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ACTH acts through the stimulation of cell surface ACTH receptors, This results in the synthesis and secretion of gluco- and mineralo-corticosteroids and androgenic steroids. The ACTH receptor is a seven-membrane-spanning G protein-coupled receptor. Upon ligand binding, the receptor undergoes conformation changes that stimulate the enzyme adenylyl cyclase, which leads to an increase in intracellular cAMP and subsequent activation of protein kinase A. This ultimately results in stimulation of steroidogenesis. Products of steroidogenesis include:
androgens
testosterone
estrogens and progesterone
corticoids
cortisol
aldosterone
ACTH acts at several key steps to influence the steroidogenic pathway in the adrenal cortex:
ACTH stimulates lipoprotein uptake into cortical cells. This increases the bio-availability of cholesterol in the cells of the adrenal cortex.
ACTH increases the transport of cholesterol into the mitochondria and activates its hydrolysis.
ACTH Stimulates cholesterol side-chain cleavage enzyme, which makes the rate-limiting step in steroidogenesis.[3] This results in the production of pregnenolone.