Active immunization against LHRH alone or combined with LHRH-analogue treatment impedes growth of androgen-dependent prostatic carcinoma.

PROBLEM: To determine whether active immunization against LHRH can serve as treatment for androgen-dependent prostatic carcinoma. METHOD: Male rats of Copenhagen X Fisher strain, implanted with Dunning R-3327 prostatic carcinoma cells were either immunized against LHRH, treated with LHRH-antagonist, or received a combined treatment of active immunization against LHRH and LHRH-antagonist. RESULTS: Testicular histology was consistent with infertility in all treatment groups. The rate of tumor growth was inhibited by all three treatment regimens. Tumor size increased by 3.8 +/- 1.4 cm2 in the LHRH-antagonist group, 3.2 +/- 1.1 cm2 in the immunized group, and 1.0 +/- 0.4 cm2 in the combined treatment group, as compared to 8.2 +/- 2.6 cm2 in non-treated control group. CONCLUSION: LHRH-antagonist administration combined with immunization against LHRH appeared to exert a synergistic effect. This may be due to the blockade of prostatic LHRH-like receptors by the antagonist, while androgen depletion was rapidly achieved by LHRH-antagonist, and maintained by continued gonadotropin suppression caused by active immunization against LHRH once antagonist treatment had been discontinued.

Development of an antifertility vaccine for pets based on active immunization against luteinizing hormone-releasing hormone.

Male dogs and cats were immunized against LHRH in order to evaluate the feasibility of an immunological approach to pet contraception. In the first study, dogs were immunized with 100, 500, or 2500 micrograms of LHRH conjugated to tetanus toxoid. A significant decline in serum testosterone (T) levels was observed in all immunized dogs, reaching castration levels in some animals by Week 4 and remaining suppressed in all the immunized dogs through the course of the study. Testicular histology suggested arrest of spermatogenesis (infertility). The effects of "immunological castration" were reversible (study 2): steroidogenesis suppressed by "immunological castration" was restored as antibody titers declined. Effective antibodies were rapidly reinduced in dogs by a single injection of LHRH1-TT. In contrast, the level of antibodies induced in male cats (study 3) was not sufficient for "immunological castration." The conclusion was that active immunization against LHRH could provide a cost-effective, nonsurgical, reversible means to control the fertility of companion animals.

Anti-LHRH and anti-pituitary gonadotropin vaccines: their development and clinical applications.

Active immunization against hormones involved in the regulation of reproduction is a promising approach to immunocontraception. The hypothalamic peptide, LHRH, controls the synthesis and release of the pituitary gonadotropins, LH and FSH, which regulate gonadal steroidogenesis, sperm production, follicular development and ovulation. Immunizing female primates against LHRH or LH induces infertility, but also disrupts the menstrual cycle. Immunization against the beta subunit of the placental hormone, chorionic gonadotropin (hCG), or its fragment prevents pregnancy without interfering with menstrual cycles or ovulation. hCG vaccines have reached the stage of clinical trials. FSH and LHRH have been tested for immunocontraception in male primates. While active as well as passive immunization against FSH reduced spermatogenesis severely, azoospermia could not be achieved consistently. Immunization against LHRH effectively suppressed spermatogenesis in rats and rabbits. Normal sexual behaviour was maintained by concomitant androgen administration. Fertility was restored when antibody titres declined and no adverse effects were observed. A number of LHRH vaccine preparations are being tested in men in several countries, including the United States. Since the LHRH vaccine reduces serum testosterone levels the first clinical studies involve men with prostate cancer. These trials will be followed by immunization of normal men if the antibody response is sufficient and no adverse effects are observed.

PIP: Long-lasting, safe, and inexpensive reversible methods of birth control that allow administration by non medical personnel are acutely needed. Among immunological approaches several contraceptive vaccines are the targets of clinical trials, and anti hormone vaccines are the most promising. The method for women is based on active immunization against human chorionic gonadotropin (hCG). Immunization against luteinizing hormone releasing hormone (LHRH) prevents endogenous LHRH from binding to pituitary receptors thereby disrupting the menstrual cycle and ovulation and suppressing not only sperm production but also testosterone synthesis. In females, immunization against LHRH appears less promising. The results from numerous animal studies suggest that active immunization against LHRH is a promising method in men, but the libido must be maintained by concomitant administration of exogenous androgen. Immunization against LHRH suppresses serum testosterone levels, thus the first clinical trials involving men with prostate carcinoma commenced in several countries show that high levels of anti-LHRH antibodies can be induced. In luteinizing hormone (I.H.) vaccine development immunization against LH in males is not superior to the LHRH vaccine, since anti-LH in males is not superior to the LHRH vaccine, since anti-LH antibodies suppress testosterone. Active immunization of females against species-specific LH can block ovulation and results in distribution of cyclicity and suppression of ovarian steroidogenesis which could lead to undesirable long-term effects. Various hCG vaccines are now in clinical trials. In follicle stimulating hormone (FSH) vaccine preparation for clinical trials in men, acute and subacute animal toxicity studies were performed in rats and monkeys with no indication of adverse effects. In rhesus an crab-eating monkeys consistent infertility did not arise after active immunization against FSH, but the bonnet monkey was encouraging.

Radioimmunoassay of 7 alpha-methyl-19-nortestosterone and investigation of its pharmacokinetics in animals.

A method for the measurement of 7 alpha-methyl-19-nortestosterone (7MENT) in serum/plasma by radioimmunoassay (RIA) is described. The antiserum, raised against 7 alpha-methyl-19-nortestosterone-3-O-oxime-bovine serum albumin, had a low titer (final dilution = 1:4500) and low affinity (Ka = 1.17 x 10(9) l/mol) but showed little or no cross-reactivity with several of the steroids tested. The sensitivity of the RIA was 28.2 pg/ml and the mean recovery of added cold steroid was 86 to 100%. Intra- and inter-assay coefficients of variation ranged from 4.3 to 7.3% and 7.3 to 8.4%, respectively. This RIA was used to follow plasma 7MENT levels after a single i.v. injection of the steroid in rats and rabbits. The metabolic clearance rates (MCR) of 7MENT as determined from the plasma disappearance curve for rats and rabbits were 50 l/day and 336 l/day, respectively. The MCR of 7MENT in rats and rabbits lies in the same range as for testosterone. When compared to other nortestosterone derivatives such as norethisterone, 7MENT is metabolized relatively faster.

Active immunization against LHRH: I. Effects of conjugation site and dose.

UNLABELLED: Active immunization against LHRH is a promising method of contraception for men. In order to be acceptable, sufficient amounts of anti-LHRH antibodies must be induced rapidly after vaccination. In previously reported animal studies, we found that it took considerable time (up to 5 months) to obtain antibody titers (AT) that were sufficiently high for complete suppression of spermatogenesis. The possibility of accelerating the immune response to LHRH by increasing the dose of immunogen was investigated in the male rat. Six doses of LHRH conjugated to tetanus toxoid (TT) in the 10 position (LHRH10-TT), ranging from 2.5 to 612 micrograms, and three doses of LHRH1-TT (50 to 612 micrograms) were tested. The magnitude of the immune response did not depend on the dose of the antigen, provided a threshold dose had been surpassed. Antigenicity of LHRH conjugated to TT at either the 1-, 6-, or 10-position was compared in rats and rabbits. In both species LHRH1-TT induced sufficient antibody concentrations to suppress pituitary gonadotropins (LH and FSH) and, subsequently, serum testosterone (T) levels faster than either the 6- or 10-conjugates. Only materials permitted for use in humans were utilized in these experiments. CONCLUSION: Active immunization against LHRH conjugated to TT at the 1-position has potential as a fast, convenient method of male contraception.

The implication of opiates in the glucocorticoid-mediated inhibition of LH secretion in rats.

The present study was designed to test the effect of acute administration of dexamethasone on the postcastration and gonadotrophin-releasing hormone (GnRH)-induced rise of LH, and to examine whether the inhibitory action of glucocorticoids on LH secretion was mediated by the opioid system. Rats were castrated and injected 10-10.5 h later in a first set of experiments with saline, dexamethasone (250 micrograms/rat), nalmefene (2 mg/kg body weight) or nalmefene plus dexamethasone. The response to GnRH was tested 11 h after castration (time 0) in all groups. Dexamethasone caused a significant (P less than 0.005) decrease in basal serum concentrations of LH, while saline and nalmefene did not induce any change. The administration of dexamethasone preceded by nalmefene increased basal concentrations of LH (1.6 times), with an effect significantly greater than that of dexamethasone (P less than 0.001), nalmefene (P less than 0.05) or saline (P less than 0.005) alone. GnRH induced a significant (P less than 0.001) increase in serum concentrations of LH in all groups. In a second set of experiments, administration of naloxone (2 mg/kg body weight) increased LH levels (P less than 0.05) and similarly reversed the inhibitory effect of dexamethasone on LH.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of long-term immunization against LHRH and androgen treatment on gonadal function.

The possibility of immunological suppression of spermatogenesis while normal libido is maintained by exogenous androgen supplementation was tested in male rats. Neither short- nor long-term treatment with androgen (testosterone-17-trans-4-N-butyl-cyclohexane carboxylate) alone influenced fertility. Active immunization against LHRH administered simultaneously with exogenous androgen supplement caused infertility in 100% of the tested animals, all of which displayed normal sexual behavior. The atrophy of the testes and accessory sex organs was reversible.

Antagonists of luteinizing hormone releasing hormone bind to rat mast cells and induce histamine release.

It was reported previously that administration of certain synthetic antagonists of LHRH to rats produced allergy-like symptoms that were attributed to their histamine releasing action. In the present study the interaction of LHRH analogs with rat peritoneal mast cells was investigated in vitro. Potent antagonists of LHRH showed strong in vitro histamine releasing activity from rat peritoneal mast cells. Membrane preparations of rat pituitary glands showed specific binding of radioiodinated LHRH antagonist as well as LHRH agonist. However, rat peritoneal mast cells and membrane preparations from those cells bound antagonist but not the agonist. Furthermore, the LHRH antagonist did not bind to membranes prepared from tissues such as prostate, liver, kidney, and brain. Competitive displacement curves of the [125I]-antagonist with different LHRH analogs showed that the ability of the analogs to compete for binding sites on mast cells was related to their histamine releasing activity. We conclude that histamine release from rat mast cells induced by LHRH analogs is mediated by specific binding of the active peptides to cell membranes. Furthermore, using rat mast cells, the binding assay in conjunction with histamine releasing assay may be utilized to predict the in vivo histamine releasing potential of new LHRH peptides which are of clinical importance.

Urinary steroid concentrations during natural and gonadotrophin-induced oestrus and pregnancy in the giant panda (Ailuropoda melanoleuca).

Urinary concentrations of conjugated oestrone and pregnanediol-3-glucuronide were measured during and after spontaneous and induced oestrus and during pregnancy. Behavioural oestrus was preceded by a rise in oestrone values from less than 10 ng/mg creatinine (Cr) to peaks of 45 ng/mg Cr. Maximal lordotic response and mating activity coincided with the decline in oestrone levels. After presumed ovulation, urinary pregnanediol glucuronide concentrations increased from less than 5 to 15-30 ng/mg Cr. Further increases in this steroid (to 60-80 ng/mg Cr) occurred 114 days after mating, presumably coincident with implantation. These high levels of pregnanediol glucuronide were maintained for 3 weeks, began to decline 1 week before parturition and fell to a nadir (less than 5 ng/mg Cr) immediately after delivery. When FSH was administered i.m. for 5 days, urinary oestrone values rose markedly and were maximal (580 ng/mg Cr) on Day 7. Mating first occurred on Day 20 and 500 i.u. hCG were given i.m. Urinary pregnanediol glucuronide levels during the next 5 months were similar to those in the previous year during pregnancy with values rising 105-108 days after mating. However, no birth occurred. These results support the suggestion that pandas exhibit delayed implantation and demonstrate that the panda is responsive to exogenous gonadotrophins.

Active immunization against gonadotropin-releasing hormone combined with androgen supplementation is a promising antifertility vaccine for males.

Male rats and rabbits were immunized against gonadotropin-releasing hormone (GnRH) conjugated to tetanus toxoid (GnRH10-TT) using only materials approved for humans. Testosterone (T)-releasing implants or the long-lasting T ester testosterone-17-trans-4-n-butyl-cyclohexane carboxylate (TE) was used as supplemental androgen for maintaining libido. Immunization against GnRH10-TT effectively suppressed fertility (spermatogenesis) in rats and rabbits. Neither T nor TE administration restored fertility. Both androgens were effective in maintaining normal libido in rats. TE, which is not hydrolyzed in rabbits, was less effective in maintaining normal ejaculatory behavior in this species. Active immunization against GnRH could be a convenient and cost-effective method of fertility control in males.

Failure of gonadotropin therapy secondary to chorionic gonadotropin-induced antibodies.

Seventeen years after first receiving treatment with hCG (at age 8 yr), a man with hypogonadotropic hypogonadism no longer responded to gonadotropin therapy. He had received hCG for 6 months when he was 8 yr old, from age 18-21 yr and from age 21-25 yr, when the resistance developed. Anti-hCG antibodies were found in his serum. Three sequential treatment regimens were tried to obviate the effect of these antibodies. 1) hCG treatment (2000 IU, three times per week) concomitant with weekly plasmapheresis (since the patient's response to an hCG challenge test was improved after a reduction of antibody titer by plasmapheresis) resulted in only a temporary increase in testosterone production. 2) Treatment with human (h) LH (400 IU/week) and hFSH (25 IU/week) was used because of the low cross-reaction of the antibodies with hLH and a response to a hLH-challenge test. This treatment maintained serum testosterone levels within the normal range for long periods, but had to be discontinued when the supply of hLH was exhausted. 3) Pulsatile LHRH administration (25 ng/kg, sc, every 2 h) for 2 months did not induce the release of pituitary gonadotropins. These results indicated that 1) conventional hCG treatment was impaired by antibody-induced changes in the kinetics of hCG after its im administration; 2) hLH was an effective substitute for hCG, and the combined hLH-hFSH administration initiated a moderate amount of spermatogenesis; and 3) the patient differs from most individuals with hypogonadotropin hypogonadism in that he did not have normal responses to repetitive LHRH administration.

Androgen binding protein in serum, testis and epididymis following treatment with the Leydig cell cytotoxic agent, ethylene dimethanesulphonate.

Androgen binding protein (ABP) was measured in the serum, testes and epididymides of adult male rats after treatment with ethylene dimethanesulphonate (EDS), which has direct cytotoxic effects on Leydig cells and secondarily affects sperm production. Serum ABP increased to a maximum 7 days after treatment and remained elevated for most of the 63 days of observation. The ABP content of both the epididymides and testes declined and were low between 14 days and 21 days following treatment. By contrast, the concentration of ABP in these tissues was maintained after EDS treatment and was sometimes elevated. This divergence between ABP content and concentration was due to atrophy of the testes and epididymides after the decline in androgen secretion. The changes in serum and tissue ABP levels after EDS occurred earlier than those observed in adult hypophysectomized animals, possibly due to local paracrine influences that are lost secondarily to destruction of the Leydig cells. Testicular testosterone did not parallel ABP content as it fell dramatically 2 days after EDS and remained low for about 21 days before returning to near control values after 63 days. Testicular and epididymal sperm heads decreased in number after EDS, but were not clearly associated with the changes in ABP. The results confirm that androgens are important for the production of ABP and for the partitioning of this protein between the blood and the lumen of the reproductive tract.

Conditional task-related responses in monkey dorsomedial frontal cortex.

Dorsomedial frontal cortex (DMFC) was studied in monkeys trained to make visually guided eye or arm movements. Portions of DMFC are involved in the execution of learned, goal-directed behaviors. Many neurons discharge with both eye and hand movements as well as when motor responses are withheld, provided these behaviors are related to the successful execution of the learned task. Similar movements, when carried out at times unrelated to the task, are not accompanied by neuronal activity. Electrical microstimulation produces either arrest of task-related, but not task-unrelated motor acts, or triggers task-related movements. The nature of stimulation elicited responses depends on the task the animal has been trained on and is altered by new training.

Long-term immunization against the beta-subunit of ovine luteinizing hormone (oLH beta) has no adverse effects on pituitary function in rhesus monkeys.

One postulated safety hazard of contraceptive methods based on immunization against gonadotropic hormones is the possibility that circulating antibodies which crossreact with pituitary hormones may impair pituitary function through the deposition of immunoglobulin and/or complement suggesting immune complexes. In order to evaluate this possibility in rhesus monkeys actively immunized against the beta-subunit of ovine luteinizing hormone (oLH beta), we used three approaches to study the effects of long-term immunization on pituitary function: a) evaluation of pituitary responsiveness to challenge with a GnRH-agonist; b) examination of pituitary histology and immunostaining with gonadotropin antisera; and c) examination of pituitary cells for deposition of immune complexes. Our results indicate that circulating anti-oLH beta antibodies did not result in significant impairment of pituitary function in rhesus monkeys.

Evidence suggesting that germ cells influence the bidirectional secretion of androgen binding protein by the seminiferous epithelium demonstrated by selective impairment of spermatogenesis with busulphan.

Androgen binding protein (ABP) was measured in the serum, testes and epididymides of adult rats up to 105 days after the induction of reversible impairment of spermatogenesis by a single injection of busulphan. This treatment decreased testicular and epididymal weights within 7-21 days after treatment, reaching a minimum at 63 days with partial recovery by 105 days. The testicular and epididymal content of sperm was unchanged up to 42 days after busulphan administration, was reduced considerably at 63 days and thereafter increased towards control values. The serum and testicular concentrations of testosterone were normal at all times after treatment, even though serum LH levels were increased at 42 and 63 days. Serum levels of FSH were also increased at 43 and 63 days after treatment. A biphasic pattern in the serum levels of ABP was observed. Concentrations were low up to 43 days post treatment when only the early germ cell types were depleted from the seminiferous epithelium and when the testicular and epididymal contents of ABP were normal. Serum levels of ABP increased as the more mature germ cells were depleted in numbers and the testicular and epididymal contents of ABP declined. It is concluded that bidirectional secretion of ABP into the interstitium (serum) and into the seminiferous tubular lumen by Sertoli cells is influenced considerably by the population of germ cells that are present in the seminiferous epithelium.

Experimental evidence supporting a mathematical theory of the physiological mechanism regulating follicle development and ovulation number.

In higher vertebrates, follicular development is regulated so that the number of follicles that periodically mature and ovulate is controlled within a narrow range. Lacker has proposed a simple mathematical model of follicle development that can account for the regulation of ovulation number. To support the assumption of the theory that follicle interactions are mediated by estradiol acting as a chemical messenger to communicate follicular maturity to the pituitary and other follicles, we have presented data to demonstrate that in the rabbit physiological concentrations of circulating estradiol inhibit follicle maturation. Implants containing estradiol were placed subcutaneously after surgical rupture of the existing follicles that were 1 mm in diameter or larger. Serum estradiol concentrations were maintained near physiological concentrations by the implants. Concentrations of circulating estradiol were 74 +/- 5.7 pg/ml in the untreated groups, whereas the concentrations with the implants were increased by approximately 50 pg/ml/implant over this basal concentration with a range of 100-300 pg/ml. In the control groups, the average number of follicles before surgical rupture was 27 +/- 2.9 and there was no significant difference (p greater than 0.05) in the number of follicles, 26 +/- 1.9, three days after follicle rupture. The follicles ranged in size from 1 mm to 4 mm, and only those over 3 mm were considered mature. In the first group of animals with implants, the total number of follicles before surgery was 19 +/- 3; three days after follicle rupture, the number of follicles was only 9 +/- 1.1.(ABSTRACT TRUNCATED AT 250 WORDS)

Reversal of testicular function after prolonged suppression with an LHRH agonist in rhesus monkeys.

Using subcutaneously implanted osmotic pumps, four male rhesus monkeys were continuously infused for 18 months with 100 micrograms/day of [(imBzl)-D-His6-Pro9-NEt]-LHRH (LHRH-A), a potent agonist of LHRH. After an initial increase, serum testosterone levels declined to 10% of pretreatment levels in three monkeys and the response to electroejaculation was lost. There was a decrease in testicular volume. Androgen replacement in the form of subcutaneous SILASTIC implants releasing 7 alpha-methyl-19-nor-testosterone acetate led to a restoration of ejaculatory response and the electroejaculates were devoid of spermatozoa. Under this treatment regimen (100 micrograms LHRH-A + 100 micrograms androgen daily), azoospermia was essentially maintained in the three monkeys for about 8 months. Withdrawal of LHRH-A and androgen treatment led to a complete restoration of testicular function. Serum testosterone returned to control levels and spermatozoa reappeared in the ejaculates with sperm counts reaching the normal range. Testicular volumes showed a gradual increase. These results indicate that continuous administration of an LHRH agonist together with an androgen can induce an extended period of azoospermia in rhesus monkeys. These results also show that after prolonged suppression (more than one year) of testicular function complete recovery occurs after cessation of treatment.

Regulation of pituitary gonadotropin-releasing hormone receptors by androgens in the male rabbit.

The regulation of pituitary GnRH receptors was studied in adult male rabbits after castration and androgen replacement with testosterone (T) or 7 alpha-methyl-19-nortestosterone acetate (U-15,614; T analog) supplied by Silastic capsules implanted sc. Castration increased pituitary GnRH receptors significantly, from 99.3 to 329.5 fmol/mg protein within 4 weeks, without a change in the equilibrium association constant. Serum LH concentrations increased from 0.45 to maximum levels of 2.6 ng/ml by day 8 after orchiectomy; these levels persisted throughout the 4 weeks of study. Serum FSH reached maximum levels of 33.6 ng/ml 5 days after castration. T replacement with 250, 500, and 1000 micrograms/kg X day, prevented a postcastration rise in both pituitary GnRH receptor concentrations and gonadotropin secretion, while 100 micrograms/kg X day prevented an increase in GnRH receptors, but did not completely inhibit hypersecretion of gonadotropins. Administration of T analog at doses of 6.25 and 12.5 micrograms/kg X day partially suppressed the castration-induced increase in pituitary GnRH receptor concentrations, while 25, 50, and 100 micrograms/kg X day suppressed GnRH-binding sites to the levels found in intact controls in 15 of 16 rabbits. By contrast, none of the T analog doses was able to prevent completely LH and FSH hypersecretion. The fact that both T and T analog induced dose-dependent stimulation of prostate and seminal vesicle weights indicates that there are tissue-specific differences in the sensitivity to androgens. We conclude that in the male rabbit 1) pituitary GnRH receptors significantly increase after castration; 2) this increase may partially mediate the postcastration hypersecretion of LH and FSH; 3) castration-induced effects can be prevented by androgen replacement. These results are similar to those obtained in rats, where castration increases LHRH receptors, but contrast with results in mice and hamsters, where castration either reduces or does not change receptor levels. This indicates significant species differences in the response of pituitary GnRH receptor concentrations to elimination of the negative feedback effects of androgens.

Unexpected effects of nalmefene, a new opiate antagonist, on the hypothalamic-pituitary-gonadal axis in the male rat.

In order to gain additional information on the role of brain opioid peptides in the regulation of the hypothalamic-pituitary-gonadal axis, we studied the effects of nalmefene, a new opiate antagonist, on gonadotropin and testosterone secretion in male rats. The results were compared with those obtained with naloxone, a well-studied antagonist. Acute injections of either nalmefene or naloxone (2 mg/kg) produced 4-fold increases in LH and testosterone secretion. In castrated male rats treated with testosterone propionate (TP), nalmefene (10 mg/kg) reversed the androgen negative feedback on LH secretion; surprisingly, when higher doses (25 and 50 mg/kg) were injected, the compound lost its ability to antagonize the testosterone-induced inhibition of LH levels. In contrast, naloxone was able to increase LH levels in TP-treated castrated rats even at the highest dose tested (50 mg/kg). Chronic administration of these antagonists resulted in suppression of the acute release of LH and T secretion in nalmefene-treated but not in naloxone-injected animals. These data are consistent with previous observations suggesting that opioid peptides a) exert a tonic inhibitory effect on LH and testosterone production and b) participate in the negative androgen-induced feedback control of LH secretion. Our results also show that the antagonistic action of nalmefene, but not naloxone, is reversed when higher doses are used or following chronic administration.