Essential Endocrinology and Diabetes. Richard I. G. Holt

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The suffix ‐ol indicates an important hydroxyl group, as at the carbon‐3 position in cholesterol. The suffix ‐one indicates an important ketone group (testosterone). The extra presence of ‐di, as in ‐diol (oestradiol) or ‐dione (androstenedione), reflects two of the groups. ‘‐ene’ (androstenedione) indicates an important double bond in the steroid ring structure.

      Storage of steroid hormones

      In contrast to peptide hormones, which are stored and capable of rapid release, steroid hormones are synthesized on demand. This delays their release into the circulation following an initial stimulus explaining, at least in part, the slower onset of action for steroid hormones compared to peptide hormones.

      Most peptide hormones are hydrophilic and can circulate free in the bloodstream with little or no association with serum proteins. In contrast, steroid hormones and thyroid hormones are hydrophobic and circulate largely bound to proteins. There are relatively specific transport proteins for many of the steroid hormones, e.g. cortisol‐binding globulin (CBG) and sex hormone‐binding globulin (SHBG), as well as for thyroid hormones [thyroxine‐binding globulin (TBG)]. These hormones also associate more loosely with other circulating proteins, especially albumin. The amounts of protein‐bound and unbound (‘free’) hormone are in equilibrium in the circulation. Only the free hormone can diffuse readily into tissues and act on target cells. Many clinical assays still measure total hormone in blood and are consequently affected markedly by changes in the concentration of the binding protein. This can be misleading because shifts in the equilibrium mean that free hormone concentrations are relatively constant and biological activity remains the same. For instance, women on the combined oral contraceptive pill have raised serum CBG and increased total cortisol. However, free cortisol levels and cortisol action is unaltered.

       Mutations in DNA and chromosomal abnormalities can cause endocrine disease

       Meiosis is central to reproductive endocrinology

       Peptides and proteins are encoded by genes, which are stretches of genomic DNA

       Many protein hormones are synthesized as prohormones, which require post‐translational modification and processing before they become active

       Enzyme cascades synthesize hormones derived from amino acids and cholesterol

       Unlike peptide hormones, steroid hormones are not stored in cells but made on demand

       Many peptide hormones circulate free in the blood, unlike steroid or thyroid hormones, which associate with binding proteins

       Key topics

        Cell‐surface receptors

        Tyrosine kinase receptors

        G‐protein–coupled receptors

        Nuclear receptors

        Key points

       Learning objectives

       To understand the principles of hormone–receptor interaction

       To know the different classes of hormone receptors and how they functionTyrosine kinase receptors and their signalling pathwaysG‐protein–coupled receptors and their signalling pathwaysNuclear receptors and how they regulate gene expression

       To appreciate the role of transcription factors that are important in endocrine development and function

       To appreciate how abnormalities in hormone receptors or their downstream signalling can cause endocrinopathy

       This chapter describes the key events that occur within the cell following stimulation by hormone

      Binding of hormone to receptor

      Using methodology similar to that for immunoassays (Chapter 4), constant amounts of labelled hormone and receptor preparations can be incubated with increasing, known amounts of unlabelled hormone for a specified time. Separating and measuring the receptor‐bound, labelled fraction allows curves to be plotted and mathematical modelling of the hormone (H)–receptor (R) interaction; e.g. whether it conforms to the equation H + R ⇆ HR. These types of experiment can also allow estimation of the number of hormone receptors present on each target cell.

      Signal transduction

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