Figure 22. Regulation of Sertoli cell AMH production by FSH. In basal conditions, SOX9, SF1,GATA4 and WT1 activate AMH transcription. FSH increases total testicular AMH output by inducing Sertoli cell proliferation and upregulating AMH transcription after binding to a specific G-coupled receptor on Sertoli cell plasma membrane. Upregulation of AMH transcription is mediated by adenylate cyclase (AC) which increases cyclic AMP levels that activate protein kinase A (PKA). Most probably, PKA phosphorylates activating protein 2 (AP2), which translocates to the nucleus and the inhibitor of kappa B (IkB) which releases the nuclear factor kappa B (NFkB) that also translocates to the nucleus. AP2 and NFkB transactivate AMH transcription by binding to specific response elements present more than 1.9 kb upstream of the AMH transcription start site. These enhancer sequences lie beyond the SAP62 gene. From ref. (337) .