17 beta-Estradiol (E2) exerts negative feedback effects at the hypothalamo-pituitary level on serum FSH. This study investigated the effects of repeated daily administration of intranasal E2 (S21400) on the pharmacokinetics (PK) of E2 and estrone (E1) and the pharmacodynamics (PD) of FSH and assessed the PK/PD relationship between E2 and FSH using population model-dependent analysis. Postmenopausal volunteers (n = 24) received according to a balanced cross-over design, two 28-d treatments separated by a 2-month wash-out period: 300 microg E2, either alone or combined with oral dydrogesterone (20 mg/d) during the last 14 d of one of the treatments. Absorption of E2 was rapid, with maximal plasma concentrations at 10-30 min, returning to postmenopausal levels within 12 h. Over the 24-h period, FSH levels showed a U curve, with a minimum around 8 h after E2 administration. Moreover, over the treatment period, FSH basal values decreased by 17% between d 1 and 14 and an additional 5% between d 14 and 28. A PK/PD model described these short- and mid-term effects, possibly reflecting separate regulation mechanisms by E2 on FSH release and biosynthesis, respectively. The administration of progestin had no influence on E1, E2, and FSH model parameters. This study suggests that daily transient tissue exposure to E2 after pulsed estrogen therapy elicits short- and mid-term effects on the gonadotropin axis.

译文

:17β-雌二醇(E2)在下丘脑-垂体水平上对血清FSH产生负反馈作用。这项研究调查了每天重复鼻内给药E2(S21400)对E2和雌酮(E1)的药代动力学(PK)和FSH的药效学(PD)的影响,并使用人群模型评估了E2和FSH之间的PK / PD关系相关分析。绝经后志愿者(n = 24)根据平衡的交叉设计方案接受两种28天的治疗,间隔2个月的洗脱期:300 microg E2,单独或与口服孕酮(20 mg / d)联合使用在其中一种治疗的最后14天期间。 E2吸收迅速,最大血浆浓度在10-30分钟,在12小时内恢复到绝经后水平。在24小时内,FSH水平呈U形曲线,在E2给药后约8 h呈最小。此外,在治疗期间,FSH基础值在d 1和14之间下降了17%,在d 14和28之间又下降了5%。PK/ PD模型描述了这些短期和中期影响,可能反映了不同的调节机制E2对FSH释放和生物合成的影响。孕激素的给药对E1,E2和FSH模型参数没有影响。这项研究表明,在脉冲雌激素治疗后,每天短暂的组织暴露于E2会对促性腺激素轴产生短期和中期影响。

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