ACTH, synthesis

Occasionally, tumors of organs that do not usually produce a given hormone (ectopic tumors) synthesize and secrete peptide hormones, as in ACTH synthesis by certain lung tumors and GRH production from a pancreatic islet... 

Within the framework of ACTH synthesis a broad knowledge of the structure-activity relationships has been acquired concerning the influence of the chain length on biological activity. 

Because ACTH synthesis originates from the POMC precursor peptide, its production by the pituitary is closely tied to the secretion of endogenous opiate peptides, such as P-endorphin. The physiological effects of endogenous opiates include (1) sedation, (2) an increased threshold of pain, and (3) autonomic regulation of respiration, blood pressure, and heart rate. These peptides are also involved in modifying endocrine responses to stress and water balance... 

In addition to the weU-defined opioid systems in the central nervous system, the three opioid peptides and their precursor mRNA have also been identified in peripheral tissues. ( -Endorphin is most abundant in the pituitary, where it exists in corticotroph cells with ACTH in the anterior lobe and in melanotroph cells with MSH in the intermediate lobe (59). Enkephalin and pre-pro-enkephalin mRNA have been identified in the adrenal medulla (60) and this has been the source of material for many studies of pro-enkephalin synthesis and regulation. Pre-pro-enkephalin mRNA has also been identified in the anterior and posterior lobes of the pituitary (61). mRNA for all three opioid precursors has been identified in the reproductive system (62—64). POMC... 

Pregnenolone is transported from the mitochondria to the ER, where a hydroxyl oxidation and migration of the double bond yield progesterone. Pregnenolone synthesis in the adrenal cortex is activated by adrenocorticotropic hormone (ACTH), a peptide of 39 amino acid residues secreted by the anterior pituitary gland. 

Adrenal hormone production is controlled by the hypothalamus and pituitary gland. Corticotropin-releasing hormone (CRH) is secreted by the hypothalamus and stimulates secretion of adrenocorticotropic hormone (ACTH), also known as corticotropin from the anterior pituitary. ACTH, in turn, stimulates the adrenal cortex to produce cortisol. When sufficient or excessive cortisol levels are reached, a negative feedback is exerted on the secretion of CRH and ACTH, thereby decreasing overall cortisol production. The control of adrenal androgen synthesis also follows a similar negative-feedback mechanism. 

Secondary adrenal insufficiency occurs as a result of a pituitary gland dysfunction whereby decreased production and secretion of ACTH leads to a decrease in cortisol synthesis. Tertiary adrenal insufficiency is a disorder of the hypothalamus that results in decreased production and release of CRH, which, in turn, decreases pituitary ACTH production and release. In contrast to Addison s disease (i.e., primary adrenal insufficiency), aldosterone production is unaffected in the secondary and tertiary forms of the disease. Chronic adrenal insufficiency often has a good prognosis if diagnosed early and treated appropriately. 

IL-1 (17.5) Monocyte/macrophage, lymphocyte, neutrophil, endothelium, fibroblast keratinocyte Activation of T cells, B cells, natural killer cells, osteoblasts, and endothelium. Induces fever, sleep, anorexia, ACTH release, hepatic acute phase protein synthesis and HSPs. Leads to myocardial depression, hypercoagulability, hypotension/sbock, and death. Simulates production of TNF, IL-6, and IL-8 and stress hormone release. Suppression of cytochrome P-450, thyro-globulin, and lipoprotein synthesis. Procoagulant activity. Antiviral activity. 

Metyrapone inhibits 11-hydroxylase activity, resulting in inhibition of cortisol synthesis. Initially, patients can demonstrate an increase in plasma ACTH concentrations because of a sudden drop in cortisol. This can cause an increase in androgenic and mineralocorticoid hormones resulting in hypertension, acne, and hirsutism. Nausea, vomiting, vertigo, headache, dizziness, abdominal discomfort, and allergic rash have been reported after oral administration. 

Stress-related immune dysregulation also involves the synthesis of hormones including ACTH, growth hormone, and prolactin.14-17 Interestingly, it has also been demonstrated that various aspects of the immune response, for example., proliferation of B- and T-cells, cytokine production, antibody production, chemotaxis of monocytes and neutrophils, and natural killer (NK) cell cytotoxicity, can be affected by glucocorticoids (including cortisol) as well as peptides such as ACTH, CRH, endorphins, substance P, and somatostatin.1218... 

Scheme 2 Synthesis of ACTH by a Combination of Stepwise and Fragment Approaches141...

It is a polypeptide of 39 amino acid residues of molecular weight approximately 4,500. It is secreted by basophil cells under the control of CRF (corticotropin releasing factor) from the hypothalamus. ACTH controls the growth of adrenal cortex and the synthesis of corticosteroids and is essential to life. The action of ACTH on adrenal cortex is mediated through cyclic AMP. 

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