Skip to main content
×
×
Home

Will GNRH antagonists be worth the wait?

  • Keith Gordon (a1) and Gary D Hodgen (a1)
Extract

Gonadotropin-releasing hormone (GnRH) is also known as luteinizing hormone-releasing hormone (LHRH), formerly luteinizing hormone releasing factor (LRF). Since this hormone regulates the secretion of both FSH and LH, we prefer to call it GnRH. GnRH antagonists, as the name implies, are a class of compounds that actively compete with GnRH for the GnRH receptor, thereby neutralizing the effects of GnRH by competitive receptor occupancy. In order to fully appreciate their potential clinical utility, it is first important to comprehend the critical role of GnRH in the regulation of the pituitary-gonadal axis and secondly to familiarize ourselves with the mechanisms of action of GnRH, GnRH agonists and GnRH antagonists.

Copyright
Corresponding author
Keith Gordon, The Jones Institute for Reproductive Medicine, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia 23507, USA.
References
Hide All
1 Matsuo, H, Baba, Y, Nair, RMG, Arimura, A, Schally, AV. Structure of the porcine LH- and FSH-releasing hormone. I: The proposed amino acid sequence. Biochem Biophys Res Commun 1971; 43: 1334–39.
2 Burgus, R, Butcher, M, Amoss, M et al. Primary structure of the ovine hypothalamic luteinizing hormone-releasing factor (LRF). Proc Natl Acad Sci USA 1972; 69: 278–82.
3 Belchetz, PE, Plant, TM, Nakai, Y, Keogh, EJ, Knobil, E. Hypophysical responses to continuous and intermittent delivery of hypothalamic gonadotropin-releasing hormone. Science 1978; 202: 631–33.
4 Crowley, WF, McArthur, JW. Stimulation of the normal menstrual cycle in Kallmans's syndrome by pulsatile administration of luteinizing hormone-releasing hormone (LHRH). J Clin Endocrinol Metab 1980; 51: 173–75.
5 Leyendecker, G, Wildt, L, Hansmann, M. Pregnancies following chronic intermittent (pulsatile) administration of GnRH by means of a portable pump (‘Zyklomat’) – a new approach to the treatment of infertility in hypothalamic amenorrhea. J Clin Endocrinol Metab 1980; 51: 1214–16.
6 Leyendecker, G, Wildt, L. Pulsatile administration of GnRH in hypothalamic amenorrhea. Ups J Med Sci 1984; 89: 1932.
7 Karten, MJ, Rivier, JE. Gonadotropin-releasing hormone analog design. Structure function studies toward the development of agonists and antagonists: rationale and perspective. Endocr Rev 1986; 7: 4466.
8 Coy, DH, Horvath, A, Nekola, MV, Coy, EJ, Ercheigyi, J, Schally, AV. Peptide antagonists of LH-RH: large increases in antiovulatory activities produced by basic D-amino acids in the six position. Endocrinology 1982; 110: 1445–47.
9 Schmidt, F, Sundaram, K, Thau, RB, Bardin, CW. [Ac-D-Nal(2)1, 4FD-Phe2, D-Trp3, D-Arg6]-LHRH, a potent antagonist of LHRH, produces transient edema and behavioral changes in rats. Contraception 1984; 29: 283–89.
10 Morgan, JE, O'Neil, CE, Coy, DH, Hocart, SJ, Nekola, MV. Antagonistic analogs of luteinizing hormone-releasing hormone are mast cell secretagogues. Int Arch Allergy Appi Immunol 1986; 80: 7075.
11 Sundaram, K, Didolkar, A, Thau, R, Chaudhuri, M, Schmidt, F. Antagonists of luteinizing hormone releasing hormone bind to rat mast cells and induce histamine release. Agents Actions 1988; 25: 307–13.
12 Rivier, JE, Porter, J, Rivier, CL et al. New effective gonadotropin releasing hormone antagonists with minimal potency for histamine release in vitro. J Med Chem 1986; 29: 1846–51.
13 Jockenhovel, F, Bhasin, S, Steiner, BS, Rivier, JE, Vale, WW, Swerdloff, RS. Hormonal effects of single gonadotropin-releasing hormone antagonist doses in men. J Clin Endocrinol Metab 1988; 66: 1065–70.
14 Pavlou, SN, Wakefield, G, Schlechter, NL et al. Mode of suppression of pituitary and gonadal function after acute or prolonged administration of a luteinizing hormone-releasing hormone antagonist in normal men. J Clin Endocrinol Metab 1989; 68: 446–54.
15 Bremner, WJ, Bagatell, CJ, Steiner, RA. Gonadotropin-releasing hormone antagonist plus testosterone: a potential male contraceptive. J Clin Endocrinol Metab 1991; 73: 465–69.
16 Leal, JA, Gordon, K, Danforth, DR, Williams, RF, Hodgen, GD. Antide: a ‘third generation’ GnRH antagonist with minimal histamine release. Drugs of the Future 1991; 16: 529–37.
17 Clayton, RN, Catt, KJ. Gonadotropin-releasing hormone receptors: characterization, physiological regulation, and relationship to reproductive function. Endocr Rev 1981; 2: 186209.
18 Clayton, RN. Mechanism of GnRH action in gonadotrophs. Hum Reprod 1988; 3: 479–83.
19 Chang, JP, McCoy, EE, Graeter, J, Tasaka, K, Catt, KJ. Participation of voltage-dependent calcium channels in the action of gonadotropin-releasing hormone. J Biol Chem 1986; 261: 9105–108.
20 Huckle, WR, McArdle, CA, Conn, PM. Differential sensitivity of agonist- and antagonist-occupied gonadotropin-releasing hormone receptors to protein kinase C activators. J Biol Chem 1988; 263: 3296–302.
21 Naor, Z. Signal transduction mechanism of Ca2+ mobilizing hormones: the case of gonadotropin-releasing hormone. Endocr Rev 1990; 11: 326–53.
22 Meldrum, DR, Tsao, Z, Monroe, SE et al. Stimulation of LH fragments with reduced bioactivity following GnRH agonist administration in women. J Clin Endocrinol Metab 1984; 58: 755–57.
23 Dahl, KD, Pavlou, SN, Kovacs, WJ, Hsueh, AJW. The changing ratio of serum bioactive to immunoreactive follicle-stimulating hormone in normal men following treatment with a potent gonadotropin releasing hormone antagonist. J Clin Endocrinol Metab 1986; 63: 792–94.
24 Conn, PM, Rogers, DC, Steward, JM, Niedel, J, Sheffield, T. Conversion of a gonadotropin-releasing hormone antagonist to an agonist. Nature 1982; 296: 653–55.
25 Blum, JJ, Conn, PM. Gonadotropin-releasing hormone stimulation of luteinizing hormone release: a ligand-receptor-effector model. Proc Natl Acad Sci USA 1982; 79: 7307–11.
26 Hazum, E, Conn, PM. Molecular mechanism of gonadotropin releasing hormone (GnRH) action. I: The GnRH receptor. Endocr Rev 1988; 9: 379–86.
27 Hodgen, GD. Uses of GnRH analogs in IVF/GIFT. Contemp Obstet Gynecol 1990; 35: 1024.
28 Gordon, K, Hodgen, GD. GnRH analogues in ovarian stimulation. Ann N Y Acad Sci 1991; 626: 238–49.
29 Fraser, HM. LHRH analogues: their clinical physiology and delivery systems. Balliere's Clin Obstet Gynecol 1988; 2: 639–58.
30 Yen, SSC. Clinical applications of gonadotropin-releasing hormone and gonadotropin-releasing hormone analogs. Fertil Steril 1983; 39: 257–66.
31 Ory, SJ. Clinical uses of luteinizing hormone-releasing hormone. Fertil Steril 1983; 39: 577–91.
32 Sandow, J. Clinical applications of LHRH and its analogues. Clin Endocrinol (Oxf) 1983; 18: 571–92.
33 McLachlan, RI, Healy, DL, Burger, HG. Clinical aspects of LHRH analogues in gynecology: a review. Br J Obstet Gynaecol 1986; 93: 431–54.
34 Smith, JA, Glode, LM, Wettlaufer, JN et al. Clinical effects of gonadotropin-releasing hormone analogue in metastatic carcinoma of prostate. Urology 1985; 25: 106–14.
35 Gordon, K, Williams, RF, Danforth, DR, Conn, PM, Hutchison, JS, Hodgen, GD. Suppression of ovarian estradiol secretion by a single injection of Antide in cynomolgus monkeys during the early follicular phase: immediate, sustained and reversible actions. J Clin Endocrinol Metab 1991; 73: 1262–68.
36 Gordon, K, Williams, RF, Danforth, DR, Hodgen, GD. Antide-induced suppression of pituitary gonadotropin and ovarian steroid secretion in cynomolgus monkeys: premature luteolysis and prolonged inhibition of folliculogenesis following single treatment. Biol Reprod 1991; 44: 701706.
37 Kenigsberg, D, Hodgen, GD. Ovulation inhibition by administration of weekly gonadotropin-releasing hormone antagonist. J Clin Endocrinol Metab 1986; 62: 734–38.
38 Chillik, CF, Itskovitz, J, Hahn, DW, McGuire, JH, Danforth, DR, Hodgen, GD. Characterizing pituitary response to a gonadotropin-releasing hormone (GnRH) antagonist in monkeys: tonic follicle-stimulating hormone/luteinizing hormone secretion versus acute GnRH challenge tests before, during, and after treatment. Fertil Steril 1987; 48: 480–85.
39 Leal, JA, Gordon, K, Williams, RF, Danforth, DR, Roh, SI, Hodgen, GD. Probing studies on multiple dose effects of Antide (Nal-Lys) GnRH antagonist in ovariectomized monkeys. Contraception 1989; 40: 623–33.
40 Gordon, K, Williams, RF, Danforth, DR, Hodgen, GD. A novel regimen of gonadotropin-releasing hormone (GnRH) antagonist plus pulsatile GnRH: controlled restoration of gonadotropin secretion and ovulation induction. Fertil Steril 1990; 54: 1140–45.
41 Sopelak, VM, Hodgen, GD. Infusion of gonadotropin-releasing hormone agonist (GnRH-Ag) during pregnancy. Maternal and fetal response in primates. Am J Obstet Gynecol 1987; 156: 755–60.
42 Hodgen, GD. Gonadotropin-releasing hormone agonists: emerging modification of treatment regimens. Curr Opin Obstet Gynecol 1991; 3: 352–58.
43 Abbasi, R, Hodgen, GD. Predicting predisposition to osteoporosis. JAMA 1986; 255: 1600–604.
44 Danforth, DR, Itskovitz, J, Chillik, C, Hahn, D, McGuire, JL, Hodgen, GD. In: Korenman, SG ed. Proceedings from the Serano Symposium for Menopause: biological and clinical consequences of ovarian failure – evaluation and management. New York: Plenum Press, 1989.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Reproductive Medicine Review
  • ISSN: 0962-2799
  • EISSN: 1469-9028
  • URL: /core/journals/reproductive-medicine-review
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 2 *
Loading metrics...

Abstract views

Total abstract views: 31 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 12th June 2018. This data will be updated every 24 hours.