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Geburtshilfe Frauenheilkd 2003; 63(8): 731-736
DOI: 10.1055/s-2003-42140
Übersicht

Georg Thieme Verlag Stuttgart · New York

Humanes Plazenta-Laktogen (hPL)

Struktur, Regulation, physiologische BedeutungHuman Placental Lactogen (hPL)Structure, Regulation, Physiological SignificanceM. Breckwoldt 1 , C. Keck 1
  • 1Univ.-Frauenklinik Freiburg
Further Information

Publication History

Eingang Manuskript: 19. September 2002 Eingang revidiertes Manuskript: 24. Februar 2003

Akzeptiert: 4. März 2003

Publication Date:
16 September 2003 (online)

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Zusammenfassung

Das humane Plazenta-Laktogen (hPL) ist vor etwas mehr als 40 Jahren charakterisiert worden. Seit dieser Zeit gibt es eine Vielzahl von neuen Erkenntnissen, die es sinnvoll erscheinen lassen, sich mit der Physiologie dieses Hormons noch einmal zu beschäftigen. Beim hPL, einem Produkt des Trophoblasten, handelt es sich um ein Proteohormon, das in seiner Struktur und Funktion dem Wachstumshormon und dem Prolaktin verwandt ist. Alle drei Hormone werden von unterschiedlichen Genen, die in unmittelbarer Nachbarschaft auf dem Chromosom 17 lokalisiert sind, kodiert. HPL ist ein Stoffwechselhormon, das im mütterlichen Organismus lipolytisch wirkt. Die freigesetzten Fettsäuren können von der Mutter als Energiesubstrat verwertet werden, dadurch spart die Mutter Glukose ein, die der Plazenta und insbesondere dem Feten als Energieträger verfügbar gemacht werden. Darüber hinaus besitzt hPL im fetalen Organismus eine direkte wachstumsstimulierende Wirkung durch eine gesteigerte Freisetzung von Wachstumsfaktoren, u. a. IGF-1 und IGF-2.

Neben hPL synthetisiert die Plazenta auch ein eigenes plazentares Wachstumshormon mit vergleichbaren biologischen Wirkungen, das vor allen Dingen aber wachstumsfördernd im kindlichen Organismus zur Wirkung kommt. Die Regulation der hPL-Freisetzung unterliegt einem komplexen Kontrollsystem, an dem sich vor allen Dingen Insulin, Glukose, Lipoproteine, Neuropeptide und Neurotransmitter beteiligen. Trotz dieser vielschichtigen Bedeutung des hPL für die physiologischen Vorgänge während der Schwangerschaft gilt die Bestimmung dieses Hormons zur Beurteilung des kindlichen Befindens angesichts der modernen Methoden der Sonographie und Doppler-Sonographie als obsolet.

HPL konnte inzwischen auch in verschiedenen Tumoren nachgewiesen werden. Die spezifische Bedeutung dieses Hormons für das Tumorwachstum bzw. die Tumorzellproliferation sind allerdings bis heute unklar.

Abstract

HPL was first described and characterized some 40 years ago. Since then a lot of new data on its structure, regulation and physiological significance have been published which will be summarized in this review.

HPL is secreted by the trophoblast as a proteohormone composed of 191 amino acides in structure and function similar to growth hormone (GH) and prolactin (hPRL). The coding genes for all three hormones are located in close vicinity on chromosome 17. In the first place hPL is a lipolytic agent in the maternal compartment. Elevated levels of free fatty acids can be utilized as energy resources resulting in a glucose sparing effect. Glucose is essential for placental function and fetal development. In addition hPL induces increased secretion of growth factors like IGF-1 and IGF-2 in the fetal organism. Besides hPl the placenta synthesizes and secretes a specific growth hormone (PGH) with similar biological effects. Its growth promoting effects apply especially to the fetal organism.

The regulation of hPL scretion is controlled by a rather complex - yet not completely understood - system including insulin and glucose levels, lipoproteins, neuropeptides and neurotransmitters. In spite of these complex functions of human placental lactogen its determination in maternal serum as a marker of fetal development is obsolete as today ultrasound and Doppler sonography are applied in this field.

There are several reports on the determination of hPL in different tumours. However until today the role of hPL for the induction of tumour cell proliferation and tumour growth is not yet understood.

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Prof. Dr. M. Breckwoldt

Univ.-Frauenklinik

Hugstetter Straße 55

79106 Freiburg

Email: ckeck@frk.ukl.uni-freiburg.de

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