regulation of cortisol secretion
CRH (hypothalamus)–> ACTH (pituitary) –> cortisol (adrenal cortex)
addison’s disease
people who do not produce cortisol
cushing’s syndrome
people who produce too much cortisol
- adenoma in the pituitary
- adrenal tumor
NRC1
glucocorticoid receptor
NRC2
mineralocorticoid receptor
biased signaling
seperating several pathways coming from receptor type
side effects of corticosteroid therapy
osteoporosis
myopathy
GI tract: infections, peptic ulcer, pancreatitis
Endocrine: low metabolism
Eye: cataract, tissue atrophy, intraocular pressure
Cardio: dyslipedemia, hypercoagulability, hypertension
Neuro: psychosis, euphoria
Skin: hyperpigmentation, infection
Immune suppression
11b-hydroxysteroid dehydrogenase type 1
cortisone –> cortisol (liver)
11b-hydroxysteroid dehydrogenase type 2
cortisol –> cortisone (kidney)
glucocorticoid receptor
necessary for anti-inflammatory effects
cortisol
binds glucocorticoid receptor and mineralo-corticoid receptor
aldosterone
binds mineralo-corticoid receptor
pseudo-hyperaldosteronemia
high aldosterone in the blood because of high binding of cortisol to the mineralocortoid receptors
dexametasone
high GR affinity and low MR affinity
