Corticotropin-releasing hormone [Neurosurgery Wiki]

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====== Corticotropin-releasing hormone ======

see also [[Corticotropin releasing hormone receptor 1]]

[[Corticotropin]]-releasing hormone (CRH) also known as [[corticotropin releasing factor]] ([[CRF]]) or corticoliberin is a [[peptide hormone]] and neurotransmitter involved in the stress response. It is a releasing hormone that belongs to corticotropin-releasing factor family. In humans, it is encoded by the CRH gene.

Its main function is the stimulation of the pituitary synthesis of [[ACTH]], as part of the HPA Axis.

Corticotropin-releasing hormone (CRH) is a 41-amino acid peptide derived from a 196-amino acid preprohormone. CRH is secreted by the [[paraventricular nucleus]] (PVN) of the [[hypothalamus]] in response to stress. 

Increased CRH production has been observed to be associated with [[Alzheimer disease]] and major depression, and autosomal recessive hypothalamic corticotropin deficiency has multiple and potentially fatal metabolic consequences including [[hypoglycemia]].

In addition to being produced in the hypothalamus, CRH is also synthesized in peripheral tissues, such as T lymphocytes, and is highly expressed in the placenta. In the placenta, CRH is a marker that determines the length of gestation and the timing of parturition and delivery. A rapid increase in circulating levels of CRH occurs at the onset of parturition, suggesting that, in addition to its metabolic functions, CRH may act as a trigger for parturition.
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Bilateral [[inferior petrosal sinus]] sampling (BIPSS) is considered the gold standard test for anatomical localization for [[Cushing's disease]] where radiology has been inconclusive
((Lad SP, Patil CG, Laws ER Jr, Katznelson L. The role of inferior petrosal sinus sampling in the diagnostic localization of Cushing's disease. Neurosurg Focus. 2007;23:E2.)).

In a [[metaanalysis]] of 21 studies, the overall [[sensitivity]] and [[specificity]] of BIPSS were found to be 96% and 100% respectively
((Newell-Price J, Trainer P, Besser M, Grossman A. The diagnosis and differential diagnosis of Cushing's syndrome and pseudo-Cushing's states. Endocr Rev. 1998;19:647–72.)).

Anatomical localization of [[pituitary neuroendocrine tumor]] can be challenging in [[adrenocorticotropic hormone]] (ACTH)-dependent [[Cushing's syndrome]], and bilateral inferior petrosal sinus sampling (BIPSS) is considered gold standard in this regard. Stimulation using [[corticotropin releasing hormone]] (CRH) improves the sensitivity of BIPSS.

===== Corticotropin-releasing hormone stimulation test =====
[[Corticotropin-releasing hormone stimulation test]]