Thyrotropin-releasing hormone (TRH) is a hypophysiotropic hormone produced by neurons in the hypothalamus that stimulates the release of thyroid-stimulating hormone (TSH) as well as prolactin from the anterior pituitary.
TRH has been used clinically in diagnosis of hyperthyroidism, and for the treatment of spinocerebellar degeneration and disturbance of consciousness in humans. Its pharmaceutical form is called protirelin (INN) ().
Physiology
Synthesis and release
thumb|250px|left|class=skin-invert-image|The hypothalamic-pituitary-thyroid axis. TRH can be seen in green.
TRH is synthesized within parvocellular neurons of the paraventricular nucleus 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) 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, TRH travels to the anterior pituitary via the hypophyseal portal system where it binds to the TRH receptor stimulating the release of thyroid-stimulating hormone from thyrotropes and prolactin 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. 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 "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. Nausea, flushing, urinary urgency, and mild rise in blood pressure have been reported. After intrathecal 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. 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, causing awakening from sleep or sedation.
See also
- Thyrotropin-releasing hormone receptor
- Thyroid-stimulating hormone
- Hypothalamic–pituitary–thyroid axis
- Hypothalamic–pituitary–prolactin axis