Class #13 - Corticosteroids Flashcards
Endocrine signalling?
Autocrine: same cell
Paracrice: Close cell
Endocrine: Communication by travelling in blood system. Acting on remote targets.
Hormone def?
Chemical messenger that circulates in the body and has an effect on distant cells.
Endocrine system general functioning?
Hypothalamus - > Pit. ->Thyroid/parathyroid/pancreas/Adrenal glands/Ovaries/Testes/etc.
Adrenal axis?
Hypo: Corticotrophin releasing factor (CRF) or Corticotrophin releasing hormone (CRH) -> Anterior Pit.: Adrenocorticotrophic hormone (ACTH) -> Adrenal Cortex: Steroids (Cortisol)
ACTH synthesis?
CRF ->GPCR in pit. stimulating POMC (peptide) synthesis -> beta-lipotropin (B-LPH) and ACTH
ACTH effects?
- Increase the availability of precursor molecules (cholesterol) in the inner mitochondrial membrane (IMM) of the adrenal cortex cells, allowing to make the desired steroids based on needs.
- Increase the level of Cholesterol side-chain cleavage enzyme needed to initiate cleavage of cholesterol to Pregnelonone.
ACTH synthesis?
CRF -> GPCR in pit. stimulating POMC mRNA -> preprohormone (ER) -> prohormone (Golgi) -> mature POMC hormone (peptide)-> beta-lipotropin (B-LPH) and ACTH
ACTH affects which part of adrenal cortex?
Zona Fasciculata/Reticularis
Prod. of aldosterone happens in which part of the adrenal cortex?
Zona Glomerulosa
What all steroids hormones have in common?
four membered ring
Glucocosticoids mec. of actions?
- Binding with globulin forming (Corticosteroid-binding globulin (CBG) = Transcortin) carrying it around in circulation and releasing H to target cell.
- Binds to steroid hormone receptors then interact with HSP (heat-shock p+) proteins to form complexes that move into the nucleus.
- Interact with hormone-response elements inside DNA.
- Altering the transcription of DNA
Glucocosticoids mec. of actions?
- Binding with globulin forming (Corticosteroid-binding globulin (CBG) = Transcortin) carrying it around in circulation and releasing H to target cell.
- Binds to steroid hormone receptors then interact with HSP (heat-shock p+) proteins to form complexes that allow the Steroid + Glucosteroids receptor into the nucleus.
- Interact with glucocorticoids response elements (GRE) inside DNA.
- Activating or Repressing the transcription of DNA
- Then, activation or repression of gene expression
Reduction of immune system by glucocorticoïds?
Repressing both: 1. NF-kB (nuclear factor kappa B); 2. AP1 (Activator Protein 1) That activate an immune response. [- + + = -] Mainly: Reduce the creation of Arachidonic acid
Metabolic actions of glucocorticoids?
Purpose: regulate glucose level in body
- Increase the expression/synthesis of the Enz. responsible for generating glucose: Glycogenolysis, gluconeogenesis, lypolysis and lipogenesis.
- Increase p+ catabolism if lack fat of glycogen (neg. effect increase osteoporosis
Anti-inflammatory. effect of gluco.?
- Repression: NF-kB and AP1 inhibition = decrease IL-2 and plt activating factor (PAF)
- Blocking of enz. that produce prostaglandins, cytokines, leucotriens and interleukins.
- Decrease proliferation and migration of lymphocytes and macrophage to sites of inflammation.
- Decrease production of phospholipase A2 by increasing the expression of lipocortin-1 or Annexin-1.
- Indirect effect: decrease availability of Arachidonic acid
- Direct effect: Decrease transcription of COX2 enz.
Anti cancer effect?
Triggers apoptosis
Gluco. as drugs (3)?
replacement therapy
anti-inflam.
Myeloproliferative diseases
Cortisol vs dexamethasone differences in structure?
Dexa. as an extra
- fluorine: more active in gluco/mineralocorticoid properties
- methyl group: Increase activities, and prolonge T1/2
Replacement Sx 1.Too low vs 2.Too high
- hair, acne, greasy skin, irr. periods, tiredness
2. Increase appetite, weight gain, musc. weakness, thick skin, easy bruising, high BP, osteoporosis, db
Use as anti-inflammatory effect?
allergie, eye disease, GIT (Crohn), acute resp. distress, infections, neuro, organ transplant, skin, joints, auto-immune disease, asthma,
Use as myeloproliferative disease?
Triggers apoptosis
Special cases of gluco. Dx use?
Premature babies: Delay labor (few hours) so surfactant can be made in babies lungs.
Too much cortisol =
Cushing’s Syndrome: Weight gain, slow healing, fatigue, glucose intolerance, moon face, buffalo hump, weakness, hirsutism, high BP, rectile disf.
Too much exogenous cortisol?
atrophy adrenals, hard to bring back