Thyrotropin-releasing hormone (TRH) is a hypophysiotropic hormone produced by neurons in the

hypothalamus The hypothalamus (: hypothalami; ) is a small part of the vertebrate brain that contains a number of nucleus (neuroanatomy), nuclei with a variety of functions. One of the most important functions is to link the nervous system to the endocrin ...

that stimulates the release of thyroid-stimulating hormone (TSH) as well as

prolactin Prolactin (PRL), also known as lactotropin and mammotropin, is a protein best known for its role in enabling mammals to produce milk. It is influential in over 300 separate processes in various vertebrates, including humans. Prolactin is secr ...

from the

anterior pituitary The anterior pituitary (also called the adenohypophysis or pars anterior) is a major Organ (anatomy), organ of the endocrine system. The anterior pituitary is the glandular, Anatomical terms of location#Usage in human anatomy, anterior lobe that t ...

. TRH has been used clinically in diagnosis of hyperthyroidism, and for the treatment of spinocerebellar degeneration and disturbance of consciousness in humans. Its

pharmaceutical Medication (also called medicament, medicine, pharmaceutical drug, medicinal product, medicinal drug or simply drug) is a drug used to diagnose, cure, treat, or prevent disease. Drug therapy ( pharmacotherapy) is an important part of the ...

form is called protirelin (

INN Inns are generally establishments or buildings where travelers can seek lodging, and usually, food and drink. Inns are typically located in the country or along a highway. Before the advent of motorized transportation, they also provided accomm ...

) ().

Physiology

Synthesis and release

TRH is synthesized within parvocellular neurons of the

paraventricular nucleus The paraventricular nucleus (PVN) is a nucleus in the hypothalamus, located next to the third ventricle. Many of its neurons project to the posterior pituitary where they secrete oxytocin, and a smaller amount of vasopressin. Other secretions ...

of the hypothalamus. It is translated as a 242-amino acid precursor polypeptide that contains 6 copies of the sequence -Gln-His-Pro-Gly-, with both ends of the sequence flanked by Lys-Arg or Arg-Arg sequences. To produce the mature form, a series of enzymes are required. First, a protease cleaves to the C-terminal side of the flanking Lys-Arg or Arg-Arg. Second, a carboxypeptidase removes the Lys/Arg residues leaving Gly as the C-terminal residue. Then, this Gly is converted into an amide residue by a series of enzymes collectively known as peptidylglycine-alpha-amidating monooxygenase. Concurrently with these processing steps, the N-terminal Gln (

glutamine Glutamine (symbol Gln or Q) is an α-amino acid that is used in the biosynthesis of proteins. Its side chain is similar to that of glutamic acid, except the carboxylic acid group is replaced by an amide. It is classified as a charge-neutral ...

) is converted into pyroglutamate (a cyclic residue). These multiple steps produce 6 copies of the mature TRH molecule per precursor molecule for human TRH (5 for mouse TRH). TRH synthesizing neurons of the paraventricular nucleus project to the medial portion of the external layer of the median eminence. Following secretion at the

median eminence The median eminence is generally defined as the portion of the ventral hypothalamus from which the portal vessels arise. The median eminence is a small swelling on the tuber cinereum, posterior to and on top of the pituitary stalk; it lies in th ...

, TRH travels to the

via the

hypophyseal portal system The hypophyseal portal system is a system of blood vessels in the microcirculation at the base of the brain, connecting the hypothalamus with the anterior pituitary. Its main function is to quickly transport and exchange hormones between the hyp ...

where it binds to the TRH receptor stimulating the release of thyroid-stimulating hormone from thyrotropes and

from lactotropes. The half-life of TRH in the blood is approximately 6 minutes. TRH is also produced in many hypothalamic neurons not associated with the pituitary, as well as multiple other CNS regions (including the spinal cord, brainstem, thalamus, amygdala, and hippocampus), indicating various non-neuroendocrine functions. TRH is additionally produced in multiple endocrine and non-endocrine tissues outside the CNS, including the anterior pituitary, parafollicular cells of the thyroid glands, medulla of the adrenal gland, islet cells of the pancreas, Leydig cells of the testis, epididymis, prostate, GI tract, spleen, lung, ovary, retina, and hair follicles.

Regulation of release

Regulation of TRH release is regulated principally by a negative feedback loop by thyroid hormone, and a neuronal open loop by hypothalamic factors. TRH release is additionally regulated by other circulating hormones (including glucocorticoids, and oestrogens), and inhibited by cytokines. The tanycytes of the

also exert a regulatory effect on TRH release.

Function and effects

Neurotransmission and neuromodulation

Extensive production of TRH throughout the CNS various non-endocrine (neurotransmissive and neuromodulatory) functions. Indeed, artificial administration into the CNS exhibits autonomic (hyperthermic, hypertensive, positive chronotropic, and gastrokinetic effects, and promotion of insulin and gastric acid release), antiepileptic, anxiolytic, and pro-locomotive effect.

Structure

TRH is a tripeptide, with an amino acid sequence of pyroglutamyl-histidyl-proline amide.

History

The structure of TRH was first determined, and the hormone synthesized, by

Roger Guillemin Roger Charles Louis Guillemin (; January 11, 1924 – February 21, 2024) was a French-American neuroscientist. He received the National Medal of Science in 1976, and the Nobel Prize in Physiology or Medicine, Nobel Prize for Medicine in 1977 for ...

and Andrew V. Schally in 1969. Both parties insisted their labs determined the sequence first: Schally first suggested the possibility in 1966, but abandoned it after Guillemin proposed TRH was not actually a peptide. Guillemin's chemist began concurring with these results in 1969, as NIH threatened to cut off funding for the project, leading both parties to return to work on synthesis. Schally and Guillemin shared the 1977

Nobel Prize in Medicine The Nobel Prize in Physiology or Medicine () is awarded yearly by the Nobel Assembly at the Karolinska Institute, Nobel Assembly at the Karolinska Institute for outstanding discoveries in physiology or medicine. The Nobel Prize is not a single ...

''"for their discoveries concerning the peptide hormone production of the brain."'' News accounts of their work often focused on their "fierce competition" and use of a very large number of sheep and pig brains to locate the hormone.

Clinical significance

Diagnostic

Intravenous injection of TRH has been used for diagnostic purposes in the context of the TRH test; administration of exogenous TRH can be used to determine whether hypothyroidism is of hypothalamic or hypophyseal etiology. However, this diagnostic approach has been superseded by ultrasensitive TSH assays and is nowadays only seldom employed.

ACTH and GH release

TRH promotes release growth hormone (GH) in individuals with certain pathological conditions, and of adrenocorticotropic hormone (ACTH) in some individuals with

Cushing's disease Cushing's disease is one cause of Cushing's syndrome characterised by increased secretion of adrenocorticotropic hormone (ACTH) from the anterior pituitary (secondary hypercortisolism). This is most often as a result of a pituitary adenoma (spec ...

. TRH promotes GH release in individuals with

acromegaly Acromegaly is a disorder that results in excess growth of certain parts of the human body. It is caused by excess growth hormone (GH) after the growth plates have closed. The initial symptom is typically enlargement of the hands and feet. There ...

; prolonged exposure to GHRH may cause the pituitary to release GH in response to TRH. TRH may also promote GH release in individuals with hepatic disease, uremia, childhood hypothyroidism,

anorexia nervosa Anorexia nervosa (AN), often referred to simply as anorexia, is an eating disorder characterized by Calorie restriction, food restriction, body image disturbance, fear of gaining weight, and an overpowering desire to be thin. Individuals wit ...

, and depression. Conversely, TRH suppresses GH release during sleep.

Side effects

Side effects after intravenous TRH administration are minimal. Nausea, flushing, urinary urgency, and mild rise in blood pressure have been reported. After

intrathecal Intrathecal administration is a route of administration for drugs via an injection into the spinal canal, or into the subarachnoid space (sin. ''intrathecal space'') so that it reaches the cerebrospinal fluid (CSF). It is useful in several applic ...

administration, shaking, sweating, shivering, restlessness, and mild rise in blood pressure were observed.

Research

TRH has been evaluated for the treatment of various neurological disorders. It has been attempted for treatment of various epileptic disorders. TRH has been shown to improve outcomes of CNS injuries in experimental models. Efficacy for the treatment ALS and spinal muscle atrophy has not been demonstrated. Many individuals with depression exhibit a blunted endocrine response to TRH due to unknown reasons, and the response is correlated with clinical outcomes. Involvement of TRH in the pathogenesis of depression has nevertheless not been well established. TRH has undergone research for its ostensible antidepressant properties, however, results regarding efficacy have been inconsistent. One study on a small sample of people with treatment-resistant depression found short-lived anti-depressant and anti-suicidal effects when TRH was administered intrathecally. An orally bioavailable prodrug is being researched. In 2012, the U.S. Army awarded a research grant to develop a TRH nasal spray for suicide prevention amongst veterans. TRH acts as a

wakefulness-promoting agent A wakefulness-promoting agent (WPA), or wake-promoting agent, is a drug that increases wakefulness and arousal. They are similar to but distinct from psychostimulants, which not only promote wakefulness but also produce other more overt central ...

, causing awakening from sleep or sedation. TRH has been shown to exert anti-aging effect in a mice model.

References

External links

* {{DEFAULTSORT:Thyrotropin-Releasing Hormone Galactagogues Hormones of the hypothalamus Hormones of the hypothalamus-pituitary-adrenal axis Hormones of the hypothalamic-pituitary-prolactin axis Peptide hormones Thyroid Tripeptides