Hypothalamic Reproductive Endocrine Pulse Generator Activity Independent of Neurokinin B and Dynorphin Signaling

Context: Kisspeptin-Neurokinin B-Dynorphin neurons are critical regulators of the hypothalamic-pituitary-gonadal axis. Neurokinin B (NKB) and dynorphin are hypothesized to influence the frequency of gonadotropin-releasing hormone (GnRH) pulses; whereas kisspeptin is hypothesized to be a generator of the GnRH pulse. How these neuropeptides interact remains unclear. Objective: To probe the role of NKB in GnRH pulse generation and to dissect the interactions between NKB, kisspeptin, and dynorphin in humans and mice with a complete absence of NKB. Design: Case/Control Setting: Academic medical center Patients or Participants: Members of a consanguineous family bearing biallelic loss-of-function mutations in the gene encoding NKB and NKB deficient mice Interventions: Frequent blood sampling to characterize neuroendocrine profile and administration of kisspeptin, GnRH, and naloxone, a non-specific opioid receptor antagonist used to block dynorphin. Main Outcome Measure(s): Luteinizing hormone (LH) pulse characteristics Results: Humans lacking NKB demonstrate slow LH pulse frequency which can be increased by opioid antagonism. Mice lacking NKB also demonstrate impaired LH secretion which can be augmented with an identical pharmacologic manipulation. Both mice and humans with NKB deficiency respond to exogenous kisspeptin. Conclusion: The preservation of LH pulses in the absence of NKB and dynorphin signaling suggest that both peptides are dispensable for GnRH pulse generation and kisspeptin responsiveness. However, NKB and dynorphin appear to have opposing roles in the modulation of GnRH pulse frequency.