Development and function of the human fetal adrenal cortex: a key component in the feto-placental unit

H Ishimoto, RB Jaffe - Endocrine reviews, 2011 - academic.oup.com
H Ishimoto, RB Jaffe
Endocrine reviews, 2011academic.oup.com
Continuous efforts have been devoted to unraveling the biophysiology and development of
the human fetal adrenal cortex, which is structurally and functionally unique from other
species. It plays a pivotal role, mainly through steroidogenesis, in the regulation of
intrauterine homeostasis and in fetal development and maturation. The steroidogenic activity
is characterized by early transient cortisol biosynthesis, followed by its suppressed synthesis
until late gestation, and extensive production of dehydroepiandrosterone and its sulfate …
Continuous efforts have been devoted to unraveling the biophysiology and development of the human fetal adrenal cortex, which is structurally and functionally unique from other species. It plays a pivotal role, mainly through steroidogenesis, in the regulation of intrauterine homeostasis and in fetal development and maturation. The steroidogenic activity is characterized by early transient cortisol biosynthesis, followed by its suppressed synthesis until late gestation, and extensive production of dehydroepiandrosterone and its sulfate, precursors of placental estrogen, during most of gestation. The gland rapidly grows through processes including cell proliferation and angiogenesis at the gland periphery, cellular migration, hypertrophy, and apoptosis. Recent studies employing modern technologies such as gene expression profiling and laser capture microdissection have revealed that development and/or function of the fetal adrenal cortex may be regulated by a panoply of molecules, including transcription factors, extracellular matrix components, locally produced growth factors, and placenta-derived CRH, in addition to the primary regulator, fetal pituitary ACTH. The role of the fetal adrenal cortex in human pregnancy and parturition appears highly complex, probably due to redundant and compensatory mechanisms regulating these events. Mounting evidence indicates that actions of hormones operating in the human feto-placental unit are likely mediated by mechanisms including target tissue responsiveness, local metabolism, and bioavailability, rather than changes only in circulating levels. Comprehensive study of such molecular mechanisms and the newly identified factors implicated in adrenal development should help crystallize our understanding of the development and physiology of the human fetal adrenal cortex.
Oxford University Press