Hypothalamic-Pituitary Axis
The hypothalamic-pituitary axis (HPA) forms the structural and functional basis for central integration of the neurologic and endocrine systems, creating what is called the neuroendocrine system.
The hypothalamus is located at the base of the brain. It is connected to the pituitary gland by the infundibulum (pituitary stalk), to the anterior pituitary through hypophysial portal blood vessels, and to the posterior pituitary through a nerve tract referred to as the hypothalamohypophysial tract. These connections are vital to the functioning of the hypothalamic-pituitary system.
The anterior pituitary is composed of two main cell types: (a) the chromophobes, which appear to be nonsecretory, and (b) the chromophils, which are considered the secretory cells of adenohypophysis.
The tropic hormones secreted by the chromophils affect the physiologic function of specific target organs. These hormones can be grouped into three categories:
- Corticotropin-related hormones (adrenocorticotropic hormone [ACTH] and melanocyte-stimulating hormone [MSH])
- Glycoproteins (luteinizing hormone [LH], follicle-stimulating hormone [FSH], and thyroid-stimulating hormone [TSH])
- Somatotropins (growth hormone [GH] and prolactin)
The glycoprotein hormones follicle-stimulating hormone (FSH) and luteinizing hormone (LH) influence reproductive function. Adrenocorticotropic hormone (ACTH) regulates the release of cortisol from the adrenal cortex. Thyroid-stimulating hormone (TSH) regulates the activity of the thyroid gland.
Growth hormone (GH) and prolactin are called the somatotropic hormones and have diverse effects on body tissues. GH secretion is controlled by two hormones from the hypothalamus: growth hormone–releasing hormone (GHRH), which increases GH secretion; and somatostatin, which inhibits GH secretion. GH is essential to normal tissue growth and maturation and peaks during adolescence.
Prolactin primarily functions to induce milk production during pregnancy and lactation. It has immune-stimulatory effects and modulates immune and inflammatory responses with both physiologic and pathologic reactions.