Assignment of Adrenal Cortex

Submitted To:

MA’AM Javeria

Submitted By:

Mehwish Irshad, Anam Fida, Mahnoor Khan,

Khansa Akram, umme Farwa, Nawal Hussain,

Rimsha Altaf

BS Chemistry (7th Semester)

(Biochem Special)

The Women University Multan.

Adrenal Cortex

The outer portion of the adrenal gland located on top of each kidney. The adrenal
cortex produces steroid hormones which regulate carbohydrate and fat metabolism and
mineralocorticoid hormones which regulate salt and water balance in the body.

The adrenal glands (also known as suprarenal glands) are endocrine glands that produce a
variety of hormones including adrenaline and the steroids aldosterone and cortisol. They are found
above the kidneys. Each gland has an outer cortex which produces steroid hormones and an inner
medulla. Situated along the perimeter of the adrenal gland, the adrenal cortex mediates the stress
response through the production of mineralocorticoids and glucocorticoids, such
as aldosterone and cortisol, respectively. It is also a secondary site of androgen synthesis.

The adrenal cortex produces three hormones:

 Mineralocorticoids: the most important of which is aldosterone. ...

 Glucocorticoids: predominantly cortisol. ...

 Adrenal androgens: male sex hormones mainly dehydroepiandrosterone (DHEA) and

testosterone.

1. Glucocorticoid:
The name "glucocorticoid" (glucose + cortex + steroid) and is composed from its role in
regulation of glucose metabolism, synthesis in the adrenal cortex, and its steroidal
structure. A less common synonym is glucocorticosteroid. Glucocorticoids are part of the
feedback mechanism in the immune system which reduces certain aspects of immune
 function, such as inflammation. They are therefore used in medicine to treat diseases
caused by an overactive immune system, such as allergies, asthma, autoimmune diseases.
.
Role of Glucorticoid:

Corticosterone is the main secretion of glucocorticoid.

Effects:

Glucocorticoids have many diverse effects, including potentially harmful side effects, and as a
result are rarely sold over the counter. They also interfere with some of the abnormal mechanisms
in cancer cells, so they are used in high doses to treat cancer. This includes inhibitory effects on
lymphocyte proliferation, as in the treatment of lymphomas and leukemias, and the mitigation of
side effects of anticancer drugs.

Immune:

Glucocorticoids function through interaction with the glucocorticoid receptor:

 Up-regulate the expression of anti-inflammatory proteins.

 Down-regulate the expression of proinflammatory proteins.

Glucocorticoids are also shown to play a role in the development and homeostasis of T
lymphocytes. This has been shown in transgenic mice with either increased or decreased sensitivity
of T cell lineage to glucocorticoids.

Metabolic:

The name "glucocorticoid" derives from early observations that these hormones were involved
in glucose metabolism. In the fasted state, cortisol stimulates several processes that collectively
serve to increase and maintain normal concentrations of glucose in blood.

Metabolic effects:

 Stimulation of gluconeogenesis, in particular, in the liver: This pathway results in the

synthesis of glucose from non-hexose substrates, such as amino acids and glycerol from
triglyceride breakdown, and is particularly important in carnivores and certain herbivores.
 Enhancing the expression of enzymes involved in gluconeogenesis is probably the best-
known metabolic function of glucocorticoids.

 Mobilization of amino acids from extrahepatic tissues: These serve as substrates for
gluconeogenesis.

 Inhibition of glucose uptake in muscle and adipose tissue: A mechanism to

conserve glucose.
 Stimulation of fat breakdown in adipose tissue: The fatty acids released
by lipolysis are used for production of energy in tissues like muscle, and the
released glycerol provide another substrate for gluconeogenesis.
 Increase in sodium retention and potassium excretion leads to hypernatremia and
hypokalemia.
 Increase in hemoglobin concentration, likely due to hindrance of the ingestion of
red blood cell by macrophage or other phagocyte.
 Increased urinary uric acid.
 Increased urinary calcium and hypocalcemia.
 Alkalosis.

Excessive glucocorticoid levels resulting from administration as a drug

or hyperadrenocorticism have effects on many systems. Some examples include inhibition of
bone formation, suppression of calcium absorption delayed wound healing, muscle weakness,
and increased risk of infection.

Developmental:

Glucocorticoids have multiple effects on fetal development. An important example is their role
in promoting maturation of the lung. In addition, glucocorticoids are necessary for normal
brain development, by initiating terminal maturation, remodeling axons and dendrite.
Glucocorticoids stimulate the maturation of the Na+/K+/ATPase, nutrient transporters, and
digestion enzymes, promoting the development of a functioning gastro-intestinal system.
Glucocorticoids also support the development of the neonate's renal system by increasing
glomerular filtration.

Cushing’s disease:

Cushing syndrome occurs due to abnormally high levels of the hormone cortisol. This can
happen for a variety of reasons. The most common cause is overuse of corticosteroid
medications.

Cushing syndrome is also known as Cushing’s syndrome or hypercortisolism.

Symptoms:

Cushing Syndrome: Causes and Symptoms

 Symptoms

 Causes

 Diagnosis

 Treatments

 Complications

 Outlook

What is Cushing syndrome?

Cushing syndrome occurs due to abnormally high levels of the hormone cortisol. This can
happen for a variety of reasons. The most common cause is overuse of corticosteroid
medications.

Cushing syndrome is also known as Cushing’s syndrome or hypercortisolism.

Syndrome:
The most common symptoms of this condition are:

 weight gain

 obesity

 fatty deposits, especially in the midsection, the face (causing a round, moon-shaped face),
and between the shoulders and the upper back (causing a buffalo hump)

 purple stretch marks on the breasts, arms, abdomen, and thighs

 thinning skin that bruises easily

 skin injuries that are slow to heal

 acne

 fatigue

 muscle weakness

 glucose intolerance

 increased thirst

 increased urination

 bone loss

 high blood pressure

 a headache

 cognitive dysfunction

 anxiety

 irritability

 depression

 an increased incidence of infections

Women may also notice extra facial and body hair, as well as absent or irregular
menstruation.

Men may also have:

 erectile dysfunction

 a loss of sexual interest

 decreased fertility

Children with this condition are generally obese and have a slower rate of growth.

Causes:

 The most common cause of Cushing syndrome is the use of corticosteroid medications.

 High doses of injectable steroids for treatment of back pain can also cause this syndrome.

 Lower dose steroids in the form of inhalants, such as those used for asthma, or creams.

 A pituitary gland tumor in which the pituitary gland releases too much adrenocorticotropic
hormone, which is also known as Cushing’s disease
 Ectopic ACTH syndrome, which causes tumors that usually occur in the lung, pancreas,
thyroid, or thymus gland
 An adrenal gland abnormality or tumor.

Treatment:

Treatment will depend on the cause. Doctor may prescribe a medication to help. Some medications
decrease cortisol production in the adrenal glands or decrease ACTH production in the pituitary
gland. Other medications block the effect of cortisol on your tissues.
Tumors can be malignant, which means cancerous, or benign, which means noncancerous.
Surgical removal may be necessary. Doctor may also recommend radiation
therapy or chemotherapy.

2. Mineralocorticoid:

Mineralocorticoids are a class of corticosteroids, which in turn are a class of steroid hormones
and synthesized in Glomerulosa.The primary mineralocorticoid is aldosterone.

Aldosterone acts on the kidneys to provide active reabsorption of sodium and an associated
passive reabsorption of water, as well as the active secretion of potassium in the principal cells
of the cortical collecting tubule and active secretion of protons. This in turn results in an
increase of blood pressure and blood volume.

Role of Mineralocorticoid:

The main secretion of mineralocorticoid is aldosterone.

 Hyperaldosteronism: (The syndrome caused by elevated aldosterone) is

commonly caused by either idiopathic adrenal hyperplasia or by an adrenal adenoma.
The two main resulting problems:

1. Hypertension and edema due to excessive Na+ and water retention.

2. Accelerated excretion of potassium ions (K+). With extreme K+ loss there is muscle
weakness and eventually paralysis.

 Hypoaldosteronism: (The syndrome caused by underproduction of aldosterone)

leads to the salt-wasting state associated with Addison's disease, although
classical congenital adrenal hyperplasia and other disease states may also cause this
situation. Acute underproduction (hemorrhagic adrenalitis) is often lifethreatening.
 Aldosterone stimulates sodium and potassium transport in sweat glands, salivary
glands, and intestinal epithelial cells.
  Excess aldosterone ↑ ECF volume and arterial pressure, but has only a small effect on
plasma sodium concentration.

Disorders:

The disorders or diseases caused by mineralocorticoid are as follows;

Addison's disease:

Addison's disease, also called adrenal insufficiency, is an uncommon disorder that occurs when
body doesn't produce enough of certain hormones. In Addison's disease, adrenal glands,
located just above your kidneys, produce too little cortisol and, often, too little aldosterone.

Addison's disease occurs in all age groups and both sexes, and can be life-threatening.

Symptoms:

Addison's disease symptoms usually develop slowly, often over several months. Often, the
disease progresses so slowly that symptoms are ignored until a stress, such as illness or injury,
occurs and makes symptoms worse. Signs and symptoms may include:

 Extreme fatigue

 Weight loss and decreased appetite

 Darkening of your skin (hyperpigmentation)

 Low blood pressure, even fainting

 Salt craving

 Low blood sugar (hypoglycemia)

 Nausea, diarrhea or vomiting (gastrointestinal symptoms)

 Abdominal pain

 Muscle or joint pains

 Irritability
 Depression or other behavioral symptoms

 Body hair loss or sexual dysfunction in women

Treatment:

All treatment for Addison's disease involves medication. You will be given hormone
replacement therapy to correct the levels of steroid hormones your body isn't producing.

You will need to get plenty of salt (sodium) in your diet, especially during heavy exercise,
when the weather is hot or if you have gastrointestinal upsets, such as diarrhea.

Your doctor will also suggest a temporary increase in your medication dosage if your body is
stressed, such as from an operation, an infection or a minor illness. If you're ill with vomiting
and can't keep down oral medications, you may need injections of corticosteroids.

Conn Syndrome:

Primary aldosteronism, also sometimes called Conn syndrome, is an endocrine

disorder characterized by excessive secretion of the hormonealdosterone from the adrenal
glands. This overproduction leads to the retention of sodium and loss of potassium in the body,
resulting in high blood pressure (hypertension).

Symptoms:

Symptoms of primary aldosteronism can be nonspecific and similar to the symptoms of other
conditions. Often the only symptom is mild to moderate high blood pressure. Symptoms are
often associated with significant low potassium (hypokalemia) and/or hypertension. They may
include:

 Frequent urination

 Increased thirst

 Weakness
 Fatigue

 Temporary paralysis

 Visual disturbances

 Palpitations

 Headaches

 Muscle cramps, which is especially common in people from Asia

 Tingling

Treatment:

 The goals of treating primary aldosteronism are to lower blood pressure to normal or
near normal levels, decrease blood aldosterone levels.
 The type(s) of treatment depends on the cause of the excess aldosterone secretion.
 If the primary aldosteronism is due to a cancerous tumor, which is rare, then organs
located next to the affected adrenal gland will need to be evaluated during surgery and
more than the adrenal gland may need to be removed.
 Treatment for primary aldosteronism must often be adjusted to accommodate
underlying hypertension, kidney disease, congestive heart failure, and a variety of other
disorders. Lifestyle changes, such as dietary changes and exercise, may improve
response to hypertension medications.

References:

1) WWW.Wikipedia.com
2) WWW.Britanica.com
3) WWW.Labtestonline.com