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MCMP 441 Midterm #1
Adrenal Corticoids: Endocrinology, Mechanism of Action and Therapeutic Use
17
Pharmacology
Professional
10/22/2012

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Term
glucocorticoids
Definition
-important for life, essential during stress
-many different cellular effects
-increases glycogen levels in liver and circulating glucose concentrations
-potent anti-inflammatory
Term
mineralocorticoids
Definition
-essential for life
-effects primarily seen in kidney during stress
-regulates Na+/K+ levels
-controls water balance
Term
the adrenal cortex
Definition
-adrenal cortex
-zona glomerulosa- mineralocorticoid synthesis
-zona fasiculata/reticularis- glucocorticoid synthesis
-adrenal medulla- epinephrine synthesis
Term
comparison of synthesis of glucocorticoid and mineralocorticoid
Definition
-glucocorticoid: synthesized both in response to natural biorhythm (serotonin regulated) and in response to long term stress (cold, pain, prolonged loud noise), made in large amounts (up to 25 mg/day), regulation mainly by HPA axis, but can be stimulated by sympathetic nervous system (catecholamines)
-mineralocorticoid: synthesized in response to signals of immediate stress, regulation mainly by secretion of peptides by kidney
Term
regulation of aldosterone synthesis
Definition
-juxtaglomerular apparatus in kidney senses Na+/K+ levels, blood volume, norepinephrine
-can stimulate the production of renin
-ACTH only weakly stimulates aldosterone synthesis in zona glomerular cells
-high plasma K+ levels can directly simulate aldosterone synthesis/secretion through ion channel
-angiotension II acts through GPCR and PLC/PKC
Term
target cells of mineralocorticoids
Definition
-kidney, salivary glands, bladder: water and electrolyte balance, aldosterone enhances the reabsorption of Na+ and the excretion of K+ in the distal renal tubules and collecting ducts (Na+, K+ ATPase), only controls approx 2% of total Na+, but is essential for survival
-cardiovascular tissues: high aldosterone levels after MI, may contribute to organ damage
Term
contrasting modes of action of stress hormones: epinephrine and cortisol
Definition
epinephrine: binds to beta-adrenergic receptor (GPCR), initiates signal transduction cascade, induces immediate response, glycogen breakdown/glucose release
-cortisol: binds to glucocorticoid receptor (nuclear hormone receptor), regulates gene transcription, and thus translation/protein production, induces long term, persistant biological response, induces gluconeogenic enzymes
Term
regulation of GC synthesis: the HPA axis
Definition
-secretion regulated by tropins
-corticotropin releasing hormone (CRH)- 41 amino acids
-adrenocorticotropic hormone-ACTH (corticotropin)-39 amino acids
-therapeutic ramifications of the HPA axis
Term
mechanism of ACTH activation
Definition
G-protein coupled receptor --> adenylate cyclase -->PKA-->cholesteryl ester hydrolysis

overproduction of ACTH --> hypercorticoidism --> Cushing's syndrome
Term
target cells of glucocorticoids
Definition
-liver, muscle, adipose tissue: increase glycogen stores and glucose levels
-immune system: anti-inflammatory, causes thymus apoptosis in children
-vasculature: increased sensitivity to vasoactive agents
Term
major regulatory roles-gluconeogenesis
Definition
-primarily positive GRE action
-upregulate expression of phsophoenolpyruvate carboxykinase (PEPCK)-rate limiting step in glucose production
-upregulates expression of glucose 6-phosphatase
-stimulates release of fatty acids and amino acids from tissues (gene?)
-increases the activity of glucagon (insulin repressor)
2. anti-inflammatory
Term
major regulatory roles- anti-inflammatory
Definition
-positive GREs: synthesis of lippcortin, inhibitor of phospholipase A2, prevents arachadonic acid release, synthesis of IkB
-negative GRE action and interactions with other transcription factors: decreased expression of cytokine genes (IL-1, TNFa, and GM-CSF), decreased expression of PLA2
Term
comparing GR and MR
Definition
mineralocorticoid receptor (Type I corticosteroid receptor)
-found in distal renal tubules of kidney
-increase Na+, K+ ATPase activity
-aldosterone has 800x more Na+ retention activity than cortisol (cortisol binds with equal affinity)
glucocorticoid receptor (Type II corticosteroid receptor)
-found in liver, muscle, bone, lymphocytes, pituitary

-share same hormone response element
Term
hormone response elements
Definition
DBD's of activated dimers bind to specific DNA sequences called Hormone Responsive Elements, upstream of steroid responsive genes. binding alters rate of transcription
Term
3 possible effects on transcription
Definition
-positive HRE: DNA binding increases transcription factor binding, accelerating transcription rate
-negative HRE: DNA binding inhibits transcription factor binding, suppressing transcription
-protein-protein interaction: steroid/receptor dimer binds to transcription factors, modulating their activity. DNA binding not essential
Term
mechanism of repression- Nuclear Factor kappa beta (NFkB)
Definition
1. NFkB is a heterodimer- bound to an inhibitor protein IkB
2. immune cell activation removes IkB inhibition of NFkB and NFkB moves to the nucleus. turns on cytokine transcription
Term
GR repression of NFkB action
Definition
-liganded GR binds to NFkB, prevents binding of NFkB to its response element --> inhibition of cytokine transcription
-similar behavior with AP-1 transcription factor
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