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Endocrine Pathophysiology I Kyong Soo Park Dept of MMBS & Dept of Internal Medicine, Seoul National University College of Medicine 1 Introduction • The endocrine system assists the nervous system with communication and control of the body • Endocrine glands • They are ductless • They secrete hormones into bloodstream • There are also similar glands called paracrine and autocrine glands that are quasi-endocrine • Exocrine glands • They have ducts • They deliver their products directly to a specific site Hormone: is a chemical messenger secreted by one endocrine gland or cell into the bloodstream and targeted toward cells in another organ General Characteristics of the Endocrine System • The endocrine and nervous systems communicate using chemical signals Endocrine Gland 7 Chemistry of Hormones • Chemically, hormones are either: • Steroid or steroid-like hormones such as: • Sex hormones • Adrenal cortex hormones • Non-steroid hormones such as: • Amines • Proteins • Peptides • Glycoproteins 8 Action of Steroid Hormones Action of Non-Steroid Hormones Control of Hormonal Secretions • Hormones can be short-lived or may last for days Amines (2-3 minutes) polypeptides (4-40 minutes) steroid and proteins (4-170 minutes), thyroid hormones (0.75-6.7 days) • Primarily controlled by negative feedback mechanism • Hormone secretions are precisely regulated – – Hypothalamus – Nervous system Changing level of substance in plasma – Anterior pituitary gland (a) Peripheral endocrine gland Endocrine gland Endocrine gland Target cells Target cells Target cells Action Action Action (b) (c) Pituitary Gland • Lies at the base of the brain in the sella turcica • Consists of two distinct portions: • Anterior pituitary (adenohypophysis) • Posterior pituitary (neurohypophysis) Third ventricle Hypothalamus Anterior cerebral artery Optic chiasma Optic nerve Oculomotor nerve Pituitary stalk (Infundibulum) Trochlear nerve Anterior lobe of pituitary gland Sphenoidal sinus Sphenoid bone Posterior lobe of pituitary gland Sella turcica Basilar artery Anterior Pituitary Hormones • Hypothalamic releasing hormones stimulate cells of anterior pituitary to release hormones – Hypothalamus Third ventricle Releasing hormone (Hormone 1) Optic chiasma Neurosecretory cells that secrete releasing hormones + – Anterior pituitary Hypophyseal portal veins Anterior pituitary hormone (Hormone 2) Superior hypophyseal artery Secretory cells of anterior pituitary gland Capillary bed – + Peripheral endocrine gland Capillary bed Hypophyseal veins Anterior lobe of pituitary gland (Hormone 3) Stimulation + Target cells Inhibition Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Hormones from Hypothalamus GHRH SS Growth Somatostatin hormonereleasing hormone PRF Prolactinreleasing factor PIH Prolactinrelease inhibiting hormone TRH Thyrotropinreleasing hormone CRH Corticotropinreleasing hormone GnRH Gonadotropinreleasing hormone Hormones from Anterior Pituitary GH Growth hormone Bone Muscle Adipose tissue PRL Prolactin Mammary gland TSH Thyroidstimulating hormone Thyroid ACTH Adrenocorticotropic hormone Adrenal cortex LH Luteinizing hormone Ovary Testis FSH Folliclestimulating hormone Posterior Pituitary Hormones • Structurally consists of nerve fibers and neuroglia v. glandular epithelial cells of the anterior pituitary gland • The nerve fibers originate in the hypothalamus • Two hormones are produced: • Antidiuretic hormone (vasopressin) • Oxytocin Third ventricle Optic chiasma Neurosecretory cells that secrete posterior pituitary hormones Neurosecretory cells that secrete releasing hormones Hypothalamus Superior hypophyseal artery Capillary bed Inferior hypophyseal artery Hypophyseal veins Sella turcica of sphenoid bone Posterior lobe of pituitary gland Thyroid Gland • The thyroid gland has two lateral lobes and lies just below the larynx • It produces three hormones: • T4 (thyroxine), T3 (triiodothyronine), Calcitonin Larynx Colloid Thyroid gland Follicular cell Follicular cells Colloid Isthmus Extrafollicular cell (a) (b) Extrafollicular cells Thyroid Hormones OH I OH I I O I O I CH2 I I CH2 NH2CHCOOH NH2CHCOOH Thyroxine (T4) Triiodothyronine (T3) Parathyroid Glands • The parathyroid glands are on the posterior surface of the thyroid gland • There are typically four parathyroid glands • It secretes one hormone: PTH (parathyroid hormone or parathormone) Pharynx Thyroid gland Parathyroid glands Esophagus Trachea Posterior view Secretory cells Capillaries – Changing level of substance in plasma Endocrine gland Target cells Action Adrenal Glands • The adrenal glands are closely associated with the kidneys • The gland sits like a cap on each kidney • Hormones are secreted from two different areas of the gland, the adrenal cortex and the adrenal medulla • Numerous hormones are secreted by the adrenal glands Surface of adrenal gland Connective tissue capsule Zona glomerulosa Adrenal gland Kidney Zona fasciculata Adrenal cortex Adrenal cortex Adrenal medulla Zona reticularis (a) Adrenal medulla (b) Hormones of the Adrenal Gland Cushing’s syndrome Addison’s disease Pancreas • The pancreas has two major types of secretory tissue • This is why it is a dual functioning organ as both an exocrine gland and endocrine gland Pancreatic islet (Islet of Langerhans) Gallbladder Common bile duct Pancreatic duct Duct Small intestine Digestive enzymesecreting cells Pancreatic islet (Islet of Langerhans) Capillary Hormone-secreting islet cells Pancreas Hormones of the Pancreatic Islets Other Endocrine Glands Pineal Gland • Secretes melatonin • Regulates circadian rhythms Thymus Gland • Secretes thymosins – • Promotes development of certain lymphocytes • Important in role of immunity • after puberty, it starts to shrink and become replaced by fat Reproductive Organs • Ovaries produce estrogens and progesterone • Testes produce testosterone • Placenta produces estrogens, progesterone, and gonadotropin Other organs: digestive glands, heart, and kidney