Hypothalamic- Anterior pituitary axis

Dr Isam eldin- Mohamed Abd Alla

 The link between the hypothalamus and

the anterior pituitary (Adenohypophysis).
is vascular via portal hypophysial
vessels.

Hormones of the anterior pituitary:

Thyroid-stimulating hormone (TSH,
thyrotropin).
Adrenocorticotropic hormone (ACTH
Corticotropin).
Luteinizing hormone (LH),
Follicle-stimulating hormone (FSH).
Prolactin.
Growth hormone
Secretion is controlled by hypothalamic releasing
& inhibiting factors (hypophysiotropic hormones)

Hypothalamic- anterior pituitary axis

Growth hormone:
A polypeptide hormone secreted by
somatotropes of the anterior pituitary.
Physiologic effects:
Stimulates protein synthesis for growth.
Stimulates lipolysis circulating free
fatty acids (ketogenic effect).
Stimulates intestinal absorption of Ca+2
& decreases renal excretion of Na+ & K+.
electrolytes retention for growth

Stimulates chondrogenesis in epiphyseal

plate (epiphyseal growth) before fusion of
epiphysis with diaphysis in childhood.
the hepatic glucose output & increase
the response of the pancreas to the stimuli
of insulin secretion, but has antiinsulin
action in muscles.
Stimulates the liver & other tissues to
secrete polypeptide growth factors
(somatomedins) such as insulin like
growth factors (IGF , IGF ).

somatomedins are proteins anabolic,

lipogenic & stimulates epiphyseal growth.
Physiologic effects of GH &
somatomedins

Regulation of GH secretion.
via 2 hypothalamic regulating hormones :
Growth hormone releasing hormone GRH
stimulates secretion of GH.
Growth hormone inhibiting hormoneGIH
(Somatostatin) inhibits GH secretion.
plasma IGF1, IGF11 level inhibits GH
secretion by -ve feed back mechanism.
plasma GH level stimulates secretion of
somatostatin which inhibits GH secretion

Regulation
of GH
secretion

Stimuli thatGH secretion include:

Hypoglycaemia (exercise, fasting, starvation..)
circulating amino acids the units of protein
synthesis & growth (protein meal).
Stressful stimuli (emotions, pyrogens.)
Dopamine agonists (L dopa) & adrenergic
receptors agonists.
Androgens (Testosterone) & oestrogens during
adolescence.
Glucagon.
Going to sleep.

Abnormalities of GH secretion:
Dwarfism:
short stature caused by one of the following
1. Primary or secondary GH deficiency
after of GRH deficiency occurring
during childhood
2. Deficiency of somatomedins such as
IGF1 as in African pigmies
3. Unresponsiveness of GH receptors.

 Gigantism: tall stature due to due to GH

secreting tumors. occurring before
epiphyseal closure (during childhood).
Acromegaly: Caused by GH secreting
tumor in or outside the pituitary & rarely
hypothalamic GRH secreting tumor
occurring after the epiphyseal closure (in
adulthood).

 In acromegaly there is in growth of acral

bones of hands & feet & other flat bones
(skull) causing protrusion of the lower
jaw (progonathism), in size of orbital bone
that can decrease the visual field

Pituitary Gonadotropins (FSH, LH):

Are glycoproteins secreted by anterior
pituitary gonadotropes
Made up of & protein subunits &
carbohydrate
The carbohydrate in the hormones increases
their life span thus the half-life of FSH is
about 170 min; & of LH is about 60 min.

Physiologic effects of FSH:

Stimulates the initial growth of ovarian
follicles in the first days of menstrual
cycle.
Stimulates secretion of oestrogens from
the dominant growing follicle.
In the males stimulates synthesis of
androgen binding proteins in the testes
for binding of testosterone

 Physiologic effects of LH:

Stimulates the final growth of ovarian
follicle.
Stimulates ovulation: release of mature ovum
from the ovary in the mid of menstrual cycle.
Stimulates formation of the corpus luteum
from the ruptured follicle.
Stimulates oestrogens & progesterone from
the corpus luteum.
In the males stimulates testosterone secretion
from Leydige cells in the testes.

Prolactin:
A polypeptide hormone similar to GH,
secreted by lactotropes of anterior pituitary
Physiologic effects:
Stimulates growth of the breast in after
action of oestrogens & progesterone.
Stimulates milk synthesis & secretion in
the breast by increasing the production of
milk proteins casein & lactalbumin.

 Note:
progesterone facilitates, while oestrogens
antagonize prolactin action in milk
secretion, therefore progesterone only
contraceptive POP are suitable for birth
control in lactating mothers while
oestrogens containing combined contraceptive
pills are not suitable during lactation.
Hyperprolactinaemia during regular lactation
prevents gonadotropins secretion

& action on the ovary mainly LH thus

prevents ovulation & causes amenorrhoea
in 85% of lactating women, this makes
regular lactation to be one of natural
contraceptive methods.
Regulation of prolactin secretion:
The hypothalamic Thyrotropin releasing
hormone RTH and VIP stimulate
secretion of prolactin

 The hypothalamus also secretes prolactin

inhibiting hormone PIH (Dopamine)
therefore dopamine precursor (L-dopa) &
dopamine receptor agonist (bromocriptine)
also inhibits secretion of prolactin.
Chlorpromazine, Dopamine receptor
blocker, increases prolactin secretion.
The highest prolactin secretion occurs at
end of pregnancy & during suckling of
infant (Lactation) as the touch of breast
nipple is the main stimulus for secretion.