Neuroendocrinology/physiology Flashcards

1
Q

Kisspeptin

A

neuropeptide encoded by the KISS1 gene.
Acts on the kisspeptin receptor (KISS1R) found in hypothalamus
Kisspeptin binds to receptor in hypothalamus and upregulates GnRH production through effect on GnRH neurons. It a apex of the HPO axis.
GnRH neurons have no sex steroid receptors, kisspeptin neurons have oestrogen and progesterone receptors.
– Inactivating mutation of KISS1 and KISS1R cause of Hypog hypo – failure to enter puberty. Activating mutations cause precocious puberty.

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2
Q

KNDy neurons

A

Neurons within arcuate nucleus of hypothalamus.
Kisspeptin
Neurokinin B
Dynorphin
KNDy hypothesis –
NKB is the signal responsible for pulse onset of GnRH by triggering activation among KNDy neurons.
Kisspeptin serves as the output signal from KNDy neurons driving GnRH secretion
Dynorphin serves as the signal terminating each pulse.

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3
Q

Hypothalamic and pituitary hormones

A
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4
Q

Prolactin

A

PRL gene expression occurs in Lactotrophs in anterior pituitary produce as well in the decidualised endometrium and myometrium.
Main fucntion is lactogenesis.
Secretion of prolactin is chiefly under the inhibitory control of dopamine. Homeostasis regualted predominantly by negative feedback of PRL on dopamine releasing neurons.
Dopamine is stimualted by PRL and inhibited by oestrogen ie. Increasing PRL decreases prl secretion and increasing oestrogen increases PRL secretion.
Dopamine secretion - inhibited by opioids, oestrogen. Activated by prolactin, serotonin, neuropeptide Y.
Increase dopaimne will also inhibit gonadotrophin secretion

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5
Q

Gene mutations causing panhypopit

A

Pit-1, SOX2, SOX3, LHX3 LHX,4

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6
Q

GnRH pulse frequency and amplitude across menstrual cycle

A

Lower amplitude and higher frequency in follicular phase (more exagerrated before LH surge). Higher amplitude and lower freuqency in luteal phase.

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7
Q

Controls of GnRH pulses

A

Dopamine tract (inhibitory)
Noradrenaline tract (Stimulatory)
Serotonin
Neuropeptide Y - peptide by which leptin and insulin inform the hypothalamus about the nutritional state of the individual.
Kisspeptins (as above)

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8
Q

Regulatory control of the gonadotrophin independent phase of follicular development

A

Regulated by a variety of factors.
Transfomring growth factor beta (TGF-B) - include activin, inhibin, AMH and BMPs (bone morphogenic proteins).
Activin and BMP promotes and inhibin and AMH retards primordial follicle development.
Neurotrophins (nerve-growth factor) also involved.

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9
Q

Menstrual cycle - follicular phase

A

primordial oocyte - primary follicle gonadotrophin independent process occuring ~70-85 days in advance of gonadotrophin dependent recruitment.
FSH rise in late luteal phase rescues a cohort of primary follicles from apoptosis.
FSH stimulation propels follicles from primary to early preantral phase.
FSH induced aromatisation of androgen (from theca cells) in the granulosa results in oestrogen production.
FSH and E2 increase FSH receptor content in the follicle.
Dominant follicle selection day 5-7, peripheral oestrogen levels continue to rise and produces suppressive effect on FSH.
Unique responsiveness to LH in DF (more receptors and more sensitive), allows it to convert androgen rich to oestrogen rich environment within follicular fluid of antral follicle.
FSH causes LH receptor formation of grnulosa cells.
LH levels rise steadily in late follicular phase.
Follicular response to gonadotrophins is modulated by a variety of growth factors and autocrine-paracrine peptide (activin, inhibin, follistatin, IGF-1)
Inhibin B secreted by granulosa cells in response to FSH, directly suppresses pituitary FSH secretion.
Activin - augments FSH secretion and action (arising in pituitary and granulosa)
Day 10 the peak of E2 causes positive feedback and initiation of LH surge.
Until this point - primary oocyte - arrested in diplotene part of prophase in meiosis 1. 2pn (diploid cells) –> ovulation allows resumption of meiosis - extrusion of first polar body and then arrests again in metaphase of meiosis 2.
LH surge further luteinses granulosa cells, synthesises progesterone and prostaglandins within follicle.
P4 –> activation of proteolytic enzymes which alongside prostaglandin cause digestion and rupture of the follicular wall.

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10
Q

menstrual cycle luteal phase

A

normal luteal function requires preovulatory follicular development, adequate FSH stimulation and continued tonic LH support.
Early follicluar phase is marked by active angiogenesis mediated by VEGF.
P4, E2, inhibin A act centrally to suppress gonadotrophins and thus new follcular growth.
Regression of the corpus luteum causes a decrease in VEGD and angiopoietin-1 expression and an increase in angiopoetin-2 activity.
In early pregnancy bHCG rescues the corpus luteum, maintain luteal function until placental steroidogenesis is well established.
Otherwise the demise of the corpus luteum results in a nadir in circulating level of E2, P4 and inhibin.
Decrease in inhibin A removes a suppressing influence on FSH secretion in the pituitary. Decrease in E2 and P4 allows progressive and rapid increase in pulse freuqency of GnRH secretion –> greater secretion of FSH than LH.
Rising FSH rescures the primary follicles from atresia to start the new cycle again.

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11
Q

Progesterone receptors.

A
  • Three major forms - PR-A, PR-B, PR-C.
  • PR induced by oestrogen and decreased by progestins.
  • PR-A and PR-B most relevant to progesterone signalling.
  • Nuclear receptor – it is a transcription factor and stimulates DNA transcription and thus gene expression.
  • Can also signal through cell membrane (G protein receptor pathways) and cytoplasmic pathways.
  • Differ to other steroid hormone receptors by their regulatory domain – share the same DNA domain, hinge region and hormone binding domain.
  • In most cells, B is a positive regulator of P-responsive genes and A inhibits B
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12
Q

Progesterone synthesis and metabolism

A

Synthesised from cholesterol within the steroidogenic pathway.
Cholesterol carried from outer to inner mitochondrial membrane by STAR steroidogenic acute regulator converted from cholesterol into pregnenolone by CYP11a1. Pregnenolone converted to progesterone by 3b hydroxysteroid dehydrogenase in the endoplasmic reticulum.

In luteal phase and early pregnancy made and excreted from the corpus luteum.

Metabolised either through conversion to mineralocorticoids, glucocorticoids or other sex steroids within the steroidogenic pathway. Excreted in the urine from by products broken down from progesterone and 17-hydroxyprogesterone.

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13
Q

Initial recruitment phase of folliculogenesis (gonadotrophin independent)

A

Oogonia - stem cells, 2n. Migrate from yolk sac through genital ridge to fetal gonad. Undergo mitosis to replicated and reach a peak of 6-7million at 20 weeks.
Form germ cell nests with surrounding layer of squamous cells. Most will undergoing atresia and through this process each germ cell nest will produce one primordial follicle - oocyte surrounded by single layer of squamous granulosa cells.
Oocyte formed from oogonia through meiosis, arrests at diplotene phase of meiosis 1 prophase.
This all occurs during fetal life and born with ~1million oogonia. Drops to 200 000- 400 000 by puberty.

Primordial follicles one of 4 fates:
1. remain quiescent for variable amounts of time to constitue the ovarian reserve.
2. directly undergoes atresia
3. undergoes initial recruitment and eventually ovulation
4. undergo initial recruitment but later die via atresia

Primary follicle - larger oocyte, zona pellucida forms, single layer of granulosa cells becomes cuboidal. DEvoid of theca cells but precursor theca cells derived from stroma begin to surround follicle. Once the primary follicle is formed then the initial recruitment/gonadotrophin independent state is complete.

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14
Q

Intrinsic ovarian factors involved in the initial recruitment phase of folliculogenesis (gonadotrophin independent)

A

Stimulatory:
Kit and Kit ligand - stem cell growth factor - can initiate growth and development of primordial follicle
Fibroblast growth factor - regulate grnaulosa, theca and stromal cell growth
LIF (leukaemia inhibitory factor) - act upon the granulosa and oocyte to stimulate oocyte growth and to recruit thecal cells to the follicle.
Bone morphogenetic proteins 4 and 7 (BMP4 and 7), has been shown to aid in the survival of primordial follicle oocytes
PDGF (platelet derived growth factor) in oocytes acts on granulosa cells to inc kit ligand and activate primordial follicle.

Inhibitory:
AMH -belongs to the transforming growth factor beta (TGF-b) superfamily and is involved in the inhibition of initial recruitment, mechanism for this is largely unknown.
Highest levels are present in the preantral (secondary) and early antral follicles. AMH mice knowckout models shouw a depletion of the primordial dollicle reserve
FOXL2 - expressed in granulosa cells of the primordial follicle, plays a critical role in the development of granulosa cells within the primordial follicles. Mediates the squamous to cuboidal transition and proliferation of granulosa cells.

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15
Q

Transition from primary stage to early antral stage (gonadotrophin responsive but not driven by gonadotrophins)

A

The granulosa cells contained in a single layer in the primary follicle undergo mitosis and multiple layers of granulosa cells that are capable of producing steroids form, establishing the preantral follicle.
It takes roughly 120 days for this process to occur in the human.
Basement membrane and two layers of thecal cells form - theca interna - inner layer and adjacent to BM, produces steroids. Theca externa, outer layer, comprised of non-steroidogenic fibroblast cells that become part of connective tissues. Vascularisation of theca cells provides the follicle with direct acces to blood stream and hormones such as gonadotrophins.

Continued development - further thecal cell vascularistaion and granulosa cell proliferation.
substances brought in through blood stream result in formation of fluid-filled spaces within the granulosa cell layer. Coalesce to form singular fluid cavity known as the antrum/antral cavity.
Once this antral cavity is seen - moves from preantral to early antral follicle (70days).

This transition mostly driven by intraovarian factors and signalling pathways but gonadotrophins may mediate follicle development during these stages (though can occur in the absence of FSH and LH). Can remember the same factors as above.

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16
Q

Cyclic recruitment (gonadotrophin dependent)

A

Cohort of early antral follicles that are gonadotrophin responsive and further stimulate by FSH for final maturation to preovulatory stage.
FSH during late luteal and early follicular stage most importnat catalyst for preovulatory follicle development.
Without FSH early antrals undergo atresia.
Antrum grows, theca become more vascularised, FSH mediated mitosis of grnaulosa cells, leads to a massive increase in size of matural antral follicle.
Mural granulosa cells are the outermost cells surrounding the BM and are the most steroidogenically active, oestradiol-producing cells.
Cumulus granulosa surrounds the oocyte- responds differently to the mural granulosa cells to FSH stimulation.
Maturing antral follicles are the major producers of sex steroid hormones in the female and these hormones are required for further follicle development.
Two cell theory (not repeated), FSH increases aromatase activity in granulosa cells increases oestradiol.
Granulosa cells are initially devoid of LH receptors, FSH and oestradiol signalling leads to the acquisition of LH receptors on the granulosa cells, required for ovulation.
IGF-1 and activin also faciltate the increase in E2 levels.
Inhibin B and E2 negatively feedback on pituitary and reduce FSH levels.
This fall in FSH leads to atresia of all but the dominant preovulatory follicle which escapes this because it is more sensitive to and more efficiently utilises gonadotrophins, possibly due to more granulosa cells numbers, FSH/LH receptors, vascular supply.

17
Q

Ovulation

A

DF is now producing threshold levels of oestradiol that now positively feedback on kisspeptin neurons which cause LH surge.
- meiotic resumption in oocyte and extrusion of first polar body, moving to haploid cell and the arrest in metaphase of meiosis 2.
- cumulus grnaulosa cell expansion
- breakdown of follicular wall,
- differentiation of follicular cells to luteal cells.
- ~36hours between LH surge and ovulation in humans.

18
Q

Components of G protein coupled receptors

A

Large extracellular domain. (N terminus)
Transmembrane segment (7 alpha helices).
Short intracellular domain (C terminus)
Gonadotrophin receptors are G protein couple receptors.
Binding of ligand to receptor N terminus causes C terminus to activate the G protein which usually activates a intracellular process, for gonadotrophins the G protein activates adenylate cyclase (AC) which leads to Protein Kinase A activation.
This in tern leads to phosphorylation of proteins which results in the activation of genes.

19
Q

FSH and LH receptor locations

A

LH:
Ovary - theca cells, granulosa cells midfolluclar, luteal cells, interstitial cells
Testis - Leydig cells
Extragonadal - uterus, prostate, seminal vesivles, skin, breast, adrenals, thryoid, brain

FSH:
Ovary - granulosa cells
Testis - sertoli cells
Endometrium - luteal phase

20
Q

FSH and LH receptor mutations

A

Mutations can lead to inactivation or overactivation of the receptors.

FSHreceptor mutations:
OHSS (severe unexpected cases) may have mutations in the gene for FSHR, making them more sensitive to gonadotropin stimulation.

46 XX gonadal dysgenesis experience primary amenorrhea with hypergonadotropic hypogonadism. There are forms of 46 xx gonadal dysgenesis wherein abnormalities in the FSH-receptor have been reported and are thought to be the cause of the hypogonadism.

Polymorphism may affect FSH receptor populations and lead to poorer responses in infertile women receiving FSH medication for IVF.

Alternative splicing of the FSHR gene may be implicated in subfertility in males

LH:
Loss-of-function mutations in females can lead to infertility.

In 46, XY individuals severe inactivation can cause male pseudohermaphroditism, as fetal Leydig cells during embryogenesis may not respond and thus interfere with masculinization.Less severe inactivation can result in hypospadias or a micropenis

21
Q

FSH molecule structure

A

Glycoprotein Heterodimer
Two polypeptide units
alpha
beta

alpha units of LH, FSH, TSH and hCG are indentical and consist of 96 amino acids
B unit 111 amino acids - confers its specific biologic activity and is responsible for its interaction with FSHr

The different composition of these oligosaccharides affects bioactivity and speed of degradation of all the above listed molecules.

22
Q

LH molecule

A

Glycoprotein heterodimer
Two polypeptide units
alpha
beta

alpha units of LH, FSH, TSH and hCG are indentical and consist of 96 amino acids

B subunit - LH has a beta subunit of 120 amino acids (LHB) that confers its specific biologic action and is responsible for the specificity of the interaction with the LH receptor. This beta subunit contains an amino acid sequence that exhibits large homologies with that of the beta subunit of hCG and both stimulate the same receptor. However, the hCG beta subunit contains an additional 24 amino acids, and the two hormones differ in the composition of their sugar moieties.

23
Q

Receptor regulation (4 ways)

A

Upregulation - increase in the number of receptor sites on the membrane
Downregulation - decrease in the number of receptor sites
Densensitisation - receptors less responsive after long exposure
Modulators - moelcules that can interfere with receptor activity

24
Q

Progesterone role in natural cycles

A

E2 induces P4 receptors (PR-A and PR-B) expression in the endometrium preparing for the secretory phase
CL secretes P4 and E2
Secretory changes induced in the endometrium (vacuole formation, halting epithelial proliferation, increased stromal oedema, dense coiling of spiral arteries, 2-3 day WOI
Reduction in myometrial contractility and local vasodilatation by inducing N2O in the decidua
Post ovulatory cervical mucus thickening and prevention of bacterial and sperm entry
Immune changes and receptivity of endometrium for pregnancy

25
Q

Immune changes in endometrium under P4 influence

A

Modification of T cell activity
T2 >T1
Inhibition of cytotoxic T cells and inc in Tregs
Uterine NK CD56+ increase from early to late secretory
Mesenchymal epitherial transition occurs - cells become rounded and secretory and express prolactin and IGF-1

26
Q

Importance of progesterone and pregnancy

A

Establishment of pregnancy -
- decidualisation and implantation
- immune tolerance of semi-allogenic conceptus
- inhibits uterine contractions
- substrate for fetal production of mineralocorticoids and glucocorticoids

Third trimester/labour -
P4 withdrawal = uterine contractions and labour
Loss of antiinflammatory activity

27
Q

Theory behind benefit of progesterone support in luteal phase of natural FETs

A

Compensate for compromised CL progesterone production ? Advanced age
Compensates for asynchrony due to misinterpretation of window of implantation
Reduces uterine contractility/ subendometrial wave activity
Induces Th2 dominant cytokine environment -> maintains/promotes pregnancy

28
Q
A