tortex and Glucocorticoid watocortiep{steroyias alosrerone, ome and V-desoxycorticomerone ff. and 25d) are synthesized in the ane of the adrenal cortex (> AT}. he ghucocortico(sterojids corsisol sone} and cortisone {-- p24, tities) are synthesized in the fissctc- “+ A2). Androgens are synthesized ular zane of the adrenal cortex (+ of the androgens is dehyciroeptan- (DELEA) which is used (partly in its Tm, DHEA-S} to synthesire various es in other tissues (_» p. 30). transport. Ios of the plasma corti- d wo sranscorsin, or carrisol-bineling BG), a specific transport prosein heaffinity binding site for cortisol, released in response to confor anges of CBG due to inflammation ACTH regulate cortisol synthesis om(— Aa.AS: seealsop. 270). ACTH So structural preservation of the rex and supplies cortisol precur- by forming cholesterol from its fe navo synthesis of cholesterol and ing it to progesterone and T7-hy- ssterone (—>pp.256 and 294). ACTH 5s stimulared by CRH and epineph- hibited (negative feedback control) with orwichour the aid of CREA (—+ A; BA} vrhyytiems of CRH sceretion and thus of ortisol sexretion can be observed. The ris in the mornang (+ B, mean waltse=). hornane conc. sampling at shart inte awa that ACTH and cortwol sre secreted spiodes (+B. wotetns (+ p.278) for ghucocorn- ¢ found sn virtually every cell. Glu- 's are vical hormones that exert effects, the most impartant of isted below, rate and arming acid (AA) metano- iso. pp-283A and 285}: Cortisol ‘rived from prowein degradacion 1 ae plasma glucose concentration mests), which can lead 1 the so- called steroid diaberes in extreme cases. 1 corisal has a catabolic effect (degrades p ‘reins) thar resulrs an the increased excreniot urea. Cardiovascular function: Glucocortice increase myocardial contractilisy andvasoo sriction due wo enhancement of cz cholamine effects (_-pp. 184 and 214). Th are described as permissive effecrs af corti Cornsol increases the of epinephr athe adrenal medulla (a6) and of angsor sinogen in che liver (+p. wa). Especially when administered ath doses, glucocoricoids induce anti-tnfiz matory and antl-ailergic effects because tl stabilize lymphokine synthesis and histam release [—+\p. 160). On the other hand, im Jeukin-1, inverieukin-2 and TNFa (ex. severe infection) leads ro increased secret of CRH and high cortisal conc. {see below). Renal function: Ghuoocorticcids delay the eure ef weta anc help ta manta anarnal games ation rate. They can react alsowith aldasterone ceptors but are coewerted to cortisone by 1) dhowestoroid oxidoreductase in sidastrone tat falls, Norm! cortical cone. ate thersfare infec at the aldasterone reerpior. High cone... howe have the same effect 2s aldosterone (+p. 182). Gastric function: Glucocorticoids weaken prntecuve mechanisms of the gustne mucaza. Tl high-dose glucocorticoids or stress (oer below) crease the rick af gastric ulcers» p 247} Cerebral function: High ghicocorticaid cx change hypothalamic (+l) and slactrical brain tisty (FED) and lead to paychic abnormalities ‘Stress: physical or mental stress increases ¢ fisol secretion as a result of increased ¢ Secretion and increased sympathetic 0 (>A). Many of the aforementsoned effects consol therefore play a role in the body's sponse 10 stress (activation of energy meta ‘lism, increase in cardiac performance, erc.} severe physical (e.g. sepsis) or mental str (eg. depression), the cortisol plasma conc. mains at avery high level (up vo 10 times normal value) throughout the day.