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Ieva B. Akbar
Department of Physiology
Faculty Of Medicine – Universitas Islam Bandung
I. INTRODUCTION
• Neuroendocrinology
– The interaction between the central
nervous system (CNS) and endocrine
systems in the control of homeostasis
– The control of pituitary hormone secretion
by the hypothalamus
– The fundamental role of the hypothalamus
in controlling anterior pituitary function.
The Endocrine System
Pituitary Gland Anatomy
Synthesis, storage and
release of posterior
pituitary hormone
Hypothalamic and
pituitary hormones
Hormones of the hypothalamic anterior pituitary pathway
A complex endocrine
pathway
II. NEURAL CONTROL OF
GLANDULAR SECRETION
a. Neurosecretion
• The release of any neuronal secretory
product from a neuron
• Neurons that secrete substances directly
into the blood stream to act as hormones
• Neurons have basic ability to respons and
integrate input from multiple neurons
through specific receptors
• Three types of hypothalamic
neurosecretory cells
b. The autonomic nervous system contribution
to endocrine control
The neurons system controls or modifies or
both, the function of basic endocrine and
exocrine glands
• Anterior pituitary : releasing hormone
• Pancreas, Adrenal, Pineal salivary
(endocrine & exocrine) : regulated through
direct innervation from autonomic
neurons system
Brain
Postganglionic sympathetic
neuron
Sympathetic
ganglia
Preganglionic
sympathetic
neuron
Adrenal
glands
Sympathetic
ganglia
Medulla
Blood
Various
effector
organs
Epinephrine
NE
Heart
III. HYPOTHALAMICPITUITARY UNIT
a. Anatomy of the hypothalamic-pituitary unit
• Adenohypophysis
• Pars distalis
• Pars intermedia
• Pars tuberalis
• Neurohypophysis
b. The median eminence and hypophyseotropic
neuronal system
• Lies in the center of tuber cinereum
A. Human hypothalamic
Pituitary unit
B. Midsaggital nuclear
Magnetic resonance scan
of the brain of a normal
woman
IV. CIRCUMVENTRICULAR
ORGAN
a. Median eminence
The median eminence and
neurohypophysis contain the
secretory axons that control pituitary
function
Hypothalamic
magnocellular neurons
and the posterior pituitary
gland
b. Organum vasculosum of the lamina
terminalis and the subfornical organ
• Are located at the front wall of the third
ventricle, the lamina terminalis
• Involved in the maintenance of many
processes : fluid and electrolyte
balance, blood pressure, reproduction,
thermaregulation
c. Area postrema
d. Subcommissural organ
V. HYPOPHYSEOTROPIC HORMONES
AND NEUROENDOCRINE AXES
a. Feedback concepts in neuroendocrinology
b. Endocrine rhythms
c. Thyrotropin-releasing hormone
- Chemistry and evolution
- Clinical applications
- Regulating of thyrotropin release
- Feedback control : Pituitary-Thyroid Axis
- Neural control : Circadian rhythm,
Temperature, Starvation, Infection and
inflammation
d. Corticotropin-releasing hormone
- Chemistry and evolution
- Effect on the pituitary and mechanism of
action
- Clinical applications
- Feedback control
- Neural control
- Other factors influencing secretion of
corticotropin : Circadian rhythm,
corticotropin release-inhibiting factor
e. Growth hormone-releasing hormone
Chemistry
and evolution
- Growth hormone-releasing hormone
receptor
- Effect on the pituitary and mechanism of
action
- Extrapituitary functions
- Clinical applications
Neuroendocrine
regulation of growth
hormone secretion
- Neural control
- Factors influencing secretion of growth
hormone : Human growth hormone
rhythms, external and metabolic signals
f. Somatostatin
- Chemistry and evolution
- Somatostatin receptors
- Effect on target tissues and mechanism of
action
- Clinical applications of somatostatin
analogues
g. Prolactin-regulating factors
- Dopamine
- Prolactin-releasing factors
- Intrapituitary regulation of prolactin
secretion
- Neuroendocrine regulation of prolactin
secretion
- Feedback control
- Neural control
- Factors influencing secretion
h. Gonadotropin-releasing hormone and control
of the reproductive axis
- Chemistry and evolution
- Anatomic distribution
- Embryonic development
- Action at the pituitary : receptor, pulsatic
gonadotropin-releasing hormone
stimulation
- Regulating systems
- Feedback regulation
- Regulation by inhibins and activins
- Regulation of the ovarian cycle
- Early development and puberty
- Reproductive function and stress
i. Leptin and the
brain-gut-adipose
axis
- Chemistry and evolution of leptin
- Effects of leptin on the hypothalamus and
neuroendocrine axes
- Mechanism of action
- Clinical applications
- Feedback control
j. Neuroendocrine-immune interactions
- Cytokines signal the central nervous
system
- Interaction of cytokines with the
circumventricular organs
- Interaction of cytokines at the barriers of
the brain
- Entry of cytokines into the brain
- Interaction of cytokines with peripheral
nerves
- Cell groups throughout the brain
responsive to cytokines
A model of the central nervous system circuitry mediating the
activation of the PVN or PVH and HPA axis by immune system stimulation
VI. NEUROENDOCRINE DISEASE
a.
b.
c.
d.
Pituitary isolation syndrome
Hypophyseotropic hormone deficiency
Hypophyseotropic hormone hypersecretion
Neuroendicrine disorders of gonadotropin regulation
- Precocious puberty
- Idiopathic sexual precocity
- Neurogenic precocious puberty
- Hypothyroidism
- Tumors of the pineal gland
- Approach to the patient with precocious puberty
- Management of sexual precocity
- Psychogenic amenorrhea
- Neurogenic hypogonadism in males
e. Neurogenic disorders of prolactin regulation
f. Neurogenic disorders of growth hormone
decretion
- Hypothalamic growth failure
- Maternal deprivation syndrome and
psychosocial dwarfism
- Neurogenic hypersecretion of growth
hormone
- Diencephalic cachexia
- Syndrome of inappropriate growth
hormone hypersecretion
g. Neurogenic disorders of cortricotropin
regulation
h. Genetic obesity disorders involving
hypothalamic circuits
i. Nonendocrine manifestations of
hypothalamic disease