U N I T XIV

Textbook of Medical Physiology, 11th Edition

Chapter 77:
Hormonios adrenocorticais
Slides by Thomas E. Lohmeier, Ph.D.

GUYTON & HALL

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Hormonios adrenocorticais
Cortisol Aldosterona Androgenos

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Secretion of Adrenocortical Hormones by Different Zones of the Adrenal Cortex

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Figure 77-1; Guyton & Hall

Biosintese
CH3

Cholesterol

ACTH

17a-Hydroxylase (P450 c17)

CH3 C

O OH

17, 20 Lyase (P450 c17)

HO 3b-Hydroxysteroid dehydrogenase

Pregnenolone
CH3 C O

HO

17-Hydroxypregnenolone
CH3 C O OH

HO

Dehydroepiandrosterone
O

O O 21b-Hydroxylase (P450 c21)

Progesterone
CH2OH C O

17-Hydroxyprogesterone
CH2OH C O OH

Androstenedione

11-Deoxycorticosterone
O 11b-Hydroxylase (P450 c11) O CH2OH C HO O HO

11-Deoxycortisol
CH2OH C O OH

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Corticosterone

Cortisol

Cholesterol

ACTH

CH3 C O

K+, A II
HO CH3 C O

Pregnenolone

Progesterone
O

Hormonio Biosntese

CH2OH
C O

11-Deoxycorticosterone
O CH2OH C HO O

Na Zona
Glomerulosa

Corticosterone
O

+ Aldosterone K , A II Synthase
HO

CH3 O

HC C

Aldosterone
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Corticosteroids & Their Relative Glucocorticoid & Mineralocorticoid Activities

Steroids Adrenal Steroids Cortisol Corticosterone Aldosterone Deoxycorticosterone
Dehydropiandrosterone

Average Plasma Concentration Average Amount Glucocorticoid (free and bound, Secreted (mg/24 hr) Activity g/100 ml)

Mineralocorticoid Activity

12 0.4 0.006 0.006 175 __ __ __ __ __

15 3 0.15 0.2 20 __ __ __ __ __

1 0.3 0.3 0.2 __ 0.7 4 5 30 10

1 15.0 3000 100 __ 1.0 0.8 __ __ 125

Synthetic Steroids Cortisone Prednisolone Methylprednisone Dexamethasome 9-fluorocortisol

Table 77-1; Guyton & Hall
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Cortisol ligado

adrenal

Cortisol livre

Cortisol tecidual

ACTH

Hipofise anterior

Efeitos biologicos

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Tubular Effects of Aldosterone

DT PT 4%

Na+

Cortex

67% CCD 3% TAL

Outer Medulla

25%

Na+ Inner Medulla

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IMCD 1%

Ao da Aldosterona nas celulas do duto coletor

Tubular fluid Blood
Aldo

Aldo Na+ R R Aldo Na+ Na+ Channels

Aldo
K+ Proteins

ATP

K+ Channels

mRNA

K+

Basolateral cell membrane Apical cell membrane

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Capillary basement membrane

Patofisiologia da cortex adrenal

Hiperadenocorticismo

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Efeitos metabolicos do Cortisol

Glycogen Glucose Amino acids

Glucose-P
Glucose precursors

Glucose Free fatty acids + Glycerol

Protein

Liver Muscle Plasma

Inhibit

Adipose tissue

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Stimulate

Glucose Free fatty acids Amino acids

Eixo Hipotalamo-hipofisarioadrenal
Hipotalamo _

CRH +

Corticotrofo ACTH + Cortex Adrenal

Glicocorticoide
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Causes of Cushings Syndrome

Adrenal hyperplasia
Pituitary ACTH
hypothalamic dysfunction pituitary tumors (Cushings disease)

Nonpituitary tumors (ectopic)

ACTH CRH

Adrenal neoplasia
Adenoma Carcinoma

Iatrogenic
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