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ENDOCRINE SYSTEM PHYSIOLOGY Hormones • A chemical secreted by a cell or groups of cells into the blood for transport to a distant target where it exerts its effect at very low concentrations • Types – Peptide Hormones • Growth Hormone, Insulin, Vasopressin – Steroid Hormones • Cortisol, Testosterone, Estrogen – Tyrosine Derivatives • Thyroxine and Epinephrine Endocrine vs. Nervous System • Major communication systems in the body • Integrate stimuli and responses to changes in external and internal environment • Both are crucial to coordinated functions of highly differentiated cells, tissues and organs • Unlike the nervous system, the endocrine system is anatomically discontinuous. Nervous system •The nervous system exerts point-to-point control through nerves, similar to sending messages by conventional telephone. Nervous control is electrical in nature and fast. Hormones travel via the bloodstream to target cells •The endocrine system broadcasts its hormonal messages to essentially all cells by secretion into blood and extracellular fluid. Like a radio broadcast, it requires a receiver to get the message - in the case of endocrine messages, cells must bear a receptor for the hormone being broadcast in order to respond. A cell is a target because is has a specific receptor for the hormone Most hormones circulate in blood, coming into contact with essentially all cells. However, a given hormone usually affects only a limited number of cells, which are called target cells. A target cell responds to a hormone because it bears receptors for the hormone. Mechanisms of Secretion Ca++ Neuron Ca++ Neurosecretory cell Ca++ Simple Endocrine Cell Ca++ Intracellular Ca stores Capillary Hormones • Types of Secretion 1. 2. 3. 4. Autocrine – affects the secreting cell Paracrine – affects neighbouring cell Endocrine – secreted into bloodstream Exocrine – secreted onto body surface, including surface of gut Response vs. Distance Traveled Endocrine action: the hormone is distributed in blood and binds to distant target cells. Paracrine action: the hormone acts locally by diffusing from its source to target cells in the neighborhood. Autocrine action: the hormone acts on the same cell that produced it. Types of hormones • Hormones are categorized into four structural groups, with members of each group having many properties in common: – Steroids – Thyroid Hormones – Peptides and proteins – Amino acid derivatives= Catecholamines – Fatty acid derivatives - Eicosanoids Two types of hormones • Lipid Soluble – Steroid hormones (eg estrogen, testosterone) – Thyroid hormones • Lipid Insoluble – Peptides and Proteins (eg insulin) – Catecholamines (eg adrenalin) Two types of hormones 1. Lipid-soluble Carrier molecule Hormone molecule Cytoplasmic receptor Nuclear receptor Transcription & Translation long lasting effects Nucleus Two types of hormones 2. Lipid-insoluble Hormone molecule Plasma membrane receptor Second Messenger Effector Protein Cellular effects Peptide/protein hormones Range from 3 amino acids to hundreds of amino acids in size. Often produced as larger molecular weight precursors that are proteolytically cleaved to the active form of the hormone. Peptide/protein hormones are water soluble. Comprise the largest number of hormones– perhaps in thousands Peptide/protein hormones • Are encoded by a specific gene which is transcribed into mRNA and translated into a protein precursor called a preprohormone • Preprohormones are often post-translationally modified in the ER to contain carbohydrates (glycosylation) • Preprohormones contain signal peptides (hydrophobic amino acids) which targets them to the golgi where signal sequence is removed to form prohormone • Prohormone is processed into active hormone and packaged into secretory vessicles Amine hormones There are two groups of hormones derived from the amino acid tyrosine Thyroid hormones and Catecholamines Hypothalamus and pituitary gland Hypothalamus and pituitary gland Hypothalamus and posterior pituitary Midsagital view illustrates that magnocellular neurons paraventricular and supraoptic nuclei secrete oxytocin and vasopressin directly into capillaries in the posterior lobe Pituitary gland • Master gland – Secretes 9 hormones that control other glands • 2 distinct parts – Anterior pituitary (adenohypophysis) – Posterior pituitary (neurohypophysis) • Both parts controlled by neurosecretory cells of the hypothalamus (part of the brain!) Anterior pituitary: Adenohypophysis • Anterior pituitary: connected to the hypothalamus by the superior hypophyseal artery. • The antererior pituitary is an amalgam of hormone producing glandular cells. • The anterior pituitary produces six peptide hormones: prolactin, growth hormone (GH), thyroid stimulating hormone (TSH), adrenocorticotropic hormone (ACTH), follicle-stimulating hormone (FSH), and luteinizing hormone (LH). Anterior Pituitary Hypothalamus Hormone 1 Portal blood vessels Hormone 1 Target Tissue Anterior Pituitary Hormone 2 Posterior Pituitary Hypothalamus Hormone 1 Portal blood vessels Target Tissue Posterior Pituitary • Neurosecretory neurons Anterior Pituitary – Secrete hormones into portal blood vessels – Regulate secretion of other hormones from anterior pituitary • Neurosecretory neurons Posterior Pituitary – Secrete hormones directly into capillaries Anterior Pituitary • 2 hormone system • 1st hormone stimulates or inhibits release of other hormones from anterior pituitary • 2nd hormone has effect on target tissue Examples: • 1st hormone • 2nd hormone – Corticotropin-releasing hormone (CRH) – Adrenocorticotropin hormone (ACTH) – Thyroid hormone releasing hormone (TRH) – Thyroid stimulating hormone (TSH) – Prolactin-inhibiting hormone (PIH) – Prolactin Posterior Pituitary • • Neurosecretory cells secrete hormones directly onto capillaries Only 2 hormones: 1. Antidiuretic hormone (ADH, also called vasopressin) • Water retention by the kidney 2. Oxytocin • • Uterine contractions during childbirth Milk ejection during breast feeding Hypothalamic releasing hormones Hypothalamic releasing hormone Effect on pituitary Corticotropin releasing hormone (CRH) Thyrotropin releasing hormone (TRH) Growth hormone releasing hormone (GHRH) Somatostatin Stimulates ACTH secretion Gonadotropin releasing hormone (GnRH) Prolactin releasing hormone (PRH) Prolactin inhibiting hormone (dopamine) Stimulates TSH and Prolactin secretion Stimulates GH secretion Inhibits GH (and other hormone) secretion Stimulates LH and FSH secretion Stimulates PRL secretion Inhibits PRL secretion Thyroid Thyroid Hormone Thyroid hormones are basically a "double" tyrosine with the critical incorporation of 3 or 4 iodine atoms. Thyroid hormone is produced by the thyroid gland and is lipid soluble Thyroid hormones are produced by modification of a tyrosine residue contained in thyroglobulin, posttranslationally modified to bind iodine, then proteolytically cleaved and released as T4 and T3. T3 and T4 then bind to thyroxin binding globulin for transport in the blood • Thyroid Hormones – Produced in the follicle cells of the thyroid – T3 triiodothyronine – T4 thyroxine • Both require iodine to be produced • Thyroid hormones increase metabolic rate in brain, muscle, heart, liver, kidney, etc. – Produces heat as a by-product Thyroid hormones Hypothyroid • Lack of iodine during fetal development Stunted growth, called cretinism Hypothyroid • Lack of Iodine in diet • Lack of selenium in diet • Genetic defect on chromosome 15 – 15q25.3-26.1 • Receptor insensitivity • Increased Antibody levels – Due to Environmental Factors? • Decreased Adrenal Function Enlargement of the thyroid, called goiter Due to lack of thyroid hormones and overstimulation of the thyroid gland by TSH Because no negative feedback Thyroxine Triiodothyronine feedback on the Anterior Pituitary and Hypothalamus to decrease TSH levels If TSH levels are high then there is a lack of negative feedback A lack of negative feedback means low T4, T3 levels in the circulation. Hoshimoto’s Thyroiditis • • • • • • • • • • • • Increased sensitivity to cold Constipation Pale, dry skin A puffy face Hoarse voice An elevated blood cholesterol level Unexplained weight gain — occurring infrequently and rarely more than 10 to 20 pounds, most of which is fluid Muscle aches, tenderness and stiffness, especially in your shoulders and hips Pain and stiffness in your joints and swelling in your knees or the small joints in your hands and feet Muscle weakness, especially in your lower extremities Excessive or prolonged menstrual bleeding (menorrhagia) Depression Control of Thyroid Cold If –’ve feedback lost Too much TSH Get goiter Hypothalamic neurons Thyroid releasing hormone (TRH) Anterior Pituitary Thyroid Stimulating Hormone (TSH) Thyroid Release of thyroid hormones – T3 and T4 Hyperthyroid • Also known as Graves’ Disease • Excessive secretion of T4 • An antibody called thyrotropin receptor antibody (TRAb) stimulates the thyroid to make excessive amounts of thyroid hormone. Graves’ Disease • • • • • • • • • • • • • Anxiety Irritability Difficulty sleeping Fatigue A rapid or irregular heartbeat A fine tremor of your hands or fingers An increase in perspiration Sensitivity to heat Weight loss, despite normal food intake Brittle hair Enlargement of your thyroid gland (goiter) Light menstrual periods Frequent bowel movements Control of extracellular Calcium • Two hormones 1. Parathyroid hormone 2. Calcitonin Parathyroid Gland Parathyroid • Low blood Ca++ stimulates release of parathyroid hormones • Act to increase blood Ca++ by – Ca++ release from bone – Ca++ absorption in gut – Ca++ reabsorption in kidney Calcitonin • Produced in parafollicular cells of the thyroid gland • High Blood Ca++ stimulates release of calcitonin • Act to decrease blood Ca++ by – ↓ Ca++ release from bone – ↓ Ca++ reabsorption in kidney High Ca++ Low Ca++ Calcitonin Mobilize Ca From Bone Parathyroid hormone Reabsorb Ca In the kidney Increase absorption of Ca from intestine Hormones • Robert Wadlow – 8’-11” tall – 496 pounds – Size 37 shoe • Too much growth hormone Growth Hormone: Somatostatin • • Direct effects are the result of growth hormone binding its receptor on target cells. Fat cells (adipocytes), for example, have growth hormone receptors, and growth hormone stimulates them to break down triglyceride and suppresses their ability to take up and accumulate circulating lipids. Indirect effects are mediated primarily by a insulin-like growth factor-I (IGF-I), a hormone that is secreted from the liver and other tissues in response to growth hormone. A majority of the growth promoting effects of growth hormone is actually due to IGF-I acting on its target cells. • Growth hormone-releasing hormone (GHRH) is a hypothalamic peptide that stimulates both the synthesis and secretion of growth hormone. • Somatostatin (SS) is a peptide produced by several tissues in the body, including the hypothalamus. Somatostatin inhibits growth hormone release in response to GHRH and to other stimulatory factors such as low blood glucose concentration. • Ghrelin is a peptide hormone secreted from the stomach. Ghrelin binds to receptors on somatotrophs and potently stimulates secretion of growth hormone. • Growth hormone secretion is also part of a negative feedback loop involving IGF-I. High blood levels of IGF-I lead to decreased secretion of growth hormone not only by directly suppressing the somatotroph, but by stimulating release of somatostatin from the hypothalamus. • Growth hormone also feeds back to inhibit GHRH secretion and probably has a direct (autocrine) inhibitory effect on secretion from the somatotroph. Gigantism v Acromegaly The Adrenal Glands • An example of Pituitary control over other endocrine tissue • One gland attached to the top of each kidney Adrenal Medulla Adrenal Cortex Kidney Adrenal Cortex • Steroid hormones – Mineralcorticoids • Aldosterone – Glucocorticoids • Cortisol – Small amounts of estrogen, testosterone, progesterone Adrenal Medulla • Catecholamine – Epinipherine (adrenalin) – Norepinipherine (noradrenalin) Control of Adrenal Cortex Stress, circadian rhythm and other neural input Hypothalamic neurons Corticotropin releasing hormone (CRH) Anterior Pituitary Adrenocorticotropic hormone (ACTH) Adrenal cortex Release of steroid hormones Adrenal Cortex • Glucocorticoids; cortisol is the major representative in most mammals • Mineralocorticoids; aldosterone being most prominent • Androgens such as testosterone • Estrogens, including estradiol and estrone • Progestogens (also known a progestins) such as progesterone Adrenal Cortical Steroids • Mineralocorticoids – eg. aldosterone – Controls ion transport in the kidney function – Regulates expression of a Na+ Channel – Important for water reabsorption • Glucocorticoids – eg. cortisol – Important for metabolism esp. glucose – Activate enzymes (in liver) that increase glucose production – blood glucose Cortex Medulla Zona Glomerulosa mineralocorticoids (aldosterone) Zona fasiculata glucocorticoids (cortisol) Zona reticularis sex steroids (androgens) catecholamines (epinephrine and norepinephrine) Adrenal Medulla • Catecholamines stored in large vesicles within chromaffin cells of the adrenal medulla • Chromaffin cells innervated by neurons of the sympathetic nervous system • ‘Fight or flight’ response Sympathetic nerve terminal Acetycholine synapse Ca++ Adrenal medulla Catecholamine containing vesicles Chromaffin cell Blood vessel Adrenal Medulla • Ach depolarizes chromaffin cell by activating nicotinic Ach receptors • Opens voltage-gated Ca++ channels • Ca++ causes fusion of vesicles • Release of catecholamine into blood stream Catecholamines • Catecholamines released by adrenal medulla: – epinipherine 80% – norepiniphrine 20% – Also neurotransmitter • Norepinephrine primary SNS Effects of Catecholamines depend upon receptor type • Activate adrenoreceptors – Two types: and 1 Phospholipase C IP3 & DAG 2 1 2 Adenylate cyclase cAMP Potential effects of catecholamine receptor activation • Heart – , mediated - contraction, HR • Smooth Muscle (Blood vessels and lungs) – contraction – relaxation • Metabolism – - glycogenolysis glucose • Neural – - K+ channel conductance Some clinical stuff • adrenoreceptor agonists used to treat asthma • blockers used to treat high blood pressure Addison’s Disease • Severe or total deficiency of the hormones made in the adrenal cortex, caused by the destruction of the cortex • Symptoms – steadily worsening fatigue – a loss of appetite, and some weight loss – Blood pressure is low and falls further when a person is standing, producing lightheadedness – Nausea, sometimes with vomiting, and diarrhea are common – The muscles are weak and often go into spasm – There are often emotional changes, particularly irritability and depression – Because of salt loss, a craving for salty foods is common – Finally, the increase in ACTH due to the loss of cortisol will usually produce a darkening of the skin that may look like an inappropriate tan on a person who feels very sick. Cushing’s Disease/Syndrome • Cushing's Syndrome is a disease caused by an excess of cortisol production or by excessive use of cortisol or other similar steroid (glucocorticoid) hormones. • Symptoms – General physical features include a tendency to gain weight, especially on the abdomen, face (moon face), neck and upper back (buffalo hump) – fatigue, weakness, depression, mood swings, increased thirst and urination, and lack of menstrual periods in women. Blood Glucose Regulation • Endocrine pancreas – Only 2% of entire pancreas, – the rest produces digestive enzymes (exocrine) – Islets of Langerhans • Insulin ( cells) • Glucagon ( cells) • Somatostatin ( cells) Islets of Langerhans • Alpha cells (A cells) secrete the hormone glucagon. • Beta cells (B cells) produce insulin and are the most abundant of the islet cells. • Delta cells (D cells) secrete the hormone somatostatin, which is also produced by a number of other endocrine cells in the body. Diabetes • Diabetes – 2 million Canadians – $9 billion per year health care costs – Insulin isolated by Banting & Best 1922, U of T Dept of Physiology (1923 Nobel Prize) • Type 1 – No or very little insulin produced • Type 2 – Reduced cellular response to insulin • Consequences – – – – Death Blindness Kidney disease Limb amputation Hormonal control of blood glucose In the GI tract, 80% of all carbohydrate is digested to glucose Basically: Glucose Used for ATP production Glycogen Used for glucose storage Insulin • Stimulus for secretion is high blood glucose • Secreted by cells • Leads to glucose uptake and storage in liver, muscle and fat tissue. • Effect is to blood glucose • Danger of Diabetes is hyperglycemia Insulin Effects on Muscle and Fat Tissue • Insulin initiates transfer of glucose transporters to cell membrane • blood glucose • production of glycogen Effects in Muscle & Fat Glycogen synthesis Glucose transporter glucose SNARE dependent transport Glucose transporter Insulin storage vesicle In the Liver • Insulin stimulates the synthesis of an enzyme (glucokinase) • Required to ‘trap’ glucose in the cell • initiates glycogen production Effects in Liver GLUT2 Glycogen synthesis Glucose transporter glucose X glucose Glucose 6-phosphate glucokinase ‘trapped’ Hemoglobin • Hemoglobin is the oxygen-carrying pigment that gives blood its red color and also the predominant protein in red blood cells. • About 90% of hemoglobin is hemoglobin A. (The "A" stands for adult type.) Although one chemical component accounts for 92% of hemoglobin A, approximately 8% of hemoglobin A is made up of minor components that are chemically slightly different. • These minor components include hemoglobin A1c, A1b, A1a1, and A1a2. Hemoglobin A1c (HbA1c) is a minor component of hemoglobin to which glucose is bound. HbA1c also is referred to as glycosylated or glucosylated hemoglobin. Hemoglobin A1c • Sugar sticks, and when it's around for a long time, it's harder to get it off. In the body sugar sticks particularly to proteins. • The red blood cells that circulate in the body live for about 3 months before they die off. • When sugar sticks to these cells, it gives us an idea of how much sugar is around for the preceding 3 months. In most labs, the normal range is 4-5.9 %. • In poorly controlled diabetes, its 8.0% or above, and in well controlled patients it's less than 7.0%. The benefits of measuring A1c is that is gives a more reasonable view of what's happening over the course of time (3 months) ADA’s Goal is Less than 7% • A1c(%) Mean blood sugar (mg/dl) • • • • • • • 135 170 205 240 275 310 345 6 7 8 9 10 11 12 Other hormones • Glucagon – Secretion stimulated by low blood glucose – Activates enzymes for gluconeogenesis and glycogenolysis – Leads to blood glucose levels • Somatostatin – Regulates secretion of insulin and glucagon Glucose Regulation Summary • Endocrine pancreas • Secretion of several hormones important for blood glucose regulation • Insulin glucose uptake and storage – Different effects on liver and muscle & fat • Glucagon glucose production What hormone increases intestinal calcium absorption? • • • • • A. B. C. D. E. Parathyroid Hormone Calcitonin Glucagon Cortisol Heparin The Target Tissue of ACTH is? • • • • • A. B. C. D. E. Hypothalamus Pituitary Gland Thyroid Gland Adrenal Cortex Adrenal Medulla Which of the following are NOT a catecholamine? • • • • A. Epinephrine B. Dopamine C. Cortisol D. Norepinephrine Which of the following are called a second messenger? • • • • A. B. C. D. PIP DAG cGMP cAMP Which disease results from over production of Growth Hormone before the epiphyseal plates close? • • • • A. B. C. D. Gigantism Acromegaly Dwarfism Obesity Which hormone is secreted from the neurohypophysis? • • • • • A. B. C. D. E. LH FSH TSH ADH ACTH Addison’s Disease is caused by • • • • A. B. C. D. an increase in Aldosterone secretion a decrease in Aldosterone secretion an increase in ACTH secretion a decrease in ACTH secretion The following type of hormonal release affects the cell next to the cell that secreted the hormone. • • • • • A. B. C. D. E. Autocrine release Paracrine release Endocrine release Steroidal release None of the Above Which test is best to use for a patient with Diabetes? • • • • • A. B. C. D E. Glucose Tolerance Test Glucose Infusion Test Hemoglobin A1c Test Urinalysis None of the Above If you ate 25 sugar cubes and followed them with a chaser of Mountain Dew, which hormone might be secreted in large amounts? • • • • • A. Glucagon B. Insulin C. Cortisol D. Somatastatin E. ACTH Signal Transduction Signal Reception, Transduction Amplification Second Messengers Regulators Specific Effectors Cellular Response