ESPE Yearbook of Paediatric Endocrinology

To read the full abstract: JCI Insight 2018;3. pii: 99109

The effects of kisspeptin administration in adults are well known. Whatever, the mode of administration, kisspeptin elicits an increase of LH and FSH blood levels in normal men and women. By analogy to rodents and non-human primates, it has been speculated that the response to kisspeptin is majorated at puberty in humans, which could be explained by a higher sensitivity of GnRH neurons to Kisspeptin. The capacity of the gonadotropic axis to respond to Kisspeptin may thus represent an interesting functional trait, to test the ability of the gonadotropic axis to be fully reactivated in children with delayed or stalled puberty.

Here, Chan et al. report two groups of patients. One group were responders to kisspeptin and the other group were non-responders. Responder children showed spontaneous nighttime LH pulses and positive response to GnRH before pituitary priming, which indicates that their pubertal neurobiological reactivation of the gonadotropic axis had already started. Non-responders required 6-days of pituitary priming by exogenous GnRH in order to achieve a robust response to GnRH, which indicates a more severe functional defect in those children as compared to responders. The follow-up of these children will be important to establish their final diagnoses and to determine whether the ‘kisspeptin stimulation test’ might be a good predictor of the clinical outcomes for children with delayed or stalled puberty.