, before endotoxin, GnRH pulses corresponded to LH pulses. After endotoxin, this one to one correspondence was much less evident. In these instances, the LH pulse pattern was profoundly disrupted, whereas GnRH pulses were not suppressed (Fig. 2AGo), were minimally suppressed (Fig. 2BGo), or were only transiently disrupted compared with LH pulses (Fig. 2CGo). Thus, this dose of endotoxin appeared to be near or below threshold for GnRH inhibition, but it markedly disrupted pulsatile LH secretion. In all ewes endotoxin stimulated a large increase in circulating cortisol within 30–60 min and induced fever (data not shown).



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Figure 2. Profiles of GnRH in pituitary portal blood (top panels) and LH in jugular blood (bottom panels) in three representative ovariectomized ewes treated with the low dose of endotoxin (40 ng/kg; arrows).

 
Exp 2: endotoxin decreases pituitary responsiveness to exogenous GnRH
Run 1. The time courses of LH in two representative ewes after vehicle and the 400 ng/kg dose of endotoxin are illustrated in Fig. 3Go, A and B. In five of seven ewes, endotoxin clearly suppressed LH pulse amplitude in response to the exogenous GnRH pulses; this effect was not seen with vehicle (Fig. 3AGo). Analysis of the results, however, was complicated, as two of the ewes expressed LH pulses that did not coincide with the exogenous GnRH pulses (Fig. 3BGo, asterisks; top, 0.5 h after vehicle; bottom, 3 h after endotoxin). These extra LH pulses were presumed to reflect episodes of endogenous GnRH secretion escaping progesterone blockade. These endogenous GnRH pulses precluded definitive assessment of the response to exogenous GnRH pulses because they occurred shortly before the next exogenous GnRH pulse and thus could have altered pituitary responsiveness. Further, the transients in circulating LH produced by the extra LH pulses obscured the response to the exogenous GnRH pulse (see Fig. 3Go). This complication was dealt with in two ways. First, the experiment was repeated under conditions in which extra LH pulses did not occur (Run 2, below). Second, because the extra LH pulses occurred during the first 5 h after vehicle or endotoxin, this period was excluded from the analysis and LH responses 0–5 h before endotoxin or vehicle were compared with those 5–10 h after treatment. This analysis revealed no suppression in LH pulse amplitude after vehicle, but significant suppression after endotoxin to 52 ± 3% of the pretreatment value (P <= 0.05; Fig. 3CGo). As expected, endotoxin stimulated cortisol secretion and induced fever (Fig. 4Go).



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Figure 3. LH responses to hourly exogenous GnRH pulses in Exp 2, Run 1. Plasma LH profiles in two ewes treated (arrows) with vehicle (top) and endotoxin (bottom) are shown in panels A and B. This was a cross-over experiment in which each ewe received both treatments. Solid symbols represent times of GnRH bolus injections. Asterisks in B depict LH pulses that did not coincide with exogenous GnRH pulses. Summary of the LH responses in all seven ewes is shown in panel C. Values are expressed as the mean + SEM amplitude of LH pulses after vehicle ({blacksquare}) or endotoxin () relative to the LH pulse amplitude before treatment (percentage of pretreatment value). See text (Materials and Methods) for further details.

 


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Figure 4. Mean ± SEM (seven ewes) plasma cortisol (top) and rectal temperature (bottom) values in responses to endotoxin (open symbols) or vehicle (solid symbols) injected at 0 h (arrows).

 
Run 2. Representative time courses of LH in response to vehicle, endotoxin, and endotoxin plus flurbiprofen are illustrated in Fig. 5Go. Fig. 6Go depicts composite results comparing percent suppression of LH pulse amplitude in all ewes over time for each of the three treatments. In this run, LH pulses occurred only immediately after exogenous GnRH pulses, suggesting that endogenous GnRH pulses were totally blocked. As in Run 1, LH pulse amplitude decreased after endotoxin (to 44 ± 4% of pretreatment value) but not vehicle (Figs. 5Go and 6Go). Statistical analysis revealed a highly significant treatment by time interaction (P < 0.0001). Further analysis to identify the source of the significant interaction revealed that responses to both endotoxin and endotoxin plus flurbiprofen differed from the response to vehicle (P < 0.0001 in each case). However, the responses to endotoxin vs. endotoxin plus flurbiprofen did not differ from each other in terms of either treatment by time interaction (P > 0.15) or overall mean value (P > 0.6). Thus, endotoxin suppressed the pituitary response to GnRH, and flurbiprofen did not reverse this effect.



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Figure 5. LH responses to hourly exogenous GnRH pulses in Exp 2, Run 2. LH pulse profiles are shown for two representative ewes treated with vehicle (top panels), endotoxin (middle panels), and endotoxin plus flurbiprofen (bottom panels). This was a cross-over experiment in which each ewe received all three treatments. Fb, Flurbiprofen; V, its vehicle. Solid symbols indicate times of exogenous GnRH pulses. Arrows depict times of treatment with endotoxin, flurbiprofen, or vehicle.

 


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Figure 6. Summary of LH responses in Exp 2, Run 2, for ewes treated with vehicle, endotoxin, or endotoxin plus flurbiprofen. Values are expressed as the mean ± SEM (eight ewes) LH pulse amplitude (percentage of basal value) during five 3-h time periods (indicated along x-axis) relative to that of the first pretreatment period (-6 to -3 h). See text (Materials and Methods) for further details.

 
Unexpectedly, LH pulse amplitude in some vehicle-treated ewes appeared to increase 9–12 h posttreatment (Figs. 5BGo and 6Go). Of interest, the increment in plasma GnRH produced by the exogenous GnRH pulses also increased later in the sampling period, possibly accounting for this late increase in LH pulse amplitude (P <= 0.001, by paired t test on mean peak values -5 to -2 h vs. 4 to 6 h; Fig. 7Go). The reason for this late increase in GnRH pulse amplitude is not known. The overall mean amplitude of the GnRH pulses produced in jugular plasma by the infusion, which should be comparable to that in portal plasma during GnRH infusion (36), was 81.4 ± 11.2 pg/ml. This was approximately 2-fold larger than the natural GnRH pulses amplitude we previously observed in ovariectomized ewes during the anestrous season, the time of year this study was performed (41.8 ± 5.5 pg/ml; recalculated from Ref. 22). Further, the exogenous GnRH pulses produced a more prolonged increment in plasma GnRH than that seen during a natural pulse (compare patterns in Figs. 2Go and 7Go). Endotoxin or flurbiprofen did not alter the time course of circulating GnRH produced by exogenous GnRH pulses (not shown).



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Figure 7. Time course of GnRH concentration in peripheral plasma produced by delivery of GnRH pulses to ovariectomized ewes in which endogenous GnRH pulses were blocked in Exp 2, Run 2. Values are the mean ± SEM (8 ewes) for three GnRH pulses before and three GnRH pulses after treatment with endotoxin or vehicle. Hormonal profiles are discontinuous because not all samples were assayed for GnRH.

 
As in Run 1, endotoxin induced fever (Fig. 8Go). Flurbiprofen prevented this fever response, suggesting effective blockade of PG synthesis.



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Figure 8. Mean ± SEM (eight ewes) rectal temperature values in response to vehicle, endotoxin, and endotoxin plus flurbiprofen in Exp 2, Run 2. Note that flurbiprofen blocked endotoxin-induced fever.

 

    Discussion
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
This study provides two lines of evidence that endotoxin can impair reproductive neuroendocrine activity by suppressing the pituitary response to GnRH. Exp 1 suggests endotoxin inhibits responsiveness to endogenous GnRH pulses; Exp 2 indicates the same holds true for exogenous GnRH pulses. In Exp 1, GnRH and LH pulse suppression were uncoupled in ovariectomized ewes treated with a low dose of endotoxin (40 ng/kg). This treatment markedly disrupted LH pulsatility in all ewes tested. In contrast, this dose of endotoxin only marginally suppressed pulsatile GnRH secretion, and in some ewes, it appeared to be essentially ineffective in this regard. The uncoupling of GnRH and LH pulse suppression after the low dose of endotoxin complements the earlier finding (2) that recovery from suppression of GnRH pulsatility can precede the recovery of pulsatile LH secretion in ovariectomized ewes treated with a higher dose of endotoxin (400 ng/kg). Taken together, these observations provided circumstantial evidence that endotoxin inhibits the pituitary response to GnRH, and they prompted a more definitive test of this possibility.

In Exp 2 we directly tested the hypothesis that endotoxin inhibits pituitary responsiveness to exogenous GnRH pulses, using ovariectomized sheep in which endogenous GnRH secretion was blocked by ovarian steroids. Note, in this experiment we used a higher dose of endotoxin (400 ng/kg), as it is the dose we have typically used to inhibit both GnRH and LH pulsatility in ovariectomized ewes (2, 19). Additionally, prior results describing the time course of GnRH and LH suppression suggested that this dose may inhibit pituitary responsiveness to GnRH (2).] The results of Run 1 supported the hypothesis that endotoxin reduced the amplitude of the LH response to exogenous GnRH pulses, although technical difficulties precluded definitive conclusion. These difficulties were overcome in Run 2, and the results demonstrated conclusively that endotoxin inhibited pituitary responsiveness to GnRH.

It is important to consider our findings in the context of the prior conclusion that the pituitary response to GnRH in the rat is not suppressed by central delivery of IL-1, one component of the cytokine cascade that mediates responses to immune/inflammatory challenge (16). Although seemingly at odds with the present conclusion, the design of the two studies differed substantially: vastly different GnRH doses, single vs. multiple GnRH injections, assessment of response to GnRH at one vs. multiple time points, etc. Most notably, the immune/inflammatory challenges themselves differed: a specific cytokine delivered centrally in the prior study and peripheral endotoxin used here. In essence, the prior study in rats is not comparable to that reported here, and it does not weaken our present conclusion that endotoxin inhibits pituitary responsiveness to GnRH.

Our study indicates the effect of endotoxin on responsiveness to GnRH is evident regardless of whether the pituitary is stimulated by endogenous or exogenous GnRH pulses (Exp 1 and 2, respectively). Nevertheless, from the data presented it might seem as if endotoxin had a more potent inhibitory effect when endogenous GnRH pulses stimulated the pituitary (compare Figs. 2Go and 5Go). It is important to point out, however, that the two experiments were not strictly comparable, because different doses of endotoxin were employed, and the exogenous GnRH pulses in Exp 2 did not fully replicate those produced endogenously in Exp 1. In addition, the animal models differed in the two experiments, ovariectomized ewes in Exp 1 and steroid-treated ovariectomized ewes in Exp 2. As discussed below, ovarian steroids modify responses to immune challenge. Thus, a quantitative comparison between responses in the two experiments is not appropriate. The main point is that endotoxin compromises pituitary responsiveness regardless of whether endogenous or exogenous GnRH pulses stimulate the pituitary.

The present demonstration that endotoxin inhibits pituitary responsiveness to GnRH raises questions related to the mechanisms that mediate this effect. Recent work in rodents has shown that systemic endotoxin decreases GnRH receptor gene expression in the pituitary (17). This effect was seen within 3 h, a time frame consistent with the endotoxin-induced suppression of pituitary responsiveness that we observed in the ewe. We can hypothesize, therefore, that endotoxin reduces GnRH receptor expression in sheep, thereby suppressing the responsiveness of the gonadotrope to GnRH. Further work is required to test this hypothesis and to assess other mechanisms within the pituitary that may mediate the response to this immune challenge.

It is also important to assess whether endotoxin acts directly upon the pituitary to exert these effects and whether it acts via the same intermediates that generate other pathophysiological responses to immune/inflammatory stimuli. At the level of GnRH secretion, endotoxin stimulates a cascade of peripheral and central cytokines such as IL-1 and TNF{alpha} that, together with enhanced synthesis of PGs and perhaps hormones of the neuroendocrine stress axis, inhibit GnRH release (7, 8, 9, 10, 11, 19, 37, 38). The question arises of whether the same mediators suppress LH secretion at the level of the pituitary. Recent evidence indicates that endotoxin enhances pituitary expression of IL-1, TNF{alpha}, and both their receptor messenger RNAs (39), but whether these cytokines act locally within the pituitary to suppress responsiveness to GnRH remains to be tested. With regard to PGs, we recently demonstrated that administration of a PG synthesis inhibitor, flurbiprofen, abolished endotoxin-induced suppression of pulsatile GnRH and LH secretion in the ovariectomized ewe (19). Here, we tested whether flurbiprofen would also reverse endotoxin-induced suppression of pituitary responsiveness to GnRH. To our surprise, flurbiprofen was ineffective in this regard, although it did abolish the generation of fever, suggesting that PG synthesis was effectively blocked.

One interpretation of this finding is that PGs do not mediate endotoxin-induced suppression of pituitary responsiveness. There is, however, another explanation, one related to the presence or absence of estradiol. Our prior observation that flurbiprofen prevented endotoxin-induced LH suppression was obtained in ovariectomized ewes not replaced with ovarian steroids (19). Of considerable interest, we recently obtained preliminary evidence that flurbiprofen failed to reverse endotoxin-induced LH suppression in ovariectomized ewes treated with estradiol (Breen, K. M., and F. J. Karsch, unpublished data). Importantly, in the present study the response to flurbiprofen was tested in ovariectomized ewes treated with estradiol. Substantial evidence demonstrates that estradiol influences responses to immune/inflammatory stimuli. For example, IL-1 inhibits LH secretion in ovariectomized monkeys, but estradiol protects against this inhibitory effect (11, 40). Estradiol regulates production of the proinflammatory cytokines IL-1, IL-6, and TNF{alpha} (41) and influences the extent to which endotoxin stimulates cytokine synthesis (42). Collectively, these findings not only suggest that estradiol regulates the response to immune challenge, but also that it does so by modulating underlying intermediary pathways and possibly dependence upon PGs. Thus, we suggest that in the presence of estradiol, a pathway not involving PG synthesis mediates endotoxin-induced suppression of pituitary responsiveness to GnRH.

Although this putative intermediary pathway remains to be identified, we are intrigued by the possibility that it may involve cortisol. Recent work indicates that an elevation of cortisol to levels that we observed during endotoxin challenge inhibits expression of the GnRH receptor and suppresses pulsatile LH secretion in gonadectomized sheep, provided that they are treated with estradiol (43, 44). In the absence of estradiol, cortisol is ineffective. Although the acute stimulation of cortisol does not appear to be necessary for endotoxin-induced inhibition of LH pulsatility in ovariectomized ewes (45), a mediatory role for cortisol in the presence of estradiol has not yet been tested. Further experiments are thus warranted to determine whether, in the presence of estradiol, endotoxin inhibits pituitary responsiveness to GnRH via a PG-independent mechanism, possibly one involving cortisol.

In summary, this study provides exciting new evidence that the pituitary is an important site for reproductive inhibition in response to immune/inflammatory challenge. Specifically, we observed that systemic endotoxin suppresses pituitary responsiveness to GnRH. It is now important to ascertain whether this inhibition at the level of the pituitary is influenced by the ovarian steroid milieu, if this inhibitory effect changes during the course of the ovulatory cycle, and what mediators are involved. Such studies would help clarify mechanisms for the well documented disruptive effects of immune/inflammatory challenge on ovarian cyclicity.


    Acknowledgments
 
The authors are sincerely indebted to Doug Doop and Gary McCalla for maintaining the sheep and for expert assistance with the animal experimentation; to Martha Brown for conducting and analyzing GnRH RIAs; to Dr. Vasantha Padmanabhan, Dr. Heather Billings, Nathalie Briard, and Ms. Aphrodite Nikolovski for their help with conducting and interpreting experiments; to Dr. Morton Brown and Lei Liu for help with data analysis; and to Drs. Gordon D. Niswender, Leo E. Riechert, Jr., and Alain Caraty for supplying RIA reagents.


    Footnotes
 
1 This work was supported by NIH Grant HD-30773, the Center for the Study of Reproduction (NIH Grant P30-HD-18258), Standards and Reagents, Data Analysis and Sheep Research Core Facilities, and the Office of the Vice President for Research at the University of Michigan. A preliminary report of this work has appeared (46 ). Back

2 Present address: INSERM, U-501, IFR Jean Roche, Faculté Nord, boulevard Pierre Dramard, 13016 Marseilles Cedex 16, France. Back

Received September 19, 2000.


    References
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 

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