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Hormones of Adrenal Medulla The adrenal medulla is considered as neuro-endocrine unit because it is a part of the sympathetic nervous system & also produces the catecholamines hormones which are dopamine, norepinephrine, & epinephrine. Control of Catecholamines The release of catecholamines from the adrenal medulla is stimulated by the low level of catecholamines in the body & vice versa when the level of catecholamines is elevated it inhibit its release from the adrenal medulla. Biosynthesis of Catecholamines Catecholamines (dopamine, norepinephrine & epinephrine) are synthesized in the final form from the amino acid tyrosine by chromaffin cells of the adrenal medulla & stored in these cells to be released on need. , these cells are also present in some of the extramedullary tissues such as heart, liver, kidney, gonads, sympathetic fibers & CNS. However, the main differences between catecholamines produced by adrenal medulla & catecholamines produced by the extramedullary tissues are:1- Epinephrine is the main product of the adrenal medulla (80% of catecholamines produced by adrenal medulla) while norepinephrine is the main product of extramedullary tissues. 2-Catecholamines produced by the adrenal medulla are transported by blood circulation to act on other tissues while catecholamines produced by extramedullary tissues act locally. The conversion of tyrosine to epinephrine requires four sequential steps which are:(1) Ring hydroxylation. (2) Decarboxylation. (3) Side chain hydroxylation (4) N-Methylation. (1) Ring hydroxylation:- It occurs in the cytoplasm of chromaffin cells, by this step ring hydroxylation of L-tyrosine result in the formation of L-3,4-dihydroxyphenylalanine (L-dopa),this reaction is irreversible & is catalyzed by tyrosine hydroxylase enzyme in the presence of tetrahydropteridine as a cofactor. Ring hydroxylation is the rate limiting step of catecholamines biosynthesis. Tyrosine hydroxylase is regulated in a variety of ways; the most important mechanism involves feedback inhibition by catecholamines itself, which compete with tyrosine hydroxylase for the tetrahydropteridine binding. Catecholamines cannot cross the blood-brain barrier, hence, in the brain they must be synthesized locally. In certain CNS diseases (e.g. Parkinson's disease), there is local catecholamine deficiency in the brain & treatment is by giving L-Dopa which can readily crosses the blood-brain barrier & converted into catecholamine inside the brain. (2) Decarboxylation: - It occurs in the cytoplasm of chromaffin cells, by this step decarboxylation of L-dopa result in the formation of 3,4-dihydroxyphenylethylamine (dopamine), this reaction is irreversible & is catalyzed by dopa decarboxylase enzyme in the presence of pyridoxal phosphate as a coenzyme. Compounds that resemble L-dopa, such as α-methyldopa are competitive inhibitors of this reaction and can stop the reaction , therefore , α-methyldopa is effective in the treatment of some kinds of hypertension caused by high catecholamine level. (3) Side chain hydroxylation:- It occurs in the secretion granules of chromaffin cells, by this step side chain hydroxylation of dopamine result in the formation of norepinephrine, this reaction is irreversible & is catalyzed by dopamine β-hydroxylase (DBH) enzyme in the presence of ascorbate ,copper & fumarate as coenzymes. Once norepinephrine is formed it returns back into the cytoplasm for further step. (4) N-Methylation:- It occurs in the cytoplasm of chromaffin cells, by this step N-methylation of norepinephrine results in the formation of epinephrine, this reaction is irreversible & is catalyzed by phenylethanolamine-N-methyltransferase (PNMT) enzyme. The synthesis of PNMT requires induction by high glucocorticoid hormones concentration (100-fold concentration gradient over systemic arterial blood) which is present in the adrenal medulla & this explain why epinephrine is the main product of adrenal medulla while norepinephrine is the main product of extramedullary tissues (do not contain high glucocorticoid concentration). After formation of norepinephrine & epinephrine they are stored by secretion granules of chromaffin cells to be released on need. Functions of Catecholamines The main functions of catecholamines especially norepinephrine & epinephrine are the followings:1- Share in the metabolic response toward trauma. 2-Provide fatty acids as a source of energy. 3-Provide glucose which is important source of energy to brain by:A-Increase glucose production through stimulation of glycogenolysis & gluconeogenesis. B-Inhibit insulin release, therefore, inhibit peripheral glucose utilization preserving it for the brain. Transport of Catecholamines Because catecholamines are hydrophilic, after secretions are not associated in the plasma with carrier proteins, therefore, they have short plasma half-life (10-30 seconds).