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Pharmaceutical Biochemistry Β· Semester 1

Unit 6: Biochemistry of Hormones

Hormone classification, mechanisms of action, second messengers (cAMP, IP3/DAG), steroid hormones, thyroid hormones and insulin signalling.

Unit 6 of 614 minAdvanced
Unit Overview (click to enlarge)
Biochemistry of Hormones overview

Unit 6: Biochemistry of Hormones

Introduction to Hormones

Hormones are chemical messengers synthesized and secreted by specialized glands or cells, transported through the bloodstream to target organs, where they bind to specific receptors and elicit physiological responses. They regulate a wide range of processes including growth, development, metabolism, reproduction, and homeostasis.

Historical Perspective:

  • The term "hormone" (from Greek "hormon" meaning "to set in motion") was coined by Ernest Starling in 1905.
  • Early discoveries: Secretin (first hormone identified, 1902), insulin (1921), thyroid hormones, steroid hormones.

General Characteristics of Hormones:

PropertyDescription
SpecificityHormones act only on cells with specific receptors
PotencyEffective at very low concentrations (picomolar to nanomolar)
Half-lifeVaries from seconds (peptide hormones) to days (thyroid hormones)
RegulationUsually controlled by feedback mechanisms (negative feedback predominates)
IntegrationHormones interact in complex networks (endocrine axes)

1. Chemical Classification of Hormones

Hormones are classified based on their chemical structure, which influences their synthesis, storage, secretion, transport, mechanism of action, and half-life.

1.1 Peptide/Protein Hormones

PropertyCharacteristics
StructureChains of amino acids (small peptides to large glycoproteins)
SynthesisRibosomal synthesis as preprohormones β†’ processed to prohormones β†’ active hormone
StorageStored in secretory vesicles
SecretionExocytosis (regulated by calcium and cAMP)
TransportDissolved in plasma (water-soluble)
Half-lifeShort (minutes)
Receptor locationCell membrane (cell surface receptors)
Second messengerscAMP, IP₃/DAG, calcium, tyrosine kinase

Examples:

HormoneAmino AcidsSourceMajor Actions
Insulin51 (two chains)Pancreatic Ξ²-cellsGlucose uptake, glycogen synthesis, lipogenesis
Glucagon29Pancreatic Ξ±-cellsGlycogenolysis, gluconeogenesis
Growth hormone (GH)191Anterior pituitaryGrowth, protein synthesis, lipolysis
Prolactin199Anterior pituitaryLactation
Adrenocorticotropic hormone (ACTH)39Anterior pituitaryStimulates cortisol release
Thyroid-stimulating hormone (TSH)Glycoprotein (Ξ±,Ξ²)Anterior pituitaryStimulates thyroid hormone synthesis
Follicle-stimulating hormone (FSH)GlycoproteinAnterior pituitaryGametogenesis, follicular development
Luteinizing hormone (LH)GlycoproteinAnterior pituitaryOvulation, testosterone synthesis
Parathyroid hormone (PTH)84Parathyroid glandsIncreases blood calcium
Oxytocin9Posterior pituitaryUterine contraction, milk ejection
Vasopressin (ADH)9Posterior pituitaryWater reabsorption (kidney)
Somatostatin14Hypothalamus, pancreatic Ξ΄-cellsInhibits GH, TSH, insulin, glucagon

1.2 Steroid Hormones

PropertyCharacteristics
StructureDerived from cholesterol (cyclopentanoperhydrophenanthrene ring)
SynthesisEnzymatic modifications of cholesterol in mitochondria and ER
StorageNot stored; synthesized on demand
SecretionSimple diffusion (lipid-soluble)
TransportBound to carrier proteins (albumin, specific binding globulins)
Half-lifeLong (hours to days)
Receptor locationIntracellular (cytoplasmic or nuclear receptors)
MechanismHormone-receptor complex binds DNA, regulates gene transcription

Classes of Steroid Hormones:

ClassExamplesSourceMajor Actions
GlucocorticoidsCortisolAdrenal cortexStress response, metabolism, anti-inflammatory
MineralocorticoidsAldosteroneAdrenal cortexSodium retention, potassium excretion
AndrogensTestosteroneTestes (Leydig cells)Male sexual characteristics, anabolic effects
EstrogensEstradiolOvaries (follicles)Female sexual characteristics, menstrual cycle
ProgestinsProgesteroneCorpus luteum, placentaMaintain pregnancy, menstrual cycle
Vitamin D derivativesCalcitriolKidney (activation)Calcium homeostasis

1.3 Amino Acid-Derived Hormones (Amines)

PropertyCharacteristics
StructureDerived from tyrosine or tryptophan
SynthesisEnzymatic modification of amino acids
StorageStored in vesicles (thyroid hormones stored in follicles as thyroglobulin)
SecretionExocytosis (catecholamines) or diffusion (thyroid hormones)
TransportDissolved (catecholamines) or bound to proteins (thyroid hormones)
Half-lifeMinutes (catecholamines) to days (thyroid hormones)
Receptor locationCell membrane (catecholamines) or intracellular (thyroid hormones)

Examples:

HormonePrecursorSourceMajor Actions
Epinephrine (adrenaline)TyrosineAdrenal medullaFight-or-flight response
Norepinephrine (noradrenaline)TyrosineAdrenal medulla, sympathetic neuronsVasoconstriction, neurotransmitter
DopamineTyrosineHypothalamus, brainInhibits prolactin; neurotransmitter
Thyroxine (Tβ‚„)Tyrosine (iodinated)Thyroid folliclesBasal metabolic rate, growth, development
Triiodothyronine (T₃)Tyrosine (iodinated)Thyroid (and peripheral Tβ‚„ conversion)More active thyroid hormone
MelatoninTryptophanPineal glandCircadian rhythm regulation
SerotoninTryptophanVarious tissues (not classic hormone but neurotransmitter)Mood, sleep, appetite

1.4 Eicosanoid Hormones

PropertyCharacteristics
StructureDerived from arachidonic acid (20-carbon polyunsaturated fatty acid)
SynthesisCyclooxygenase (COX) or lipoxygenase pathways
StorageNot stored; synthesized on demand from membrane phospholipids
SecretionDiffusion (local mediators, paracrine/autocrine)
TransportLocal action; rapidly inactivated
Half-lifeSeconds to minutes
Receptor locationCell membrane (G protein-coupled receptors)

Examples: Prostaglandins, thromboxanes, leukotrienes, prostacyclin (covered in Unit 4)


2. Summary Table: Classification of Hormones by Chemical Structure

TypeExamplesSynthesisStorageTransportReceptor LocationHalf-life
Peptide/proteinInsulin, glucagon, GH, PTHRibosomes (as preprohormones)VesiclesFree in plasmaCell membraneMinutes
SteroidCortisol, aldosterone, testosterone, estradiolFrom cholesterol (enzymatic)Not storedBound to carrier proteinsIntracellular (nuclear/cytoplasmic)Hours-days
Amine (catecholamines)Epinephrine, norepinephrine, dopamineFrom tyrosine (enzymatic)VesiclesFree in plasmaCell membraneMinutes
Amine (thyroid)T₃, Tβ‚„From tyrosine (iodinated)Follicles (as thyroglobulin)Bound to carrier proteinsIntracellular (nuclear)Days
EicosanoidProstaglandins, thromboxanes, leukotrienesFrom arachidonic acid (enzymatic)Not storedLocal diffusionCell membraneSeconds-minutes

3. Mechanisms of Hormone Action

3.1 Cell Surface Receptors (for Water-Soluble Hormones)

A. G Protein-Coupled Receptors (GPCRs) :

  • Seven transmembrane domain receptors
  • Activated hormone causes conformational change β†’ G protein activation (exchange GDP for GTP on Ξ± subunit)
  • G protein subunits (Ξ±, Ξ², Ξ³) regulate effector enzymes (adenylyl cyclase, phospholipase C)

Major Second Messenger Systems:

SystemG ProteinEffectorSecond MessengerProtein KinaseExamples
cAMP systemGβ‚› (stimulatory)Adenylyl cyclase ↑cAMP ↑PKAGlucagon, epinephrine (Ξ²), ACTH, TSH, FSH, LH, PTH, calcitonin, vasopressin (Vβ‚‚)
Gα΅’ (inhibitory)Adenylyl cyclase ↓cAMP ↓(PKA ↓)Somatostatin, epinephrine (Ξ±β‚‚)
IP₃/DAG systemGqPhospholipase CIP₃, DAGPKCEpinephrine (α₁), angiotensin II, vasopressin (V₁), GnRH, TRH
cGMP system-Guanylyl cyclase (membrane or soluble)cGMPPKGAtrial natriuretic peptide (ANP), nitric oxide (NO)

B. Tyrosine Kinase Receptors:

  • Single transmembrane domain
  • Ligand binding causes dimerization and autophosphorylation
  • Phosphorylated tyrosines recruit signaling proteins (via SH2 domains)
  • Activate Ras-MAPK pathway, PI3K-Akt pathway

Examples: Insulin, insulin-like growth factor (IGF-1), growth hormone (GH) – GH receptor uses JAK-STAT pathway (cytokine receptor family)

3.2 Intracellular Receptors (for Lipid-Soluble Hormones)

  • Located in cytoplasm (steroid receptors) or nucleus (thyroid hormone receptors)
  • Hormone diffuses across membrane, binds receptor β†’ conformational change
  • Hormone-receptor complex translocates to nucleus (if cytoplasmic)
  • Binds to hormone response elements (HRE) on DNA
  • Recruits coactivators/corepressors, regulates gene transcription
  • Response time: Hours to days (requires protein synthesis)

Examples: Steroid hormones, thyroid hormones, vitamin D, retinoids


4. Major Endocrine Glands and Their Hormones

4.1 Hypothalamus

The hypothalamus integrates neural and endocrine signals. It produces releasing and inhibiting hormones that regulate the anterior pituitary.

Hypothalamic HormoneAction on Anterior Pituitary
Thyrotropin-releasing hormone (TRH)Stimulates TSH and prolactin release
Corticotropin-releasing hormone (CRH)Stimulates ACTH release
Gonadotropin-releasing hormone (GnRH)Stimulates FSH and LH release
Growth hormone-releasing hormone (GHRH)Stimulates GH release
Somatostatin (growth hormone-inhibiting hormone)Inhibits GH and TSH release
Dopamine (prolactin-inhibiting factor)Inhibits prolactin release

4.2 Pituitary Gland (Hypophysis)

A. Anterior Pituitary (Adenohypophysis) :

HormoneTargetMajor ActionsRegulation
Growth hormone (GH, somatotropin)Liver, bone, musclePromotes growth (via IGF-1); protein synthesis, lipolysisStimulated by GHRH, inhibited by somatostatin
Thyroid-stimulating hormone (TSH)ThyroidStimulates thyroid hormone synthesis and releaseStimulated by TRH, inhibited by T₃/Tβ‚„ (negative feedback)
Adrenocorticotropic hormone (ACTH)Adrenal cortexStimulates cortisol and androgen releaseStimulated by CRH, inhibited by cortisol
Prolactin (PRL)Mammary glandsMilk productionInhibited by dopamine; stimulated by TRH, suckling
Follicle-stimulating hormone (FSH)GonadsGametogenesis (sperm/egg development)Stimulated by GnRH, inhibited by sex steroids, inhibin
Luteinizing hormone (LH)GonadsOvulation, corpus luteum; testosterone synthesisStimulated by GnRH, inhibited by sex steroids

B. Posterior Pituitary (Neurohypophysis) :

HormoneTargetMajor ActionsRegulation
Vasopressin (antidiuretic hormone, ADH)Kidney (collecting duct)Increases water reabsorption (concentrates urine)Stimulated by increased plasma osmolality, decreased blood volume
OxytocinUterus, mammary glandsUterine contraction (labor), milk ejection (let-down reflex)Stimulated by cervical dilation, suckling

4.3 Thyroid Gland

HormoneTargetMajor ActionsRegulation
Thyroxine (Tβ‚„) and Triiodothyronine (T₃)Most cellsIncrease basal metabolic rate; promote growth and development (especially CNS)Stimulated by TSH; negative feedback on pituitary and hypothalamus
CalcitoninBone (osteoclasts)Lowers blood calcium (inhibits bone resorption)Stimulated by high blood calcium

Thyroid Hormone Synthesis:

  1. Iodide uptake (NIS symporter)
  2. Oxidation to iodine (thyroperoxidase, TPO)
  3. Iodination of tyrosine residues on thyroglobulin (MIT, DIT)
  4. Coupling (MIT + DIT β†’ T₃; DIT + DIT β†’ Tβ‚„)
  5. Proteolysis releases T₃/Tβ‚„ into blood

Transport: Bound to thyroxine-binding globulin (TBG), transthyretin, albumin; free fraction (0.03% Tβ‚„, 0.3% T₃) is active.

Peripheral conversion: Tβ‚„ β†’ T₃ (more active) by deiodinases (selenoproteins).

4.4 Parathyroid Glands

HormoneTargetMajor ActionsRegulation
Parathyroid hormone (PTH)Bone, kidney, intestine (indirect)Increases blood calcium: stimulates bone resorption, renal calcium reabsorption, phosphate excretion; stimulates calcitriol synthesis (↑ intestinal calcium absorption)Stimulated by low blood calcium; inhibited by high calcium

4.5 Adrenal Glands

A. Adrenal Cortex (Zones) :

ZoneHormonesMajor ActionsRegulation
Zona glomerulosaMineralocorticoids (aldosterone)Sodium retention, potassium excretion, blood pressure regulationStimulated by angiotensin II, high K⁺; inhibited by ANP
Zona fasciculataGlucocorticoids (cortisol)Stress response, gluconeogenesis, anti-inflammatory, immunosuppressionStimulated by ACTH; negative feedback on pituitary/hypothalamus
Zona reticularisAdrenal androgens (DHEA, androstenedione)Androgen precursors (converted to testosterone/estrogen in periphery)Stimulated by ACTH

B. Adrenal Medulla :

HormoneTargetMajor ActionsRegulation
Epinephrine (80%)Most tissuesFight-or-flight: increased heart rate, blood pressure, glycogenolysis, lipolysis, bronchodilationStimulated by sympathetic preganglionic fibers (acetylcholine)
Norepinephrine (20%)SimilarSimilar; more potent vasoconstriction

4.6 Pancreatic Islets (Islets of Langerhans)

Cell TypeHormoneTargetMajor ActionsRegulation
Ξ²-cells (60-70%)InsulinLiver, muscle, adipose↑ Glucose uptake (muscle, adipose), glycogen synthesis, protein synthesis, lipogenesis; ↓ gluconeogenesis, glycogenolysis, lipolysisStimulated by high blood glucose, amino acids, incretins (GLP-1, GIP), parasympathetic; inhibited by somatostatin, sympathetic (Ξ±β‚‚)
Ξ±-cells (15-20%)GlucagonLiver (mainly)↑ Glycogenolysis, gluconeogenesis, ketogenesis; ↑ blood glucoseStimulated by low blood glucose, amino acids, sympathetic; inhibited by insulin, somatostatin
Ξ΄-cells (5-10%)SomatostatinParacrine on Ξ±, Ξ² cells; also GI tractInhibits insulin and glucagon secretionStimulated by glucose, amino acids, GI hormones
F cells (PP cells)Pancreatic polypeptideGI tract, liver?Inhibits pancreatic exocrine secretion, gallbladder contractionStimulated by meals, vagal tone

4.7 Gonads

A. Testes:

Cell TypeHormoneTargetMajor ActionsRegulation
Leydig cellsTestosteroneMany tissuesMale sexual differentiation, spermatogenesis, anabolic effects, secondary sexual characteristicsStimulated by LH; inhibited by testosterone (negative feedback on hypothalamus/pituitary)
Sertoli cellsInhibinAnterior pituitaryInhibits FSH secretionStimulated by FSH

B. Ovaries:

Cell TypeHormoneTargetMajor ActionsRegulation
Granulosa cellsEstradiol (estrogen)Many tissuesFemale sexual characteristics, menstrual cycle, endometrial proliferationStimulated by FSH; feedback on hypothalamus/pituitary (positive/negative)
Theca cellsAndrostenedione (precursor)Granulosa cellsConverted to estrogen by aromataseStimulated by LH
Corpus luteumProgesteroneUterusMaintains endometrium (pregnancy), menstrual cycleStimulated by LH (luteotropic support)

4.8 Other Endocrine Tissues

TissueHormoneMajor Actions
Heart (atria)Atrial natriuretic peptide (ANP)Promotes Na⁺ excretion, vasodilation, lowers blood pressure
KidneyErythropoietin (EPO)Stimulates RBC production
Calcitriol [1,25(OH)β‚‚D]Increases calcium absorption
Adipose tissueLeptinSuppresses appetite, increases energy expenditure
AdiponectinIncreases insulin sensitivity, anti-inflammatory
ResistinMay contribute to insulin resistance
GI tractGastrin, secretin, cholecystokinin (CCK), GLP-1, GIPRegulate digestion, motility, appetite, insulin secretion (incretins)
Pineal glandMelatoninRegulates circadian rhythm
PlacentahCG, estriol, progesteroneMaintain pregnancy

5. Hormonal Regulation and Feedback Mechanisms

5.1 Negative Feedback (Predominant)

  • The response to a hormone inhibits further hormone secretion.
  • Maintains homeostasis.

Examples:

  • Thyroid axis: Low T₃/Tβ‚„ β†’ increased TRH and TSH β†’ increased T₃/Tβ‚„ production β†’ high T₃/Tβ‚„ inhibit TRH and TSH.
  • Cortisol: CRH β†’ ACTH β†’ cortisol β†’ cortisol inhibits CRH and ACTH.
  • Calcium: Low Ca β†’ PTH β†’ increases Ca β†’ high Ca inhibits PTH.
  • Glucose: High glucose β†’ insulin β†’ lowers glucose β†’ low glucose inhibits insulin.

5.2 Positive Feedback (Less Common)

  • The response to a hormone amplifies further hormone secretion.
  • Creates a self-reinforcing cycle; usually terminated by an external event.

Examples:

  • Oxytocin during labor: Uterine contractions stimulate oxytocin release, which strengthens contractions β†’ further oxytocin release.
  • LH surge before ovulation: Rising estradiol (late follicular phase) triggers a surge in LH (positive feedback) β†’ ovulation.
  • Platelet aggregation: Thromboxane Aβ‚‚ promotes further platelet aggregation (local positive feedback).

5.3 Hierarchical Control (Endocrine Axes)

Hypothalamic-Pituitary Axis:

Hypothalamus (releasing/inhibiting hormones)
         ↓ (portal blood)
Anterior Pituitary (trophic hormones)
         ↓ (blood)
Peripheral Endocrine Gland (hormones)
         ↓
Target Tissues
         ↓
Feedback (usually negative) to Hypothalamus and Pituitary

Examples:

  • Hypothalamic-Pituitary-Thyroid (HPT) axis
  • Hypothalamic-Pituitary-Adrenal (HPA) axis
  • Hypothalamic-Pituitary-Gonadal (HPG) axis

5.4 Circadian Rhythms

Many hormones exhibit daily rhythmic secretion:

HormonePeak TimeTrough Time
CortisolEarly morning (6-8 AM)Midnight
Growth hormoneNight (during deep sleep)Daytime
MelatoninNightDaytime
TSHLate eveningMorning

6. Pharmaceutical Importance of Hormones

Hormones and their analogs are extensively used in therapy for hormone deficiencies, as pharmacological agents to exploit their physiological actions, and as antagonists to block hormone action.

6.1 Hormone Replacement Therapy

ConditionHormone ReplacementExamples
Type 1 diabetesInsulinHuman insulin (regular, NPH), insulin analogs (lispro, glargine, detemir)
HypothyroidismThyroid hormoneLevothyroxine (Tβ‚„), liothyronine (T₃)
Adrenal insufficiencyGlucocorticoidsHydrocortisone, prednisone
MineralocorticoidsFludrocortisone
Hypogonadism (male)TestosteroneTestosterone enanthate, cypionate, gels, patches
Hypogonadism (female)Estrogen + progestinEstradiol, conjugated estrogens, progesterone
Menopause symptomsEstrogen Β± progestinVarious HRT preparations
Growth hormone deficiencyGrowth hormoneSomatropin (recombinant human GH)
HypoparathyroidismPTH analogTeriparatide (for osteoporosis, not deficiency) – but calcitriol and calcium used
Diabetes insipidusVasopressin analogDesmopressin (DDAVP)

6.2 Hormone Agonists and Antagonists

Hormone SystemAgonists (Clinical Use)Antagonists (Clinical Use)
GlucocorticoidsPrednisone, dexamethasone (anti-inflammatory, immunosuppression)Mifepristone (Cushing's syndrome – blocks glucocorticoid receptor)
MineralocorticoidsFludrocortisone (adrenal insufficiency)Spironolactone, eplerenone (hypertension, heart failure – aldosterone antagonists)
EstrogenEstradiol (HRT, contraception)Tamoxifen (breast cancer – SERM), fulvestrant (breast cancer – pure antagonist), aromatase inhibitors (letrozole, anastrozole)
ProgesteroneProgestins (contraception, HRT)Mifepristone (abortifacient – antiprogestin)
AndrogenTestosterone (replacement), anabolic steroids (oxandrolone)Flutamide, bicalutamide (prostate cancer), finasteride (5Ξ±-reductase inhibitor for BPH)
GnRHGnRH agonists (leuprolide, goserelin) – initially stimulate, then downregulate (prostate cancer, endometriosis)GnRH antagonists (cetrorelix, ganirelix) – immediate suppression (IVF)
SomatostatinOctreotide, lanreotide (acromegaly, carcinoid syndrome)-
VasopressinDesmopressin (diabetes insipidus, nocturnal enuresis, hemophilia A)Conivaptan, tolvaptan (hyponatremia – Vβ‚‚ antagonists, vaptans)
OxytocinOxytocin (labor induction)Atosiban (preterm labor – oxytocin antagonist)
PTHTeriparatide (osteoporosis – anabolic)-
CalcitoninSalmon calcitonin (osteoporosis, Paget's disease, hypercalcemia)-
InsulinInsulin, insulin analogs-
GlucagonGlucagon (severe hypoglycemia)-

6.3 Hormone Analogs and Derivatives

HormoneAnalogModificationAdvantage
InsulinLisproReversed Pro-Lys at B28-29Faster absorption (mealtime)
GlargineGly at A21, two Arg added at B30Soluble at pH 4, precipitates at neutral pH β†’ long-acting
DetemirMyristic acid attached to Lys B29Binds albumin β†’ prolonged action
GnRHLeuprolideSubstituted amino acids; D-Leu⁢, Pro⁹-NHEtMore potent, longer-acting
SomatostatinOctreotideD-Phe, cyclic structureLonger half-life (oral? Injectable depot)
VasopressinDesmopressinDeaminated, D-ArgLonger-acting, selective Vβ‚‚ (antidiuretic), minimal V₁ (pressor)
OxytocinCarbetocinModifiedLonger-acting
PTHTeriparatidePTH(1-34) fragmentActive fragment, easier to synthesize

6.4 Hormones as Diagnostic Tools

Hormone/AgentDiagnostic Use
ACTH stimulation testAssess adrenal function (cosyntropin)
CRH stimulation testDifferentiate pituitary from hypothalamic Cushing's
TRH stimulation testAssess thyroid and pituitary function
GnRH stimulation testAssess gonadotropin reserve
Insulin tolerance testAssess GH and cortisol reserve (hypoglycemia stimulates)
Metyrapone testBlocks cortisol synthesis β†’ assess pituitary ACTH reserve
Dexamethasone suppression testDiagnose Cushing's syndrome (low-dose, high-dose)
hCG testPregnancy test
Measurement of hormone levelsDiagnose endocrine disorders (TSH, Tβ‚„, cortisol, testosterone, etc.)

6.5 Hormones in Contraception

TypeExamplesMechanism
Combined oral contraceptivesEthinyl estradiol + progestin (levonorgestrel, drospirenone)Inhibit ovulation (negative feedback on FSH/LH); alter cervical mucus, endometrium
Progestin-only pills (mini-pill)Norethindrone, desogestrelThicken cervical mucus, alter endometrium, inhibit ovulation (variable)
Long-acting progestinsDepot medroxyprogesterone acetate (DMPA), levonorgestrel IUD, etonogestrel implantSimilar to mini-pill; long-lasting
Emergency contraceptionLevonorgestrel, ulipristal acetate (antiprogestin)Inhibit or delay ovulation; may interfere with fertilization/implantation

6.6 Hormones in Cancer Therapy

Hormone/AgentCancer TypeMechanism
Tamoxifen (SERM)Breast cancer (ER+)Estrogen receptor antagonist in breast
Aromatase inhibitors (letrozole, anastrozole, exemestane)Breast cancer (postmenopausal)Inhibit estrogen synthesis
FulvestrantBreast cancerPure estrogen receptor antagonist
GnRH agonists (leuprolide, goserelin)Prostate cancer, premenopausal breast cancerSuppress gonadotropins β†’ medical castration
GnRH antagonists (degarelix)Prostate cancerImmediate suppression of gonadotropins
Anti-androgens (flutamide, bicalutamide)Prostate cancerBlock androgen receptor
Abiraterone acetateProstate cancerInhibits CYP17 (androgen synthesis)
Prednisone/dexamethasoneVarious (lymphoma, multiple myeloma)Anti-inflammatory, pro-apoptotic in lymphocytes
Progestins (megestrol acetate)Endometrial cancer, breast cancer (palliative)Antiestrogenic effects, appetite stimulation

6.7 Hormones in Other Therapeutic Areas

ApplicationHormone/AgentUse
Anti-inflammatoryGlucocorticoidsAsthma, rheumatoid arthritis, inflammatory bowel disease, allergic reactions
ImmunosuppressionGlucocorticoidsTransplant rejection, autoimmune diseases
Anabolic effectsGrowth hormone, IGF-1, anabolic steroidsGrowth failure, wasting syndromes (controversial)
Appetite stimulationMegestrol acetate (progestin)Cancer cachexia, AIDS wasting
OsteoporosisEstrogen (HRT), raloxifene (SERM), teriparatide (PTH analog), calcitoninIncrease bone density, reduce fractures
Preterm laborAtosiban (oxytocin antagonist), nifedipine (not hormone)Tocolysis
Labor inductionOxytocin, dinoprostone (PGEβ‚‚)Induce or augment labor
Postpartum hemorrhageOxytocin, ergometrine, carboprost (PGFβ‚‚Ξ±)Uterine contraction
Erectile dysfunctionTestosterone (if hypogonadal); not first-lineReplace deficiency
EndometriosisGnRH agonists (leuprolide), danazol (androgen), progestinsSuppress ovarian function
AcromegalySomatostatin analogs (octreotide, lanreotide), GH receptor antagonist (pegvisomant)Reduce GH and IGF-1

7. Summary Table: Major Hormones and Their Pharmaceutical Applications

HormoneSourceMajor ActionsPharmaceutical Applications
InsulinPancreatic Ξ²-cellsLowers blood glucoseType 1 diabetes, Type 2 diabetes (as needed)
GlucagonPancreatic Ξ±-cellsRaises blood glucoseSevere hypoglycemia (injection)
Growth hormone (GH)Anterior pituitaryGrowth, anabolicGH deficiency, Turner syndrome, chronic renal failure, AIDS wasting
Thyroid hormones (T₃, Tβ‚„)ThyroidIncrease metabolismHypothyroidism, myxedema coma
CalcitoninThyroid C-cellsLowers blood calciumOsteoporosis, Paget's disease, hypercalcemia
PTH (teriparatide)Parathyroid (analog)Bone formationOsteoporosis (anabolic)
Cortisol (hydrocortisone)Adrenal cortexStress response, metabolism, anti-inflammatoryAdrenal insufficiency, inflammation, allergy, immunosuppression
Aldosterone (fludrocortisone)Adrenal cortexSodium retention, potassium excretionAdrenal insufficiency (mineralocorticoid replacement)
EpinephrineAdrenal medullaFight-or-flightAnaphylaxis, cardiac arrest, severe asthma
TestosteroneTestes (Leydig cells)Male sexual characteristics, anabolicMale hypogonadism, delayed puberty
EstradiolOvariesFemale sexual characteristicsHRT, contraception
ProgesteroneCorpus luteum, placentaMaintains pregnancyHRT, contraception, luteal phase support
GnRH agonistsHypothalamus (analogs)Initially stimulate, then suppress gonadotropinsProstate cancer, endometriosis, precocious puberty
Somatostatin analogs (octreotide)Hypothalamus (analogs)Inhibit GH, insulin, glucagonAcromegaly, carcinoid syndrome, variceal bleeding
DesmopressinPosterior pituitary (analog)Antidiuretic, ↑ factor VIIIDiabetes insipidus, nocturnal enuresis, hemophilia A, von Willebrand disease
OxytocinPosterior pituitaryUterine contraction, milk ejectionLabor induction, postpartum hemorrhage

References

  1. Lippincott Williams & Wilkins. (2020). Lippincott's illustrated reviews: Biochemistry. (Chapters on Hormones)

  2. Berg, J. M., Tymoczko, J. L., & Gatto, G. J. (2019). Stryer's biochemistry (8th ed.). W. H. Freeman and Company. (Chapters on Signal Transduction and Hormones)

  3. Nelson, D. L., & Cox, M. M. (2017). Lehninger principles of biochemistry (7th ed.). W. H. Freeman and Company. (Chapters on Hormonal Regulation and Signal Transduction)

  4. Rodwell, V. W., Bender, D. A., Botham, K. M., Kennelly, P. J., & Weil, P. A. (2017). Harper's illustrated biochemistry (31st ed.). McGraw-Hill Education. (Chapters on Hormones and Endocrine Function)

  5. Devlin, T. M. (2016). Textbook of biochemistry with clinical correlations (8th ed.). Wiley-Liss. (Chapters on Hormones and Their Actions)

  6. Melmed, S., Auchus, R. J., Goldfine, A. B., Koenig, R. J., & Rosen, C. J. (2020). Williams textbook of endocrinology (14th ed.). Elsevier. (Comprehensive endocrinology reference)

  7. Gardner, D. G., & Shoback, D. (2017). Greenspan's basic & clinical endocrinology (10th ed.). McGraw-Hill Education. (Clinical endocrinology)

  8. Brunton, L. L., Hilal-Dandan, R., & Knollmann, B. C. (2017). Goodman & Gilman's: The pharmacological basis of therapeutics (13th ed.). McGraw-Hill Education. (Chapters on hormone therapy)

  9. Katzung, B. G., & Vanderah, T. W. (2021). Basic & clinical pharmacology (15th ed.). McGraw-Hill Education. (Chapters on endocrine pharmacology)


Recommended Textbooks for Further Reading:

  • Lippincott Williams & Wilkins. (2020). Lippincott's illustrated reviews: Biochemistry. (Excellent for visual summaries and clinical notes on hormones)
  • Melmed, S., et al. (2020). Williams textbook of endocrinology (14th ed.). (Comprehensive clinical resource)
  • Gardner, D. G., & Shoback, D. (2017). Greenspan's basic & clinical endocrinology (10th ed.). (Concise clinical endocrinology)