,按一下以編輯母片標題樣式,按一下以編輯母片,第二層,第三層,第四層,第五層,*,生殖內分泌學,蔡永杰醫師,財團法人奇美醫院,生殖醫學中心,生殖內分泌學蔡永杰醫師,1,內分泌學概論,外分泌腺(有管腺),汗腺、乳腺、唾液腺。,內分泌腺(無管腺),下視丘、腦下腺、甲狀腺、副甲狀腺、腎上腺、性腺、松果腺、胰臟、胸腺。,內分泌學概論外分泌腺(有管腺),2,人體的內分泌腺,人體的內分泌腺,3,分泌的種類,分泌的種類,4,分泌的種類,Autocrine:a,mode,of,hormone,action in which a hormone,binds,to,receptors,on and affects the function of the,cell,type that produced it.,Paracrine:a type of,hormone,function in which hormone,synthesized,in and released from,endocrine cells,binds,to its,receptor,in nearby,cells,of a different type and affects their function.,Endocrine:applied to,organs,and structures that release their products into the blood or,lymph,and to substances(,hormones,)that exert specific effects on other organs.,分泌的種類Autocrine:a mode of hormo,5,荷爾蒙的種類,固醇類(steroid),三個六碳環與一個五碳環,Cortisol,testosterone,progesterone,estrogen,Polypeptides&醣蛋白類(glycoprotein),Polypeptides：ADH,insulin,oxytocin,glycoprotein：TSH,Amines,Epinephrine,norepinephrine,T3,T4,荷爾蒙的種類固醇類(steroid),6,荷爾蒙的種類,荷爾蒙的種類,7,Endocrine,的作用機轉,Receptor vs Target cell,Endocrine 的作用機轉Receptor vs Tar,8,Endocrine 的作用機轉,固醇類激素,脂溶性,Receptor 在細胞質內,Estrogen-receptor complex,Estrogen-receptor complex/DNA,DNARNA,RNAProtein,Proteinreaction,Polypeptides,激素,水溶性,Receptor 在細胞核內,T4 T3 T3-binding protein,T3/DNA,DNARNA,RNAProtein,Proteinreaction,Endocrine 的作用機轉固醇類激素 Polypepti,9,Endocrine 的作用機轉,Endocrine 的作用機轉,10,Endocrine 的作用機轉,Endocrine 的作用機轉,11,Endocrine 的作用機轉,Amines,類激素,水溶性,Receptor 在細胞膜內,Primary messengersecondary messenger,cAMP(環單磷酸腺甘酸),cGMP(環單磷酸鳥甘酸),Calcium,IP3(肌醇三磷酸),DAG(二乙硫甘油脂),secondary messenger Protein kinase A,Protein kinase Areaction,Endocrine 的作用機轉Amines類激素,12,Endocrine 的作用機轉,Endocrine 的作用機轉,13,Endocrine 的作用機轉,cAMP(,環單磷酸腺甘酸,),H+RATP cAMPactivated PKA,cGMP(,環單磷酸鳥甘酸,),H+RGTP cGMPactivated PKA,Calcium,H+Rcalcium channel open Ca,+,+calmodulin(,調鈣蛋白,),IP3(,肌醇三磷酸,),H+RG-proteinphospholipase C(PLC),PIP2 IP3+DAG,DAG(,二乙硫甘油脂,),Endocrine 的作用機轉cAMP(環單磷酸腺甘酸),14,Endocrine,的回饋控制,負回饋作用(大部份),GnRHFSH,LH,TRH TSH,CRH ACTH,SS GH,正回饋作用(少部份),Oxytocin,Endocrine 的回饋控制負回饋作用(大部份),15,生殖内分泌学课件_003,16,生殖内分泌学课件_003,17,下視丘與腦下垂體,下視丘與腦下垂體,18,下視丘,位於大腦正中底部、腦下腺上方、緊臨視丘區的下方圍繞第三腦室。,可分泌調節激素經由門脈系統進入腦下腺。,下視丘位於大腦正中底部、腦下腺上方、緊臨視丘區的下方圍繞第三,19,生殖内分泌学课件_003,20,下視丘,GnRH(性腺刺激素釋放激素)FSH,LH,TRH(甲狀腺刺激素釋放激素)TSH,CRH(腎上腺皮質素刺激素釋放激素)ACTH,GHRH(生長激素刺激素釋放激素)GH,PRH(泌乳刺激素釋放激素),PIH泌乳刺激素抑制激素),MRF(黑色素刺激素釋放因子),MIF(黑色素刺激素抑制因子),下視丘GnRH(性腺刺激素釋放激素)FSH,LH,21,G,nRH,GnRH的神經元位於中底下視丘(MBH)的弓狀神經核與前下視丘的視神經前區,GnRHGnRH的神經元位於中底下視丘(MBH)的弓狀神經核,22,G,nRH,GnRH is a small peptide with 10 amino acids,with some variation in the amino acid,sequence among various mammals.,GnRHGnRH is a small peptide wi,23,生殖内分泌学课件_003,24,G,nRH,半生期 2-4 分鐘,膜動式分泌,濾泡前期 90 分鐘,濾泡後期 60 分鐘,黃體前期 100分鐘,黃體後期 200分鐘,GnRH半生期 2-4 分鐘,25,下視丘-腦下腺-卵巢,The hypothalamus-pituitary-ovarian(H-P-O)axis,下視丘-腦下腺-卵巢The hypothalamus-,26,生殖内分泌学课件_003,27,生殖内分泌学课件_003,28,下視丘與腦下垂體解剖與功能上的相關性,下視丘與腦下垂體解剖與功能上的相關性,29,腦下腺,腦下腺又稱腦下垂體約1.3公分位於蝶鞍內。以腦下垂體柄(漏斗)與下視丘相連。,分三部份,前葉75%(腦下腺腺體部)、來自為外胚層。,中間部、可分泌黑色素細胞刺激素,後葉25%(腦下腺神經部,neurohypophysis,),含有下視丘的神經軸突末端,腦下腺腦下腺又稱腦下垂體約1.3公分位於蝶鞍內。以腦下垂體柄,30,生殖内分泌学课件_003,31,腦下腺,腦下腺前葉的細胞,嗜酸性細胞,GH、PRL,嗜鹼性細胞,TSH、FSH、LH,無顆粒性細胞,ACTH,腦下腺腦下腺前葉的細胞,32,濾泡刺激素,(follicle-stimulating hormone；FSH),和黃體生成素合稱性腺刺激素,：刺激睪丸製造精子與支持細胞分泌抑制素,：刺激濾泡的發育與動情素的分泌,濾泡刺激素(follicle-stimulating h,33,FSH/LH,在男性的作用,FSH/LH在男性的作用,34,FSH/LH,在女性的作用,FSH/LH在女性的作用,35,黃體刺激素,(Luteinizing hormone；LH),和濾泡刺激素合稱性腺刺激素,：刺激卵巢的排卵作用、刺激黃體的生成並分泌黃體激素。,：刺激睪丸的間質細胞生成與分泌睪固酮(testosterone)。,黃體刺激素(Luteinizing hormone；LH,36,泌乳激素,(Prolactin),加強黃體生成素的作用。,促進乳腺的發育與分泌乳汁。,平常:濃度低,排卵後：濃度上升,月經時：濃度下降,剛生產後：濃度下降,哺乳時：濃度上升,泌乳激素(Prolactin)加強黃體生成素的作用。,37,催產激素,(Oxytocin),刺激子宮平滑肌的收縮,促進乳腺管平滑肌上皮的收縮將乳汁排出,催產激素(Oxytocin)刺激子宮平滑肌的收縮,38,催產激素,(Oxytocin),的作用,催產激素(Oxytocin)的作用,39,Q(AQ-DW6P2q4w#K9LEcXZHtHBz#-aQ2vgUuxjczGTrTje%R05iHdJHUXsbU&iu8-N%kAg7W0pBc-GM$&u4zqrdvW)EjRLNyN05Eayf3IGKuHZYeJUm$d#F+UI91&Czx89aY!%ILNrtt530I&2AM!wQ4ScJy2LMugvrrW-f#kUOqaomr!bDrATGIB)I9cuCb-KYfub3V2vMtl0h$Q5kNItt*o(69qcZSfFod9Y-ecF4l*L8-%FJOZIon(BqZm3uTuQA&Nx&QD2ZMb-UitKfyTuS9#lTImPQ2kajp2-#8qPx(CBj8r6)s5JS7o99v0r#XGyZ1bqS0SNxRd-dhxeUDXCfrMTo3D*W*Ic*jzEELBWepC!xKR62GwP37E5aC#zR*4*YwuuolgzskA8h2bkrjcupl$%!AumIV1J(dv)wBFkrgax)Xj)EOj(3GJg3Tt&DIz1En(7+U38bx*j7oy9Ig55%gTyQMsF$vY9IY*iFvgEVgdi67SL9-n6*($sFXVl!RgX6R2K$8#OEpwCEzv4vyZGC9sz&4kUF7O0bw2!PjHI$oBu6PG3K04fHCLC-Fsp5Flh42wXyMr8na-7EchniSaUQXNjNe6ozdT2NXbwOPfIj7sM-hjPcKreMM$PBfdRh-pXgvH3rpure-nakvMZGeb+NU646N)Dl4mAU-IN44s-HUa#&Lr#AbHyZNnhwu3!V2isr1zjO%f0hdv6(qa1xzWfh+(7J5xMSg*25CwHuR%+g4SWpwxnatj%#7LySFmbfvgC%BwXh!fzUcm5NVOs+Gp-LxXYNG6Bonlbyd6yigjE#Tca%a1JFuFBl$wFYkcytt#RpsgckL&d5W5E)Go-DMGAb-n+N6iAmCRueE47ytOmbw6Uk!pg%xifXd-g3YKPIGhmLsSuiQY%iawdzPPu5xFq)1&Sa$nSm$cP1#c5(0KoGLtv3QzZwaG$Iuf234YWhF(OMy5gZiN!jujdtzpKU+pUXqZ39bn-pGhqaxqGgt3J9&UB80pp5!-$PQyV)vCozdkXG2Dg#PkGfCQgl9M#AU0hc0WJgLPfUIpI2&rjOk2Bu&-u+YlavVCUKD%C9zTeHxWnC)R&XJCxPb)&iqdmSwseKFTO&BCAB7rZmJE8mRvAwfhRqYPIQs$Y$08h0)(GMFilA2KkApJknrSYzI8w+DtIlL9Y%xVJow%z48)*C$CApr1J*2yYNnDL3T9#9KQnxuLM%GD7FY*B0u7!prdO-6iKGTQJ6Rgc%LmaLw4JrmubQwSNvXvgDQrzSOdCpik6aTI1mICCm-NJbHb!MfbnGvglyZ(u(dO3N)fT(nZQIe83Z%)quz%+7DTH6!K3StOlX+vYLq