5. Feedback regulation of
hypothalmus/pituitary
A prominent feature of each of the hormonal
sequences initiated by the hypothalamic
releasing hormones is negative feedback
exerted upon the hypothalamic-pituitary
system by the hormones whose production
are stimulated in the sequence.
11. Regulation of Growth
Hormone Secretion
• GH secretion controlled primarily by
hypothalamic GHRH stimulation and
somatostatin inhibition
• Neurotransmitters involved in control of
GH secretion– via regulation of GHRH and
somatostatin
12. • Neurotransmitter systems that stimulate
GHRH and/or inhibit somatostatin
– Catecholamines acting via α2-adrenergic
receptors
– Dopamine acting via D1 or D2 receptors
– Excitatory amino acids acting via both NMDA
and non-NMDA receptors
Regulation of Growth
Hormone Secretion
13. β-adrenergic receptors stimulate
somatostatin release and inhibit GH
β-adrenergic receptors inhibit hypothalamic
release of GHRH
Regulation of Growth
Hormone Secretion
14. • Additional central mechanisms that control
GH secretion include an ultra-short
feedback loop exerted by both somatostatin
and GHRH on their own secretion
Regulation of Growth
Hormone Secretion
15. Growth hormone vs.
metabolic state
• When protein and energy intake are adequate, it is
appropriate to convert amino acids to protein and stimulate
growth. hence GH and insulin promote anabolic reactions
during protein intake
• During carbohydrate intake, GH antagonizes insulin
effects-- blocks glucose uptake to prevent hypoglycemia.
(if there is too much insulin, all the glucose would be taken
up).
• When there is adequate glucose as during absorptive
phase, and glucose uptake is required, then GH secretion is
inhibited so it won't counter act insulin action.
16. • During fasting, GH antagonizes insulin action and helps
mediate glucose sparing, ie stimulates gluconeogenesis
• In general, during anabolic or absorptive phase, GH
facilitates insulin action, to promote growth.
• during fasting or post-absorptive phase, GH opposes
insulin action, to promote catabolism or glucose sparing
Growth hormone vs.
metabolic state
18. Clinical assessment of GH
• Random serum samples not useful due to pulsatile
pattern of release
• Provocative tests necessary
– GH measurement after 90 min exercise
– GH measurement immediately after onset of sleep
• Definitive tests
– GH measurement after insulin-induced hypoglycemia
– Glucose suppresses GH levels 30-90 min after
administration– patients with GH excess do not suppress
– Measurement of IGF-1 to assess GH excess
19. Acromegaly and Gigantism
• Caused by eosinophilic adenomas of somatotrophs
• Excess GH leads to development of gigantism if
hypersecretion is present during early life– a rare
condition
– Symmetrical enlargement of body resulting in true
giant with overgrowth of long bones, connective tissue
and visceral organs.
• Excess GH leads to acromegaly if hypersecretion
occurs after body growth has stopped.
– Elongation of long bones not possible so there is over
growth of cancellous bones– protruding jaw, thickening
of phalanges, and over growth of visceral organs
22. ACTH: adrenocorticotropic hormone:
synthesis and regulation of secretion
• Produced in corticotrophs
• ACTH is produced in the anterior pituitary by
proteolytic processing of Prepro-opiomelanocortin
(POMC).
• Other neuropeptide products include β and
γ lipotropin, β-endorphin, and α-melanocyte-
stimulating hormone (α-MSH).
• ACTH is a key regulator of the stress response
24. ACTH
ACTH is made up of 39 amino acids
Regulates adrenal cortex and synthesis of
adrenocorticosteroids
α-MSH resides in first 13 AA of ACTH
α-MSH stimulates melanocytes and can darken
skin
Overproduction of ACTH may accompany
increased pigmentation due to α-MSH.
25. Addison’s Disease
• Disease in which patients lack cortisol from
zona fasiculata, and thus lacks negative
feedback that suppresses ACTH production
• Result: overproduction of ACTH
• Skin color will darken
• JFK had Addison’s disease and was treated
with cortisol injections
26. β-endorphin
• Produced as a result of ACTH synthesis
• Binds to opiate receptors
• Results in “runner’s high”
• Role in anterior pituitary not completely
understood
• One of many endogenous opioids such as
enkephalins
27. Melanocyte-stimulating hormone
(MSH)
• MSH peptides derived by proteolytic cleavage of
POMC
∀ α-MSH has antipyretic and anti-inflammatory
effects
– Also inhibits CRH and LHRH secretion
• Four MSH receptors identified
• May inhibit feeding behavior
• ACTH has MSH-like activity
• However– MSH has NO ACTH like activity
29. Regulation of ACTH secretion
• Stimulation of release
– CRH and ADH
– Stress
– Hypoglycemia
• CRH and ADH both synthesized in hypothalamus
– ADH (a.k.a. vasopressin) is released by posterior
pituitary and reaches anterior pituitary via inferior
hypophyseal artery.
30. • Deficiency of vasopressin (ADH) in
hereditary diabetes insipidus is
accompanied by decreased ACTH release.
• Vasopressin potentiates CRH at both
hypothalamic and pituitary levels.
• Many vasopressinergic neurons also contain
CRH resulting in co-release of two peptides
into portal blood.
Regulation of ACTH secretion
31. ACTH
• Circadian pattern of release
– Highest levels of cortisol are in early AM
following ACTH release
– Depends on sleep-wake cycle, jet-lag can result
in alteration of pattern
• Opposes the circadian pattern of growth
hormone secretion
33. ACTH
• Acts on adrenal cortex
– stimulates growth of cortex (trophic action)
– Stimulates steroid hormone synthesis
• Lack of negative feedback from cortisol results in
aberrantly high ACTH, elevated levels of other
adrenal corticosteroids– adrenal androgens
• Adrenogenital syndrome: masculization of female
fetus
34. Glycoprotein hormones
LH, FSH, TSH and hCG
α and β subunits
Each subunit encoded by different gene
α subunit is identical for all hormones
β subunit are unique and provide biological
specificity
36. Gonadotrophs
• Cells in anterior pituitary that produce LH and
FSH
• Synthesis and secretion stimulated by GnRH–
major effect on LH
• FSH secretion controlled by inhibin
• Pulsitile secretion of GnRH and inhibin cause
distinct patterns of LH and FSH secretion
37. LH/FSH
• Pulsatile pattern of secretion
– LH pulses are biphasic (every 1 minute, then large
pulse at 1 hour)
– FSH pulses are uniphasic
• Diurnal– LH/FSH more pronounced during
puberty
• Cyclic in females– ovarian cycle with LH surge at
time of ovulation
• Males are not cyclic, but constant pulses of LH
cause pulses of testosterone to be produced
39. Regulation of LH/FSH
• Negative feed-back
– Inhibin produced by testes and ovaries Decreases FSH
β-subunit expression
– Testosterone from Leydig cells– synthesis stimulated
by LH, feedsback to inhibit GnRH production from
hypothalamus and down-regulates GnRH receptors
– Progesterone– suppresses ovulation, basis for oral
contraceptives. Works at both the level of pituitary and
hypothalamus.
40. • Dopamine, endorphin, and prolactin inhibit GnRH
release.
– Prolactin inhibition affords post-partum contraceptive
effect
• Overproduction of prolactin via pituitary tumor
can cause amenorrhea– shuts off GnRH
– Treated with bromocryptine (dopamine agonist)
– Surgical removal of pituitary tumor
Regulation of LH/FSH
41. • Positive feedback
– Estradiol at high plasma concentrations in late
follicular phase of ovarian cycle stimulates
GnRH and LH surge– triggers ovulation
Regulation of LH/FSH
43. Thyrotrophs
• Site of TSH synthesis
• Pattern of secretion is relatively steady
• TSH secretion stimulated by TRH
• Feedback control by T3 (thyroid hormone)
45. Grave’s disease
• Hyperthyroidism caused by circulating
antibodies to the TSH receptor.
• Associated with diffuse goiter.
• Autoantibodies bind to TSH receptor and
mimic the action of TSH itself leads to
persistent stimulation of thyroid and
elevated levels of thyroid hormones.
46. Lacotrophs
• Site of production of prolactin
• Lactogenesis (milk synthesis) requires prolactin
• Tonically inhibited
– Of the anterior pituitary hormones, the only one
– Multifactoral control, balance favors inhibition
• Dopamine inhibits prolactin
• Prolactin releasing hormone is TRH
– Ocytocin also stimulates prolactin release
– Estradiol enhances prolactin synthesis
47. Prolactin
• Stimulates breast development and
lactogenesis
• May be involved in development of Leydig
cells in pre-pubertal males
• Immunomodulatory effects– stimulates T
cell functions
– Prolactin receptors in thymus
48. Clinical assessment of PRL
• Single basal serum PRL measurement sufficient to
determine excess
– PRL deficiency not a usual clinical concern
• PRL is only anterior pituitary with predominant
negative control by hypothalamus– often elevated
by lesions that interfere with portal blood flow.
• Elevated by primary PRL adenomas of pituitary
49. Posterior pituitary hormones:
ADH (AVP) and Oxytocin
(hypothalamic hormones)
Both are synthesized in the cell bodies of
hypothalamic neurons
ADH: supraoptic nucleus
Oxytocin: paraventricular nucleus
Both are synthesized as preprohormones and
processed into nonapeptides (nine amino acids).
They are released from the termini in response to
an action potential which travels from the axon
body in the hypothalamus
52. In uterus during parturition
In mammary gland during
lactation
Oxytocin: stimulates
myoepithelial contractions
53. Oxytocin: milk ejection from
lactating mammary gland
suckling is major stimulus for release.
sensory receptors in nipple connect with
nerve fibers to the spine, then impulses
are relayed through brain to PVN where
cholinergic synapses fire on oxytocin
neurons and stimulate release.
54. Oxytocin: uterine contractions
• Reflexes originating in the cervical, vaginal
and uterus stimulate oxytocin synthesis and
release via neural input to hypothalamus
• Increases in plasma at time of ovulation,
parturition, and coitus
• Estrogen increases synthesis and lowers
threshold for release