The HPA Axis And Growth Hormone Flashcards

1
Q

What is the HPA axis?

A

The hypothalamus and pituitary gland form a

complex functional unit that serves as the major link between the endocrine and nervous systems

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2
Q

Where is the pituitary gland located?

A

The pituitary gland sits beneath the hypothalamus in a socket of bone called the sella turcica

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3
Q

Name some processes the hypothalamus and pituitary glans modulate

A
Body growth
milk secretion - oxytocin 
reproduction - FSH and LH
lactation - prolactin 
adrenal gland function
thyroid gland function 
water homeostasis - ADH
puberty
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4
Q

What are the 2 parts of the pituitary gland?

A

•Anterior pituitary gland
(Adenohypophysis) - arises from evagination of oral ectoderm (Rathke’s pouch - primitive gut tissue)
•Posterior pituitary gland
(Neurohypophysis) - originates from neuroectoderm (primitive brain tissue)

  • The anterior and posterior pituitary glands have distinct embryological origins and distinct functions
  • The posterior pituitary gland is physically connected to the hypothalamus, since the hypothalamus drops down through the infundibulum to form the posterior pituitary - Posterior pituitary is not a gland as it dos not make its own hormones - it stores hormones from the hypothalamus - travel via neurones
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5
Q

What is the neurocrine function of the posterior pituitary

A

•Oxytocin and antidiuretic hormone produced by neurosecretory cells in the supraoptic and paraventricular nuclei of the hypothalamus - both nuclei generate oxytocin and ADH
•Transported down nerve cell axons to the capillary bed of the posterior pituitary.
•Stored and released from posterior pituitary into the general circulation to act on distant target tissues
NOTE: the posterior pituitary gland does not synthesise these hormones. It just releases them.

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6
Q

What is the function of the anterior pituitary?

A

• Hormones synthesised in hypothalamus are transported down axons and stored in median
eminence before release into
hypophyseal portal system.
(Terminate in primary capillary plexus - hypophyseal portal system
Portal system allows hormones to travel directly to anterior pituitary from capillary plexus though hypophyseal portal vein to capillary bed in anterior pituitary)
• These hormones stimulate (or inhibit)
target endocrine cells in the anterior pituitary gland (neurocrine
function).
• Endocrine cells of anterior pituitary
secrete a variety of hormones into the
bloodstream to act on distant target
cells (i.e. endocrine function).
• Anterior pituitary hormones also
effect neighbouring cells (autocrine
and paracrine function).

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7
Q

What are 2 pathways that the hormones produced by the hypothalamus act by

A

The hormones produced by nerve cells in the hypothalamus act via two distinct neurocrine pathways
• Direct effects on distant target tissues via oxytocin and
antidiuretic hormone from the posterior pituitary - produced in hypothalamus
• Hormones secreted exclusively into hypophyseal portal system affect endocrine cells within the anterior pituitary

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8
Q

What connects the posterior pituitary to hypothalamus

A

Infundibulum (pituitary stalk)

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9
Q

What are the 2 hormones RELEASEd from the posterior pituitary?

A

OT Oxytocin
(Milk let down and uterus contractions during birth) - Travels around systemic circulation - myoepithelial cells in mammary tissue surrounding alveoli where milk produced - contract myoepithelial cells - squeezes milk into collecting duct
Pressure on the cervix, OT released and binds to receptors on uterine wall - contractions

ADH Antidiuretic hormone (also called vasopressin)
(Regulation of body water volume) - ADH binds to receptors - receptors activated promote aquaporins into walls - higher reabsorption - more concentrated urine - absorbing more water from the blood

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10
Q

What are tropic hormones?

A

Hormones that have an affect on other hormones in the target tissue

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11
Q

What are the 6 tropic hormones of the hypothalamus?

A

• TRH Thyrotropin releasing hormone - stimulates release of TSH
- (PRH) Prolactin releasing hormone (not rly this) = TRH (minor +ve control on prolactin)
• PIH Prolactin release-inhibiting hormone (Dopamine) - dominant control of prolactin
• CRH Corticotropin releasing hormone - stimulates release of ACTH which acts on adrenal gland
• GnRH Gonadotropin releasing hormone
• GHRH Growth hormone releasing hormone
• GHIH Growth hormone-inhibiting hormone (Somatostatin)
(RH= releasing hormone, IH = inhibitory hormone)

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12
Q

What are hormones produced by the anterior pituitary?

A
  • TSH Thyroid stimulating hormone - Secretion of thyroid hormone from thyroid gland
  • ACTH Adrenocorticotropic hormone - Secretion of hormones from adrenal cortex
  • LH Luteinising hormone - Ovulation and secretion of sex hormones
  • FSH Follicle stimulating hormone - Development of eggs and sperm
  • PRL Prolactin - Mammary gland development and milk secretion
  • GH Growth hormone - Growth and energy metabolism. Stimulates IGFs
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13
Q

Summarise the hormones of the anterior pituitary

A

See slide for diagram

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14
Q

How are the hypothalamus and ant pituitary hormones release regulated?

A

The pathways by which hypothalamic and anterior pituitary hormones are produced are often regulated by NEGATIVE FEEDBACK

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15
Q

Name sone factors which influence growth

A

Genetics, environment, nutrition, hromones (growth hormones is the most important endocrine regulator of postnatal growth)

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16
Q

What is necrosis?

A

Cell death by damage

17
Q

What is apoptosis?

A

Programmed cell death

18
Q

What is atrophy?

A

Decrease in cell size or number

19
Q

What is hyperplasia

A

Increase in cell number eg tumours

20
Q

What is hypertrophy

A

Increase in cell size - muscles can only grow by hypertrophy

21
Q

What is growth hormone?

A

•Produced in the anterior pituitary:
- Stimulated by hypothalamic GHRH
- Inhibited by hypothalamic Somatostatin (growth hormone inhibiting hormone)
•Protein hormone (191 aa) has signal peptide that must be cleaved before proper folding
•Growth-promoting effects mainly exerted indirectly via insulin-like growth factors (Somatomedins)
- Can also act directly by binding to receptors itself
•In response to GH cells of the Liver and Skeletal muscle produce and secrete IGFs

22
Q

What is growth hormone needed for?

A

• GH stimulates long bone growth
- Length & width prior to epiphyseal closure
- Width after epiphyseal closure
• IGFs stimulate both bone and
cartilage growth In adults GH and IGFs help maintain muscle and bone mass and promote healing and tissue repair as well as modulating metabolism and body composition - lack of wellbeing - essential for feeling of wellbeing

23
Q

How is growth hormone secretion controlled?

A

Principal control is via the hypothalamus
•GHRH (↑ GH secretion)
•Somatostatin (→ GH secretion)

CNS regulates GH secretion via inputs into the hypothalamus effecting GHRH and somatostatin levels:
• Surge in GH secretion after onset of deep sleep - important that young children have uninterrupted sleep
• Rapid Eye Movement (REM) sleep → GH secretion
• Stress (e.g. trauma, surgery fever) ↑ GH secretion
• Exercise ↑ GH secretion.
• → in glucose or fatty acids leads to ↑ in GH secretion
• ↑ in glucose or free fatty acid leads to → in GH secretion
• Fasting ↑ GH secretion, Obesity → GH secretion.

24
Q

What are the long loops nd short loop negative feedback mechanisms for GH secretion?

A

See slide for diagram

Long loop negative feedback: Mediated by IGFs
•Inhibit release of GHRH from
hypothalamus
•Stimulates the release of
somatostatin from hypothalamus. •Inhibit release of GH from anterior
pituitary

Short loop negative feedback: Mediated by GH itself via stimulation of somatostatin release - feed back to hypothalamus directly

25
Q

What Weill result from GH deficiency in childhood

A
Pituitary dwarfism 
• Proportionate type of dwarfism 
• Complete or Partial deficiency 
• Both types respond to GH therapy 
• Height below 3rd percentile on
standard growth charts 
• Growth rate slower than expected for age 
• Delayed or no sexual development during teen years
26
Q

What happens in growth hormone excess

A

In childhood - results in gigantism (rare, 3 cases in 10^6 people)
Often caused by pituitary adenoma

In adulthood leas to actomegaly - large extremities - hands, feet, lower jaw

27
Q

How does GH exert effects on cells?

A

GH receptors activate Janus kinases (JAKs)
GH has direct and indirect effects
Directs start of by binding to GH receptor (a tyrosine kinase receptor) - causes it to dimerase
These activate Janus kinases (JAKs)
Cross phosphorylation of JAK
Phosphorylation of intracellular domains
-ve charges phosphate groups that are added form a docking site for signalling scaffold - this activates downstream signalling pathways
These include transcription factor activation and IGF productio

28
Q

What is IGF?

A

Insulin like growth factors (IGFs)
• 2 IGFs in mammals (IGF1 and IGF2)
• IGF2 mainly involved in fetal growth
• IGF1 major growth factor in adults
• Binding proteins modulate their availability.
• Actions of IGFs can be paracrine and autocrine as well as endocrine
• IGFs act through IGF receptors (distinct from GH receptors) to modulate:
• Cell growth (Hypertrophy)
• Cell number (Hyperplasia)
• Increase in the rate of protein synthesis
• Increase in the rate of lipolysis in adipose tissue

IGF produded in liver travel around
IGF produce in skeletal muscle more local

29
Q

What are insulin like growth factor receptors

A

Insulin receptor - metabolic effects, mitogenic effects
Hybrid - had insulin half IGF - metabolic and mitogenic
IGF1 - dimer of 2 IGF receptor component - metabolic and mitogenic
IGF2 - single receptor - targets IGF2 for lysosomal degradation but no tyrosine kinase activity

30
Q

What are other hormones that influence growth?

A

Insulin - Enhances somatic growth; interacts with IGF receptors
Thyroid hormones - Promote CNS development and enhance GH
secretion
Androgens - Accelerate pubertal growth spurt; increase muscle mass; promote closure of epiphyseal plates
Estrogen - Decrease somatic growth; promote closure of epiphyseal plates
Glucocorticoids - Inhibit somatic growth