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Related Concept Videos

The Pituitary Gland01:17

The Pituitary Gland

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The pituitary is a small endocrine organ in the sphenoid bone under the hypothalamus. Primarily, the pituitary in adults has two distinct anatomical and functional regions— the anterior and posterior lobes. During human fetal development, a third pituitary gland region called the pars intermedia atrophies and disappears. However, some of its cells migrate and exist adjacent to the anterior pituitary in adults.
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Regulation of Hormone Secretion01:19

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Regulation of hormone secretion is a finely tuned orchestration driven by various types of stimuli, encompassing neural, humoral, and hormonal signals. Environmental cues instigate neural stimuli, where action potentials traverse nerve fibers to reach their designated targets. An illustrative scenario is the body's response to stress, wherein the sympathetic nervous system releases epinephrine from the adrenal glands, inducing the well-known 'fight or flight' reaction.
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Hormones of the Pituitary Gland01:27

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The small, pea-sized pituitary gland is located at the base of the brain. It is crucial in regulating various bodily functions, from growth to reproduction. The gland is divided into the anterior lobe and the posterior lobe. The secretory cell clusters in the pars distalis of the anterior pituitary lobe are controlled by hypothalamic regulators and synthesize six primary hormones.
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Nature and Nurture01:10

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Many human characteristics, like height, are shaped by both nature—in other words, by our genes—and by nurture, or our environment. For example, chronic stress during childhood inhibits the production of growth hormones and consequently reduces bone growth and height. Scientists estimate that 70-90% of variation in height is due to genetic differences among individuals, and 10-30% of variation in height is due to differences in the environments that individuals experience,...
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Cortisol production is normally governed by the hypothalamic–pituitary–adrenal (HPA) axis, which maintains hormonal balance through tightly regulated feedback mechanisms. Disruption of this regulatory system is central to the development of Cushing syndrome, whether the excess cortisol originates from external medications or internal pathology. Persistent cortisol elevation alters metabolism, immune function, and endocrine signaling, producing the characteristic clinical features...
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Development of Organoids from Mouse Pituitary as In Vitro Model to Explore Pituitary Stem Cell Biology
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The pituitary stalk effect: is it a passing phenomenon?

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Summary

Large pituitary tumors often cause normoprolactinemia due to lactotroph insufficiency, not just stalk effect. This insufficiency, particularly in males, may be missed due to fewer symptoms, masking the hyperprolactinemia phase.

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Area of Science:

  • Endocrinology
  • Neurosurgery
  • Oncology

Background:

  • Pituitary macroadenomas can cause hyperprolactinemia via the stalk effect, but normoprolactinemia is also common.
  • Increased intrasellar pressure is linked to both stalk effect hyperprolactinemia and pituitary insufficiency.

Purpose of the Study:

  • To investigate the hypothesis that lactotroph failure, not just disinhibition, causes normoprolactinemia in patients with large pituitary macroadenomas.
  • To explore sex-based differences in the presentation of hyperprolactinemia and insufficiency related to pituitary macroadenomas.

Main Methods:

  • Prospective study of 98 patients with clinically nonfunctional pituitary adenomas undergoing surgery.
  • Lactotroph insufficiency inferred from other pituitary axis failures; stalk effect inferred from pre- vs. post-operative prolactin levels.

Main Results:

  • 87% of normoprolactinemic patients with tumors >20 mm had pituitary insufficiency.
  • Pre-operative prolactin levels were lower in patients with pituitary insufficiency compared to those with intact function.
  • Premenopausal women had smaller tumors and higher pre-operative prolactin levels than males; none showed pituitary insufficiency.

Conclusions:

  • Normoprolactinemia in large pituitary macroadenomas is likely due to lactotroph insufficiency, with the stalk effect being the norm.
  • The hyperprolactinemia phase may be transient and missed, especially in males due to a lack of symptoms.