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Endocrine hormones
RVS Chaitanya Koppala
Assistant professor,
Lovely professional university, Punjab
Anterior pituitary
• Anterior pituitary: connected to the
hypothalamus by hypothalmoanterior pituitary
portal vessels.
• The anterior pituitary produces six peptide
hormones:
– prolactin, growth hormone (GH),
– thyroid stimulating hormone (TSH),
– adrenocorticotropic hormone (ACTH),
– follicle-stimulating hormone (FSH),
– luteinizing hormone (LH).
Anterior pituitary cells and hormones
Cell type Pituitary
population
Product Target
Corticotroph 15-20% ACTH
β-lipotropin
Adrenal gland
Adipocytes
Melanocytes
Thyrotroph 3-5% TSH Thyroid gland
Gonadotroph 10-15% LH, FSH Gonads
Somatotroph 40-50% GH All tissues, liver
Lactotroph 10-15% PRL Breasts
gonads
Anterior pituitary hormones
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.
Hypothalamus-pituitary axis
Feedback control
Feedback
control of
thyroid
function
Feedback
leads to
restoration of
homeostasis
Feedback
control of
growth
hormone
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
• 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
 β-adrenergic receptors stimulate
somatostatin release and inhibit GH
 β-adrenergic receptors inhibit hypothalamic
release of GHRH
Regulation of Growth
Hormone Secretion
• 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
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.
• 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
Growth
hormone
and
metabolic
state
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
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
Acromegaly
A) before
presentation;
B) at admission
Harvey Cushing’s
first reported case
Acromegaly
Gigantism
Identical twins, 22 years old, excess GH secretion
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
ACTH synthesis
Processing and cleavage of pro-opiomelanocortin (POMC)
ACTH
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.
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
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
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
Regulation
of ACTH
secretion
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.
• 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
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
Regulation
of ACTH
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
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
Glycoprotein hormones
Glycoprotein hormones contain two subunits, a
common α subunit and a distinct β subunit:
TSH, LH, FSH and hCG.
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
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
Pulsitile secretion of GnRH and LH
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.
• 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
• 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
Regulation of
gonadotropin
secretion
Thyrotrophs
• Site of TSH synthesis
• Pattern of secretion is relatively steady
• TSH secretion stimulated by TRH
• Feedback control by T3 (thyroid hormone)
Feedback
control of
thyroid
function
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.
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
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
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
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
Hypothalamus and posterior
pituitary
Structures of ADH and oxytocin
In uterus during parturition
In mammary gland during
lactation
Oxytocin: stimulates
myoepithelial contractions
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.
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
Oxytocin secretion is stimulated
by nursing
Thanq

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ANAPHYLAXIS BY DR.SOHAN BISWAS,MBBS,DNB(INTERNAL MEDICINE) RESIDENT.pptx
ANAPHYLAXIS BY DR.SOHAN BISWAS,MBBS,DNB(INTERNAL MEDICINE) RESIDENT.pptxANAPHYLAXIS BY DR.SOHAN BISWAS,MBBS,DNB(INTERNAL MEDICINE) RESIDENT.pptx
ANAPHYLAXIS BY DR.SOHAN BISWAS,MBBS,DNB(INTERNAL MEDICINE) RESIDENT.pptx
 

endocrine hormones

  • 1. Endocrine hormones RVS Chaitanya Koppala Assistant professor, Lovely professional university, Punjab
  • 2. Anterior pituitary • Anterior pituitary: connected to the hypothalamus by hypothalmoanterior pituitary portal vessels. • The anterior pituitary produces six peptide hormones: – prolactin, growth hormone (GH), – thyroid stimulating hormone (TSH), – adrenocorticotropic hormone (ACTH), – follicle-stimulating hormone (FSH), – luteinizing hormone (LH).
  • 3. Anterior pituitary cells and hormones Cell type Pituitary population Product Target Corticotroph 15-20% ACTH β-lipotropin Adrenal gland Adipocytes Melanocytes Thyrotroph 3-5% TSH Thyroid gland Gonadotroph 10-15% LH, FSH Gonads Somatotroph 40-50% GH All tissues, liver Lactotroph 10-15% PRL Breasts gonads
  • 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
  • 20. Acromegaly A) before presentation; B) at admission Harvey Cushing’s first reported case Acromegaly
  • 21. Gigantism Identical twins, 22 years old, excess GH secretion
  • 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
  • 23. ACTH synthesis Processing and cleavage of pro-opiomelanocortin (POMC) ACTH
  • 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
  • 35. Glycoprotein hormones Glycoprotein hormones contain two subunits, a common α subunit and a distinct β subunit: TSH, LH, FSH and hCG.
  • 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
  • 38. Pulsitile secretion of GnRH and LH
  • 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
  • 51. Structures of ADH and oxytocin
  • 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
  • 55. Oxytocin secretion is stimulated by nursing
  • 56. Thanq