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RAPID COMMUNICATION
Effects of metoclopramide on the mouse anterior pituitary during the estrous cycle
Regina Célia Teixeira GomesI, Carina VernaII, Ricardo S SimõesIII, Roberta B WolffII, Edmund C BaracatIII, José Maria Soares JrII,
Corresponding author
jsoares415@hotmail.com

Tel.: 55 11 5081-3685
I Federal University of São Paulo – Morphology, São Paulo/SP, Brazil.
II Federal University of São Paulo – Gynecology Department, São Paulo/SP, Brazil.
III Faculdade de Medicina da Universidade de São Paulo - Departamento de Obstetrícia e Ginecologia, São Paulo/SP, Brazil.
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          "en" => "<p id="spara10" class="elsevierStyleSimplePara elsevierViewall">Immunohistochemical localization of prolactin in adenohypophyseal lactotrophs in female control &#40;Ctr&#41; mice or mice treated with metoclopramide &#40;HPrl&#41; in the estrous phase&#46; Arrows indicate prolactin-positive cells&#46; P &#61; Proestrus&#59; E &#61; Estrus&#44; M &#61; Metaestrus&#59; D &#61; Diestrus&#46; Scale bar &#61; 20&#160;&#956;m&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="cesec10" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle10">INTRODUCTION</span><p id="para10" class="elsevierStylePara elsevierViewall">The symptoms of hyperprolactinemia in women mainly result from changes in the release of gonadotropins and the consequent repercussions on ovarian function&#46;<a class="elsevierStyleCrossRefs" href="#bib1">1&#8211;3</a> Metoclopramide is a hyperprolactinemic drug that is used as an antiemetic agent&#46;<a class="elsevierStyleCrossRefs" href="#bib4">4&#44;5</a> In female mice&#44; metoclopramide-induced hyperprolactinemia causes changes in the reproductive system&#44; mainly in ovarian function and the endometrium&#46;<a class="elsevierStyleCrossRefs" href="#bib6">6&#8211;10</a> While there is extensive data regarding prolactin regulation and hyperprolactinemic states&#44; the direct effects of metoclopramide on the morphological and functional aspects of pituitary cells remain unknown&#46; Therefore we have evaluated the histomorphological and immunohistochemical changes in lactotrophs of female mice upon treatment with metoclopramide&#46;</p></span><span id="cesec20" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle20">MATERIALS AND METHODS</span><p id="para20" class="elsevierStylePara elsevierViewall">Eighty adult&#44; virgin female mice of the Swiss EPM-1 strain were kept on food and water <span class="elsevierStyleItalic">ad libitum</span> at room temperature &#40;22&#176;C&#41; and under artificial light with a photoperiod of 12&#160;hours &#40;lights on 7 a&#46;m&#46;&#8211;7 p&#46;m&#46;&#41;&#46; The animals were randomly divided into 2 groups of 40 animals each&#58; control &#40;Ctr&#41;&#44; which were injected daily with drug vehicle &#40;0&#46;2&#160;ml of saline solution&#41;&#44; and experimental &#40;HPrl&#41;&#44; treated with metoclopramide &#40;6&#46;7&#160;&#956;g&#47;g daily&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib6">6&#8211;10</a> Injections were made by the subcutaneous route at 11 a&#46;m&#46;&#44; and the treatments lasted 50 days&#46; The experimental protocol was approved &#40;Report No&#46;&#160;0809&#47;04&#41; by the UNIFESP-EPM Review Board&#46;</p><p id="para30" class="elsevierStylePara elsevierViewall">On day 50&#44; 1&#160;h after the last injection&#44; colpocytological examination of vaginal smears was carried out for all animals&#44; which were in each of the 4 phases of the estrous cycle &#40;10 mice per phase in both Ctr and HPrl groups&#41;&#44; before they were euthanized by decapitation&#46; The animals not typified remained on treatment and were euthanized once their phase was diagnosed&#46; Hormone levels were measured in blood samples taken immediately after euthanasia&#46; Pituitary glands were carefully dissected out and immediately immersed in Bouin&#39;s liquid for further histological processing&#46;</p><p id="para40" class="elsevierStylePara elsevierViewall">Serum 17&#946;-estradiol and progesterone was determined using their respective kits &#40;ICN Biomedicals Inc&#46;&#44; Costa Mesa&#44; CA&#44; USA&#41;&#46; The samples were assayed in duplicate and processed on the same day&#46; The detection limits for estradiol and progesterone were approximately 0&#46;1&#160;pg&#47;ml and 0&#46;15&#160;ng&#47;ml&#44; respectively&#46; Crossreactivity with other steroids for both assays was less than 0&#46;01&#37;&#46; Serum prolactin &#40;PRL&#41; was determined using a mouse PRL radioimmunoassay kit&#46;</p><p id="para50" class="elsevierStylePara elsevierViewall">For immunohistochemistry analyses&#44; pituitaries were fixed in Bouin&#39;s fluid for 6&#160;hours and embedded in paraffin&#59; 5-&#956;m sections were microwaved in 1&#160;M sodium citrate buffer &#40;pH&#160;6&#46;0&#41; for 8&#160;min in order to retrieve the antigen&#46;<a class="elsevierStyleCrossRef" href="#bib11">11</a> After treatment with 0&#46;1&#37; Triton X-100 for 10&#160;min&#44; endogenous peroxydase activity was blocked with 0&#46;3&#37; H<span class="elsevierStyleInf">2</span>O<span class="elsevierStyleInf">2</span> in methanol for 30&#160;min&#46; Antibody non-specific binding was blocked with normal goat serum &#40;VECTASTAIN Elite ABC kit&#44; Vector Laboratories&#41; for 20&#160;min at room temperature&#46; The sections were then incubated overnight with primary antibody at 4&#8211;8&#176;C &#40;1&#58;600&#44; A0569&#44; Dako Cytomation&#41;&#46; After washing in PBS&#44; sections were incubated with the secondary antibody&#44; rabbit anti-chicken IgG &#40;1&#58;800&#44; DakoCytomation&#41; for 15&#160;min&#46; Reaction products were visualized by using 3&#44;3&#8242;-diaminobenzidine &#40;DAB&#44; Sigma Chemical Co&#41;&#46; The negative control was prepared by incubating sections with rabbit immunoglobulin fraction &#40;DAKO Cytomation&#41; instead of the primary antibody&#46; Sections were counterstained with hematoxylin&#46;</p><p id="para60" class="elsevierStylePara elsevierViewall">The number and the nuclear volume of prolactin-immunolabeled cells &#40;lactotroph cells&#41; were evaluated in images taken by a high-resolution camera &#40;AxioCam MRC&#44; Carl Zeiss&#41; at a final magnification of x400&#46; The camera was connected to a computer coupled to a light microscope &#40;Axiolab Standard 2&#46;0&#44; Carl Zeiss&#41; and images were analyzed using REL AxionVision 4&#46;6 software &#40;Carl Zeiss&#41;&#46; To evaluate the number of lactotroph cells&#44; 8 fields were captured for every sample with a x40 objective &#40;37&#44;745&#46;55&#160;&#956;m<span class="elsevierStyleSup">2</span> field area&#41; and a total of 80 fields were analyzed for each group &#40;total area for group &#61; 299&#44;644&#46;00&#160;&#956;m<span class="elsevierStyleSup">2</span>&#41;&#46; To calculate nuclear volume&#44; the largest &#40;a&#41; and the shortest &#40;b&#41; nuclear diameters from 50 lactotroph cells for every animal were measured at a final magnification of x1000 and then used in the formula V &#61; a<span class="elsevierStyleBold">&#46;</span>b<span class="elsevierStyleSup">2</span>&#47;1&#44;91&#46;<a class="elsevierStyleCrossRef" href="#bib12">12</a> The results were analyzed by analysis of variance &#40;ANOVA&#41; followed by the Kruskal-Wallis test &#40;p&#60;0&#46;05&#41;&#46;</p></span><span id="cesec30" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle30">RESULTS</span><p id="para70" class="elsevierStylePara elsevierViewall">The level of 17&#946;-estradiol was higher in the control &#40;Ctr&#41; group than in the HPrl group in all phases&#44; particularly during the proestrous phase &#40;<a class="elsevierStyleCrossRef" href="#tbl1">Table 1</a>&#41;&#46; However&#44; the level of progesterone was higher in the Ctr group &#40;<a class="elsevierStyleCrossRef" href="#tbl1">Table 1</a>&#41;&#46; Also&#44; the highest level of prolactin in the HPrl group occurred during the proestrus phase &#40;<a class="elsevierStyleCrossRef" href="#tbl1">Table 1</a>&#41;&#46; PRL immunolabeling of pituitary glands revealed markedly stronger expression in the metoclopramide group &#40;<a class="elsevierStyleCrossRef" href="#fig1">Fig&#46; 1</a>&#41;&#46; Metoclopramide-treated female mice had significant increases in the number and the volume of lactotroph cells of the pituitary gland during all phases of the estrous cycle &#40;<a class="elsevierStyleCrossRef" href="#tbl1">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl1"></elsevierMultimedia><elsevierMultimedia ident="fig1"></elsevierMultimedia></span><span id="cesec40" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle40">DISCUSSION</span><p id="para80" class="elsevierStylePara elsevierViewall">In the neuroendocrine axis&#44; dysfunction of hypothalamic dopamine or its pituitary receptors leads to hyperprolactinemia and reproductive disturbances&#46;<a class="elsevierStyleCrossRefs" href="#bib13">13&#44;14</a> The PRL secretory profile is well established in female mice&#59; circulating PRL remains low in normal cycling animals throughout most of the estrous cycle&#46; There is one prominent PRL surge at proestrus&#44; which is coincident with luteinizing hormone &#40;LH&#41;&#44; for a period of 4&#8211;5 days&#46;<a class="elsevierStyleCrossRef" href="#bib3">3</a> Our serum PRL results also revealed higher levels in Ctr proestrus animals than control rats in other phases&#46;</p><p id="para90" class="elsevierStylePara elsevierViewall">Metoclopramide has been used to study the effects of the elevation of prolactin &#40;PRL&#41; plasma levels on the body for many years<a class="elsevierStyleCrossRef" href="#bib15">15</a>&#46; However&#44; the pituitary synthesizes and secretes several distinct hormones&#46; Therefore&#44; we employed an immunohistochemical PRL marker to identify lactotroph cells&#46;<a class="elsevierStyleCrossRef" href="#bib16">16</a></p><p id="para100" class="elsevierStylePara elsevierViewall">We found that metoclopramide not only increased the number but also stimulated the metabolic activity of lactotrophs&#44; as indicated by the enlarged nuclear volumes in hyperprolactinemic animals irrespective to the phase of the estrous cycle&#46; Given the existence of a definite relationship between nuclear volume and cell metabolism&#44;<a class="elsevierStyleCrossRef" href="#bib12">12</a> it is conceivable that the observed increase of circulating PRL is due to an increase of the number and the activity of lactotrophs&#46; Interestingly&#44; metoclopramide-treated animals showed high levels of circulating PRL and increased number and nuclear volumes of lactotrophs&#44; and this profile did not change throughout the phases of the estrous cycle&#46;</p><p id="para110" class="elsevierStylePara elsevierViewall">Dopamine and its agonists regulate many systems through stimulation of adrenergic and dopaminergic receptors and also regulate PRL production&#46;<a class="elsevierStyleCrossRef" href="#bib17">17</a> As a D2 receptor antagonist&#44; metoclopramide affects PRL secretion&#46;<a class="elsevierStyleCrossRefs" href="#bib7">7&#44;8&#44;13&#44;18</a> The long and short isoforms of the dopamine receptor &#40;D2L and D2S&#41; exhibit similar pharmacological properties and are co-expressed in the same cells&#46;<a class="elsevierStyleCrossRef" href="#bib19">19</a> The D2L isoform is predominant in the rat pituitary&#44; striatum&#44; and olfactory tubercle&#44; whereas D2S is more abundant in the hypothalamus&#46;<a class="elsevierStyleCrossRefs" href="#bib20">20&#8211;22</a> Activation of either isoform in rat lactotrophs mediates dopamine suppression of the PRL gene&#46;<a class="elsevierStyleCrossRef" href="#bib23">23</a></p><p id="para120" class="elsevierStylePara elsevierViewall">While PRL directly inhibits secretion of gonadotropins from the anterior pituitary&#44; there is accumulating evidence that PRL also exerts a direct inhibitory effect on gonadotropin actions in the ovary<a class="elsevierStyleCrossRef" href="#bib24">24</a>&#46; Physiological levels of PRL suppress follicle-stimulating hormone &#40;FSH&#41;-induced estradiol production through a reduction in aromatase expression and PRL increases progesterone production by augmenting StAR&#44; P450scc&#44; and 3&#946;HSD expression in granulosa cells&#46;<a class="elsevierStyleCrossRef" href="#bib25">25</a> However&#44; hyprolactinemia may inhibit GnRH release and reduce ovulation&#44; explaining the reduction in progesterone&#46;<a class="elsevierStyleCrossRefs" href="#bib7">7&#44;8&#44;24</a> Also&#44; metoclopramide-induced hyperprolactinemia correlates with a low number of luteal bodies&#44; which are ovarian structures responsible for progesterone production&#46;<a class="elsevierStyleCrossRef" href="#bib7">7</a></p><p id="para130" class="elsevierStylePara elsevierViewall">The central PRL-secretion regulator dopamine inhibits lactotroph proliferation and decreases the size of hypertrophied lactotrophs&#46;<a class="elsevierStyleCrossRefs" href="#bib26">26&#44;27</a> Our results show that daily treatment with metoclopramide induces a consistent hyperprolactinemic state and increases the number and the volume of lactotrophs&#46; Thus&#44; our data suggest that besides the increase of pituitary PRL secretion&#44; significant proliferation of the pituitary gland occurrs&#46; If this process were to continue&#44; we would predict an evolution towards pituitary gland tumorigenesis&#46; We also observed a significant decrease in progesterone levels coexisted with PRL serum elevation&#46; Overall&#44; these disturbances may have deleterious effects on ovarian function&#44;<a class="elsevierStyleCrossRef" href="#bib7">7</a> endometrial tissue&#44;<a class="elsevierStyleCrossRef" href="#bib9">9</a> and embryo implantation&#46;<a class="elsevierStyleCrossRef" href="#bib8">8</a> Finally&#44; hyperprolactinemia caused by metoclopramide in mice is due to an increase in the number and activity of lactotrophs and these alterations seem to be independent of the cycle phase&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
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        0 => array:2 [
          "identificador" => "cesec10"
          "titulo" => "INTRODUCTION"
        ]
        1 => array:2 [
          "identificador" => "cesec20"
          "titulo" => "MATERIALS AND METHODS"
        ]
        2 => array:2 [
          "identificador" => "cesec30"
          "titulo" => "RESULTS"
        ]
        3 => array:2 [
          "identificador" => "cesec40"
          "titulo" => "DISCUSSION"
        ]
        4 => array:1 [
          "titulo" => "REFERENCES"
        ]
      ]
    ]
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    "tienePdf" => true
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      0 => array:7 [
        "identificador" => "fig1"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
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          "en" => "<p id="spara10" class="elsevierStyleSimplePara elsevierViewall">Immunohistochemical localization of prolactin in adenohypophyseal lactotrophs in female control &#40;Ctr&#41; mice or mice treated with metoclopramide &#40;HPrl&#41; in the estrous phase&#46; Arrows indicate prolactin-positive cells&#46; P &#61; Proestrus&#59; E &#61; Estrus&#44; M &#61; Metaestrus&#59; D &#61; Diestrus&#46; Scale bar &#61; 20&#160;&#956;m&#46;</p>"
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        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
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        "tabla" => array:3 [
          "leyenda" => "<p id="spara30" class="elsevierStyleSimplePara elsevierViewall">Data are shown as mean &#177; SD&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Proestrus</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Estrus</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Metaestrus</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Diestrus</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col">Ctr&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col">HPrl&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col">Ctr&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col">HPrl&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col">Ctr&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col">HPrl&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col">Ctr&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col">HPrl&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="9" align="left" valign="top">Serum hormones&#58;</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top">17&#946;-Estradiol &#40;pg&#47;mL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">121&#46;2&#177;8&#46;2<a class="elsevierStyleCrossRef" href="#tfn2">a</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">90&#46;3&#177;3&#46;9<a class="elsevierStyleCrossRef" href="#tfn3">b</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">92&#46;3&#177;2&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">45&#46;3&#177;3&#46;1<a class="elsevierStyleCrossRef" href="#tfn3">b</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">65&#46;8&#177;5&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">55&#46;3&#177;2&#46;8<a class="elsevierStyleCrossRef" href="#tfn3">b</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">72&#46;4&#177;3&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">59&#46;3&#177;4&#46;2<a class="elsevierStyleCrossRef" href="#tfn3">b</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top">Progesterone &#40;ng&#47;mL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">11&#46;6&#177;0&#46;5<a class="elsevierStyleCrossRef" href="#tfn2">a</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">3&#46;7&#177;0&#46;1<a class="elsevierStyleCrossRef" href="#tfn3">b</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">5&#46;7&#177;0&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">2&#46;7&#177;0&#46;2<a class="elsevierStyleCrossRef" href="#tfn3">b</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">6&#46;1&#177;0&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">1&#46;9&#177;0&#46;4<a class="elsevierStyleCrossRef" href="#tfn3">b</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">7&#46;7&#177;0&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">2&#46;9&#177;0&#46;3<a class="elsevierStyleCrossRef" href="#tfn3">b</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top">Prolactin &#40;ng&#47;mL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">44&#46;1&#177;7&#46;1<a class="elsevierStyleCrossRef" href="#tfn2">a</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">301&#46;2&#177;42&#46;1<a class="elsevierStyleCrossRef" href="#tfn3">b</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">28&#46;8&#177;8&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">274&#46;3&#177;35&#46;5<a class="elsevierStyleCrossRef" href="#tfn3">b</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">20&#46;8&#177;5&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">264&#46;1&#177;42&#46;9<a class="elsevierStyleCrossRef" href="#tfn3">b</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">19&#46;3&#177;5&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">269&#46;1&#177;42&#46;1<a class="elsevierStyleCrossRef" href="#tfn3">b</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="9" align="left" valign="top">Pituitary lactotrophs&#58;</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top">Density &#40;cells&#47;1000&#160;&#956;m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">9&#46;1&#177;0&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">12&#46;2&#177;0&#46;1<a class="elsevierStyleCrossRef" href="#tfn3">b</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">8&#46;4&#177;0&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">10&#46;2&#177;0&#46;2<a class="elsevierStyleCrossRef" href="#tfn3">b</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">8&#46;0&#177;0&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">11&#46;0&#177;0&#46;1<a class="elsevierStyleCrossRef" href="#tfn3">b</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">8&#46;1&#177;0&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">9&#46;7&#177;0&#46;2<a class="elsevierStyleCrossRef" href="#tfn3">b</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="top" style="border-bottom: 2px solid black">Cell volume &#40;&#956;m<span class="elsevierStyleSup">3</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top" style="border-bottom: 2px solid black">151&#44;33&#177;7&#46;1<a class="elsevierStyleCrossRef" href="#tfn2">a</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top" style="border-bottom: 2px solid black">176&#46;2&#177;9&#46;1<a class="elsevierStyleCrossRef" href="#tfn3">b</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top" style="border-bottom: 2px solid black">128&#44;58&#177;7&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top" style="border-bottom: 2px solid black">169&#46;3&#177;8&#46;5<a class="elsevierStyleCrossRef" href="#tfn3">b</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top" style="border-bottom: 2px solid black">102&#46;48&#177;5&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top" style="border-bottom: 2px solid black">166&#46;1&#177;8&#46;9<a class="elsevierStyleCrossRef" href="#tfn3">b</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top" style="border-bottom: 2px solid black">106&#46;1&#177;4&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top" style="border-bottom: 2px solid black">165&#46;1&#177;8&#46;1<a class="elsevierStyleCrossRef" href="#tfn3">b</a>&nbsp;\t\t\t\t\t\t\n
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Article information
ISSN: 18075932
Original language: English
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es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos