Prolactin — a pleiotropic factor in health and disease

• Published in: Nature reviews. Endocrinology 2019-06, Vol.15 (6), p.356-365
• Main Authors: Bernard, Valérie, Young, Jacques, Binart, Nadine
• Format: Article
• Language: English
• Subjects: 631/45/776; 692/163/2743; 692/698/1460/444; Adipose tissue; Autocrine signalling; Body weight; Breastfeeding & lactation; Cattle; Causes of; Cellular signal transduction; Complications and side effects; Development and progression; Dopamine; Dopamine receptors; Endocrine gland diseases; Endocrinology; Endocrinology and metabolism; Follicles; Growth hormones; Health aspects; Homeostasis; Human health and pathology; Hypogonadism; Infertility; Lactation; Life Sciences; Maternal behavior; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; Metabolic regulation; Pancreas; Paracrine signalling; Physiological aspects; Pituitary (anterior); Prolactin; Review Article; Skin; Stem cells
• ISSN: 1759-5029; 1759-5037
• DOI: 10.1038/s41574-019-0194-6

The principal role of prolactin in mammals is the regulation of lactation. Prolactin is a hormone that is mainly synthesized and secreted by lactotroph cells in the anterior pituitary gland. Prolactin signalling occurs via a unique transmembrane prolactin receptor (PRL-R). The structure of the PRL-R has now been elucidated and is similar to that of many biologically fundamental receptors of the class 1 haematopoietic cytokine receptor family such as the growth hormone receptor. The PRL-R is expressed in a wide array of tissues, and a growing number of biological processes continue to be attributed to prolactin. In this Review, we focus on the newly discovered roles of prolactin in human health and disease, particularly its involvement in metabolic homeostasis including body weight control, adipose tissue, skin and hair follicles, pancreas, bone, the adrenal response to stress, the control of lactotroph cell homeostasis and maternal behaviour. New data concerning the pathological states of hypoprolactinaemia and hyperprolactinaemia will also be presented and discussed. Prolactin is mainly known for its involvement in the regulation of lactation. In this Review, the authors describe other newly discovered roles of prolactin in human health and disease and discuss new data on the pathological states of hypoprolactinaemia and hyperprolactinaemia. Key points Prolactin exerts its actions via a transmembrane prolactin receptor (PRL-R), the structure of which has now been elucidated. Prolactin signalling is essential for the ontogenesis of pancreatic stem cells for the establishment of a functional β-cell reserve. In addition to its role in increasing dopaminergic inhibitory tone, prolactin exerts autocrine and paracrine feedback on lactotroph cells. Prolactin deficiency is rare and causes failure of lactation. Hyperprolactinaemia can be caused by medications or pituitary disease, can have systemic causes or can be idiopathic; this condition frequently leads to hypogonadism and infertility.