13. Advanced Neurology and Endocrinology

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This is a great place to 'enter the stream' in this lecture series. Thanks, DD!

👍︎︎ 5 👤︎︎ u/[deleted] 📅︎︎ Jun 23 2018 🗫︎ replies

I discovered these sapolsky lectures one night after I fell asleep and YouTube was on auto-play, let's just say I didn't sleep the rest of that night.

👍︎︎ 4 👤︎︎ u/TrippinDannyTanner 📅︎︎ Jun 23 2018 🗫︎ replies

Thanks.

Here is a listing of some of his lectures: https://www.youtube.com/playlist?list=PLwBQo3_FPH5WZo7IVrDyP_LlqqMAUtmXB

👍︎︎ 3 👤︎︎ u/marianco 📅︎︎ Jun 24 2018 🗫︎ replies
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[MUSIC PLAYING] Stanford University. Where have we got to now? You guys have all the basics in hand now for our next two buckets-- neurobiology and endocrinology. What you have now, I hope, is a sense of especially the neuro as the final common funnel out of which comes all that behavior stuff we've been thinking about-- genes-- whether they are changing in a static and then punctuated way or a gradualist way. What they code for we now know are proteins. And in the realm of behavior, what that's all about, you now know, are enzymes that make neurotransmitters, enzymes that break them apart, receptors for neurotransmitters, the ion channels that allow all the excitability stuff-- all of that should be a way of conceptualizing what all that gene stuff that we've had so far funnels into. Likewise with the endocrinology-- all those ways in which reproductive status is going to change how the brain works, all of those great evolutionary models, blah, blah. That's now endocrinology. That's now the ability of hormones to affect the nervous system. And what came through, hopefully, over and over for all of you in the lectures over the last week are two themes-- lots of different ways by which the nervous system and the endocrine system can change its function over time. And number two, lots of different realms where there will be individual differences-- all the ways in which you will have a brain and a bunch of glands that are different than the person sitting next to you. And what you should be able to piece apart readily by now is where some of those individual differences are coming from in the form of genetic influences, where some of them are coming from environmental ones, to begin to take some of those if/then clauses back in the genetics lectures-- if it smells like a relative, then cooperate with them-- to begin to imagine now how the nervous system, how hormones would actually translate that stuff into this next bucket. So this will be our last bucket. Today we'll be looking at all the ways in which everything you heard in the last week is vastly more complicated. And on Friday what we will do is focus in on the part of the nervous system that is most pertinent to rest of the course. Should you ever happen by some chance to stumble into medical school somewhere down the line, when they get around to the nervous system there, you are going to hear about the spinal cord endlessly. You're going to hear about the cerebellum. You're going to hear about parts of the cortex. You are going to hear next to nothing about the part we'll be talking to on Friday. And what it's about is emotion, and behavior, and affect-- a part of the brain called the limbic system. In medical school, they will pound into your head over and over and over how the spinal cord moves different motor systems. Because that's 99% of what neurology can concern itself with. Because it at least has a fighting chance of doing something therapeutic there. This is the part of the brain that is most defining to who we are-- personality, temperament, all of that. And it will be central to making sense of all of this stuff coming in the second half of the course. So it's going to be a very different domain of the nervous system. So what today is about is taking everything you've learned over the last week, and discovering that the ways in which it is tragically distortive and not quite right, and comes with all of these but wait-a-seconds and qualifiers, and all the ways in which this first pass you had in the last week sets you up now for appreciating an enormously more complicated system than you've already seen, one which generates, thus, vastly more possibilities of communication, of information contained within these neural pathways, one which generates vastly more possibilities of individual differences and of experience leaving its imprint, one that generates vastly more possibilities for things to go really wrong in the realms of abnormal behavior. OK so a lot of what we'll be doing is taking what you got in the last week and seeing where, in fact, current research shows that it is much, much more complicated. OK, first version-- one of the rules that runs through all of neurobiology-- you start learning the field and at some point, they pull out the name of this guy Dale. Dale who was the law giver. Dale was some neurobiologist early in the 20th century who generated two laws that every single child was forced to learn throughout the 1920s and 1930s about how the nervous system worked. Some time later than that, Dale's two laws-- and we will start off with one of them. And it makes perfect sense until you see that, in fact, it has no basis in reality. Here is Dale's first law, which was you got your neuron-- and you should know by now we are dealing with our schematic neuron. And once we get into circuits in more detail, we will give up the diamond shape on the neuron cell bodies and switch over to circles, showing just how fast evolution can be. But we've got the neuron here. And what we've got are the axon and the axon terminals. And what Dale's law number two-- and of course, it's irritating that we're doing number two before number one, but tough-- what you've got here with Dale's law number two is, each neuron has one characteristic type of neurotransmitter-- one and only one. And that's what it's releasing from all of its axon terminals. And thus, you could categorize any given neuron as this is one that releases serotonin. This one is one that releases dopamine, et cetera, et cetera. Notice that's a world of difference as to what types of neurotransmitters it has receptors for. That's something else entirely. That's what neurons over there it's listening to. But any given neuron is releasing only one kind of neurotransmitter. So that one went down the tube during the '80s with the discovery, in fact, that there are multiple neurotransmitters released by neurons. And this was boggling to people, and forced people to give up on Dale number two. And initially, this just seems like pointless complication. What you wind up seeing is it puts a lot more potential for information into the whole business here. OK, so here we have our archetypal synapse here, going from left to right as always. And we've got the one on the left here with its vesicles-- those little water balloons filled with neurotransmitter. Along comes the action potential. As a result, the vesicle moves to the cell membrane, merges with it, dumps the neurotransmitter into there. As you might guess, that actual process of exocytosis, dumping the neurotransmitter, is vastly more complicated. But this is our general model. And what people began to realize was that all sorts of neurons, all sorts of neurotransmitter types, in fact, came with two different colors of neurotransmitters in the vesicles-- came with two different kinds. Notice this is different from in this axon terminal you release this type of neurotransmitter. And in this one, you release that type. No, every single axon terminal would contain both of these types of neurotransmitters. And notice also, it would not be one vesicle was a blue neurotransmitter vesicle and one was a red. Each one of them had a mixture of the two types. What has been found is that occurs in lots of different types of neurons. I believe the record is that there are now some vesicles that contain three different types of neurotransmitters. So what we've got here are two different classes of messengers coming out. And what you should be able to immediately imagine is, that's going to produce a lot more potential for information. Two different types of messengers-- one of the characteristics that tends to be the pattern is that when you get two neurotransmitters in the same neuron, the same axon terminal and the same vesicle, they tend to be structurally very different sorts of classes of neurotransmitters. One might be a type made from a simple single amino acid. Another one is somewhat of a complicated protein. They tend to have fairly different structures. And what that often tells you is, they're going to have different mechanisms of action. They're going to have different speeds of action. What you wind up seeing is very often, when two different types of neurotransmitters are contained in the neuron, one of them works much more rapidly than the other. One has a rapid, short-term effect-- quickly decrementing. The other will have a longer effect. And by now, you can begin to imagine what counts as a longer effect. You change gene transcription in that neuron. You change structural stuff happening, as opposed to the short one, where just suddenly some little ionic excitability change occurs in a couple of milliseconds. You begin to see this pattern of two different ways of coding-- coding for different types of information. What we'll see shortly is one of the truly bizarre things that pops up a lot with these cases of multiple neurotransmitters. One of them will have receptors for it on the neuron itself. And we will focus on that shortly. That actually winds up making a fair amount of sense. OK, so Dale trashed in terms of the notion of any given neuron having only one neurotransmitter. In some types of neurons you have, instead, pairs, but following the same sort of rules. And thanks to the typical structural difference between the pairs of neurotransmitters, you tend to get different sorts of functions. You see a similar principle over at the endocrine end of things-- a world of more than one single messenger carrying the same message, or the same source of information carrying multiple messengers. Where we see here is what by now should be familiar as well, here where you got your pituitary, and you got your anterior pituitary, which is always facing left. And the anterior here, we have the glandular cells releasing, as you saw the other day, ACTH. Lots of this lecture is going to be about the regulation of the adrenal cortical system-- the glucocorticoid system-- because it's the best hormone on Earth. And I'm willing to prove it. But what we have here is ACTH coming out. And you remember what you had the other day, which is incorrectly named. You've got CRH. That's that business about the brain as an endocrine gland, the brain releasing hormones into this little portal circulatory system. And out comes its characteristic pituitary hormone. So what you saw the other day is CRH is the hormone, the hypothalamic hormone at the base of the brain here that's released into this local circulatory system, which stimulates these cells to dump ACTH into the general circulation. And that's the pattern you've gotten already of neuroendocrine axis. The brain releases a hormone into the local circulation, which stimulates the pituitary to release a typical hormone in response to it, which then goes and does something rather to a distant gland. You've got that one already. You have Follicle Stimulating Hormone, releasing hormone up here, which triggers Follicle Stimulating Hormone, which then goes does something or other to your follicles or to your sperm if you don't have follicles, and these sort of three-step cascades. What we see with the CRH system here is one example of how you can also have a version of multiple messengers. Turns out CRH is not the only hormone coming out of the base of the hypothalamus that could release ACTH during stress. And instead, you've got a whole array of these. There are neurons in the hypothalamus that instead release vasopressin into the circulation here, others that release oxytocin, others that release norepinephrine, others that release epinephrine. And collectively, what they're doing is stimulating the release of ACTH. You have an entire array of these. And a huge amount of work in the '80s went into sorting this out. And what's going on here-- what you have are stress signatures. Different types of stressors will trigger different orchestrations of these ACTH-releasing neurons up there-- different orchestrations as to which hormones bring it about. And it will be things like low blood pressure or hypotension will tend to trigger CRH and vasopressin. Low blood sugar, I think, was CRH and epinephrine and norepinephrine. The whole point is that you get a signature up at the hypothalamic level regulating this release of ACTH. Why have all these different ways of doing it? Two advantages-- one is depending on which orchestration of these you use, the shape of the ACTH secretory curve will be different. It's the same deal here. You use two of these to get a short, rapid effect, a more prolonged one. Here, depending on which mixture you have, you will have a different profile of ACTH secretion. That's so you get control on that level. The other thing is that each one of these not only helps to release ACTH from the pituitary. It does other stuff down here as well, so that you get a way of coding under this sort of stressor you want to release ACTH and do something or other in addition. The way you bring it about is getting these two. With some other stressor, you want to secrete ACTH, and bring about some additional step there. And you do it with these three-- that sort of thing. So you get control over the shape of the stress response, and to fine tune it there. So here we've got this completely more complicated picture of all these different releasers of ACTH. In addition, just to make things even more complicated, there are clearly hormones coming in there which, instead of releasing ACTH from the pituitary, they inhibit its release. And they release their hormone into the circulation also. And people have had evidence for these corticotropin-inhibiting factors for decades and decades and decades. And people have had an amazingly tough time trying to figure out what these things actually are. The best implicated molecule so far is a peptide called Delta Sleep Inducing Factor. Think about that-- you go to sleep. And that's a very good time for turning off your stress response. So that making wonderful sense there. The main point for our purposes is you've got bi-directional control. You've got a bunch of hormones that stimulate the release of ACTH. You've got at least one fairly well-implicated that inhibits the release. There is no way that there's not a whole bunch of other ones doing the same sort of signature coding at the inhibitory end. And you've got different ways of translating different stressors into different endocrine profiles. And of course, what that winds up meaning is you get stressed-- like your big toe is telling you you just burned it-- and you are going to have projections to a different array of these than if you were getting stressed, you were thinking about mortality. That's going to be having a different projection profile onto these neurons. What that suggests is a huge amount of coding information going on in the brain and the spinal cord producing these different arrangements of how you dump out ACTH and the other hormones. OK, so that as a first complication in these various neural and endocrine systems. You can actually have multiple neurotransmitters coming out of the same neuron. You can have an array of different hormones that bring about the same general response, but they differ in terms of fine-tuning the system. Next elaboration-- one now having to do with some spatial characteristics of how these systems work. And here we have the same exact neuron again. And now we deal with Dale's law number one, which is you know by now you get the depolarization here, sufficient to get to the axon hillock. You get your action potential. All hell breaks loose-- very exciting ionic of events of excitation-- all or none regenerating go shooting down the axon to the axon terminals. Dale's lawyer number one was you get an action potential started here, and it is going to result in the release of neurotransmitter from every single axon terminal. So Dale's two laws-- an action potential causes neurotransmitter to be released from every single axon terminal of a neuron. Dale's law number two just trashed. And it's going to be the same neurotransmitter released from every single axon terminal. And Dale's law number one has held reasonably well, except for some work by a guy. And this is one of these sort of mad geniuses of neuroscience, a guy at MIT named Jerry Lettvin. What he did was, as far as I can tell, he just sat around in a dark, sort of abandoned warehouse for decades on end. And about once every decade, he would write a paper that would transform neuroscience. And he actually was like this. I met the guy once. And it was one of the more terrifying experiences I had. I was working in a lab where I had to go get an oscilloscope from someplace, and pick up one because ours was broken. And everybody agreed the place to find it was in Jerry Lettvin's warehouse that he lived in, because he lived with oscilloscopes. And going in there, and it was basically pitch dark. And there was this sweaty, Sydney Greenstreet kind of guy sitting there. And he was in a ripped t-shirt. And he had been in there for decades. And he was chain smoking and sweating in there, because it was 150 degrees. So he spent a large part of the last part of the 20th century inside that warehouse writing one paper per decade that was transforming. So this was his particular paper. And I think this one was from the '70s. And what he showed was that under some circumstances, with him lined up with his hundreds of oscilloscopes proving this, you in fact had a violation of Dale's law number one, which was you can get blockades here or there that would stop the action potential from propagating down some of the branches of this whole axonal treee-- in other words, a whole different domain of controlling the flow of information. More subtlety there-- neurons could regulate which of their branches actually were sending on the message. And remarkably little has been learned in the years since then as to how this works, let alone how common a phenomenon it is. Most people wound up ignoring it. What has since been shown also is the wave of excitation that could come in through different dendritic spines back at the end-- that there are ways in which branch points can be sort of blocked on one side so that the flow is shunted in one direction on the branches and not the other. This is this whole unexplored world suggesting there's all sorts of regulation going on at these branch points. It's not simply the case, action potential and you are going to dump neurotransmitter from every single axon terminal. So down goes Dale on that one as well. Equivalent over at the endocrine end-- and here we have our pituitary, which now no longer has a brain connected to it. But you've got the theme by now, which is you've got the hypothalamic hormone and out comes the pituitary hormone. And there's a whole bunch of different pituitary hormones producing the acronym flat bread, peg leg, flat, flat peg. FLAT PEG-- go to your death bed remembering that acronym, because it will make you happy and fulfilled. OK, so here's a bunch of pituitary hormones, and whatever verkakte acronym these guys came up with. But what we have here, just to make life simpler, is we'll focus in on four of them. FLAT PEG-- so we're missing some of them there. But we've got growth hormone that comes out, prolactin ACTH, Follicle Stimulating Hormone. I'm picking these completely randomly. OK, in the simplest possible of worlds, you would have all sorts of secretory cells, glandular cells, sitting in here. And each one of them is capable of secreting all of those flat bread hormones coming out of there. It could be doing that. And it would simply be choosing which as a result of which hypothalamic hormone is coming down the pike there. That's not what you see. Instead, you have specialized cells within the pituitary. There's one type that only secretes growth hormone, which causes somatic growth, somatic body, somatic something or other. And those are called somatotrophs, and don't memorize that. Ones that only secrete prolactin, which cause lactation-- these are lactotrophs, corticotrophs, gonadotrophs, something or other. So all of these, in fact, have specialized cells. Within the pituitary, there are cells that specialize in releasing only one of these types of hormones. So you got into that. So what would be the next simplest thing going on? So here's the growth hormone releasing into the pituitary, and there is going to be the ACTH releasing end. No, that's not what you see. Instead, there is a mosaic all across the pituitary of all the different flat bread cell-secreting types there, all throughout it. OK, so that's just this mosaic. Good, somebody was sloppy at the sort of fetal end gluing it all together, and just scattered them all over. And what winds up happening is you get local, little neighborhood effects. For example, here we have somatotrophs that secrete growth hormone. And one is in a FSH neighborhood and the other is in a prolactin neighborhood. And what you see is you throw in the hypothalamic hormone, which causes growth hormone to get secreted. And this particular cell is going to be secreting totally different amounts of growth hormone than this one will. Because it's in a different sort of neighborhood. And what's the implication of that? There's all sorts of communication going on between the individual cells in the pituitary. And it depends on what sort of neighborhood each particular cell is living in, how it is responding to the hypothalamic signal coming down, wildly complicating. What that lets you do instead is different areas of the hypothalamus will turf its hormones to different parts of the pituitary where its particular cell targets will be living in different sorts of neighborhoods. Simply more regulation, more complexity going on there. Next theme that comes through in terms of elaboration-- we all have the negative feedback concept by now that came through throughout the lectures last week. The whole notion you get excited. You release a neurotransmitter into your synapse if you're a neuron. You've got to do some regulation there. You have to clean up after yourself. You remove the neurotransmitter from the synapse. You break down the neurotransmitter. You have to finish the whole thing. You are the endocrine system. You are the brain. And you have gotten it into your head that you want your adrenals to secrete glucocorticoids. And you start that whole cascade in which everywhere-- and you need to know when to stop secreting those hormones up on top. You need negative feedback information. All of these biological systems are characterized by that-- you have enzymes where this enzyme turns this into this. And how does it know when they should stop doing it? When there is so much of this stuff building up that this inhibits its activity. You get negative feedback, feedback regulation. You're making a lot of x. And whatever is making it has to be able to measure the levels of x. That is the simple rule of all this negative feedback stuff. So a first example on the neurobiological level-- so what we have are what are called auto receptors. What I inferred before, which is this weirdo world in which you not only will have receptors for a neurotransmitter exactly where they should be on the post-synaptic neuron on the other side of the synapse, but you will have them on the neuron that's releasing the neurotransmitter. It is an auto receptor. It is a receptor right there on it. What's it doing? It's for bookkeeping. What you have is some sort of rule. If the neurotransmitters come pouring out of there, and most of them go floating across-- let's assume these are only red neurotransmitters here, and bind to their red receptors there, and do their thing to the next neuron. And just thanks to the floating around, random life in the Brownian synaptic sludge there, a certain number of them are going to, instead, bind to this one. And all there has to be is some sort of rule in this pre-synaptic neuron that for every time one of these hits here, it means I've released 1,000 copies of this neurotransmitter, or 1,000 molecules of that. And that's how I keep track of the numbers. And I will have a rule that if it gets below a certain level of my picking up this bookkeeping signal, that will be a signal to start making more of the stuff. If I'm getting too much of a signal, decrease the release-- feedback regulation along those realms. This is where you see one of the elaborations on this two-neurotransmitter business. What you very often see is one of the neurotransmitters will exclusively work on a pre-synaptic auto-receptor. That one is stuck in there merely in order to do the bookkeeping. You would think neurons might have figured out a more direct way of keeping track, like how many vesicles they dump. But instead, this theme is there is some pre-synaptic auto-receptor, which tells you on some statistical basis, every time we get buzzed at this end, it means we buzz these guys 100 zillion times. And that's how we keep track of how much we want to make-- negative feedback loops there. You then see the exact same equivalent in endocrine systems, which is all this negative feedback stuff. Something that was under-emphasized in the endocrine lectures last week has been this element of neuroendocrinology. What you mostly heard about is what's going to be most dominating in the classes to come, which is hormones get into the brain and change how you think, and feel, and behave, and all of that stuff. But also, some of the time what hormones are doing in the brain is letting the brain know how much hormones there were in the circulation, in order to do the bookkeeping, the negative feedback regulation. Your brain decides it wants to have this much growth hormone in the bloodstream. And thus, it releases its hypothalamic hormone, which goes. And all over, the pituitary gets those somatotrophs to release growth hormone and does its thing elsewhere in the body. And the brain has to be measuring some consequence of that growth hormone doing its thing, measuring up there, in order to figure out, have we gotten where we want to yet? Same thing with prolactin. Same thing with every one of those. You have to have negative feedback regulation. So what do you need to do to pull that off? You need to have a part of the brain that is sensitive to that hormone signal-- sensitive in some sort of quantitative way, where it can, in effect, count how much of the stuff there is in the bloodstream using the exact same sort of rule. If I've had one of those hormones in the circulation come and bind to one of my receptors, it means I have released 100 billion copies of it, thanks to my starting this whole cascade. Did we want 100 billion? Did we want 107 billion? Do we want 93 billion? What do we do now? Does that tell us we've completed what we want? You get this negative feedback signal there. So the first thing you have to have is cells-- parts of the brain-- that will measure, that will be responsive to a hormone signal. Those cells have to be able to have some kind of set point rule in there. This is the point of life that I am at, the point of my menstrual cycle. This is the point of reaching adolescence. This is the point of am I stressed or not? This is the set point. This is the amount of hormone I would like to have in the bloodstream-- this particular type of hormone. And what you need to then be able to do is, if levels have not reached that set point yet, you send a stimulatory signal to the hypothalamus. Keep doing what you were doing. We need to push the levels up higher. And if the levels reach here or get even higher, you need to be able to turn this into an inhibitory signal going to the hypothalamus. So what you see are all sorts of regions of the brain that are sensitive to these various hormones, not just in terms of hormones affecting all the behaviors we're going to hear about, but also negative feedback regulation-- so a way now of showing just how much more complicated it can be. So what would you assume is the general rule? Here's an example of-- OK, let's make it simpler. OK, so what would you expect to see? You're able to measure CRH coming out of the base of the hypothalamus. And the deal is something stressful occurs, and so it's pumping out CRH. And at some point, you've got as much glucocorticoids in the blood stream as the brain would like for that sort of stressor. And that leads to the negative feedback signal, which stops the hypothalamus from releasing CRH. What measuring is the brain doing? Most obvious version would be what the brain does is measure how much glucocorticoids are in the bloodstream. And a simple rule, the more glucocorticoids there are in the bloodstream, the more likely levels are to have reached the threshold, the set point, that you want. So the higher the levels, the more of a negative feedback signal. And thus, the less CRH being secreted. Totally straightforward, logical, measuring the level of hormone in the bloodstream. And this is how most endocrine negative feedback works. Measuring how much of the stuff-- the more stuff there is, the greater the likelihood that you shut down the system. You put in the negative feedback signal. But in addition, there's a whole other domain of glucocorticoid negative feedback regulation, where in this domain, what the brain is doing is not measuring how much glucocorticoids there are in the bloodstream, but measuring the rate of change-- the rate at which levels are increasing. And that's a totally different domain of information there. Now what you're doing is measuring how many units of increase per second are you getting. And what you've got is this bizarre world there, where you go from 10 units of glucocorticoids in the bloodstream to 12 units in one minute. And that means the same exact thing as going from a million and 10 units to a million and 12 units in the same length of time. It's not measuring absolute levels. It's measuring rate of change. And the faster the rate of change, the less likely CRH is to get secreted. And it turns out there are some domains of stress responses where what the brain is paying attention to is rate of change of hormone in the bloodstream. There are other circumstances where it's paying attention to absolute level. This tends to be what the brain listens to very early on in a stress response. This tends to be the more delayed response. But totally different dynamics there-- cells that measure the amount of hormone-- that's not that hard to imagine-- number of receptors, stuff like that. Cells that measure the rate of change, where going from 10 to 12 is the exact same thing as going from a million 10 to a million 12. What is that wiring going to be like? To this day, nobody has a clue. This was first sort of figured out in the 1960s. An amazing scientist up in UCSF named Mary Dallman who just sat and out of sheer just modeling work in terms of endocrine systems predicted with glucocorticoids, there are going to be two different domains of feedback. There is going to be a rapid rate-of-change sensitive system. There is going to be a delayed level of hormone in the bloodstream system. And here's exactly why I'm predicting this. And she turned out to be absolutely right. And decades later, people still don't fully understand how a cell measures the rate of change of something independent of the absolute levels. One thing that makes life a little bit easier is it's different parts of the nervous system that do each type here. The very rapid rate-of-change stuff, in fact, is not even occurring at the brain. It's occurring at the level of the pituitary. And thus, it's not so much regulating CRH release, but ACTH release. OK, complicated-- the main point of that is, even something as logical as how do you keep your toilet bowl sort of thing from overflowing the tank in the back there? You need a negative feedback signal. You need a way for the toilet bowl tank to measure how much water there is there, and the flotation device, and for that to have a set point and a way of then transducing, reaching that point into putting the lid on the top of the pipe that's generating the water. Totally all these logical negative feedback loop stuff, and then suddenly, in these neuroendocrine systems, you get much, much more subtle, complicated things going on. In some cases, you have positive feedback. The more of a hormone in the bloodstream, the more you stimulate the system to do more. You get that at certain points in reproduction-- reproductive life histories where you have massive changes of estrogen, progesterone. And what you have will be transient periods where you have positive feedback. All of these somehow have to get translated into how cells are working-- very unclear. OK, so negative feedback-- the next elaboration-- something going on at the receptor level. It's something known as auto-regulation. And you could probably begin to figure out what that one's about. And it will make perfect sense as follows-- if somebody screams at you all the time, you stop listening to them. And what you have done is just down-regulated your sensitivity to this pain-in-the-neck person. If they give a very large signal, you down-regulate your sensitivity to the signal. If a signal, instead, becomes very weak, very often you will increase the attention you pay to it. You are showing auto-regulation. Within the realm of neuroendocrine stuff, you will be changing the amount of receptor for a neurotransmitter or hormone as a function of the levels in the bloodstream. And thus, you have this logic-- if you get a huge increase in the levels of some hormone in the blood stream, there will be a likelihood that various target tissues will begin to down-regulate the number of receptors for that hormone or neurotransmitter. Conversely, levels go way down, they go right up. And this is a general feature all these neural and endocrine systems. Why is that interesting? When this regulatory, auto-regulatory stuff screws up. In principle, it should work perfectly. OK, for some reason, there's a doubling of the hormone message coming through in the bloodstream under some circumstance where it's going on for a long time. And that's not right. And somebody down at some gland down there is messing up and drooling out way too much hormone. So what are we going to do? We have no idea what's up with them. But you've doubled the level of hormone. Most folks down there, OK, let's have an auto-regulatory response. Let's cut the number of our receptors in half to compensate. You can see in a rough way that's going to compensate. So massively increase the signal thanks to some disease state, something weird going on, and do a compensatory decrease. Have some disease or abnormal state where levels of some hormone or neurotransmitter go way down-- what do you do? Let's up the amount of receptor enough to compensate for it. That's great. Where problems occur is if you don't compensate quite enough, or if you overshoot, if you begin to get a mismatch. And that's where you've got problems. We will see, as you read in the [INAUDIBLE] book-- with hopefully great detail-- the chapter on depression, that's probably a critical thing that's happening. Because we'll see with depression what's probably wrong are levels of a few different neurotransmitters-- serotonin, dopamine, norepinephrine. All of this is going to come soon. And all of the standard anti-depressant drugs change the levels of these neurotransmitters in the bloodstream. And that's great. And we know just how it works, except there's always a problem making sense of that. Which is you throw in some of these standard drugs-- SSRIs, things of that sort-- don't worry about the details. All of this will come later. The main point being that these anti-depressant drugs, when you throw them in, they're changing levels of neurotransmitters within minutes to hours. You get somebody who is deeply depressed. And you start them off on an SSRI like Prozac. And they don't start feeling better for days to weeks. There is some sort of lag time going on there. And as people have sorted it out, what the common sort of conclusion is, these drugs are not working so much by changing the levels of these neurotransmitters. What they're really doing is by changing the levels, they are eventually going to cause an auto-regulatory change in the number of receptors. And these change within minutes to hours. These change within days to weeks. And that's what these drugs are probably doing. We will go through that. Just to give you a sense of how awful it is going to get, there are some reasons to think that some of these anti-depressant drugs work not by changing the level so much of this neurotransmitter, or not so much secondarily causing an auto-regulatory change here, but instead, causing an auto-regulatory change in these auto-receptors. Unbelievably complicated. We will come to that. For our purposes right now, what that begins to tell you is that certainly, the amount of hormone and the amount of neurotransmitter makes a difference. The amount of receptor, as well. And have big pathological changes in the levels of the messengers. The body attempts to regulate with auto-regulatory changes. And a lot of what disease is about is overshooting or undershooting. So that's one realm within the nervous system-- neurotransmitters-- pertinent to depression. OK within endocrine systems, an equivalent one is as follows-- something that you see that goes wrong in diabetes-- adult-onset diabetes. One of the things you have is a number of ways things can go wrong. But what your body does is, when there's glucose in the bloodstream, when you've just had a meal, when you have all these nutrients in the bloodstream, your pancreas can detect the levels of glucose in your bloodstream and secretes insulin. Sugar shows up in the bloodstream-- glucose. You secrete insulin. And what insulin does is tell your fat cells to absorb the sugar and store it away. Great, but you've got a problem, which is that your fat cells are already full. Because you are a typical Westernized human, and you've been eating to excess. And what you have is fat cells that are full up. And they stop listening to insulin, because they can't take it anymore. Because they can't take up any more stuff and store it away. The cells begin to be insulin resistant. And we'll see in a minute how that works. So suddenly, you have fat cells that aren't responding to insulin. And what happens is your pancreas says, this is crazy. We're trying to get rid of the sugar from the bloodstream. And it's not disappearing. The person just ate eight Hershey bars, and their fat cells are already full. But we're not clearing the sugar out of the bloodstream. So let's secrete even more insulin. And let's secrete even more insulin. And what happens at the fat cells, they say, this is ridiculous. We're full up. Forget it. We're not taking up any more of these nutrient things. And in fact, what we're going to do is, we're going to decrease the number of our insulin receptors. We're going to down-regulate our number of insulin receptors. And the pancreas freaks out, and secretes even more insulin as a result. And you down-regulate even more. And what you have is this downward spiral. Because at some point, your pancreas is working so hard to dump these boatloads of insulin into the bloodstream that your body's paying no attention to, that you burn out the cells in your pancreas that make insulin. And now you've got yourself a real serious problem. What's the key of what's gone wrong here? Too much nutrients, and thus too much insulin. And the fat cells begin to say, we're not going to listen to it. And they down-regulate receptors. More insulin, down-regulate, down-regulate-- and this is at the core of what goes wrong in diabetes. So we see these auto-regulatory changes. And they can emerge slowly. They can help explain why some of these drugs work. Almost certainly, they help explain what's wrong in some of these psychiatric diseases, metabolic diseases. What's the punchline there? Number one, the amount of a messenger is important, but the sensitivity to the messenger is at least as important. You have as much capacity to regulate this as this in these biological systems, and thus you have as much potential for screwing up at this end as screwing up with the amount of messenger. Yeah, did I see a hand up someplace? Yes. [INAUDIBLE] but wouldn't the SSRI example, then, be the opposite of what you're saying [INAUDIBLE]? Because you'd expect increasing neurotransmitters to eventually cause a decrease in receptors. So you should see that [INAUDIBLE]. Great, OK. Don't listen to anything she just said, because she's just gotten to an incredibly subtle, complicated point about how this stuff works. Go and read, and memorize, and recite to your roommates the section on the zebra chapter about-- the section in zebras-- on depression, looking at the paradoxical things where, at the end of the day, people are not sure say, an SSRI, a selective serotonin re-uptake inhibitor. What it does is it blocks the re-uptake of serotonin. And thus, you wind up with more serotonin in the bloodstream. Somebody feels less depressed. I bet their problem was they didn't have enough serotonin. Work through the logic of all this auto-regulatory stuff going on. And people still are not positive if the problem with depression is too little serotonin or too much. Because depending on whether the auto-regulation partially compensates, completely, whether it overshoots, and whether it's these receptors or these, will completely determine whether the problem is too much or too little of a neurotransmitter-- incredibly complicated, exactly some of the complexities there. And that is so complicated, in fact, that it is essential that everybody stand up now and go to the bathroom for five minutes. OK, again, back from the other [INAUDIBLE] day. Your pituitary is releasing all sorts of different types of hormones under the control of all sorts of different types of hormones signaling from the brain. What you get is, the pituitary is not just made up of one type of cell that can secrete every single type of hormone and response to each type there of messenger from the brain. Instead, you've got specialized cells. You've got types of pituitary cells that only secrete prolactin in response to what's happening there, types that only secrete ACTH, or secrete luteinizing hormone, follicle stimulating hormone, so on. OK, so they're specialized cells. Rather than having one part of the pituitary, which is the we're in charge of secreting growth hormone neighborhood, and one part that's the we do prolactin, and rather than it being broken up like that, instead, it's just a mosaic of all the different types that are scattered throughout there. So that would initially just seem like sheer sloppiness. Embryology-- they didn't quite get it together to have discrete neighborhoods, that sort of thing. But it's just scattered there. What's interesting about that is, you will see any given cell in the pituitary will go about its business, which is responding to its specific hypothalamic signal by secreting whichever hormone it specializes in. Every single cell in the pituitary going about its business will be a little bit more or less sensitive to its hypothalamic signal, depending on what sort of neighborhood it's living in, depending on which other types of these cells it's surrounded by. So that you will get, for example, FSH secreting cells, when they tend to be in a GH neighborhood, are far more responsive to their signal than when they're in an ACTH neighborhood or one that's a hodgepodge of any of these. I don't know what the rules are. But what you've got there are increased ways for regulation of the amount of secretion by determining which way you, the hypothalamus, turf the signals. Are you aiming for these types? Or are you aiming for these types? More regulation that way-- how does that work? What it has to be is all sorts of communication going on amongst the various pituitary cells. So the pituitary is not just sitting there passively responding to whatever the hypothalamus is saying. Instead, there's all this local regulatory stuff happening. One additional thing that was asked-- so in this case, what we go back to is that business of the more glucocorticoids in the bloodstream in this boring, level-sensitive domain of you're just measuring how much of the stuff there is in the bloodstream, you're measuring there-- some part of the brain is measuring the levels of glucocorticoids. And the part is actually known. It's measuring there, and it has its rule. Once glucocorticoid levels get this high, I will send an an inhibitory signal to those CRH neurons. And as a result, they'll secrete less CRH. And that turns off the stress response. The more glucocorticoids in the bloodstream, the more of a negative feedback signal. What the person brought up was the very astute observation that wait, what about all those other types up there-- oxytocin, vasopressin, epinephrine? What that means is there are sensors that are talking to each one of those types there. And the brain at any given point, depending on the stressor, is saying, well, we want this much CRH, and we want this much of vasopressin and this much oxytocin. And we're going to determine it all by measuring the level and the shape of glucocorticoid levels in the bloodstream, so that there's feedback going on-- not just onto the CRH neurons, but to all those other types of neurons as well-- incredibly messy and complicated, nonetheless very elegant. Pushing on-- next version of complications. Now what we've got is another feature of how receptors go about their business. This general principle doesn't apply all the time. But in general, more of a ligand for a receptor. A ligand, for folks not familiar with this, a neurotransmitter is a ligand for a neurotransmitter receptor. A hormone is a ligand for a hormone receptor. The ligand is whatever the receptor normally binds. So this general-- not universal, but general-- rule of the higher the ligand levels, the more likely you are to trigger this compensatory down-regulation to lower the levels, all of that. Here's another level of regulation that can go on. So you've got these receptors. They are complicated, because their job is to bind their ligand and to then do something or other. And the cell, as a result, opens up some channel that allows a change in excitability in the neuron, that sort of thing. These receptors tend to be very complicated. And what you wind up seeing is, in lots of realms of receptors for different types of hormones, neurotransmitters, et cetera, you actually have the receptor made up of a number of different proteins, of a complex of proteins. So that for example, here we have a receptor that's binding a ligand that looks like that, just like your premolars. And what you have there is, it's got to come up with a complementary shape and lock and key, blah, blah, all of that. And in this particular case, this receptor complex is made up of three different proteins that are needed to pull this off-- three different proteins, three different genes-- a receptor being coded for by multiple genes. When you get the more fancy, complicated receptors they tend to be complexes of more than one protein forming this pattern. So you've got multiple genes. That's interesting. And of course, we're off and running with that. What that means, then, is you've got the potential for variation, different flavors of the different genes, more different ways that this could appear. There's two different variants on this gene. There's 17 on this one. And you just do the combinatorial stuff. And thus, you've got a huge number of ways of generating different versions of that same receptor, which, of course, will work a little bit better, or a little slower, or a little whatever-- variation like that. Next complexity that you get with receptors-- you can have a receptor that's made up of three different proteins. And there's four different genes that make proteins that can help construct one of these receptors. So you can make a receptor out of proteins 1, 2, 3, or 1, 2, 4, or 1, 3, 4, or off you go with that. Or you can make a receptor out of three copies of number one, or two copies of number two and one copy of number four. There's these possibilities of all these different subunits being different-- variability that way. So another realm of regulation is when cells change the subunits on their receptors, when cells will cause, say, degradation of-- OK, so here we've got this three-protein receptor complex. And there's four different proteins that potentially plug into it. And this version has one copy of A, one copy of B, and one copy of C. Something may happen which will cause the neuron to degrade the copies of B and replace it with D, or replace it with another copy of A, replace all this combinatorial stuff, and thus change a little bit how well the receptor is doing its job. And you see these subunit changes all over the place. One domain, in terms of the neurobiology neurotransmitter stuff-- aspects of glutamate receptors-- you guys heard something about that the other day-- glutamate receptor's essential for learning, very complicated receptors, insanely complicated. Part of what learning appears to be about is not only increasing the number of copies of a certain type of glutamate receptor, but changing the subunit composition, and making for a more responsive, more excitable version of that receptor. There's other realms with a different type of receptor where, in fact, you've got an abnormal subunit that's not supposed to be there. And as a result, this now produces a cell that is prone towards insanely high levels of excitation. This is a congenital reason for causing epilepsy. This is one of the genetic forms of epilepsy, where you've got the wrong subunit winding up in another neurotransmitter and its receptor. All we're seeing here is lots of room for more regulation here, mixing and matching, changing the subunit stuff. That's how you begin to do that critical principle. Remember, all the stuff from the basic functioning, the flow of information from the dendrites to the axon hillock-- what's that all about? No single dendritic input is enough to trigger an action potential. Instead, you have to have enough of them, enough summation, to reach the threshold that the axon hillock has to initiate the action potential. And the threshold could change over time. Translate that into this. What does it mean when an axon hillock's threshold is changed? Those critical first channels that open up-- you've changed the subunit composition. So that is a theme all throughout this world of receptorology and channels that open and close and stuff, where cells can change which are the pieces that make it up, and change the properties subtly. Similar theme that could come through with hormone receptors-- same exact deal. A whole bunch of them are multi-protein complexes-- exact same story. You can see something a little different when you have steroid hormone receptors. And as we saw the other week, remember, it's got two domains-- one which binds the hormone-- glucocorticoid, just to pick a random steroid or estrogen, progesterone, or whatever-- and one that binds to the promoter element in the DNA. We've got our if/then clause. If and only if this steroid hormone shows up, then you go and you activate that gene-- our conditional clause. But what turns out to be the case is all sorts of steroid hormone receptors have various other proteins that they bind there. Co-factors is the term given for it. And you get different arrays of co-factors in different cell types. And as a result, when you activate this, it will do different things in different cell types-- cell-type specific coding. And of course, the exact same theme here-- under some circumstances, cells will change which cofactors they have holding onto those receptors. So what we see here are these additional layers of potential regulation. More complexities-- next one-- now we've hurdled past the notion of only one type of neurotransmitter per neuron. We have hurdled past the notion of the same action potential will be manifest in every single axon terminal. Now we see all sorts of additional information built around changing the number of receptors, changing the composition of them, regulating those ways. One additional complication here with these receptors, which is a lot of them can bind more than one thing, can bind more than one ligand. And we see an amazing example of this at the neurotransmitter end of the world. You guys heard about the neurotransmitter GABA. GABA is the main inhibitory neurotransmitter in the brain. It is the workhorse for doing that. The GABA receptor-- no surprise-- binds GABA. Its ligand is GABA. It is found on the dendritic spines of GABA-responsive neurons. And the neurons just upstream of it will release GABA in response to its action potential, and just goes about its thing. So what does the GABA receptor do? It binds GABA. And when it binds GABA, something or other happens so that this neuron becomes less excitable. It's an inhibitory neurotransmitter. It turns out the GABA receptor is insanely complicated. It is, instead, a receptor complex of a whole bunch of different proteins. And what the GABA receptor does is it binds some other things as well-- three different classes, all of which are very interesting. The first class of additional things that it binds are things called major tranquilizers. What does the GABA complex bind? And here we have our GABA receptor. And GABA fits right in there. And it turns out the GABA receptor also has another binding site here for major tranquilizers. What are major tranquilizers? Barbiturates-- this is how barbiturates work in the brain. There are not barbiturate receptors. They bind to the GABA receptor. There is a side complex on it. There is a minor binding site on the GABA receptor for barbiturates. OK, so GABA, inhibitory neurotransmitter-- when barbiturates are around, does that increase or decrease GABA signaling? OK, who says increase? Who says decrease? Who says, what? OK, me, too. I wasn't listening either. I'll tell you, lurking around in the back during those TA's lectures, you really do get a sense of what interesting, non-academic things are going on people's computer screens. But I digress. So what barbiturates do is they make GABA more inhibitory-- inhibitory enough that you keel over. And now they can slice you open for surgery. This is how one of the main classes of surgical anesthetics work. Then there is another binding site on the GABA receptor complex. And what that does is it binds the minor tranquilizers. And what are those? We've heard about those a bunch of times already. Those are the benzodiazepine, the valium, and the librium. And they work there as well. And we've already heard about how anxiety disorders in some rodent lines are related to different versions of the gene for the benzodiazepine receptor. We've just defined what that gene is. That gene codes for one of the subunits of this massive GABA complex. So there's another domain there that binds benzodiazepines-- the minor tranquilizers. What do they do? They increase the force of GABA signaling as well? Do they do it as much as the major tranquilizers? Of course it's not the case, because you wouldn't call them minor tranquilizers then. These guys potentiate GABA signaling a moderate amount. These guys potentiate it enormously. So now we have these additional factors binding to these GABA receptors. A third class-- and this is, in lots of ways the most interesting one of all, which is an additional binding site there. That responds to a hormone or a derivative of a hormone. What is it responding to? Derivatives of progesterone. Progesterone has a binding site on the GABA receptor. Progesterone is a steroid hormone. It's normally doing its thing here. And now we have, instead, having a minor slot there on the side there that responds to progesterone. What does progesterone do? It also potentiates the effects of GABA. What's that about? Two implications-- one is, in the 1950s, one of the most common surgical anesthetics used was a drug called Althesin, and it was a derivative of progesterone. People in the '50s would be anesthetized with this supposedly reproductive steroid hormone, because it has this effect on the then undiscovered GABA receptor. It potentiates inhibitory GABA signaling. That's weird. So progesterone-- clearly, this relationship did not evolve so that people could do surgery on people who didn't want to get major tranquilizers, and instead deal with the progesterone route. Where is this relevant? It seems to have something to do with some of the mood shifts over the course of the reproductive cycle. There are reasons, and pretty good evidence in lots of domains, where perimenstrual syndrome-- pre-menstrual syndrome, PMS-- which is more accurately called perimenstrual-- both before and after. What that involves, clearly in some women, is a shortage of progesterone having some of these minor tranquilizing effects by way of the GABA receptor complex. So this is incredibly complicated stuff going on here, as you can see. Final domain-- final interesting elaboration, which is now bringing in a whole additional concept-- and deserves a board all of its own. So here we have circular neurons. And what we've got is, this is the neuron we're interested in. What's it up to? And this is neuron A. And just to force some cognitive flexibility, this is neuron B, going in the wrong direction. So we've got neuron B releases an excitatory neurotransmitter, and thus, excites A. OK, this is not earth shattering. It's probably releasing, say, glutamate for example. So remember GABA-- that inhibitory neurotransmitter we just heard about. So GABA does inhibitory stuff. So maybe there is a GABA neuron here sending its projection, and this one is inhibitory. Notice what we've done by turning neurons into spheres. We've lost all the little dendritic spines. So translate that into back to what it actually looks like. This is just schematic. So we've got two inputs. We've got an excitatory input by way of glutamate. We have an inhibitory one with GABA. What does that imply? Dendritic spines in this neuron contain both receptors for glutamate and receptors for GABA. That would be straightforward. That would be simple, if that's how it works. That's not what you see. Instead, GABA neurons never send a projection onto what would be neuron A. What they do is they send a projection onto neuron B. What's that about? What's that about is what GABA is doing is making this neuron less excitable. It's working as an inhibitory neurotransmitter. It's making this neuron less excitable. What's happening here-- this neuron has just started an action potential that's coming down the axon. And thanks to a heavy GABA signal coming out, it silences it. It never gets to the end, and dumps the neurotransmitter. This is totally weird. This is completely different from all the wiring you've seen already. What's bizarre about it? Number one, this is a neuron forming synapses not on the dendrites of this neuron. It's forming a synapse on the axon of this. And thus, we have what is termed an axoaxonic synapse. What does that also imply? That there have to be GABA receptors sitting there at the pre-synaptic end-- just as bizarre as the pre-synaptic autoreceptors. Remember, those are for measuring the amount of release-- bookkeeping stuff. But here, this is perfectly conventional neuronal responding to a neurotransmitter, but coming at the completely wrong end with this weird axoaxonic projection. But what's most important here is seeing this implication. So what is it that this neuron does to A? What does this GABA neuron do to the excitability of A? And the answer is, it does nothing. It has no effect on the excitability of A. What this GABA neuron does is alter the ability of neuron B to do something to A. This neuron has no direct effect here. What it does is it modulates the activity of this neuron. And thus, you have a whole new class of type of communication. Technically, rather than working as a neurotransmitter, it would be termed GABA typically serves a neuromodulatory role in the nervous system. And that's this wonderful conditional clause yet again-- yet another if/then clause. GABA decreases excitability if and only if this neuron is trying to send an excitatory signal. All that GABA does is snuff out an excitatory signal coming down here-- so modulation in that regard. We've already seen another example of that writ small. Back to the GABA complex here. What do the major tranquilizers do there? What do barbiturates do? They do not make this neuron less excitable. What they do is, if and only if there is GABA coming in, it makes the GABA work even better. The tranquilizers do not inhibit the neuron. The tranquilizers modulate, potentiate, the activity of GABA. The minor tranquilizers the same thing, the progesterone the same thing. So this is a different level of this concept of neuromodulation-- if/then clauses all over the place here. So if and only if GABA is doing its thing, any of these minor ligands will potentiate it. If and only if this neuron is trying to stimulate here, GABA will have an inhibitory effect on the whole system. So you see lots and lots of this modulatory stuff. Final example, seeing the same principle of modulation, now occurring in an endocrine system. OK, so now we're measuring the amount of ACTH coming out of the pituitary, and back to that deal that we've got all these different ways in which the brain can cause the release of ACTH. And starting off, we saw CRH. So suppose you throw in some CRH on top of the pituitary there, inject it into the circulation. And this much ACTH comes out. OK, that's good. Now, instead of putting on CRH, you put in both CRH and vasopressin-- a second one of those. And what do you see? That's perfectly logical. You've got two things driving ACTH secretion. Now you put on vasopressin just by itself. And what you get is this. You get no secretion. Does vasopressin stimulate the release of ACTH? No, it doesn't. What vasopressin does is it potentiates the activity of CRH. It modulates CRH's activity. Vasopressin does nothing by itself. If and only if there is CRH getting to those pituitary cells, then vasopressin will potentiate its actions. All of those other releasors-- the vasopressin, the oxytocin, epinephrine, norepinephrine-- none of them are direct releasors on their own. They all are modulating, potentiating CRH's effects. So what we've got here is this enormous realm of complexity of all of these if/then clauses, various hormones that are not directly causing anything, neurotransmitters that are not directly causing anything, ligands for receptors that are not, either. What they're all doing is, if and only if something else is happening, something else is going on, there's an additional ligand, they do their thing-- lots and lots of these conditional clauses. More complexity there. OK, so what does all of this get us here at the end? Obvious-- lots of individual variability, lots of ways in which these systems are changing in response to experience, all that subunit changing business. Something happens and you get rid of one subunit. Replace it with another, and you've changed the excitability of the system. All sorts of over and over conditional if/then clauses, tremendous increase in the complexity. These themes will come through again and again in the second half of the course. So let's stop at this point. Are there any questions, since this was a major download? Check the extended notes. Are the extended notes posted yet? Not yet. They will be some time or other. OK, any questions? OK, so go read those notes as soon as they're up. For more, please visit us at Stanford.edu.
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Channel: Stanford
Views: 305,816
Rating: 4.9075603 out of 5
Keywords: Science, Interdisciplinary, Bioengineering, Genetic, Sociobiology, Darwin, Evolution, Endocrine, Neurobiology, Sexual, Species, Natural Selection, Learning, Animal, Organism, Environment, Heritability, Reproduce, Reproduction, Survive, Gene, Variability
Id: kAfz0yAcOyQ
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Length: 73min 0sec (4380 seconds)
Published: Tue Feb 01 2011
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