Kisspeptin Role in Functional Hypothalamic Amenorrhea

Abstract

Functional hypothalamic amenorrhoea (FHA) is a disorder that, by definition, excludes organic disease. It is based on functional disruption of pulsatile, hypothalamic gonadotropin-releasing hormone (GnRH) secretion. KISS1 gene was discovered in 1996 in nonmetastatic melanoma cells as human malignant melanoma metastasis-suppressor gene. The role of KISS1 in regulation of reproduction was strongly suggested after discovery of mutation in GPR54 gene, leading to pubertal failure and normosomic hypogonadotropic hypogonadism. Kisspeptin is a novel neuromodulator that acts upstream of GnRH and is sensitive to sex steroid feedback and metabolic cues. Kisspeptin-54 was used numerous times in women with different endocrine disturbances in the last decade. However it should be stressed that kisspeptin administration was for the first time used in patients with hypothalamic amenorrhoea. Several such studies evaluated influence of kisspeptin administration on gonadotropin (FSH, LH) secretion in women with hypothalamic amenorrhoea. Results of these studies can have important implication for possible kisspeptin therapeutic use in patients with functional hypothalamic amenorrhoea.