PNA Medical Corner: Puberty and the Pituitary

George ChrousosThis month the PNA Medical Corner features and article co-authored by Dr. George Chrousos, a member of the PNA’s Scientific Advisory Panel. The study looks at the process of puberty and the role of various hormones.

Front Endocrinol (Lausanne). 2019 Dec 6;10:828. doi: 10.3389/fendo.2019.00828. eCollection 2019.
Molecular and Environmental Mechanisms Regulating Puberty Initiation: An Integrated Approach.
Livadas S1, Chrousos GP2

1Endocrine Unit, Metropolitan Hospital, Athens, Greece.
2UNESCO Chair on Adolescent Health Care, University Research Institute of Maternal and Child Health and Precision Medicine, Aghia Sophia Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece.

Abstract

The mechanisms underlying the initiation of puberty, one of the cornerstones of human evolution, have not been fully elucidated as yet. However, recently, an accumulating body of evidence has helped unravel several critical aspects of the process. It is clear that a change in the pattern of pituitary gonadotropin secretion serves as a hormonal trigger for puberty induction. This change is directly guided by the hypothalamic GnRH pulse generation, a phenomenon regulated by the Kisspeptin-Neurokinin-Dynorphin (KNDy) system also in the hypothalamus. This represents the kisspeptin molecule, which is crucial in augmenting GnRH secretion at puberty, whose secretion is fine-tuned by the opposing signals neurokinin B and dynorphin. Recently, the novel kisspeptin inhibitory signal MKRN3 was described, whose role in puberty initiation provided further insight into the mechanistic aspects of pubertal onset. Furthermore, the description of higher inhibitory and stimulatory signals acting upstream of the KNDy neurons suggested that the trigger point of puberty is located upstream of the KNDy system and the GnRH pulse generator. However, the mechanism of pubertal onset should not be considered as an isolated closed loop system. On the contrary, it is influenced by such factors as adipose tissue, gastrointestinal function, adrenal androgen production, energy sensing, and physical and psychosocial stress. Also, fetal and early life stressful events, as well as exposure to endocrine disruptors, may play important roles in pubertal initiation, the latter primarily through epigenetic modifications. Here we present the available data in the field and attempt to provide an integrated view of this unique and crucial phenomenon.

Copyright © 2019 Livadas and Chrousos.

KEYWORDS:
adrenarche; endocrine disruptor (ECD); epigenetics; puberty; stress

Print

Available Now!

PPRG6-500 Cover
The Pituitary Patient Resource Guide Sixth Edition is now available! Be one of the first to have the most up-to-date information. The Pituitary Patient Resource Guide a one of a kind publication intended as an invaluable source of information not only for patients but also their families, physicians, and all health care providers. It contains information on symptoms, proper testing, how to get a diagnosis, and the treatment options that are available. It also includes Pituitary Network Association's patient resource listings for expert medical care.

Buy Now

  • November

    CalendarNov
  • December

    CalendarNov

Continuing Education Program

Knowledge Icon 500

If you are a nurse or medical professional, register for PNA CEU Membership and  earn CEU credits to learn about the symptoms, diagnosis and treatment options for patients with pituitary disorders. Help PNA reduce the time it takes for patients to get an accurate diagnosis.

button registerNow

For more information click here!