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  • Review Article
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Prolactin — a pleiotropic factor in health and disease

Nature Reviews Endocrinology volume 15, pages 356–365 (2019)Cite this article

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Abstract

The principal role of prolactin in mammals is the regulation of lactation. Prolactin is a hormone that is mainly synthesized and secreted by lactotroph cells in the anterior pituitary gland. Prolactin signalling occurs via a unique transmembrane prolactin receptor (PRL-R). The structure of the PRL-R has now been elucidated and is similar to that of many biologically fundamental receptors of the class 1 haematopoietic cytokine receptor family such as the growth hormone receptor. The PRL-R is expressed in a wide array of tissues, and a growing number of biological processes continue to be attributed to prolactin. In this Review, we focus on the newly discovered roles of prolactin in human health and disease, particularly its involvement in metabolic homeostasis including body weight control, adipose tissue, skin and hair follicles, pancreas, bone, the adrenal response to stress, the control of lactotroph cell homeostasis and maternal behaviour. New data concerning the pathological states of hypoprolactinaemia and hyperprolactinaemia will also be presented and discussed.

Key points

  • Prolactin exerts its actions via a transmembrane prolactin receptor (PRL-R), the structure of which has now been elucidated.

  • Prolactin signalling is essential for the ontogenesis of pancreatic stem cells for the establishment of a functional β-cell reserve.

  • In addition to its role in increasing dopaminergic inhibitory tone, prolactin exerts autocrine and paracrine feedback on lactotroph cells.

  • Prolactin deficiency is rare and causes failure of lactation.

  • Hyperprolactinaemia can be caused by medications or pituitary disease, can have systemic causes or can be idiopathic; this condition frequently leads to hypogonadism and infertility.

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Fig. 1: Topology of the human PRL-R.
Fig. 2: New acceptance of prolactin physiological roles.
Fig. 3: Consequences of abnormal prolactin levels in humans.

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Nature Reviews Endocrinology thanks D. Grattan, and other anonymous reviewers, for their contribution to the peer review of this work.

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Authors and Affiliations

  1. Inserm U1185, Faculté de Médecine Paris Sud, Université Paris-Saclay, Le Kremlin Bicêtre, France

    Valérie Bernard, Jacques Young & Nadine Binart

  2. Hôpital Saint Antoine, Service d’Endocrinologie et des Maladies de la Reproduction, Paris, France

    Valérie Bernard

  3. Hôpital Bicêtre, Service d’Endocrinologie et des Maladies de la Reproduction, Paris, France

    Jacques Young

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Bernard, V., Young, J. & Binart, N. Prolactin — a pleiotropic factor in health and disease. Nat Rev Endocrinol 15, 356–365 (2019). https://doi.org/10.1038/s41574-019-0194-6

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