Essential Endocrinology and Diabetes. Richard I. G. Holt

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href="#ud28c96f5-2efb-553e-9deb-2fe52e2e48b1">Chapter 4).

      Synthesizing hormones derived from amino acids

       Thyroid hormones: sequential addition of iodine and coupling of two tyrosines together (Chapter 8)

       Adrenomedullary hormones: hydroxylation steps and decarboxylation to form dopamine and catecholamines (Chapter 6)

       Hypothalamic dopamine formed by hydroxylation and decarboxylation (Chapter 5)

      Synthesizing hormones derived from cholesterol

      Cholesterol from the diet and from de novo synthesis (mostly in the liver) used to synthesize:

       Vitamin D (Chapter 10)

       Steroid hormones:Adrenal cortex: aldosterone, cortisol and sex steroid precursors (Chapter 6)Testis: testosterone (Chapter 7)Ovary and placenta: oestrogens and progesterone (Chapter 7)

Schematic illustration of synthesis of cholesterol. Step 1 is catalyzed by the enzyme thiolase; otherwise, the enzymes are shown to the right of the cascade. The individual steps between squalene and cholesterol have been omitted.

Schematic illustration of an overview of the major steroidogenic pathways. The enzymes are shown by proper name and common name according to their action. Note some enzymes perform multiple reactions and some reactions are performed by multiple enzyme isoforms. For 17-OH progesterone, the enzymatic change illustrated is that catalyzed by HSD3B activity rather than CYP17A1. The simplified pathways are grouped into three blocks: (a) common to both the adrenal cortex and the gonad; (b) adrenocortical steroidogenesis; and (c) pathways characteristic of the testis or ovary and placenta.

      In steroidogenic cells, cholesterol is largely deposited as esters in large lipid‐filled vesicles (Figure 2.3b). Upon stimulation, cholesterol is released from these stores and transported into the mitochondria, a process that is facilitated by the steroid acute regulatory (StAR) protein in the adrenal and gonad and by the related protein, start domain containing 3 (STARD3), in the placenta. The first step in the synthesis of a steroid hormone is the rate‐limiting conversion of cholesterol to pregnenolone. Pregnenolone then undergoes a range of sequential modifications in the mitochondria or the ER to produce the wide range of steroid hormones.

      Nomenclature of steroidogenic pathways

      Figure 2.6 shows an overview of steroid hormone biosynthesis in human. Many of the enzymes that catalyze steps in these pathways are encoded by the cytochrome P450 (CYP ) family of related genes that is also critical for hepatic detoxification of xenobiotic compounds and drugs. Some of the enzymes are common to both the adrenal cortex and gonad (e.g. CYP11A1), whereas others are restricted and explain the distinct steroid profiles in each tissue (e.g. CYP21A2, needed for cortisol and aldosterone biosynthesis, is very largely limited to the adrenal cortex).

      Historically, the enzymes have been named according to function at a specific carbon atom (e.g. hydroxylation), with a Greek letter indicating orientation above or below the four‐carbon ring structure (e.g. 17α‐hydroxylase attaches a hydroxyl group in the alpha position to carbon 17; Figure 2.6).

      The

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