Endocrinology Vol. 143, No. 1 107-116
Copyright © 2002 by The Endocrine Society
Acidic Mix of FSH Isoforms Are Better Facilitators of Ovarian Follicular Maturation and E2 Production than the Less Acidic
Christine R. West1,
Nichole E. Carlson,
James S. Lee,
Alan S. McNeilly,
Tejinder Pal Sharma,
Wen Ye and
Vasantha Padmanabhan
Department of Pediatrics (V.P., J.S.L.), Biostatistics (N.E.C.,
W.Y.), and the Reproductive Sciences Program (C.R.W., T.P.S., V.P.),
University of Michigan, Ann Arbor, Michigan 48109; and Medical Research
Council Human Reproductive Sciences Unit (A.S.M.), Edinburgh,
Scotland EH3 9ET, United Kingdom
Address all correspondence and requests for reprints to: Vasantha Padmanabhan, Reproductive Sciences Program, 300 North Ingalls Building, Room 1109 SW, Ann Arbor, Michigan 48109-0404. E-mail:
vasantha{at}umich.edu
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Abstract
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FSH is secreted as a mix of isoforms with varying biologic
attributes. To determine the functional significance of FSH
heterogeneity, an acidic (ovine pituitary FSH; C-FSH) and less acidic
mix (C-FSH exposed to neuraminidase; N-FSH) were administered to
prepubertal lambs. Production of GnRH- induced less acidic FSH was
blocked with a competitive GnRH receptor antagonist, Nal-Glu. Beginning
24 h after Nal-Glu, lambs were injected with C-FSH or N-FSH and
LH. Controls included untreated, GnRH-treated, and Nal-Glu-treated
groups. Blood samples were obtained at 2-h intervals. Plasma FSH levels
were similar before treatment and increased over time in the C-FSH but
not the N-FSH group (P < 0.001). Three of the six
GnRH-treated ewes exhibited an LH surge. Peak E2 concentrations in the
GnRH-treated animals were achieved 3036 h after initiation of
treatment. Peak circulating E2 levels tended to be higher in the C-FSH
than in the GnRH-treated group. Only two of six N-FSH-treated ewes had
a serum E2 rise. The C-FSH ewes had more estrogenic follicles than the
GnRH and N-FSH groups (P < 0.05). Our findings
show that C-FSH clears more slowly than N-FSH, and C-FSH is a better
facilitator of follicular development and maturation than N-FSH.
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Introduction
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FSH CONSISTS OF A FAMILY of related
isoforms differing in their charge, metabolic clearance rates, and
in vitro biological activities (1, 2, 3, 4). A
mixture of circulating gonadotropin isoforms reaches target tissues to
influence a variety of biologic end points. Although the factors
affecting final gonadotropin isoform distribution within the
circulation are multifaceted and complex, it is evident that endocrine
changes regulate the proportion of FSH isoforms both within the
pituitary and in the peripheral circulation (1, 2, 3, 4). For
instance, studies characterizing changes in FSH heterogeneity during
onset of puberty (5, 6) and the late follicular phase
(7, 8, 9, 10) have suggested that changes in FSH heterogeneity
may be important in the pubertal process and reproductive
cyclicity.
Considering the multitude of functions FSH mediates such as maturation
of follicles, prevention of follicular atresia, aromatase induction,
granulosa cell proliferation, LH receptor induction, and induction of
its own receptors (11, 12, 13), changes in FSH heterogeneity
that occur during various physiologic states may have important
biologic consequences in the mediation of the many FSH-induced
functions and thus are of physiologic importance. A large body of
evidence has been generated using chemically and enzymatically produced
isoform mixes to show that the FSH isoforms vary in their
receptor-binding ability, immunologic detection, in vitro
biologic activity, and metabolic clearance (1, 2, 3, 4). More
recent studies with gonadotropins suggest that the different FSH
isoforms vary not only in their biologic potency but also in their
ability to mediate the different FSH functions (3, 4, 14, 15, 16). Missing, however, are studies that establish the
relevance of FSH heterogeneity in vivo during the
maturational process and ovulatory cyclicity, especially using natural
pituitary FSH isoforms. Such studies have been hampered by the
difficulty in obtaining naturally occurring FSH isoforms in large
quantities.
To overcome this limitation, in this study we blocked the endogenous
production of less acidic FSH isoforms in prepubertal ewes with
Nal-Glu, a competitive GnRH receptor antagonist, and provided them with
two different mixes of ovine pituitary FSH, a more acidic native mix
(purified ovine pituitary FSH, C-FSH) and a less acidic mix generated
by exposing the C-FSH to neuraminidase (N-FSH). Previous studies have
shown that FSH released in a GnRH-associated pulse is less acidic, fast
clearing, and more biopotent than what is secreted in the tonic mode
(1, 3, 17). The C-FSH and N-FSH mixes varied in their
profile of FSH isoform distribution and to a certain degree mimicked
the distribution profile of circulating FSH that elutes during the
prepubertal and pubertal period (5). Specifically, we
tested the hypothesis that C-FSH is a better facilitator of ovarian
follicular development/maturation than N-FSH. Prepubertal female lambs
were used as the in vivo model to test this hypothesis.
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Materials and Methods
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General materials
The GnRH antagonist Nal-Glu
[Ac-D2Nal1,D4ClPhe2,D3Pal3,Arg5,4-(methoxybenzoyl)-D-2-aminobutyric
acid6, D-Ala10] GnRH used in
these studies was synthesized at the Salk Institute under contract
NO1-HD-02906 with the NIH and made available by the Contraceptive
Development Branch, Center for Population Research, NICHD. Highly
purified ovine pituitary FSH (code G4227B; potency 50 times NIH-S1)
was provided by Dr. Harold Papkoff (University of California, Davis,
CA).
Generation of more acidic and less acidic mixes of FSH
isoforms
To address the physiological relevance of FSH heterogeneity in
the facilitation of follicular development during the pubertal process,
we compared the efficacy of an acidic and a less acidic mix of FSH
isoforms. The ability of neuraminidase to cleave terminal sialic acid
residues from purified ovine pituitary FSH was exploited to generate a
less acidic mix of asialo FSH isoforms (N-FSH). Untreated ovine
pituitary FSH (C-FSH) was used as the acidic mix of FSH isoforms.
To maintain molar equivalency between the two mixes during treatment,
we began with 50 ml ovine pituitary FSH stock solution [85.0 ±
1.7 µg/ml as measured by a validated RIA (18), mean
± SE, n = 4] in phosphate buffer (0.1 M,
pH 5.1) containing 0.1% BSA. Following thorough mixing, the solution
was split into two equal 25-ml aliquots. One unit of neuraminidase
(type VI: chromatographically purified from Clostridium
perfringens; N3001; Sigma, St. Louis, MO) in 0.5 ml
of the above-described buffer was added to one aliquot, and 0.5 ml
buffer alone was added to the other. Both aliquots were then incubated
for 2.5 h at 37 C with mixing (100 rpm in a Dubnoff shaking water
bath). At the end of this time, 17 mg sodium azide was added to each
aliquot to stop the reaction (the sodium azide concentration in each
delivered pulse of FSH was 64 µg/animal several magnitude lower than
the reported LD 50 of sodium azide, which is 27 mg/kg (orally in the
rat) (MSDS 52906, Mallinckrodt Baker Inc.,
Phillipsburg, NJ) (19). This treatment was shown to give
limit digests of this material in analytical pilot studies and
essentially paralleled what was reported earlier (20).
After processing, final FSH concentrations averaged 89.2 ± 2.6
and 88.1 ± 4.3 µg/ml in the C-FSH and N-FSH, respectively,
suggesting no loss of immunoreactivity because of neuraminidase
digestion.
Chromatofocusing of FSH
Distribution patterns of FSH isoforms in the two mixes of FSH
were determined following analytical chromatofocusing of C-FSH and
N-FSH. Details of the chromatofocusing procedure were described
previously (7). Equal volumes of the two FSH stocks
containing equimolar concentrations of FSH were dialyzed against 0.025
mol/liter imidazole-HCL, pH 7.4, overnight and then applied to a
preequilibrated 15 x 0.9 cm column PBE 94 resin
(Pharmacia, Piscataway, NJ). After entry of the sample,
polybuffer (Pharmacia, pH 4.0) was used to elute the
sample, and 2-ml fractions were collected. When the pH of the eluent
reached 4.0 (i.e. after collection of 80 fractions), 1
M NaCl was used to elute any remaining FSH, and
10 additional 2-ml fractions were collected. The pH and immunoreactive
FSH content of the fractions were determined. Recovery of FSH following
analytical chromatofocusing separation, assessed by summing up FSH
recovered in all fractions and relating to starting amount
chromatofocused, was 94% and 89% for the C-FSH and N-FSH,
respectively.
Animal experimentation
Pilot studies: validation of a method to block GnRH action long
term. To test the efficacy of the C-FSH and N-FSH in facilitating
follicular development and E2 production, it was essential to block the
action of GnRH and limit the endogenous production of less acidic FSH
isoforms. Previous studies have shown GnRH facilitates the release of
fast-clearing, less acidic FSH isoforms in ovary-intact female animals
(1, 3, 17). We conducted two pilot studies. In the first
pilot study, six prepubertal lambs (
25 wk of age) were bled for
33 h at 30-min intervals. Beginning 8 h into the collection,
all animals were administered bolus injections of Nal-Glu (10 µg/kg
body weight) iv at 8-h intervals. In previous studies we had shown that
iv injections of Nal-Glu suppresses LH release with the duration of
suppression being dependent on the dose of Nal-Glu used. A 10-µg/kg
dose suppressed LH for up to 10 h (21). In the second
pilot study, after collecting samples every 30 min for 3 h, lambs
were injected sc with Nal-Glu (50 µg/kg body weight) at 12-h (n
= 3) or 24-h (n = 3) intervals and blood collection continued
every hour for 72 h. Previous studies have shown administration of
GnRH-antagonist sc provides long-term suppression of LH
(22). We compared the suppression of LH observed with
administration of Nal-Glu at the doses of 50 µg/kg sc every 12 or
24 h and 10 µg/kg iv every 8 h. We concluded that
administration of 50 µg/kg Nal-Glu sc at 12-h intervals achieved
complete suppression of LH during the 72-h study (Fig. 1
) as opposed to the 24-h interval sc
delivery and the 8-h interval iv delivery in which there was incomplete
LH suppression. Hence, this mode of Nal-Glu delivery was chosen as the
approach for blocking endogenous GnRH action in the main study.

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Figure 1. The efficacy of Nal-Glu, a competitive GnRH
antagonist in suppressing circulating LH concentrations (as an index of
GnRH action). Left panel shows response to Nal-Glu
administered iv at 8-h intervals. Top and bottom right
panels show responses to sc administration of 50 µg/kg body
weight of Nal-Glu given every 12 and 24 h, respectively.
Shaded area represents the Nal-Glu treatment period.
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Main study. The objective of the experiment was to determine
the differential effects of C-FSH and N-FSH on follicular maturation.
The experimental design is summarized in Fig. 2
. Treatment groups consisted of: 1) an
untreated control group (n = 6; mean body weight = 44.7
± 2.2 kg); 2) a positive control group that received GnRH (iv 2 ng/kg;
n = 6; mean body weight = 47.0 ± 1.6 kg); 3) a negative
control group that received Nal-Glu (sc 50 µg/kg; n = 6; mean
body weight = 45.3 ± 1.5 kg); 4) a group that received
Nal-Glu sc plus C-FSH (iv 8 µg/pulse; n = 6; mean body
weight = 46.3 ± 1.5 kg); and 5) a group that received
Nal-Glu sc plus N-FSH (8 µg/pulse; n = 6; mean body weight
= 46.5 ± 1.7 kg). LH (15 µg/pulse) was coadministered with both
mixes of FSH because earlier studies have shown that LH is required
along with FSH for achieving normal steroidogenesis (23);
this paralleled the physiologic drive; and outcomes from C-FSH and
N-FSH drive can be compared with that achieved following GnRH drive, a
known stimulator of both LH and FSH. The experiment was conducted using
prepubertal Suffolk lambs (2530 wk of age) maintained under normal
husbandry conditions at the Sheep Research Facility in Ann Arbor,
Michigan. All experimental procedures were approved by the Committee
for the Use and Care of Animals at the University of Michigan.

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Figure 2. Schematic showing the design of the study.
Arrows indicate the time of administration of Nal-Glu.
C-FSH and N-FSH were injected in conjunction with purified ovine
pituitary LH every 2 h from 0 to 24 h and hourly from
2548 h. Starting from 6 h before Nal-Glu administration,
blood samples were collected at 2-h intervals throughout the course of
the study. Closed boxes represent the 2-h pulse bleed
conducted at the end of study to assess delivery patterns of C-FSH and
N-FSH.
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Administration of Nal-Glu (diluted in 5% glucose-sterile
H2O) occurred every 12 h in the indicated
groups beginning 24 h before administration of GnRH or FSH plus
LH. Lambs were fitted with indwelling catheters in the jugular vein and
blood samples were collected every 2 h, starting 6 h before
administration of Nal-Glu and 30 h before the administration of
GnRH or FSH plus LH. A second indwelling catheter was placed in the
other jugular vein of lambs that received pulsatile GnRH or FSH plus LH
to prevent contamination of the sampling catheter. GnRH or
gonadotropins were diluted in 0.1% BSA-saline and were administered
every 2 h for the first 24 h (024 h) and then hourly for
the next 24 h (2548 h). From 4648 h, blood samples were
collected every 6 min to characterize the circulatory pattern of LH and
FSH following pulsatile administration of GnRH or FSH plus LH. When
sampling overlapped with administration of GnRH or gonadotropins, the
blood sample was collected first, followed by administration of GnRH or
gonadotropins. Patency of the catheters was maintained with heparinized
saline.
Lambs were euthanized with Beuthanasia (Schering-Plough Corp. Animal Health Corps, Kenilworth, NJ) 48 h after the
initiation of GnRH or gonadotropin treatment. The ovaries were
collected immediately after euthanasia and the diameters of follicles
were measured. Follicular fluid (550 µl) was aspirated from all
follicles greater than or equal to 3 mm in diameter and frozen at -80
C for subsequent measurement of intrafollicular E2 levels. Follicular
responses of animals in the various treatment groups were assessed by
counting the number of follicles reaching sizes greater than or equal
to 3 mm and determining their estrogenic status by classifying them as
estrogenic (potential preovulatory, >50 ng/ml E2), estrogen active
(1050 ng/ml E2), and nonestrogenic (<10 ng/ml) based on criteria
established by McNeilly et al. (24).
Radioimmunoassays. Peripheral LH and FSH were assayed in
duplicate using well-validated RIAs (18, 25). An ovine
serum-based standard, B1371, calibrated against NIH-LH-S1 and
NIDDK-ovine FSH-1 were used as the reference standards in the LH and
FSH assays, respectively. All samples from a given animal were measured
in a single assay. Sensitivity (two standard deviations from the buffer
control) of the LH (n = 10) and FSH (n = 9) assays averaged
0.16 ± 0.01 and 0.05 ± 0.01 ng, respectively. Samples were
assayed in duplicate 200-µl (25 µl for high values) volumes for the
LH and 100200 µl in the FSH assay. The half-maximal displacement
points of the LH and FSH assays were 0.68 ± 0.02 and 0.48 ±
0.02 ng, respectively. Intraassay coefficients of variation averaged
7.2 ± 0.9 and 8.3 ± 0.5, respectively, for the LH and FSH
assays. Interassay coefficients of variation of the LH averaged 10.3%,
7.1%, 6.8%, and 9.21% for the four quality pools measuring 0.8,
22.2, 74.1, and 195.9 ng/ml, respectively. Interassay coefficients of
variation of the FSH averaged 9.3%, 6.8%, 5.0%, and 4.4% for the
four quality pools 3.4, 8.3, 22.5, and 25.9 ng/ml, respectively.
Plasma E2 concentrations were determined in duplicate diethyl ether
extracts of 200 µl plasma using a modification (26) of
the E2 MAIA assay (Serono-Baker Diagnostics Inc.,
Allentown, PA). The sensitivity and 50% displacement point of this E2
assay averaged 0.06 ± 0.01 and 1.19 ± 0.13 pg (n = 15
assays), respectively. All samples were assayed in duplicate 200-µl
aliquots. Intra- and interassay coefficient of variation of this E2
assay averaged 13.9% ± 0.8% and 13.5% ± 3.5% (n = 5 quality
control pools), respectively. The median variance ratio for LH, FSH,
and E2 assays averaged 0.06 ± 0.01 and 0.03 ± 0.00, and
0.05 ± 0.01, respectively. Follicular fluid E2 concentrations
were determined using a well-validated in-house RIA (27).
The sensitivity, half-maximal displacement, intra- and interassay
coefficient of variation, and median variance ratio of this E2
assay (n = 2) averaged 1.38 pg, 27.5 pg, 12.02%, and 11.45%
(based on four quality control pools), respectively.
Statistical analyses
To compare the patterns of LH, FSH, and E2 concentrations over
time between treatments, the 12 time points of 2-h observation for each
of the 3 d of study were divided into four 6-h intervals. Mean
hormone concentration was calculated for each 6-h interval.
Repeated-measures ANOVA was performed to test for day, time, and
treatment effect for each hormone. All data were analyzed by
repeated-measures ANOVA; general linear models or mixed models
procedure of SAS, Cary, NC) to evaluate the effects of
treatment, and log (base-e) transformed before analysis. A Tukey
adjustment was made for all pairwise comparisons.
To assess effects of Nal-Glu, the ratios of mean hormone concentration
at each 6-hr time period after Nal-Glu were compared with the mean
hormone concentration for the 6 h before Nal-Glu administration
(baseline). Repeated-measures ANOVA was used to test for time
differences between the control and Nal-Glu treatments and to test for
Nal-Glu suppression of LH, FSH, and E2 (i.e. if the mean
ratio was less than 1). All ratios were log (base-e) transformed before
analysis, and a Tukey adjustment was used for all pairwise comparisons.
One ewe was missing her baseline E2 concentration (loss of sample), and
that concentration was imputed. For analysis of E2 data, the maximum
value of E2 achieved during the 3 d of study in the GnRH, C-FSH,
and N-FSH groups were analyzed by ANOVA following log (base-e)
transformation. Two different analyses were performed, one including
all animals and the other including only those ewes that showed an
estrogen response (in the C-FSH group only five of the six showed an E2
response, and in the N-FSH group only 2 of the six ewes showed an E2
increase).
Follicular data were analyzed using absolute number of follicles as
well as the percentage distribution within size classes as the
variables. For the first, data were transformed using square root
transformation. Tukey adjustment was used when comparing the means of
different groups for all the variables. Two different analyses were
performed, one using all ewes in each group and the other including
only those that showed follicles greater than or equal to 3 mm.
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Results
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Distribution profile of C-FSH and N-FSH
Comparison of the distribution pattern of FSH isoforms in the
C-FSH and N-FSH revealed a relatively less acidic mix of FSH isoforms
in the N-FSH than C-FSH (Fig. 3
). One
hundred percent of FSH isoforms in C-FSH eluted in fractions with pH
less than 5.4 and the salt peak. In contrast, 50% of isoforms in N-FSH
eluted in pH range more than 5.4. Comparison of the distribution
profiles of C-FSH and N-FSH with previously published distribution of
FSH in the prepubertal and pubertal animals during onset of puberty
(5) (Fig. 3
, bottom left) revealed similar
directionality of changes although they did not exactly match. In terms
of similarities, 50% of FSH isoforms in the N-FSH and pubertal lambs
existed in pH range more than 5.4. On the contrary, although none of
the C-FSH eluted at pH more than 5.4, approximately 18% of FSH in
prepubertal lambs eluted in this pH range. The proportion of C-FSH
eluting in the salt peak was also much greater in C-FSH, compared with
the proportion eluting in prepubertal lambs. The present approach did
facilitate the generation of two different FSH isoform mixes, one more
acidic and one less acidic that were similar to the directionality of
changes observed in the prepubertal and pubertal lambs but failed to
completely reproduce what was present in the prepubertal and pubertal
lambs. Although C-FSH and N-FSH differed in the FSH isoform
distribution profiles, they had similar immunopotencies (Fig. 3
, inset).

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Figure 3. Top panels show the elution
patterns of FSH isoforms as measured by the FSH RIA (closed
circles) following chromatofocusing separation of C-FSH and
N-FSH. Inset in top shows the displacement curves of the
original ovine pituitary FSH (C-FSH-pre), ovine pituitary FSH subjected
to neuraminidase digestion (N-FSH), and ovine pituitary FSH processed
in parallel with N-FSH but in the absence of neuraminidase
(C-FSH-post), all plotted against starting FSH equivalents.
Bottom panels show the percent C-FSH and N-FSH isoforms
eluting in pH ranges less than 5.4, more than 5.4 and the salt peak.
For comparison, the distribution patterns of circulating FSH in
prepubertal and pubertal lambs from a previously published study
(5 ) are shown on the bottom left.
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Patterns of gonadotropin release before and after treatment
Figure 4
summarizes the circulating
patterns of LH achieved following the various treatments. As predicted
by the pilot study (Fig. 1
), administration of 50 µg/kg Nal-Glu sc at
12-h intervals effectively suppressed LH below the detection limit of
the assay throughout the study in the negative control animals (Nal-Glu
group) (P < 0.01). Reflective of Nal-Glu suppression,
LH concentrations in the C-FSH and N-FSH treatment groups were
significantly lower on d 1 than that of the GnRH nonsurge group. On d 2
(d 1 of gonadotropin treatment) levels of LH in the C-FSH and N-FSH
group were comparable with that of the GnRH nonsurge group. On d 3 (d 2
of gonadotropin treatment) LH concentration in the C-FSH and N-FSH were
higher than the GnRH nonsurge group. Pulsatile administration of GnRH
resulted in the induction of LH surges in three of the six animals
studied. As expected and consistent with the efficacy of Nal-Glu in
blocking GnRH action, none of the animals in the C-FSH or N-FSH
groups showed an LH surge. Although the replacement levels of LH
achieved in the C-FSH and N-FSH groups were similar, the final levels
of LH achieved in these two groups were higher than those seen at
48 h in the GnRH nonsurge group (P < 0.001 for
C-FSH/nonsurge GnRH comparison and P < 0.01 for
N-FSH/nonsurge GnRH comparison).

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Figure 4. Mean circulating concentrations of LH achieved in
the different treatment groups. Because three of the six GnRH-treated
animals had an LH surge during this period, mean circulating levels of
LH in the nonsurge (NS) and surge (S) subsets are shown separately.
Note the efficacy of Nal-Glu in suppressing LH (top
right) and the similarity in replacement patterns LH achieved
in the C-FSH and N-FSH groups (bottom panels).
Shaded area represents the Nal-Glu treatment period.
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Patterns of circulating FSH in the five treatment groups are shown in
Fig. 5
. Nal-Glu, although effective in
suppressing LH levels, had minimal effect on circulating FSH levels.
FSH levels in the GnRH surge group, as one would expect, showed a
decline before the onset of the surge. Although C-FSH and N-FSH did not
show loss of immunoreactivity following neuraminidase treatment and
similar molar concentrations of C-FSH as N-FSH were administered,
circulating levels of FSH in the C-FSH group increased progressively
from the time of administration. In contrast, circulating levels of FSH
did not change during the course of N-FSH treatment. At the 42- to 48-h
interval, FSH levels in the C-FSH group were 3 times higher than that
of the N-FSH-treated group and 5 times higher than that of the
GnRH nonsurge group (P < 0.001, Fig. 5
). FSH levels
achieved in the N-FSH treated animals were not different from GnRH
nonsurge group. The amplitude of N-FSH pulses as determined from 6-min
samples during the last 2 h of study (4648 h) was slightly lower
than that of C-FSH (Fig. 5
, insert). The amplitudes of FSH
and LH pulses following GnRH administration were not evaluated because
of the potential confounding effects of endogenous pulses of GnRH and
the expected loss of pituitary sensitivity that would follow the
generation of LH surges in three of the six animals.

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Figure 5. Mean circulating concentrations of FSH achieved in
the different treatment groups. Note the inability of Nal-Glu to
suppress FSH as it did LH. Mean circulating levels of FSH in the
nonsurge (NS) and surge (S) groups are shown separately. The
indent shows FSH pulse amplitude achieved following
pulsatile administration of C-FSH and N-FSH. Shaded area
represents the Nal-Glu treatment period. Note the increased circulating
levels of C-FSH but not of N-FSH achieved following administration of
similar molar concentrations of C-FSH as N-FSH.
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Follicular responses
Concentrations of E2 in follicular fluid were used to determine
estrogenic status and as an index of follicular maturation. Estrogenic
status was defined using previously established criteria
(24). Follicles with less than 10 ng/ml follicular fluid
were classed as nonestrogenic, follicles with 1050 ng/ml E2 were
classed as estrogen active, and follicles with more than 50 ng/ml E2
were classed as estrogenic (potential preovulatory) follicles. The
total number of follicles greater than or equal to 3 mm in size and
their relative estrogenic status are summarized in Table 1
, and the percentage of distribution in
Fig. 6
. The total number of follicles in
the 2.0- to less than 3-mm size range as well as follicles in the
greater than or equal to 3-mm range was not significantly different
among groups. No differences in absolute number of estrogen-active
follicles were evident among the various treatment groups. However, the
largest number of estrogenic follicles were found in the C-FSH-treated
group (P < 0.05 when all ewes were included in the
analysis and P < 0.01 when only those animals that had
follicles greater than or equal to 3 mm were included in the
analysis). Pairwise comparisons of the means with Tukey adjustment
found that the mean number of estrogenic (potential preovulatory)
follicles in the C-FSH group were significantly larger than the mean
number of estrogenic follicles in the Nal-Glu treated (negative
control) group. No estrogenic follicles were found in the
Nal-Glu-treated animals. All the greater than or equal to 3-mm
follicles (100%) in the GnRH surge group were nonestrogenic.

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Figure 6. Shown are the percent distribution of estrogenic
(>50 ng/ml E2), estrogen active (1050 ng/ml E2), and nonestrogenic
(<10 ng/ml) follicles in the various treatment groups. For percent
calculation animals that did not show follicle greater than or equal to
3 mm are excluded (see Table 1 for the number of animals responding).
For the GnRH-treatment group the nonsurge (NS) and surge (S) subsets
are shown separately.
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ANOVA revealed significant differences in percentage distribution of
estrogenic (P < 0.05) and nonestrogenic
(P < 0.001) follicles among groups (those animals not
having follicles greater than or equal to 3 mm were not included
in this analysis). Among all groups, the largest percentage of
estrogenic follicles and the smallest number of nonestrogenic follicles
were found in the C-FSH group. Pairwise comparison of means with Tukey
adjustment found that the percentage of estrogenic follicles of C-FSH
group was significantly greater than the Nal-Glu group
(P < 0.05). On the contrary, the percentage of
nonestrogenic follicles of C-FSH group were significantly smaller
(19.8% ± 12.3%) than the GnRH surge group (100%). The majority of
the greater than or equal to 3-mm follicles in the Nal-Glu-treated
animals (93.7% ± 6.2%) were nonestrogenic. This is consistent with
the ability of Nal-Glu to arrest follicular growth. Thirty percent of
the greater than or equal to 3-mm follicles in the GnRH-treated animals
that did not show an LH surge during the study period were estrogenic.
Only three of the N-FSH-treated animals had follicles greater than or
equal to 3 mm, and only two of these had estrogenic follicles.
Circulating E2 responses
Mean circulating levels of E2 achieved in the various groups are
summarized in Fig. 7
. E2 levels remained
low and constant throughout the Nal-Glu treatment period. Pulsatile
GnRH administration increased circulating E2 concentrations in all
animals (P < 0.01). In the three animals that showed
an LH surge during the study period, peak circulating E2 levels
achieved during the presurge period averaged 2.63 ± 0.19 pg/ml.
In the three animals that did not surge during the study period,
circulating E2 concentrations at hour 48 averaged 1.74 ± 0.34
pg/ml. Corresponding means for the Nal-Glu group was 0.32 ± 0.05
pg/ml. Mean levels of E2 in the five C-FSH-treated animals with
follicles greater than or equal to 3.0 mm tended to be higher than the
GnRH-treated group and averaged 3.67 ± 0.73 pg/ml. One animal did
not show follicles greater than or equal to 3 mm and its E2
concentration throughout collection stayed at 0.22 pg/ml. Two of the
N-FSH-treated animals that had an estrogenic follicle achieved peak E2
levels of 2.76 and 3.02 pg/ml, respectively. Overall, although E2
tended to increase over days in all three groups, the daily incremental
increases in E2 were higher in the C-FSH group than the GnRH group. The
mean E2 concentrations in the other four averaged 0.40 ± 0.09
pg/ml. Circulating levels of E2 in each group correlated well with the
estrogenic status of the follicular population and the total E2
produced by the greater than or equal to 3 mm follicles (not
shown).

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Figure 7. Mean circulating concentrations of E2 achieved in
the different treatment groups. Each E2 value represents a measure from
three pooled samples (e.g., -24 is a measure of a
sample obtained by pooling equal volumes of plasma from -28, -26, and
-24 h; -12 of -16, -14 and -12 h; 0 of -4, -2, and 0 h and
so on) and hence likely to be an underestimate. For the
GnRH-treatment group, the nonsurge (NS) and surge (S) subsets are shown
separately. Shaded area represents the Nal-Glu treatment
period. Note the ability of Nal-Glu to suppress E2, ability of GnRH and
C-FSH in inducing E2 production, and the relatively reduced potency of
N-FSH to elicit E2 response of magnitude such as that seen in the GnRH
and C-FSH treatment groups. The increase at 48 h in the N-FSH
group is the outcome of two of the six animals responding to N-FSH
administration.
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 |
Discussion
|
|---|
Previously, we had outlined four criteria for establishing the
biologic significance of FSH heterogeneity (3, 4).
Criteria 1 and 2, namely the existence of FSH heterogeneity and its
neuroendocrine regulation, have been adequately met and remain
uncontested. A mix of FSH isoforms resides in the pituitary and
circulation and is under neuroendocrine control (1, 2, 3, 4). In
general, increases in E2 and GnRH in gonad-intact models lead to
increased release of less acidic FSH isoforms and progesterone
counteracts this increase (3, 4). Evidence supporting
criterion 3, namely that it should change in a biologically meaningful
manner, also exists. For example when sustained gonadal stimulation is
essential, such as during the early follicular phases of the
estrous/menstrual cycles in the female when follicular recruitment and
growth of the follicle is occurring, a more acidic mix of FSH isoform
prevails in the circulation (3, 4, 7, 8, 9, 10). On the
contrary, at times when an acute and a potent signal is essential to
facilitate selection and accelerated growth of the preovulatory
follicle, such as that seen during pubertal onset and the preovulatory
period, increased proportion of less acidic FSH isoforms are present in
the circulation (3, 4, 5, 6, 7, 8, 9, 10).
Missing, however, is the evidence for fulfilling criterion 4 that links
manifestation of physiologic changes in FSH heterogeneity with biologic
consequences in vivo. Results of this study, which show
C-FSH to be a better facilitator of ovarian follicular
maturation/differentiation and E2 production than the N-FSH, provide
evidence that the type of FSH signal delivered does indeed dictate
biologic consequences. These results differ from the in
vitro studies of Vitt et al. (28), which
show less acidic isoforms to be better facilitators of follicular
maturation and E2 production than the acidic isoforms. Such opposing
outcomes bring to the forefront the dissociation between in
vitro and in vivo studies and the need for assessment
of functional significance at the in vivo level.
The ability of C-FSH to promote follicular maturation appears to relate
in part to the differences in clearances of C-FSH and N-FSH. In spite
of administering equimolar concentrations of FSH in a pulsatile manner,
circulating levels of FSH in the N-FSH-treated animals showed no FSH
increase. Previous studies have shown that asialo ovine FSH clears
faster than intact FSH in mouse in vivo bioassays (32
vs. 565 min for asialo and intact, respectively)
(29). Similarly, studies with rat and human FSH have also
shown a high degree of correlation between the metabolic clearance
rate, charge, and sialic acid content of the FSH isoforms
(1, 2, 3, 4). That pituitary FSH from ovariectomized ewes are
more acidic and clear more slowly than FSH obtained from intact ewes
(30, 31) are consistent with these findings. Although
ovine FSH contains high amounts of terminal sulfate residues
(32), our results with N-FSH agree with earlier studies
(1, 2, 3, 4, 29, 30, 31) in showing a major role for sialic acid in
determining the circulatory half-life of FSH in sheep.
Considering the expected differences in clearance kinetics of C-FSH and
N-FSH, our rationale for selecting C-FSH and N-FSH for testing the
physiologic relevance of FSH heterogeneity needs to be reviewed. First,
the proportion of less acidic and acidic FSH isoforms in C-FSH and
N-FSH, broadly speaking, reflect the relative proportion of less acidic
and acidic FSH isoforms prevailing during the prepubertal period and
the onset of puberty, respectively. It should, however, be recognized
that C-FSH and N-FSH are not true mimics of circulating FSH because
purification of FSH from the pituitary leads to elimination of less
acidic FSH isoforms, and the processing of FSH in circulation involves
more than removal of sialic acid. As such, structural differences are
likely to exist between our test preparations and the circulating
prepubertal and pubertal FSH. Second, N-FSH, similar to circulating FSH
at the time of onset of puberty in female lambs (5), is
more bioactive in eliciting E2 increases in in vitro FSH
bioassays (33). Third, in spite of its fast clearance,
N-FSH may facilitate different types of FSH receptor(s) interactions,
couple to different signaling cascades, and result in different
outcomes than what would be achieved by the slow clearing C-FSH. For
example, FSH can lead to calcium increases within minutes of its
addition to target cells (34, 35). Similarly, effective
activation of adenyl cyclase by N-FSH is also possible because G
proteins can have half-lives in the order of seconds (36).
More recent studies have also shown that the ovine FSH receptor gene
undergoes alternate splicing and generates multiple transcripts and FSH
function is predominantly mediated through an alternatively spliced
novel growth factor type 1 receptor that exists in the ovary (37, 38). Considering all the above, N-FSH administered in a
pulsatile manner has the ability to provide an acute yet potent
stimulus and exert qualitatively different effects on target tissues
than C-FSH.
In this regard, the mode of FSH presented is also worthy of some
comment. Because of the long circulating half-life of available FSH,
FSH is conventionally administered once or twice daily during
gonadotropin stimulation protocols (39, 40, 41). In this
study, FSH was administered in a pulsatile manner at 2-h intervals for
the first 24 h and then hourly for the next 24 h for the
following reasons: 1) The mode of delivery paralleled the pattern of
GnRH/LH secretion heralding the onset of puberty (5, 42);
2) our recent study showed that, although not clearly discernible at
the peripheral level, FSH secretion is comprised of both basal and
episodic components and each pulse of GnRH was associated with an FSH
pulse (18); and 3) Nal-Glu administration blocked GnRH
action and ablated the GnRH-associated component of pulsatile FSH
secretion (Padmanabhan, V., N. P. Evans, G. E. Dahl,
F. J. Karsch, and J. Van Cleeff, unpublished
data). GnRH administration in intact animals is shown to
increase the release of less acidic FSH isoforms (5). The
levels of circulating FSH we achieved following pulsatile N-FSH also
paralleled that of the GnRH-treated group (although it failed to mimic
the fall that occurred during the late follicular phase of the
GnRH-driven animals) but much lower than that achieved with C-FSH.
Frequent sampling did confirm that N-FSH was delivered in the intended
pulsatile mode (Fig. 5
, inset).
In terms of outcome measures (follicular development and E2
production), C-FSH facilitated maturation of a greater number of
follicles than GnRH, thus possibly accounting for the higher level of
circulating E2 achieved by this group of lambs. Considering that the
breed we were working with was selected for twinning, an optimal
outcome would be achievement of dominance by two follicles per animal.
GnRH-treated animals provided the optimal drive in this context because
they showed development of one or two estrogenic follicles. In
contrast, two of the C-FSH-treated animals showed four to six
estrogenic follicles. From the standpoint of overcoming human
infertility with exogenous FSH, the outcome achieved with C-FSH is
optimal for in vitro fertilization protocols but not for
gonadotropin stimulation protocols in which the end goal is to
facilitate monoovular condition. It has been long debated whether a
short-acting FSH would help facilitate monoovular condition.
Our findings with N-FSH show that provision of less acidic FSH isoforms
throughout follicular development (as done in this study) is not an
optimal alternative. Although N-FSH administration limited the
development of estrogenic follicles to one or two in the two animals
that responded, they were not optimal in terms of consistency of
response among animals. Only two of the six animals driven with N-FSH
developed estrogenic follicles. Inconsistent responses we achieved with
N-FSH may relate to when N-FSH was administered during follicular
development. In this study, prepubertal lambs were stimulated
throughout with one or the other form of FSH, namely C-FSH or N-FSH
(Fig. 8
, left and middle
panels). This drive contrasts with the type of FSH the ovary sees
during natural pubertal progression or during ovulatory cycles (Fig. 8
, right panel). Previous studies have shown that during the
prepubertal period (5) and the early follicular phase of
the estrus/menstrual cycle (5, 6, 7, 8, 9), the ovary is provided
with an acidic mix of FSH. In contrast, during pubertal onset and late
follicular phase of the estrus/menstrual cycle ovary receives a
different type of signaling via the less acidic mix of FSH
(5, 6, 7, 8, 9).

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Figure 8. Schematic showing the pattern of FSH/GnRH
delivery, the nature and levels of circulating FSH expected in the
circulation, maturational and estrogenic status of the follicles, and
circulating levels of E2 achieved. Note the nature of FSH in the three
groups: more acidic in C-FSH, less acidic in N-FSH, more acidic during
the first part, and less acidic during the latter part of GnRH
administration as predicted based on the nature of C-FSH and N-FSH
delivered and the nature of circulating FSH seen from a previous study
in the GnRH-drive group (5 ). Larger number of estrogenic
follicles and the higher level of circulating E2 is the outcome in
C-FSH group, inconsistent response in N-FSH group (small number of
animals responding optimally and others did not), and optimal response
in the GnRH-driven animals (optimum response will be one to two
follicles achieving dominance).
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|
Provision of C-FSH and N-FSH in the sequence mimicking what naturally
occurs during pubertal transition and early to late follicular phase
transition, namely C-FSH during the first 24 h and N-FSH for the
subsequent 24 h, may help achieve optimal outcomes both in terms
of number of follicles becoming estrogenic and consistency of animal
responses. As such, the switch from more acidic to a less acidic mix of
FSH signal during pubertal onset and reproductive cyclicity may be a
means to limit the amount of circulating FSH and thus restrict the
number of follicles being selected. Although this premise remains to be
tested, it is in agreement with the better success rate achieved with
the physiologic step-down approach for avoiding multifollicular cycles
(43, 44).
 |
Acknowledgments
|
|---|
We are grateful to Douglas D. Doop and Gary McCalla for the
quality care and maintenance of the ewes used in this study; Drs.
Gordon Niswender and Leo E. Reichert for supplying LH assay reagents;
Dr. Morton B. Brown for statistical advice; Dr. Harold Papkoff for the
provision of purified pituitary FSH; and the National Pituitary Hormone
Program for their generous gift of the FSH standard and FSH
antisera.
 |
Footnotes
|
|---|
Preliminary report, 11th International Congress of Endocrinology,
Sydney, Australia, October 2000, p. 120 (Abstract P102).
This work was supported by USPHS Grant HD 23812.
1 Present address: Pfizer, Inc., Global Research and
Development, Ann Arbor, Michigan 48105. 
Abbreviations: C-FSH, Acidic native mix (purified ovine
pituitary FSH); N-FSH, less acidic mix generated by exposing the C-FSH
to neuraminidase.
Received June 19, 2001.
Accepted for publication September 25, 2001.
 |
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