Prolactin in critical illness

Prolactin, which is secreted by the anterior pituitary to promote lactation, also has an immunoregulatory role. Both T and B lymphocytes have prolactin receptors. The immunosuppressive effect of cyclosporin is probably due, in part, to the fact that it competes for the prolactin binding site on T cells.

Prolactin concentrations increase in acute stress but are normal or reduced in long-term stress such as that associated with critical illness. This may be explained by the prolonged increase in glucocorticoid production which is thought to inhibit prolactin release. This prolactin deficiency state would impair immune function, particularly cell-mediated immunity, although the physiological significance is unclear.

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