Endocrinology 1
Endocrinology 1
Endocrinology is the branch of science that deals with endocrine system, its diseases and
its secretions known as Hormones.
Hormone is a mediator molecule that is released in one part of body but regulates the
activity of cells in other parts of body.
ENDOCRINE GLANDS:
1. Exocrine gland
2. Endocrine gland
3. Secretions reach the target cell via duct Hormones are released into blood
4. Have localized effect of secretions Hormones have widespread effect on body
1. Steroid hormones
2. Protein hormones
3. Amino acid derivatives
Steroid hormones –
Protein hormones-
Thyroid and medullary hormones are derived from amino acid tyrosine.
Eg: Thyroxine (T4), triiodothyronine (T3), adrenaline, noradrenaline
1. Hypothalamic control:
It produces 4 releasing hormones (GHRH, CRH, TRH, GnRH) and 2 inhibiting
hormones (prolactin inhibiting hormone and somatostatin/somatotropin release-
inhibiting hormone)
The releasing hormones stimulate the anterior pituitary
For eg: CRH (Corticotropic releasing hormone) – stimulates corticotrophs of anterior
pituitary –> release of ACTH
2. Control of anterior pituitary
Produces 5 tropic hormones
Tropic hormones are the hormones that have other endocrine glands as target cells
They are : GH, ACTH, TSH, Prolactin and Gonadotropin
These hormones stimulate their target organ
Eg: CRH from hypothalamus anterior pituitary ACTH stimulates adrenal
cortex cortisol released
3. Control by Feedback
Control can be done by negative and positive feedback
In endocrinology negative feedback control are frequent
Negative feedback occurs when the rate of process decrease as product concentration
increases
Positive feedback occurs when rate of process increases as product concentration
increases
Eg for negative feedback: CRH from hypothalamus stimulates ACTH of anterior
pituitary ACTH stimulates secretion of cortisol from adrenal cortex level of
Plasma cortisol increases cortisol inhibits CRH and ACTH secretion via negative
feedback
Eg for positive feedback: - LH surge during ovulation:
In late follicular phase estrogen results in increase secretion of GnRH triggers LH
secretion LH causes further secretion of estrogen which further causes LH
secretion .
4. Neural control:
Via the autonomic nervous system
Neuroendocrine reflex:
PITUITARY GLAND
Pituitary gland or hypophysis or “master gland” is a pea shaped structure that measures
1-1.5cm and lies in hypophyseal fossa of sella turcica of sphenoid bone
It attaches to hypothalamus by a stalk called infundibulum
Pituitary gland is divided into: i) Anterior pituitary (Adenohypophysis)
ii) Posterior pituitary ( Neurohypophysis)
In between the 2 divisions there is an avascular structure called pars intermedia
which later atrophies and forms part of anterior pituitary
ANTERIOR PITUITARY:
Functions:
skeletal growth- it helps in proliferation of tissues in epiphyseal cartilage of long bones ,
which helps in linear growth. If it is deficient then may cause dwarfism and if it is in
excess then can cause gigantism
muscle growth- stimulates growth of muscle
stimulates growth of viscera
action on metabolism:
i. carbohydrate metabolism – it favors storage of glucose by decreasing peripheral
utilization . Therefore, overaction of GH has diabetogenic effect
ii. protein metabolism – it accelerates synthesis of proteins
iii. fat metabolism – it mobilizes fat from adipose tissue . So, concentration of fatty
acids increases in body fluids which is used for energy production by cells
GONADOTROPIC HORMONES:
- FSH and LH are the gonadotropic hormones
- Their release is controlled by GnRH from hypothalamus
PROLACTIN:
- Controls production and secretion of cortisol and other glucocorticoids from adrenal
cortex
- ACTH secretion is stimulated by Corticotropic releasing hormone (CRH) from
hypothalamus
- It causes hyperglycemia and lipolysis
MELANOCYTE STIMULATING HORMONE (MSH):
POSTERIOR PITUITARY
Also called as neurohypophysis
It consists of neuroglial cells and nerve fibers but no glandular cells
It consists of 3 parts – pars nervosa
-infundibular stem
- median eminence
Hormones of posterior pituitary are synthesized in hypothalamus and are then transported
via nerve fibers and stored in posterior pituitary.
2 hormones released from posterior pituitary are – i. ADH/Vasopressin
-ii. Oxytocin
OXYTOCIN:
In females: -2 major functions – uterine contraction during labour
- milk ejection after delivery
a) Uterine contraction :- during delivery oxytocin enhances uterine wall
contraction
- It helps in expulsion of fetus and placenta
- After expulsion of placenta though raw area is present in endometrium ,
minimum bleeding is seen due to powerful oxytocin induced contraction
THYROID GLAND
FUNCTIONAL ANATOMY:
Thyroid= shield
It weighs 15-20 gms
Situated at root of neck around trachea below larynx.
It has 2 lobes which are connected in the middle by Isthmus
On the posterior side of thyroid there are 4 parathyroid glands
Microscopically, Thyroid gland is composed of large number of closed follicles which
are lined by follicular cells
Follicular cavity is filled with colloidal substance known as thyroglobulin which is
secreted by the follicular cells.
Follicular cells also secrete T3 ( Tri-iodothyronine) and T4 (Thyroxine)
In between the follicles, parafollicular cells are present which secrete Calcitonin
Tetraiodothyronine ( T4 or Thyroxine)
Tri iodothyronine (T3)
Calcitonin
Formation of Thyroid hormones
1. Iodide trapping- the follicular cells trap iodide ions by actively transporting them from
blood to cell. As a result thyroid gland contains most of iodide.
2. Synthesis of thyroglobulin- while follicular cells are trapping iodide, they are also
synthesizing thyroglobulin which is released into the lumen of follicle.
3. Oxidation of iodide- For the iodide ions to bind to thyroglobulin they must be oxidized
and converted to iodine. They are oxidized in presence of peroxidase enzyme and are
released into the follicular lumen.
4. Iodination of tyrosine – the formed iodine then react with tyrosine that are part of
thyroglobulin. Binding of one iodine atom yields T1 (monoiodotyrosine) and second
iodination produces T2 (diiodotyrosine). This bound thyroglobulin forms a sticky
material in lumen called colloid.
5. Coupling of T1 and T2 – 2 molecules of T2 may join to form T4 or T1 and T2 may join
to form T3.
6. Pinocytosis and digestion of colloid – droplets of colloid re-enter follicular cells ,
whenever required, by Pinocytosis and merge with lysosomes. Digestive enzymes in the
lysosomes break down thyroglobulin separating T3 and T4.
7. Secretion of thyroid hormone – As T3 and T4 are lipid soluble they diffuse through
plasma membrane and into blood.
8. Transport in blood – most of T3 and T4 combine with transport proteins in blood mainly
thyroxine binding globulin and reach the target cells
Calcitonin:
ii) TSH – Thyroid Stimulating hormone from anterior pituitary stimulate synthesis and
release of thyroid hormones
iii)Feedback – Elevated hormone levels of T3 & T4 inhibit release of TRH and TSH by
negative feed back mechanism and low levels of T3 & T4 stimulate hypothalamus to
secrete TRH
iv)Autoregulation – is done by the thyroid gland via Iodide trapping mechanism. Iodide is
necessary for hormone synthesis. When dietary level of iodine is moderate , blood level
of thyroid hormone is normal. When its uptake is high the enzymes necessary for
hormone synthesis are inhibited by iodide itself, resulting in suppression of hormone
synthesis. This effect of iodide is called Wolff-Chaikoff effect.
APPLIED ASPECTS:
GOITER:
- is enlargement of thyroid gland which may occur in both hyper and hypothyroidism
- Goiter in hyperthyroidism is called as toxic goiter and in hypothyroidism called as non
toxic goiter
a) Toxic Goiter – there is enlargement of gland with increased hormone secretion
b) Non toxic Goiter - can be classified as Iodine deficiency Goiter and Idiopathic non
toxic Goiter
- Iodine deficiency goiter / endemic colloid goiter – due to deficiency of iodine in diet
there is no synthesis of thyroid hormones , but increased TSH secretion takes place which
causes gland to enlarge due to increased thyroglobulin formation.
- Idiopathic non toxicGoiter- some food stuffs contain goitrogenic substance such as
Goitrin which suppress the synthesis of thyroid hormones . Eg: Turnip, cabbage
PARATHYROID GLANDS
Are 4 in number and are located in posterior surface of thyroid gland
They contain 2 kinds of cells : Chief cells that produce parathyroid hormone
(Parathormone) and Oxyphil cells, which may be depleted chief cells.
Functions of PTH:
It has 4 major functions:
- It increases bone resorption by intensifying osteoclastic activity
- It facilitates conversion of Vitamin D into its active form Calcitriol.
- It facilitates absorption of Calcium from jejunum via Calcitriol.
- It acts on renal tubules to increase calcium reabsorption and phosphate excretion
ENDOCRINE PANCREAS
Pancreas is both an endocrine and exocrine gland
Is located in curve of duodenum
Has a head, body and tail
Pancreas is composed of 2 types of tissues: acini and islet of Langerhans
Acini - secrete digestive juice and flow out through a duct forming the exocrine portion
In between the acini are tiny clusters of endocrine tissue called islet of Langerhans
o Each pancreatic islet includes 4 types of cells:
= alpha or A cells- secretes Glucagon
= Beta or B cells- secretes Insulin
= Delta or D cells- secretes Somatostatin
= F cells – secretes pancreatic polypeptide
INSULIN:
Is an anti- diabetic hormone
Its effect on carbohydrate metabolism:
o it decreases blood glucose level and increases storage in form of glycogen
o it promotes glycogenesis and increases peripheral utilization of glucose
o it inhibits gluconeogenesis and glycogenolysis
on protein metabolism:
o helps in storage of proteins
o helps in protein synthesis
o prevents degradation of proteins
on fat metabolism:
o helps in storage of fat in adipose tissue
o promotes synthesis of lipids
o inhibits lipolysis
major target organs of insulin are liver, muscle and adipocytes.
Effect on liver:
o it promotes glycogenesis and protein synthesis
o inhibits gluconeogenesis
on skeletal muscle:
o allows glucose and amino acid uptake by muscles
o promotes protein synthesis and glycogenesis
on adipocytes:
o inhibits lipolysis
o allows synthesis and storage of fat
GLUCAGON:
its action is opposite to insulin
it increases blood glucose level,by peripheral utilization of lipids and conversion of
proteins to glucose
major target cell is hepatocyte
On hepatocytes:
o It promotes hepatic glycogenolysis and increases blood glucose level (by
breaking glycogen)
o Promotes gluconeogenesis (formation of glucose from non carbohydrate source)
It promotes lipolysis
Level of blood glucose controls secretion of insulin and glucagon by negative feedback
mechanism
Low blood glucose stimulates glucagon secretion from alpha cells resulting in
glycogenolysis in liver, and gluconeogenesis
This leads release of glucose into blood leading to raise in blood glucose level
As blood glucose level rises, hyperglycemia may occur which results in inhibition of
glucagon secretion by negative feedback mechanism
The high blood glucose causes stimulation of insulin secretion resulting in lowering
blood glucose level.
If blood glucose level drops below normal then by negative feedback mechanism insulin
secretion is inhibited
SOMATOSTATIN:
PANCREATIC POLYPEPTIDE
1. DIABETES MELLITUS:
Is a metabolic disorder characterized by high blood glucose level and other symptoms
Diabetes= polyuria and mellitus= honey
2 types: Type I and Type II
Type II DM:
Is due to insulin resistance (failure of insulin receptors to give response to insulin)
Usually occurs after 40 years
Most of the time can be controlled by oral hypoglycemic drugs rarely requires insulin
So also called as non insulin dependant DM (NIDDM)
2. HYPERINSULINISM:
- hypersecretion of insulin
- Develops hypoglycemia due to which neurological symptoms develop like tremors, convulsions and
coma
ADRENAL GLANDS
Adrenal glands (supra renal glands) lie superior to each kidney and have
flattened pyramidal shape
It is structurally divided into peripheral adrenal cortex and central adrenal
medulla
A connective tissue capsule covers the gland
Adrenal medulla is functionally related to sympathetic nervous system; it
secretes hormones epinephrine and nor epinephrine in response to sympathetic
stimulation
Adrenal cortex secretes an entirely different group of hormones called
corticosteroids which are essential for life.
ADRENAL CORTEX:
is subdivided into 3 zones , each of which secretes different hormones
-i) The outer zone – zona glomerulosa secretes mineralocorticoids
-ii) Middle- zona fasciculata- secretes glucocorticoids
- iii) Inner zone- zona reticularis- secretes androgens
Mineralocorticoids
are the corticosteroids that affect mineral homeostasis (electrolytes)
- Aldosterone is the major mineralocorticoid.
- It regulates homeostasis of 2 mineral ions, namely sodium ions and potassium
ions and helps adjust BP and blood volume
-it increases reabsorption of Na+ and water from renal tubules and increases
excretion of K+ through renal tubules
- It also promotes H+ ion excretion in urine and maintains pH of blood
Glucocorticoids
Are the corticosteroids which affect glucose homeostasis
hormones include cortisol(hydrocortisone), corticosterone and cortisone,
amongst which cortisol is abundant
Effects of glucocorticoids:
- increases protein breakdown
- stimulates gluconeogenesis and lipolysis
- provides resistance to stress. It provides additional glucose to tissues in
conditions of fasting, exercise, bleeding etc
- reduces inflammation and depress immune responses (hence prescribed after
organ transplantation to avoid tissue rejection by immune system)
Androgens
are steroid hormones that have masculinizing effects
mainly secreted is DHEA (dehydroepiandrosterone)
- in females, they promote libido, and are converted to estrogen (which are main
source of estrogen after menopause)
-stimulates growth of axillary and pubic hair in both sexes
ADRENAL MEDULLA:
Is a modified sympathetic ganglion of ANS.
The hormone producing cells- Chromaffin cells- are innervated by sympathetic
preganglionic neurons of ANS
2 major hormones synthesized are epinephrine and nor epinephrine
Functions:
In stressful situations hypothalamus stimulates the sympathetic preganglionic
neurons which stimulate the chromaffin cells to secrete epinephrine and nor
epinephrine. These 2 hormones carry out the fight and flight response
On metabolism- Adrenaline increases BMR
- Increases blood levels of glucose by glycogenolysis
- Also causes fat mobilization
On Blood vessels- They also increase blood flow to heart, liver, skeletal muscles
On Heart- They increase the cardiac output by increasing heart rate and force of
contraction
On respiration- Adrenaline increases rate of respiration and causes
bronchodilation
OVARIES
Progesterone:
- is concerned mainly with preparation of uterus for pregnancy and breasts for lactation
1. effect on fallopian tube –
a. promotes secretory activity of mucosal liming
these secretions are necessary for nutrition of fertilized ovum
2. effect on uterus-
a. promotes secretory activity of uterine endometrium during secretory phase of
menstrual cycle
b. increases thickness of endometrium
c. increases blood supply to endometrium
d. decreases frequency of uterine contraction
e. these prepare uterus for implantation of fertilized ovum
3. effect on cervix-
a. increases thickness of cervical mucosa and thereby inhibits the entry of sperm
4. effect on mammary glands-
a. promotes the development of lobules and alveoli of mammary glands by
proliferating and enlarging the alveolar cells
5. effect on hypothalamus –
a. it inhibits secretion of LH by negative feedback, this helps in contraceptive
action
Hormones functions
3. Relaxin Increases flexibility of symphysis pubis during
pregnancy and helps cervix dilatation
4. Inhibin Inhibits secretion of FSH
TESTES
= Testosterone-
i) In fetal life –
a. Helps in sex differentiation
b. Development of accessory sex organs
c. Descent of the testes
= Inhibin-
These hormones are regulated by the GnRH released by hypothalamus which stimulate
anterior pituitary to release Gonadotropic hormones – namely LH and FSH which inturn
act on Ovaries and Testes to release estrogen, progesterone and testosterone
PINEAL GLAND
Pineal gland or epiphysis is a small endocrine gland attached to roof of third ventricle
at midline
Has 2 types of cells : parenchymal cells and neuroglial cells
In adult pineal gland is calcified but the parenchymal cells exist and secrete the
hormonal substance
Melatonin:
Is secreted by parenchymal cells of pineal gland
It acts mainly on gonads
In humans it inhibits the onset of puberty by inhibiting the gonads
Its secretion is more in darkness (night) than day
As it is liberated during darkness, it is thought to promote sleep
In response to visual impulse sent from retina there is stimulation of pineal
gland for secretion of melatonin
THYMUS
Is a bilobed organ located behind sternum in the mediastinum.
Each thymic lobule consists of outer cortex and inner medulla
Outer cortex is composed of large number of T cells and macrophages. Immature T cells
migrate from red bone marrow to thymic cortex and begin to mature here
The medulla consists of more mature T cells
In infants thymus is large but after puberty thymic tissue is replaced by adipose and
areolar connective tissue . by the time person reaches maturity gland is atrophied
Functions of Thymus:
It plays an important role in lymphoid function and endocrine function
=Lymphoid function:
o It helps in processing T lymphocytes and hence helps in development of
immunity
=Endocrine function:
o secretes 2 hormones thymosin and thymin
o Thymosin accelerates lymphopoiesis and proliferation of T lymphocytes
o Thymin suppresses neuromuscular activities by inhibiting acetylcholine release