General Concepts of Endocrinology

Have you seen someone with a 'potbelly' and round moon face?  

Photo credits to: potbellysyndrome
Above picture shows a person diagnosed with Cushing's Syndrome which is one of the endocrine system diseases. This is due to hypercortisolism which is caused by the overproduction of cortisol over a period of time. Cortisol is a hormone secreted by one of the endocrine glands.





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Get ready and take up the gauntlet =)


Nervous system is known as regulatory system that transmits information through electrical impulses. This system works together with the endocrine system  which has ductless glands that release hormones.




Photo credits to: Junquiera

Hormones,  released by endocrine glands into the blood stream, are chemical messengers that facilitate cell signalling in our body. They act upon all organs by interacting with specific receptors on cell. Hormones have structural specificity and their physiologic activity will be affected if there's an alteration in their molecular composition. They bring about their specific action to their target tissues and this is mediated by receptor molecules. The receptors must be able to identify the hormone among other substances and transmit the binding information into postreceptor events.

 
 

Photo credits: Danton,  Human Cell Biology
Hormones can reach their target tissues not only through the circulation but can also act locally in the region in which they are released. The action is considered paracrine if the hormones act locally on cells other than those that produced them. E.g. sex steroids in the ovary. Autocrine action, on the other hand, is acting on the cell in which it is produced; the hormone may be released by the cell and then act on it. An example is the insulin released by the pancreatic islet B cells can inhibit insulin release by the same cell.


  • to preserve homeostasis
  • to regulate the body's growth and development
  • to regulate metabolism
  • to promote sexual maturation and reproductive processes
  • to promote or inhibit the production & release of other hormones



(1) Releasing hormones
  •  from hypothalamus
  • promote the secretion of Anterior Pituitary hormones.
  • example: Corticotropin -Releasing-Hormone (CRH)- release of ACTH (anterior pituitary hormone)
(2) Inhibitory hormones
  • from hypothalamus/ gastrointestinal tract
  • supress the secretion of particular hormones
  • example: Somatostatin (Growth Hormone Inhibitory Hormone)- supress GH release
(3) Tropic hormones
  • stimulate the growth and activity of other endocrine gland
  • example: Thyroid Stimulating Hormone (TSH)
(4) Effector hormones
  • hormones secreted by all the endocrine glands other than the anterior pituitary and hypothalamus
  • target cells are non endocrine tissue cells

  • protein
  • glycoprotein
  • peptides
  • steroids
  • amino acid derivatives






Hypothalamus secretes selective hormones that release or inhibit secretion of specific Anterior Pituitary hormones.

Hypothalamic Hormones

     Source: Clinical Chemistry, Theory, Analysis & Correlations 2nd Edition by Kaplan and Pesces



   Two distinct parts: Anterior lobe or Adenohypophysis and Posterior lobe or Neurohypophysis.


-secretes tropic hormones (Thyroid Stimulating Hormone, Adenocorticotropin Hormone, Follicle Stimulating Hormone, Luteinizing Hormone) and two effector hormone (Growth hormone & Prolactin)


Source: Clinical Chemistry, Theory, Analysis & Correlations 2nd Edition by Kaplan and Pesces

*Growth Hormone (GH, Somatotropin)-  promote skeletal growth and protein synthesis in young mammals
  • Plasma Concentration: low during the day, sharp increase when asleep (Deepest sleep- eight to tenfold higher than the basal level)


  • DWARFISM- deficiency of GH among children ( low serum IGF-1)
  • GIGANTISM- excessive growth due to increase GH
  • ACROMEGALY- hypersecretion of GH by pituitary tumor in adulthood (elevated GH & IGF-1)

 *Adenocorticotropin Hormone (ACTH)
  • Plasma Concentration: highest between 6am-8am, lowest between 6pm-11pm
  • Normal ACTH range: 5pg/ml-50pg/ml
       Pathologic conditions(High levels of ACTH):
  •  Primary adrenal cortical deficiency
  • Cushing's syndrome
  • Ectopic tumors

*Thyroid Stimulating Hormone (TSH)
  • major regulator of throid secretion
  • under negative feedback control by the level of T4
  • HYPOTHYROIDISM- Increase TSH
  • HYPERTHYROIDISM- decrease TSH

*Gonadotropins (Follicle Stimulating Hormone, Luteinizing Hormone)
  • for proper maturation and functioning of gonads
  • Both female & male, small rise at puberty
  • Menopausal women-great increased& remains elevated
  • Ovulating women- rise sharply from the basal before ovulation& then fall

*Prolactin
  • for breast development during pregnancy
  • stimulates milk secretory
  • increase prolactin may result to: menstrual irregularity, infertility & galactorrhea (inappropriate production of breast milk) 
Reference range:
  • Women:  <30 ng/ml 
  • Men: <20ng/ml
  • >100ng/ml-Prolactinomas(secretory pituitary tumors)



Posterior pituitary stores and secretes Anti-diuretic hormones and oxytocin.
Source: Clinical Chemistry, Theory, Analysis & Correlations 2nd Edition by Kaplan and Pesces


*Anti-diuretic Hormone
  • increases the reabsorption of water in the renal tubules when plasma osmolality is elevated
  • Diabetes insipidus-deficiency of ADH
*Oxytocin
  • stimulates the contraction of smooth muscle
  • contracts uterus during child labor
  • stimulates ejection of milk





 
 
Thyroid Hormones
  • release Triiodothyronine(T3) and Tetraiodothyronine (T4) which are the basic metabolic hormones
  • for growth and development
Source: Clinical Chemistry, Theory, Analysis & Correlations 2nd Edition by Kaplan and Pesces



T3 (3,5,3'-triiodothyronine)-more potent, active
T4 / thyroxine ( 3,5,3',5-tetraiodothyronine)-principal iodinated hormone

TBG (Thyroxine-binding proteins) -transports 70%-75% T3 & T4 (excess 25-30% - albumin & pre-albumin)

Parathyroid Hormones
  • release Calcitonin and Parathormone
Source: Clinical Chemistry, Theory, Analysis & Correlations 2nd Edition by Kaplan and Pesces






ADRENOCORTICAL HORMONES
Adrenal gland composed of an outer cortex and an inner core of medulla.


Adrenal Cortex- produces many steroid hormones derived from cholesterol


Source: Clinical Chemistry, Theory, Analysis & Correlations 2nd Edition by Kaplan and Pesces
Cortisol-principal glucocorticoid
  • insulin antagonist (inhibits the uptake of glucose by muscle)
  • daily cortisol secretion of adrenal gland : 25mg
  • normal conc. of plasma cortisol: 5.0 ug/dl-22.0 ug/dl (138 to 607 nmol/L)
  • early morning hours: highest; at night: lowest
Transported in the plasma by:
  • 75% - by Corticosterioid binding globulin
  • 15%- bound to albumin
  • 10%- free
CUSHING'S SYNDROME-hypersecretion of Cortisol
causes: adrenal hyperplasia, carcinoma, pituitary adenoma, ectopic carcinoma
*Dexamethasone Suppression Test- low plasma cortisol and increase secretion of free cortisol in urine


ADDISON'S DISEASE-low plasma cortisol concentration
causes: destruction of cortical tissue by autoimmune disease/infection, ACTH deficiency
*Administration of exogenous ACTH (rapid ACTH Stimulation Test)- subnormal cortisol response

Adrenal Medulla- releases Epinephrine and Norepinephrine hormones
Source: Clinical Chemistry, Theory, Analysis & Correlations 2nd Edition by Kaplan and Pesces






Pancreas release insulin and glucagon which help in the regulation of serum glucose.
Source: Clinical Chemistry, Theory, Analysis & Correlations 2nd Edition by Kaplan and Pesces





 Male Sex Hormones

Testes are the male gonads. These secrete the male hormone testosterone and to produce spermatozoa, which are essential for fertilization of the ovum in the reproductive process.




Source: Clinical Chemistry, Theory, Analysis & Correlations 2nd Edition by Kaplan and Pesces


Female Sex Hormones

The female gonad, or ovary, has a double function: it produces the female sex hormones and a site of production and maturation of the ova.

Source: Clinical Chemistry, Theory, Analysis & Correlations 2nd Edition by Kaplan and Pesces

  • Estrone (E1)- weaker biologic action
  • Estradiol (E2)- principal & most potent estrogen
  • Etriol (E3)-no hormonal activity; for fetoplacental viability




regulate the entire digestive process, from the secretion of the gastrointestinal juices  to the absorption of the final products of digestion.

Source: Clinical Chemistry, Theory, Analysis & Correlations 2nd Edition by Kaplan and Pesces

 






Pineal gland secretes two neurotransmitters, erotonin and melanin, that modulate some circadian rythms of the endocrine system.


Source: Clinical Chemistry, Theory, Analysis & Correlations 2nd Edition by Kaplan and Pesces



Let's try to trigger those neurons and release some hormones! :)
 Try to identify the parts of the endocrine system and enumerate some of the hormones being secreted. Don't cheat, test yourself.
Photo credits: Junquiera
Domo arigato!




References:


Greenspan, F., Baxter, J., Basic Clinical Endocrinology, 4th edition


Kaplan, L., Pesce, A., Clinical Chemistry: Theory, Analysis and Correlation, 2nd edition


Kaplan, A., Toivola, B., Ophain, K., Lyon, A., Jack, R., Clinical Chemistry: Interpretation and Techniques, 4th edition









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