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Thursday, 25 June 2020

Psychoendoimmunoneurology for Medical Students - Part 1


Semmal Sir Online Classes
Psychoendoimmunoneurology for Medical Students
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Time Period Corresponding to maximum  in Melatonin Serum Levels ____________?
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Night & Early Morning
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Melatonin is IL-2/IL-2 Receptor Modulator
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Circadian Rhythm of Melatonin is Marker For ________?
Healthy Ageing
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Melatonin Metabolite
6-Hydroxymelatonin Sulfate (Amt6s) Elevated at Night
Among which age group _________?
All ages
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Melatonin is a Wonderful Multitasking Molecule
Multiple Advantages +
Anti-Ageing Drug Due its Amphiphilic Feature
So it can cross BBB
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Melatonin acts against the Undesirable Facets of Ageing
And it acts against ____?______degeneration
Neurodegeneration
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Anti-Inflammation effect of melatonin in CNS due to _______?
 Microglial Activity In CNS
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Longevity Protein Protected by Melatonin _____________?
SIRTUIN 1
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How melatonin  DNA Damage
L1 Retrotransposons  DNA Damage
Melatonin  Inhibit L1 Retrotransposons
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Melatonin  Inhibit B-Fibrillogenesis
Melatonin →↓B-Amyloid
Melatonin   Abnormal Nitration of Proteins
Melatonin  Inhibits Tau Phosphorylation
Melatonin  Better Sleep Quality
………

Daily Light / Dark Cycle is by itself a stress
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Life must tackle many
External & Internal Stressors Like
 Food Scarcity, Pathogen Invasion,
  Temperatures
Hurtful Memories & Injuries
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Name the HPA Axis End-Effectors for
Stress System in Mammals ________?
Glucocorticoids
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Locus Coeruleus / Norepinephrine –
ANS and its End-Effectors – NE & E
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 Circadian Clock Dynamically Communicates With ________?

HPA Axis
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Dysregulation of Stress System  Deleterious
Over Course of Time
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HPA Axis Attritions & Clock Disorders
Share Common Metabolic Syndromes like ___________?
(Obesity, Diabetes)
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Glucocorticoids made by Adrenal Cx 
Influences All Organs & Tissues
Extremely Necessary to Preserve ___?__ Vital Biologic Activities
(Homeostasis of CNS, CVS, Intermediary Metabolism)
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Immune/Inflammatory Reaction  Influences ___?_____
Expression in Genome
M RNA 
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SCN Modulates Secretion of Glucocorticoids by Influencing ______?
HPA Axis
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ANS is  HPA Axis (Dep/ Indep) endent Pathway
Independent
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Glucocorticoids Exhibits 3  Rhythms, what are they ______?
Human Glucocorticoid Receptor Acetylation 
 during Which time of the day ______? ______
Name some Age-Related Disorders in which Glucocorticoid Rhythms Fluctuates ?
In young ages GH Levels in blood is 
 
x
Pulsatile, Ultradian (1–2 Per Hour), Circadian
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Circadian Peak for Glucocorticoids
Strongly Based on Activity Phase of body
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Peak + in Early Morning in Diurnal Body
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Peak + in Early Night in Nocturnal Animals
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Bmal1 Gene
Plays Significant Role in Rhythmic Expression of Glucocorticoids in Adrenals
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Release of Glucocorticoids - Tightly Regulated By __?____Gene
Per 1 & Per 2
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Glucocorticoids Exerts Circadian Regulatory Function
By Modulating Several Clock Related Genes In
Peripheral Clocks
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Glucocorticoids Exert Functions via
Glucocorticoid Receptors (GR)
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Morning & Nadir at Evening
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Circadian Machinery Maintains
Counter Regulatory Feedback to HPA Axis Via CLOCK & BMAL1
By Blocking Active Sites of which hormone?
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GR
This is Very Essential for Proper Response to Stressors
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AD, Cushing’s Syndrome, Mood Disorders & Metabolic Syndromes
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 External Administration of Glucocorticoids  (Mention any 9 effects)
 1. CVS Mortality
2. Disrupted Glucose Homeostasis
3. Bone Loss
4. ROS Levels & Cell Death In Hippocampus
5.  Learning ,  Memory,
6. Neuronal Apoptosis
7.   Amyloid Precursor Protein,
8. B-Secretase & Caspase-3 Expression
9. Senescence

Aged Hippocampus & Cortex  11b -HSD1 (GC Enhancer) 
 Impaired ________?______ Learning
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Spatial Learning 
So, Inhibition of 11b-HSD1  Reversal of  Spatial Memory to better levels
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Stress in Early Life   Glucocorticoids Exposure  Shortening of _____?______ Fast Ageing
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Telomere
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Pregnant mother with  Stress  Child with Shorter Telomeres at Birth  will live less years
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CRH MRNA in PVN Region has Rhythmic Function
It shows  Expression during Lights On
 Expression during Lights Off
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In Ant. Pit. & Ad Cx the Clock Genes Expression are Robust and in Synchrony with which part of Brain?
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SCN
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ACTH  Stimulated Release of Glucocorticoid From which part of Adr. Cx ?
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Zona Fasciculata
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Glucocorticoid & ACTH has Circadian Rhythms
Characteristic Feature of Adrenocortical System
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ACTH has Nocturnal Rhythm in Expression
Peak in _________?
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Night
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Dehydroepiandrosterone (DHEA)
Intermediate for Synthesis of Sex Steroids
 Produced by Adrenal, ______, Gonads
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Brain
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Cholesterol - Precursor Molecule
Acted Upon by P450 becomes Pregnenolone which becomes 17a-Hydroxypregnenolone by Cytochrome P450 Finally becomes DHEA
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DHEA Exhibits Rhythmic Pattern
Peak During Night
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Gender Difference In DHEA
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 in Young Adult Women
 due to Ageing in both genders
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Caucasian Women have  DHEA then Caucasian Men During Day time
Flat DHEA Diurnal Slope  Longer Telomere Length
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DHEA Sold in some countries
Humans with Good Functional Status have  DHEA Levels
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 DHEA in old Men  Predicts Death In Smokers 
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DHEA  Good Cognition (Physical & Psychological) In both genders
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How DHEA Helps to ↓ Inflammation ?
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.
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DHEA   Insulin Resistance
 Inflammatory Cytokines
DHEA  Inhibits IL-8, NF-Kb, TNF-A , ROS
DHEA  Reductant for many Enzymes which creates  Oxygen-Free Radicals
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 DHEA  Inhibits ERK-1 Phosphorylation & C-Fos
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DHEA  Good Sleep Quality , Mood, Energy & Stress-Healing,  Fat Body Mass In Men
DHEA  Improved Bone Mineral Density (BMD), Skin Hydration, Epidermal Thickness, 
Sebum Production & Pigmentation in Older Women
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Growth Hormone (GH) = Somatotropin
Peptide Hormone  Stimulates Growth, Cell Reproduction, Cell Regeneration
Specialized Somatotroph Cells of Anterior Pituitary  GH production
Peak During Sleep
SCN - Site that makes Potent GH Inhibitor, Somatostatin.
Rapid Somatic Growth
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As age  Levels 
After Reproductive Maturation & Attainment Of Adult Body Size.
As Age  more Levels  more
Age related  in GH - Consistent Across Different Mammalian Groups
 GHRH    GH
 GHRH    IGF-I (Key Regulator for GH)
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Age related  in activity of Somatotropic Axis is called as ‘Somatopause’
Somatopause is due to Interaction of IGF-I
GH Exerts Its Action to Initiate
Synthesis of DNA, RNA, Protein
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Prolonged Treatment with GH when it is deficient   QOL,  Bone Mineral Density
But when we give GH for Normal Healthy Elders using Rhgh (Recombinant Human Growth Hormone)
It is bad
It  Arthralgias, Edema, Carpal Tunnel Syndrome, Insulin Resistance, DM
Children may get Stroke also
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IGF-1 - Pulsatile Bursts from Pituitary
 in Night Time
Associated with Slow-Wave Sleep
Secretion of IGF-1 - Dependent on GHRH which releases GH
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IGF-I - Involved in Skeletal & Muscular Development
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Age Related  of IGF-1
Highly Consistent Across Species & Sexes

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