1. Endocrine Physiology lecture 3
Dale Buchanan Hales, PhD
Department of Physiology & Biophysics

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 b-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
PRL
Breasts
gonads

4. Anterior pituitary hormones

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.

6. Hypothalamus-pituitary axis

7. Feedback control

8. Feedback control of thyroid function

9. Feedback leads to restoration of homeostasis

10. Feedback control of growth hormone

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. Regulation of Growth Hormone Secretion
Neurotransmitter systems that stimulate GHRH and/or inhibit somatostatin
Catecholamines acting via a2-adrenergic receptors
Dopamine acting via D1 or D2 receptors
Excitatory amino acids acting via both NMDA and non-NMDA receptors

13. Regulation of Growth Hormone Secretion
b-adrenergic receptors stimulate somatostatin release and inhibit GH
b-adrenergic receptors inhibit hypothalamic release of GHRH

14. 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

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. Growth hormone vs. metabolic state
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

17. Growth hormone and 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 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 Acromegaly A) before presentation; B) at admission
Harvey Cushing’s first reported case

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 b and g lipotropin, b-endorphin, and a-melanocyte-stimulating hormone (a-MSH).
ACTH is a key regulator of the stress response

23. ACTH synthesis Processing and cleavage of pro-opiomelanocortin (POMC)

24. ACTH ACTH is made up of 39 amino acids
Regulates adrenal cortex and synthesis of adrenocorticosteroids
a-MSH resides in first 13 AA of ACTH
a-MSH stimulates melanocytes and can darken skin
Overproduction of ACTH may accompany increased pigmentation due to a-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. b-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
a-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

28. Regulation of ACTH secretion

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. Regulation of ACTH secretion
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.

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

32. Regulation of ACTH

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
a and b subunits
Each subunit encoded by different gene
a subunit is identical for all hormones
b subunit are unique and provide biological specificity

35. Glycoprotein hormones
Glycoprotein hormones contain two subunits, a common a subunit and a distinct b 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 b-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. Regulation of LH/FSH
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

41. 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

42. Regulation of gonadotropin secretion

43. Thyrotrophs Site of TSH synthesis
Pattern of secretion is relatively steady
TSH secretion stimulated by TRH
Feedback control by T3 (thyroid hormone)

44. Feedback control of thyroid function

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

50. Hypothalamus and posterior pituitary

51. Structures of ADH and oxytocin

52. Oxytocin: stimulates myoepithelial contractions
In uterus during parturition
In mammary gland during lactation

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