Pepe G J, Albrecht E D
Department of Physiology, Eastern Virginia Medical School, Norfolk 23501.
Endocr Rev. 1990 Feb;11(1):151-76. doi: 10.1210/edrv-11-1-151.
Significant advances in our understanding of the regulation of fetal adrenal growth, differentiation, and steroidogenesis have been made in the past several years. In vitro studies employing molecular biological techniques have demonstrated that the placenta and several fetal tissues synthesize growth factors and/or oncogene-related products, which have the capacity to modulate growth and maturation of the fetal adrenal. Moreover, there is evidence that the fetal adrenal itself produces IGF-I and IGF-II and that the mRNAs for these growth factors are responsive to ACTH and perhaps other peptides originating in the fetal pituitary and/or the placenta. Most fascinating are the studies demonstrating that growth factors may also regulate the pattern of steroidogenesis elicited by the fetal adrenal. For example, TGF beta modulates binding, internalization, and degradation of LDL-cholesterol in adult adrenals while IGF-I increases fetal adrenal steroidogenesis by mechanisms that do not involve induction of P-450scc or enhanced metabolism of LDL. These studies, coupled with the observation that activation of protein kinase C by EGF or bFGF can block ACTH and/or other cAMP-induced increases in the activity of P-450(17 alpha), provide new insight into the subcellular mechanisms that underlie the regulation of fetal adrenal function. However, in vivo investigations must be aggressively pursued because the latter provide a major and perhaps exclusive means to elucidate the complex and multiple mechanisms that are apparently operative in utero in the regulation of fetal adrenal development. Moreover, in vivo studies remain the only valid means to delineate whether the factors that have been shown to modulate fetal adrenal function in vitro are indeed operable in vivo. Thus, in vivo investigations have shown that a multifactorial regulation of the fetal adrenal exists in utero in which PRL and perhaps other peptides as well as ACTH selectively stimulate fetal adrenal androgen production. Moreover, in vivo studies have demonstrated that a feedback mechanism operates in utero whereby estrogen produced in the placenta from androgen precursors of fetal adrenal origin feeds back to modulate the responsivity of the fetal adrenal to tropic peptides perhaps by regulating peptide binding to cell membrane receptors and/or other mechanisms. Evidence has also been provided from in vivo studies to support the concept that the placenta via metabolism of maternal cortisol and cortisone regulates fetal pituitary production of ACTH by modulating the extent to which maternal cortisol arrives at the fetus.(ABSTRACT TRUNCATED AT 400 WORDS)
在过去几年里,我们对胎儿肾上腺生长、分化和类固醇生成调节的理解取得了重大进展。采用分子生物学技术的体外研究表明,胎盘和几种胎儿组织能合成生长因子和/或癌基因相关产物,这些产物有调节胎儿肾上腺生长和成熟的能力。此外,有证据表明胎儿肾上腺自身能产生胰岛素样生长因子-I(IGF-I)和胰岛素样生长因子-II(IGF-II),且这些生长因子的信使核糖核酸(mRNAs)对促肾上腺皮质激素(ACTH)以及可能源自胎儿垂体和/或胎盘的其他肽有反应。最引人入胜的是那些表明生长因子可能还调节胎儿肾上腺引发的类固醇生成模式的研究。例如,转化生长因子β(TGFβ)调节成年肾上腺中低密度脂蛋白胆固醇(LDL-胆固醇)的结合、内化和降解,而IGF-I通过不涉及诱导细胞色素P450侧链裂解酶(P-450scc)或增强LDL代谢的机制增加胎儿肾上腺类固醇生成。这些研究,再加上表皮生长因子(EGF)或碱性成纤维细胞生长因子(bFGF)激活蛋白激酶C可阻断ACTH和/或其他环磷酸腺苷(cAMP)诱导的细胞色素P450(17α)活性增加这一观察结果,为胎儿肾上腺功能调节背后的亚细胞机制提供了新的见解。然而,必须积极开展体内研究,因为后者是阐明子宫内显然在调节胎儿肾上腺发育中起作用的复杂多样机制的主要且可能是唯一的手段。此外,体内研究仍然是确定那些已被证明在体外调节胎儿肾上腺功能的因素在体内是否确实起作用的唯一有效手段。因此,体内研究表明子宫内存在对胎儿肾上腺的多因素调节,其中催乳素(PRL)以及可能的其他肽与ACTH一起选择性刺激胎儿肾上腺雄激素的产生。此外,体内研究已证明子宫内存在一种反馈机制,即胎盘由胎儿肾上腺来源的雄激素前体产生的雌激素进行反馈,可能通过调节肽与细胞膜受体的结合和/或其他机制来调节胎儿肾上腺对促性腺肽的反应性。体内研究也提供了证据来支持这样一种观点,即胎盘通过母体皮质醇和可的松的代谢,通过调节母体皮质醇到达胎儿的程度来调节胎儿垂体ACTH的产生。(摘要截断于400字)