Free α-Subunit Is the Most Sensitive Marker of Gonadotropin Recovery after Treatment of Central Precocious Puberty with the Histrelin Implant

Background: Gonadotropin free α-subunit (FAS) levels paradoxically increase during GnRH agonist (GnRHa) treatment of central precocious puberty (CPP). The histrelin implant suppresses gonadotropins and estradiol (E2) levels for 1 yr, but effects on FAS have not been described. Objectives: We aimed t...

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Published in:The journal of clinical endocrinology and metabolism 2010-06, Vol.95 (6), p.2841-2844
Main Authors: Hirsch, Harry J., Lahlou, Najiba, Gillis, David, Strich, David, Rosenberg-Hagen, Binyamina, Chertin, Boris, Farkas, Amicur, Hartman, Hadassa, Spitz, Irving M.
Format: Article
Language:English
Subjects:
Biological and medical sciences
Child
Delayed-Action Preparations
Drug Implants
Endocrinopathies
Estradiol - blood
Feeding. Feeding behavior
Female
Follicle Stimulating Hormone
Follicle Stimulating Hormone, Human - blood
Fundamental and applied biological sciences. Psychology
Glycoprotein Hormones, alpha Subunit - metabolism
Gonadotropin-Releasing Hormone - administration & dosage
Gonadotropin-Releasing Hormone - analogs & derivatives
Gonadotropin-Releasing Hormone - therapeutic use
Gonadotropins - metabolism
Humans
Hydrogels
Luteinizing Hormone - blood
Medical sciences
Puberty, Precocious - drug therapy
Puberty, Precocious - metabolism
Recovery of Function
Vertebrates: anatomy and physiology, studies on body, several organs or systems
Vertebrates: endocrinology
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Summary:Background: Gonadotropin free α-subunit (FAS) levels paradoxically increase during GnRH agonist (GnRHa) treatment of central precocious puberty (CPP). The histrelin implant suppresses gonadotropins and estradiol (E2) levels for 1 yr, but effects on FAS have not been described. Objectives: We aimed to determine whether FAS levels remain elevated during treatment with the implant, to assess the dynamics of FAS after removal, and to ascertain the reliability of FAS for monitoring gonadotropin secretion. Methods: Ten girls with CPP were studied. In eight, monthly im GnRHa preparations were given until implant insertion. Two naive girls did not receive prior GnRHa. Duration of implant treatment ranged from 18–63 months with repeated implant removals and insertions of new implants. LH, FSH, E2, and FAS were measured before implant insertion in the two naive patients and during treatment, and in all girls before and after implant removal. Results: FAS levels were 0.2 and 0.4 ng/ml (normal,
ISSN:0021-972X
1945-7197
DOI:10.1210/jc.2009-2078