Lecture 3: Growth Hormone and Acromegaly Flashcards
What kind of molecules are GHRH and GH?
Peptides
<p>What is the ubiquitous role of somatostatin?</p>
<p>It inhibits cellular proliferation and activity</p>
<p>Describe the GH peptide.</p>
<p>191 AAs with 2 disulfide bonds</p>
<p>What hormone has a similar structure to GH? What is the small difference?</p>
<p>PRL
| 3 disulfide bridges instead of 2`</p>
<p>How is the similar structure of PRL and GH put to use in real life?</p>
<p>Bovine GH can bind both GH and PRL receptors so it's administered to cows to increase their size and milk production</p>
<p>Draw the feedback loops involved with GH production by pit. </p>
<p>INSERT IMAGE HERE</p>
<p>What is the major organ destination for GH?</p>
<p>The liver</p>
<p>What hormone does the liver produce upon receiving GH? 2 names</p>
<p>Somatomedin C = Insulin-Like Growth Factor-1 (IGF-1)</p>
<p>What kind of feedback is triggered by IGF-1 production by the liver?</p>
<p>3 long feedback loops:
- GH to ant pit
\+ SS to hypo
-GHRH to hypo </p>
<p>How does GH production by ant pit affect hypo?</p>
<p>Short loop:
\+ SS
- GHRH</p>
<p>What are the main 3 cellular processes stimulated by GH?</p>
<p>1. Growth
2. Cell reproduction
3. Cell regeneration</p>
<p>Is GH a metabolic or anabolic hormone?</p>
<p>Anabolic</p>
<p>4 effects of IGF-1 on visceral tissue and organs (bones, heart, lungs, kidneys, pancreas, intestines, skin, connective tissues)? Overall effect?</p>
<p>1. + protein synthesis 2. + RNA synthesis 3. + DNA synthesis 4. + cell size/function = Increase size/function</p>
<p>7 effects of IGF-1 on chondrocytes? Overall effect?</p>
<p>1. + AA uptake 2. + protein synthesis 3. + RNA synthesis 4. + DNA synthesis 5. + collagen 6. + chondroitin sulfate 7. + cell size/number = LINEAR GROWTH when growth plates are open</p>
<p>What are chondrocytes?</p>
<p>Bone cells</p>
<p>3 effects of GH on adipose tissue? Overall effect?</p>
<p>+ lipolysis
- glucose uptake
\+ glycolysis
= DECREASED ADIPOSITY</p>
<p>4 effects of GH on liver tissue?</p>
<p>1. + RNA synthesis
2. + protein synthesis
3. + gluconeogenesis
4. + IGF-1</p>
<p>3 effects of GH on nonactive muscles? Overall effect?</p>
<p>1. - glucose uptake
2. + AA uptake
3. + protein synthesis
= LEAN BODY MASS</p>
<p>How do GNRH and SS affect each other?</p>
<p>They both inhibit each other's production</p>
What are the 8 factors that stimulate GH secretion?
- Glucose decrease
- FA decrease
- AA increase (especially Arg)
- Fasting
- Stage 4 sleep (1 hour after sleep onset)
- Exercise
- Actute stress
- Sex hormones
- Alpha-adrenergic agonists
What are the 8 factors that inhibit GH secretion?
- Glucose increase
- FA increase
- Cortisol = chronic stress
- Obesity
- Pregnancy
- SS
- GH
- IGF-1
<p>Why is GH said to be a hyperglycemic hormone?</p>
<p>Because it raises glucose levels through gluconeogenesis and decrease glucose uptake by adipose tissue and muscle </p>
Why is GH inhibited by pregnancy?
Because placenta makes its own called HPL which has a short loop negative feedback on hypo: + SS and - GHRH
<p>How often does GH secretion happen during a normal 24h day?</p>
<p>Every 4 hours </p>
<p>How does GH production vary during the life span? What hormones is this similar too?</p>
<p>GH is low at birth, increases during childhood, peaks at puberty, and continues to decrease during adult life and senescence
SAME AS SEX HORMONES</p>
What is acromegaly due to? To what patients?What are the symptoms?
Pit tumor (micro or macro) causing overproduction of GH in adults (middle age) Symptoms: overgrowth of soft tissues of face (nose and lips), hands, feet, and bones
What is gigantism due to? What are the symptoms?
Macroadenoma causing overproduction of GH in children (before closure of epiphysial endplate in puberty)
Symptoms: incredible height (7-8 feet), and sometimes acromegaly in adulthood
What is pituitary dwarfism due to? What are the symptoms?
Inability of pit to produce enough GH
Symptom: insufficient stature growth
What is Laron dwarfism due to? What are the symptoms?
Special subset of pit dwarfism due to lack of functioning GH receptors
Symptoms: insufficient stature growth and high GH because IGF-1 is not produced
What is wide-range hypopituitarism?
When a patient has a dysfunction of many cell types contained in the anterior pit
<p>How does low LH affect testosterone levels? What does this cause?</p>
<p>Low testosterone levels causing decrease in libido and body hair AND decrease in hematocrit</p>
<p>Why would administering fluids to a patient with macroadenoma worsen his condition?</p>
<p>Because the added fluid in the sella turcica will increase pressure </p>
<p>What are the post-op treatments of hypophysectomy of macroadenoma?</p>
<p>End-organ hormone replacement therapy</p>
<p>Why could macroadenoma cause increase in PRL?</p>
If tumor is really pressing hard it is cutting flow of venous blood from the hypo to pit gland so dopamine is not making it to the pit
<p>Are pit tumors usually cancerous/metastatic?</p>
<p>NOPE</p>
<p>Which predominates on GH production: GHRH or SS? </p>
<p>GHRH: net increase</p>
<p>When can GH bind to PRL receptors?</p>
<p>When GH is in excess</p>
<p>How does testosterone affect GH production? Why?</p>
<p>It substantially increases GHRH and SS so it causes episodic levels of GH (high peaks and very low baseline level)
Causes maximal somatic growth</p>
<p>How does estrogen affect GH production? </p>
<p>It moderatly increases GHRH and SS so it causes disorganized episodic levels of GH (lower peaks and higher baseline level than in males)</p>
How would a treatment of peptide hormones need to be administered?
Via IV
