THE HYPOTHALAMUS AND NEUROENDOCRINE DISORDERS in Microsoft Office

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HYPOTHALAMICNEUROHYPOPHYSIAL SYSTEM Supraoptic neuron Paraventricular neuron
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HYPOTHALAMICADENOHYPOPHYSIAL SYSTEM Monoaminergic neurons
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Optic tract Tuberoinfundibular neuron III Median eminence Pituitary stalk Neurohypophysis Adenohypophysis Long portal vein
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Internal carotid
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corticohypothalamic tract (in the stria terminalis) and are believed to account for the sleep- and stress-induced uctuations of GH and somatostatin Also, it has been demonstrated that all four biogenic amines (dopamine, norepinephrine, epinephrine, and serotonin) in uence GH regulation, as does acetylcholine, either by direct action on pituitary somatotropic cells or on hypothalamic regulatory neurons TRH also increases GH from somatotropes Many of the latter pituitary cells contain large eosinophilic granules, but others, previously identi ed incorrectly as chromophobe cells, also contain GH Somatomedin C, a basic peptide that is synthesized in the liver, exerts feedback control of GH by inhibiting the pituitary somatotropes and stimulating the release of somatostatin Growth hormone enhances skeletal growth by stimulating the proliferation of cartilage and growth of muscle It also regulates lipolysis, stimulates the uptake of amino acids in cells, and has anti-insulin effects The blood concentrations of GH uctuate from 1 or 2 to over 60 ng/ mL, being highest within the rst hour or two after the onset of sleep Corticotropin-Releasing Hormone (CRH) This hormone, a 14 amino acid peptide, acts synergistically with vasopressin to release adrenocorticotropic hormone (ACTH) from basophilic cells in the pituitary ACTH stimulates the synthesis and release of the hormones of the adrenal cortex, mainly glucocorticoids (cortisol or hydrocortisone) but also mineralocorticoids (aldosterone) and androcorticoids (converted in the tissues to testosterone) The neurons of origin of CRH lie in a particular part of the paraventricular nucleus, other cells of which form the paraventricular-supraopticohypophysial tract (neurohypophysis) and elaborate vasopressin and oxytocin and several other substances (neurotensin, dynorphin, vasoactive intestinal peptide) These hypothalamic cells receive an extensive input from other regions of the nervous system, particularly via the noradrenergic pathways (from reticular neurons in the medulla and those of the locus ceruleus and tractus solitarius) and from many of the limbic structures Presumably, these extrahypothalamic connections provide the mechanism by which stress and pain activate the secretion of ACTH and cortisol CRH itself is widely distributed in the brain There is feedback control of CRH and ACTH via glucocorticoid receptors in the hypothalamus and anterior lobe of the pituitary Serotonin and acetylcholine enhance ACTH secretion, whereas the catecholamines are inhibitory Gonadotropin-Releasing Hormone (GnRH) This 10 amino acid peptide originates in the arcuate nucleus and is present in highest concentration near the median eminence It effects the release of the two gonadotropic hormones luteinizing hormone (LH) and follicle-stimulating hormone (FSH) The ovary and testis, by secreting a peptide called inhibin, are able to suppress FSH, as do gonadal steroids ie, estrogens GnRH is under the in uence of other neuronal systems, which are modulated by catecholamines, serotonin, acetylcholine, and dopamine Puberty, menstruation, ovulation, lactation, and menopause are all related to the effects of GnRH, FSH, and LH on the ovaries, uterus, breasts, and testes Normal levels of blood FSH are 25 to 49 ng/mL in prepuberty and 75 to 11 ng/mL in the adult; levels of blood LH are 28 to 96 ng/mL in prepuberty and 10 to 18 ng/mL in the adult Prolactin-Releasing Hormone (PRH) This hormone is released by neurons in the region of the arcuate nucleus and activates lactotropic cells of the anterior pituitary However, a number of other
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Figure 27-1 Diagram of the hypothalamic-pituitary axis Indicated on the left is the hypothalamic-neurohypophysial system, consisting of supraoptic and paraventricular neurons, axons of which terminate on blood vessels in the posterior pituitary (neurohypophysis) The hypothalamic-adenohypophysial system is illustrated on the right Tuberoinfundibular neurons, the source of the hypothalamic regulatory hormones, terminate on the capillary plexus in the median eminence (Courtesy of Dr J B Martin)
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