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Effects of Prolactin in Stimulating Disease Activity in Systemic Lupus Erythematosusa

Authors

  • SARA E. WALKER,

    Corresponding author
    1. Rheumatology Section, Department of Veterans Affairs Medical Center, Columbia, Missouri 65201 USA
    2. Department of Internal Medicine, The University of Missouri, Columbia, Missouri 65212 USA
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  • ROBERT W. MCMURRAY,

    Corresponding author
    1. Department of Internal Medicine, The University of Missouri, Columbia, Missouri 65212 USA
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  • JOHN M. HOURI,

    1. Division of Immunology and Rheumatology, The University of Missouri, Columbia, Missouri 65212 USA
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  • SUSAN H. ALLEN,

    Corresponding author
    1. Rheumatology Section, Department of Veterans Affairs Medical Center, Columbia, Missouri 65201 USA
    2. Department of Internal Medicine, The University of Missouri, Columbia, Missouri 65212 USA
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  • DUANE KEISLER,

    1. Department of Animal Sciences, The University of Missouri, Columbia, Missouri 65212 USA
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  • GORDON C. SHARP,

    1. Department of Internal Medicine, The University of Missouri, Columbia, Missouri 65212 USA
    2. Division of Immunology and Rheumatology, The University of Missouri, Columbia, Missouri 65212 USA
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  • JANET A. SCHLECHTE

    1. Department of Medicine, University of Iowa, Iowa City, Iowa 52242 USA
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  • a

    This material is based upon work supported by the Office of Research and Development, Medical Research Service, Department of Veterans Affairs; the Department of Internal Medicine, University of Missouri, Columbia, Missouri; the Lupus Foundation of America, the Kansas City, Kansas and Charlotte, North Carolina chapters of the Lupus Foundation of America; and the Missouri Agricultural Experimental Station Project MO-137.

Address for correspondence: Sara E. Walker, M.D., 111-F VA Hospital, 800 Hospital Drive, Columbia, MO 65201. Telephone: 573-443-2511, Ext. 3392; Fax: 573-884-0304.

Current address: Robert W. McMurray, M.D., Division of Rheumatology/Molecular Immunology, L525 Clinical Sciences Building, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39214-4505.

Current address: Susan H. Allen, M.D., Medical Director, Kettering Osteoporosis Center, 3533 Southern Boulevard, Suite 3750, Dayton, OH 45429.

Abstract

Abstract: Systemic lupus erythematosus (SLE), a chronic autoimmune illness, is influenced by hormones. High prolactin concentrations were associated with early death from autoimmune renal disease in NZB/NZW mice, an animal model of severe SLE. NZB/NZW mice that delivered and nursed pups and those that underwent pseudopregnancy had changes in serum IgG and autoantibodies. NZB/NZW mice treated with the prolactin-suppressing drug bromocriptine had prolonged lives. Elevated serum prolactin concentrations are reported in SLE patients of both sexes. We found four women with long-standing hyperprolactinemia who developed SLE. A survey of premenopausal women whose sera were submitted for autoantibody testing showed that 20% with anti-ds-DNA antibodies also had high prolactin levels. Many hyperprolactinemic patients whose sera were referred to an endocrinology laboratory had positive FANA tests (women 33%, men 53%) but did not have SLE. Disease activity was suppressed in six of seven SLE patients treated with bromocriptine. All had elevated disease activity and five became unexpectedly hyperprolactinemic after treatment stopped. Manipulating serum prolactin affords a means of treating clinical SLE activity.

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