Androgens Flashcards

1
Q

hypothalamic-pituitary-testes axis: hormones

A
  1. hypothalamus produces GnRH → production of FSH & LH from pituitary
    2a. FSH regulates Sertoli cell proliferation and Seminiferous tubule growth
    2b. LH regulates testosterone synthesis by Leydig cells
  2. testes make:
    -testosterone (& dihydrotestosterone)
    -Mullerian inhibitory substance / AMH
    -inhibin B
    -aromatase
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2
Q

testes - 2 important cell types

A
  1. Leydig cells: produce testosterone
  2. Sertoli cells: produce 1) anti-Mullerian hormone (AMH) and 2) inhibin B; express aromatase for estradiol production; support sperm synthesis
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3
Q

Leydig cells & steroidogenesis

A

*luteinizing hormone (LH) promotes Leydig cell growth & proliferation
*LH also promotes the first step in steroidogenesis (first step in testosterone synthesis)
*Leydig cells (located close to the blood supply) receive LH and then secrete androgens, which direct sex differentiation and pubertal development
*Leydig cells also support fertility b/c developing sperm requires androgens

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4
Q

Sertoli cells - functions

A

*endocrine functions of Sertoli cells are stimulated by FSH; Sertoli cells also have receptors for androgens
1. during fetal development, Sertoli cells produce AMH → regression of Mullerian ducts
2. later in life, Sertoli cells:
a. produce inhibin (regulates FSH release)
b. produce androgen-binding protein (ABP) to maintain androgen levels in male reproductive tract
c. aromatize testosterone (from Leydig cells) to estradiol for local (paracrine) effects

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5
Q

Sertoli cells & spermatogenesis

A

*Sertoli cells SUPPORT and REGULATE spermatogenesis
*nourish & protect germ cells by mediating the biochemical environment in which they form

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6
Q

Leydig & Sertoli cell interactions

A

*growth factors from Sertoli cells have a PARACRINE effect on Leydig cells
1. LH binds Leydig cells and increases testosterone synthesis
2. testosterone goes to bloodstream and to Sertoli cells
3. FSH promotes production of ABP, inhibin, & growth factors by Sertoli cells
4. ABP concentrates testosterone in the seminiferous tubules, providing high local concentrations for spermatogenesis

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7
Q

testosterone & inhibin - feedback

A

*testosterone: provides feedback to hypothalamus & pituitary to suppress GnRH & LH release
*inhibin: provides feedback to the pituitary to attenuate FSH release

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8
Q

synthesis of androgens

A

*LH/ACTH stimulate StAR to transport cholesterol into mitochondria; products are primarily testosterone in the testes (and DHEA / other androgens in the adrenals)
*some tissues (skin, sex organs, prostate) have 5 alpha reductase activity and convert testosterone to dihydrotestosterone

note - DHT is more potent than testosterone, but with a shorter half-life; carries out more local effects

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9
Q

biotransformation of testosterone

A

*testosterone can undergo biotransformation to:
1. dihydrotestosterone (DHT) via 5 alpha reductase
2. estradiol via aromatase enzyme; estrogens: a) aid in testosterone’s feedback to the brain
b) mediate testosterone’s contribution to epiphyseal closure and bone health
c) are important for other aspects of health and sperm production

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10
Q

androgen receptor binding and signaling

A

*binding of testosterone or DHT to an intracellular androgen receptor translocates the receptor from cytoplasm to the nucleus where it dimerizes and serves as a transcription factor

note - recall that testosterone & DHT are steroid hormones

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11
Q

blood transport of androgens

A

*45-60% is tightly bound to sex hormone binding globulin (SHBG)
*40-55% is weakly bound to albumin
*about 2% is free and active

recall: testosterone is a steroid hormone: lipophilic, hydrophobic, requires a binding protein to travel in bloodstream

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12
Q

sex hormone binding globulin (SHBG)

A

*tightly binds approximately half of the testosterone in the blood
*SHBG is synthesized by the LIVER, and levels can be altered by liver disease & drugs
*SHBG is lower in males than females
*note - estrogen increases SHBG (and lowers free testosterone)

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13
Q

elimination of androgens

A

*in the liver, androgens are converted to weaker androgens and are also made to be more water soluble via various glucuronidation / sulfonation reactions
*this allows for excretion in the urine by the kidney

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14
Q

testosterone actions - during gestation

A

*presence or absence of testosterone determine whether male or female sexual organs develop
*testosterone in the male fetus is responsible for development of epididymis, seminal vesicles, and vas deferens; DHT in the male fetus is responsible for development of penis, scrotum, and prostate
*testosterone drives descent of the testes

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15
Q

testosterone activation during puberty

A

*LH/FSH/testosterone levels are all low prior to puberty
*the pubertal axis is chronically inhibited until puberty, when pulsatile release of GnRH → increased release of LH/FSH → androgen production, Leydig cell maturation, and spermatogenesis

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16
Q

testosterone actions - during puberty

A
  1. secondary sexual characteristics:
    -hair growth over pubis, face, chest
    -lowering of voice pitch: hypertrophy of laryngeal mucosa and enlargement of larynx
    -enlargement of penis, scrotum, and testes
  2. linear growth (until epiphyseal plate closure)
  3. protein synthesis → increased muscle mass
  4. increased libido
17
Q

testosterone in adulthood (overview)

A

*testosterone reaches a steady state during adulthood, then declines with increasing age
*note - variability is significant

18
Q

testosterone actions - in adulthood

A

*muscle mass / nitrogen balance
*libido, erectile function
*spermatogenesis / fertility
*increased number of RBCs due to induction of erythropoietin
*male-pattern baldness
*maintains secondary sexual characteristics
*increased thickness of skin
*sebaceous gland activity
*positive effect on bone health (mostly by being converted to estrogen)

19
Q

anabolic steroid use

A

*testosterone, DHT, and more
*people use anabolic steroids are usually seeking increase in muscle mass, muscle strength, and/or performance
*suspect in males with change in behavior (increased aggression), acne, gynecomastia (aromatization of testosterone of estrogen), erythrocytosis, small testes (suppression of endogenous HPG axis), decreased sperm count, infertility
*labs: low LH, low FSH, variable testosterone levels
*women may present with virilization (hirsutism, acne, breast atrophy, male pattern baldness)

20
Q

primary hypogonadism (low testosterone)

A

*primary issue = testis (site of testosterone production)
*lab pattern: elevated LH, elevated FSH, low testosterone
*may see elevated estrogen levels. gynecomastia
*common causes: orchitis (mumps), testicular trauma, Klinefelter

21
Q

secondary hypogonadism (low testosterone)

A

*primary issue = pituitary gland (LH and FSH production)
*lab pattern: low LH, low FSH, low testosterone
*common causes: anabolic steroid use, pituitary lesion, high prolactin, hemochromatosis