LUTEINIZING HORMONE

Agustinus, dr., Sp.And

Program Pendidikan Dokter Spesialis-1 Andrologi
Introduction
• Glycoprotein hormone that is co-secreted along with FSH by the
gonadotrophin cells in the adenohypophysis (anterior pituitary).
• Mass = 28 kDa
• Consist of two subunit:
• Alpha subunit = similar to FSH, made up of 92 amino acids
• Beta subunit = made up of 120 amino acids
• LH release is stimulated by gonadotropin-releasing hormone
(GnRH) and inhibited by sex steroid.
• LH has various functions
• Maturation of primordial germ cells
• Stimulates the Leydig cells of the testes to produce testosterone.
HISTORY
• Fevold, Hisaw, and Leonard (1931) isolated from
acetone-dried hog anterior lobes two protein
hormones with distinct actions on the rat ovary.
• Follicle Stimulating Hormone (FSH): stimulated
ovarian follicular development in
• Luteinizing Hormone (LH): caused follicles that were
stimulated by FSH to luteinize.
Biosynthesis
• GnRH stimulates gonadotropin synthesis
• GnRH interact with their membrane receptor on Gonadotroph cells in
anterior pituitary
• The stimulatory effect of GnRH on gonadotropin synthesis is
reproduced in a nonadditive manner by either cyclic AMP and
diacylglycerols.
• GnRH is required for enhanced luteinizing hormone subunit gene
expression
• Gonadotroph cells in the anterior pituitary gland produce luteinizing
hormone.
Levels
• Fetal Development:
• hCG begins at a high level in the
plasma and quickly decreases between
weeks 10 and 20 of gestation and then
slowly decline after that.
• LH secretion increases by week 10 and
reaches a peak before week 20,
followed by a gradual decrease
thereafter.
• The regulation of testosterone
formation changes to LH driven by
around weeks 15 to 20 of gestation. Burger H, DeKretzer D [eds]: The
Testis, p 41. New York, Raven Press,
1989
Levels
• Delivery:
• Sharp increase in LH levels because of the withdrawal of estrogen from the
mother
• After this temporary increase, they begin to decline and stay at low basal levels
until prepuberty starts
Levels
• Puberty:
• Slow increase in the secretion of LH
nocturnally
• As puberty progresses, LH begins to be
secreted less so in a nocturnal pattern
followed by a pulsatile pattern throughout
the whole day

(Albertsson-Wikland et al., 1997)

Levels
• Diurnal variation?
• LH levels at 16.00 h were about
18% higher than those at 08.00 h
in a 30-yr-old man but were
about 94% of those at 08.00 h in
a 70-yr-old man.

Brambilla et al., 2009

LH RECEPTOR
• Heptahelical receptor
• Can bind with high affinity either pituitary LH or human chorionic
gonadotropin (hCG)
LH RECEPTOR
Measurement
• Methods:
• Radioimmunoassay
• Immunoradiometric
• Enzyme assays 
• Sample:
• Blood
• Urine
• Do not take multivitamins or dietary supplements containing biotin
(vitamin B7), which is commonly found in hair, skin, and nail
supplements and multivitamins.
Measurement
• It is recommended that patients abstain from taking biotin for at least
72 hours before specimen collection.
• Biotin may falsely lower LH, FSH, Prolactin, SHBG levels using
sandwich biotin-streptavidin capture assays.
• Biotin doses of 300 mg/day can falsely increase testosterone levels
using competitive biotin-streptavidin capture assays
Actions
• Luteinizing hormone acts by binding to a G-protein
coupled receptor
• Activates adenylyl cyclase
• Produces cyclic-AMP
• Activates a kinase molecule called protein kinase A
(PKA)
• Phosphorylates specific intracellular proteins that
subsequently achieve the end physiological actions
of LH like steroid production
Ghigo & Mika, 2019
LH Extragonadal Role
• Alzheimer’s disease (AD) is linked with aging and is prevalent in the
female sex. Recent studies indicate that LH play a pivotal role in the
pathogenesis of AD.
• Higher LH levels are associated with poor memory recall in men,
independently of testosterone concentrations
• LH levels are also higher in patients suffering from AD than in non-AD
subjects.
• The mechanism of the neurodegenerative action of LH seems to
depend on LH/CG receptors in the brain.
This Photo by Unknown Author is licensed under CC BY