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Thoracic stimulation and prolactin secretion

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Abstract

Although galactorrhea and/or enhanced prolactin (PRL) secretion have been reported with a variety of thoracic stimuli, the effect of thoracic stimulation on dynamic prolactin secretion is not clear. A 49-year-old woman with ventilatory muscle weakness from polio presented with galactorrhea, and intermittent hyperprolactinemia but regular menses. The galactorrhea was noted following the use of a new, tight fitting cuirass (thoracic apparatus which assists ventilation). To determine if the new, “tight” cuirass elicited enhanced PRL secretion, and to assess more extensively the effect of such thoracic stimulation on PRL secretion, serum PRL was measured during brief and prolonged stimulation, sleep, and pharmacological manipulation of PRL. Basal PRL was normal (<25 ng/ml) and increased during brief stimulation (1 hour) with the “tight” (137%) and “loose” cuirass (140%). Although the absolute increments were similar, the “tight” cuirass elicited an earlier PRL peak than the “loose” cuirass and the PRL began to decrease while the “tight” cuirass was still functioning. Several hours of thoracic stimulation resulted in a transient rise in PRL and a fall to normal, prestimulatory levels despite persistent stimulation. During this stimulation, PRL did not rise after sleep nor after insulin-induced hypoglycemia despite normal cortisol and GH increments, but the PRL response after TRH was exaggerated. These data suggest that: 1) the intensity of the thoracic stimulation affects the time of onset rather than the magnitude of the PRL response; 2) extended thoracic stimulation results in the development of an adaptive or counter-regulatory response to the stimulus for PRL secretion; 3) the cuirass inhibits a normal CNS-mediated PRL response to other neurogenic stimuli (hypoglycemia and sleep) despite the presence of pituitary lactotropes which exhibit a hyperresponsive PRL response to direct stimulation by TRH.

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  1. Department of Medicine, Case Western University School of Medicine, Cleveland Metropolitan General Hospital, USA

    L. P. Kapcala M.D. & M. C. Lakshmanan

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  1. L. P. Kapcala M.D.
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  2. M. C. Lakshmanan
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Kapcala, L.P., Lakshmanan, M.C. Thoracic stimulation and prolactin secretion. J Endocrinol Invest 12, 815–821 (1989). https://doi.org/10.1007/BF03350070

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