ENDOCRINE SYSTEM

 

 

I.       INTRODUCTION

 

The endocrine system consists of ductless (endocrine) glands that secrete biologically active chemicals called hormones into the blood or surrounding interstitial fluid. Hormones affect the metabolism of their target organs and regulation of metabolism, body growth and reproduction.

Both the endocrine and nervous systems functions cooperatively in regulating body processes. The endocrine system maintains signals and the nervous system receives and provides signals both externally and internally. For example, violent and frightful reactions from outside are fed to the eyes and ears through nervous system to the brain. We respond to those reactions by either running away or fighting. The nervous system also evokes hormones (epinephrine and norepinephrine) also called adrenalin to a series of chemical reactions that responds to this situation both physically and mentally.

The concept of hormone secretion (primary function of ductless glands) is also extended to include organs that secrete hormones (including those with ducts). Organs such as skin, heart, liver, brain and kidneys have been shown recently to secrete hormones in addition to performing other functions. 

This presentation examines the types of glands and hormones, the pituitary gland and its regulation; other glands and hormones: adrenal, thyroid and parathyroid, pancreas and others; mechanism of steroids and thyroxine hormones; mechanism of catecholamines and polypeptides.

a.                  Classification of glands

 

There are two types of glands: Exocrine glands that produce non-hormone secretions (sweat, sebum, saliva) have ducts through which these chemicals are transferred to the surface. Endocrine glands are ductless glands, that is, they do not have pouches or ducts. Their secretions enter the tissues, lymphatic or blood vessels around them and are conveyed to target sites. Local hormones such as autocrines and paracrines are part considered by some as part of the endocrine system.  Autocrines are hormones (e.g. prostaglandins) that affect the same cells that release them. Paracrine hormones act locally, however, they exert their effects away from cells that produce them.

         

 

 

b.           Chemical classification of hormones

There is chemical variation in the hormones secreted by different glands in the body. However, they all can be grouped under three general categories:

1.          Catecholamines: mostly water soluble hormones including epinephrine and norepinephrine

2.          Polypeptides and glycoproteins: they include short chain peptides such as antidiuretic hormones (ADH), insulin and large glycoproteins such as thyroid-stimulating hormones.

3.          lipophilic hormones (lipid soluble): they include steroids such as cortisol and estrogens and thyroxine. All steroid hormones are derived from cholesterol. The estrogens are produced from the sex gonads: testes and ovary, which produce testosterone and estradiol respectively. Thyroxine is a hormone that contains one molecule of iodine. It is called triiodothyronine when it contains three molecules of iodine and tetraiodothyronine when it contains four molecules of iodine.

 

b.           Similarities between neural and endocrine regulation

There is close association between hormone and neural regulation of cells. Unlike endocrine system, neurons produce hormone-like chemical or neurotransmitter, which travels through the blood. Diffusion across synapse occurs only when gaps are encountered. Hormones and neuronal   chemicals have the following in common:

1.          presence of specific receptor proteins at the site

2.          Molecules binds to the receptor proteins and produce changes

3.          The chemical must be degraded after its release.

 

III.    HORMONES MECHANISMS

 

Hormones produce a response at the target site by binding to receptor proteins. The binding of hormone molecules to the receptor may produce one or more of several reactions:

a.       changes plasma membrane permeability by opening    

     or closing ion gates necessary for action potential

b.       promotes synthesis of protein or regulatory molecules

c.        activate or deactivate enzymes

d.       stimulate mitosis

Two mechanisms the binding of lipid soluble steroid hormones and water soluble peptide hormones to receptors and produce their response.

 

1.   Steroid and thyroxine hormones

 

Steroid and thyroxine are non-polar lipophilic small molecules. They easily enter their target sites by combining with carrier proteins. The hormone dissociates from the carrier and combines with receptor proteins at the target site. The hormone binds to specific targets on the chromatin or DNA in the nucleus of the cell. The binding turns on genes initiating transcription and sequent translation of proteins.

Tetraiodothyronine (T4) binds to thyroxine binding protein (TBG) where it is transported to the target site. T4 is enzymatically changed to triiodothyronine (T3). In side the target T3 is transported to the nucleus by binding proteins. Inside the nucleus, T3 binds to nuclear receptor proteins where it induces transcription and subsequently translation.

 

2.       Catecholamines and polypeptide hormones

 

Catecholamines (e.g. epinephrine and norepinephrine, and other amino acid-based hormone) are water-soluble and cannot pass through the lipid membrane barrier, therefore require a second messenger cyclic AMP (cAMP).  Since these molecules are water-soluble, they are transported initially by carrier membrane proteins (also called G-proteins) located on the surface of the cell membrane. The binding of the hormones to the G-proteins activates an enzyme called adenylate cyclase, which promotes increased synthesis of cAMP in the cell. Cyclic AMP activates inactive protein kinases that produce a cascade of cellular reactions.

·        Generally, all of the effects outline above or anyone of them may be produced in response to the binding of steroid or thyroxine at the target site. In addition, here is some properties of hormone

·        Specific receptor proteins are necessary for target cell specificity; hormones can be up-regulated (increased response) or down-regulated (decrease response); half-life (time half of the hormone clears from the blood), onset of activity (time of initiation of activity); duration (how long it remained); reaction time which involves the following:

1.           Permissiveness: a condition in which of tissues are dependent on the presence of one or more hormone. For example, the development of reproductive structures is dependent on the presence of thyroxine hormone.

2.           Synergism: a situation in which two or more hormones produce the same response but their combined effects are greater than the responses of each hormone

3.           Antagonism: a condition in which the effect of one hormone opposes or suppresses the effect of another hormone. For example, insulin promotes the uptake of glucose by lowering blood sugar level. Glucagon opposes this action by increasing blood glucose level.

 

Regulation of hormone release. Control of hormone secretion under negative feedback mechanism of which there are three categories:

1.           Humoral stimuli: this is a condition in which the secretion of one hormone turns off another hormone. A good example is insulin and glucagon cited earlier. Another example is the regulation calcium (Ca++) levels. Low blood concentration of Ca++ triggers the release of parathyroid hormone (PTH), which promotes tissue release of Ca++ in to bloodstream.

 

2.           Neural stimuli: Nerve stimulation regulates hormone secretion. During a fight or flight situation, the sympathetic nervous system stimulates the adrenal gland to secrete EPI and NOREPI. These catecholamines directs the fight or flight reactions during emergency situations.

 

3.           Hormonal stimuli: hormones stimulate the release and inhibition of other hormones. These activities occur in many tissues. The release of several hormone of the anterior or posterior pituitary occurs as a result of stimulation from the hypothalamus. For example, during thirst condition, the hypothalamus stimulates the posterior pituitary gland to release antidiuretic hormone (ADH), which promotes water absorption in the kidneys.  As we drink water, the stretching of the stomach, satiety (fullness) sends impulse to the hypothalamus which turnoff ADH. This and other negative feedback mechanisms that control hormone release.

 

IV.   GLANDS AND SECRETIONS

 

Endocrine glands consist of specialized cells or tissues that secrete hormones. Endocrine glands are ductless, therefore their secretions directly or indirectly enter the blood vessels or through surrounding lymphatic vessels. Endocrine glands that secrete hormones include: pituitary, pineal, thymus, thyroid, parathyroid, adrenal, pancreas, stomach and intestines, gonads and placenta

 

Pituitary gland (hypophysis)

1.  Anatomy:

The pituitary gland is hanging from the hypothalamic stalk (infundibulum) and secured within the sella turcica of the sphenoid bone. It consists of two structures namely: adenohypophysis (anterior), neurohypophysi (posterior). Anterior pituitary is further divided into two lobes: the pars distalis (also called anterior pituitary) and pars tuberalis (an extension of infundibulum), and pars intermedia (located between posterior and anterior pituitary and present only in fetus).

The anterior pituitary is connected to the hypothalamus by a network of blood vessels called hypothalamus-hypo physeal portal system. Through this system, releasing hormones from the hypothalamus is conveyed to the anterior pituitary. Posterior (neurohypophysis) has numerous nerve connection blood supply and secretions are under neural control.

 

2.   Regulation    

Hormones from the anterior pituitary are stimulated by releasing hormones (RIH) from hypothalamus. Releasing or inhibitory hormones travel locally to the anterior lobe where they stimulate hormone secretions from the gland. Released hormones enter systemic circulation until sufficient level is achieved. The hormones are turned off by a negative feedback mechanism.

The following hormones are secreted from the pars distalis: ACTH, TSH, FSH, LH, GH and Prolactin. Par intermedia produces melanocyte-stimulating hormone (MSH). Posterior pituitary gland produces oxytocin and antidiuretic hormone (ADH).

 

3.   Hormones

a.           Adenocorticortropic hormone (ACTH): Also called corticortropin, this hormone is controlled by corticortropin releasing hormone (CRH) from the hypothalamus, which controls its release. The target of ACTH is the adrenal gland where it stimulates the secretion of glucocorticoids.

 

b.          Thyroid stimulating hormone (Thyrotropin, TSH): The hormone is controlled by thyroid releasing hormone (TRH) from the hypothalamus. It stimulates the thyroid gland to produce thyroid hormones. It is inhibited by thyroid hormones

 

c.           Growth hormone (GH): GH (also called Somatotropin) stimulates mitosis and growth of body cells as a result of increased synthesis of proteins and biological molecules. It also promotes energy metabolism through release of fats from adipose tissues; use of fats in cellular respiration and conversion of glycogen to glucose.

Growth hormone releasing hormone from the hypothalamus stimulates its release and growth hormone inhibitory hormone (GHIH) inhibits the secretion of growth hormone. Other stimulants are: low blood sugar level (hypoglycemia), strenuous exercise and excess of amino acid in blood. Conversely, high levels of blood sugar (hyperglycemia) stimulate the release of GHIH.

 

d.          Follicle Stimulating hormone (FSH): This is one of two gonadotropic hormones secreted by cells of the pituitary gland called gonadotopes and its targets are the ovaries and testes. In the ovaries it stimulates the development of eggs and follicles and in the testes, it stimulates spermatogenesis.

 

e.           Leutinizing hormone (LH): the second of the two gonadal hormones is produced from gonadotropes and targeted for the ovaries and testes. It promotes ovulation in females and LH stimulates the follicle or the yellow body to produce progesterone, which maintains the pregnancy following ovulation. In males, LH is also called interstitial cell-stimulating hormone (ICSH), which stimulates the interstitial cells of the testes to produce testosterone (T). They are released by gonadotropin releasing hormone (GnRH) and inhibited by sex steroids (estrogen and testosterone)

 

f.            Prolactin (PRL): is secreted by lactotropes or mamotropes, which increase greatly in size during pregnancy. PRL levels rise during pregnancy but have no effect until the baby is born when it stimulates the mammary glands to synthesize milk. It remains elevated during the nursing period. In males, PRL make the testes more sensitive to LH, thus indirectly stimulating secretion of testosterone.

 

g.           MSH:  this hormone is secreted from the pars intermdia. It is responsible for stimulating the production of melanin from melanocytes of the skin. Melanin is responsible for skin pigmentation.

 

Posterior Pituitary

The posterior pituitary (neurohypophysis) produces two hormones: oxytocin (OT) and antidiuretic hormone (ADH). The pituitary has an extensive array of nerve connections therefore its secretions are indirectly regulated by neural impute from the hypothalamus.

Unlike the anterior pituitary, which relies on releasing hormones, the posterior pituitary stores and secretes these hormones from cells of the supraoptic and paraventricular neuclei of the hypothalamus and transported by the hypothalamohyposeal tract. These tracts directly connect to the blood vessels.  The effects of OT and ADH.

 

a.        Oxytocin (OT): Large amounts of this hormone are released during childbirth, which stimulates and strengthen the smooth muscles of the uterus. It also affects the mammary glands, stimulating the oxytocin release when the baby sucks the nipples, which in turn contracts the mammary glands causing them to secrete milk.

 

b.       Antidiuretic hormone (ADH):  This hormone is also called vasopressin. It promotes the retention of water by the kidneys by preventing less excretion of water in urine-increased retention in blood. It also promotes vasoconstriction in some animals (this effect remains controversial).

 

Adrenal Glands

These glands are located on top of the kidneys and contain an outer cortex and an inner medulla. The cortex is divided into three zones: zona glomerulosa, middle zona fasciculate and an inner zona reticularis.  The medulla derived from the neural crest consists of chromaffin cells innervated by sympathetic fibers. The cortex is derived from the embryonic mesoderm. Functionally they are different.

 

Adrenal Cortex:

Secretes steroid hormones called corticorsteroids which consist of three steroid hormones:

1.        Mineralocorticoids: regulate Na+ and K+ balance in kidneys. The most potent of the mineralocorticoids, aldosterone (secreted by zona glomerulosa) promotes Na+ retention in the kidneys.

2.        Glucocorticoids: regulate metabolism of glucose and other organic molecules. Cortisol (hydrocortisone) is the predominant of the glucocorticoids. It is secreted from zona fasciculate and zona reticularis. Secretion of ACTH and cortisol are caused by stress.

3.        Sex steroids: weak androgens and small amounts of estrogen

 

Adrenal medulla

The chromaffin cells of the medulla, innervated by the sympathetic nerves secrete epinephrine (EP) and norepinephrine (NEP), producing typical sympathetic effects. Many stressors activate the adrenal medulla as well as the cortex, preparing the body for maximal mental and physical performance (the fight or flight reaction).

 

Thyroid gland

Thyroxine helps regulate the metabolic rate, necessary for growth and development; formation of reproductive structures; parathyroid hormone regulate calcium metabolism in blood.

The thyroid gland is located below the larynx and in front of the trachea. It consists of two lobes called isthmus and the largest of the endocrine gland, weighing 25g. It consists of sacs called thyroid follicles lined with cuboidal epithelia follicular cells. These follicular cells secrete thyroxine. Between the follicular cells are Para follicular cells that secrete calcitonin (thyrocalcitonin).

 

Thyroid hormones

Thyroxine, T3 and T4

Three thyroid hormones are secreted. Thyroxine, triiodothyronine (T3) contains three molecules of iodine and tetraiodothyronine (T4) contain four molecules of iodine. Both T3 and T4 synthesis are dependent on iodine (I) presence.  These hormones have similar effects: they increase metabolic rate, promote growth and cell division, and promotes protein synthesis, metabolism of fat and carbohydratres.

 

Calcitonin:  The third hormone produced from the thyroid gland functions in lowering blood calcium level by stimulating the uptake and deposition of calcium ions by osteoblast cells. The function of this hormone is antagonistic to that of parathormone produced from parathyroid gland.

 

Parathyroid gland

Parathyroid hormone (PTH):  PTH is secreted from parathyroid gland. PTH regulates low blood calcium levels by stimulating osteoclast cells to demineralize bone, inhibiting the secretion of calcium ions by the kidneys and promoting the absorption of calcium ions by the intestines, thus releasing calcium ions into the blood. The antagonistic action of PTH and calcitonin maintains blood calcium homeostasis.

 

Pancreas

The pancreas is both an exocrine and endocrine gland. As an exocrine gland, small secretory cells that produce digestive enzymes merge to form pancreatic ducts, which secrete enzymes and digestive juices.  As an endocrine gland, clusters of cells called Islet of Langerhans secrete directly enter the blood stream.  The Islet of Langerhans contains alpha cells and beta cells. The beta cells secrete insulin and the alpha secretes glucagon. The actions of insulin and glucagon are antagonist to one another.

 

Pancreatic Hormones

a.   Insulin

The beta cells produce insulin in response to rising level of blood glucose. When blood glucose level is high insulin is secreted which stimulates the uptake of glucose by hepatocytes. Glucose is then converted into glycogen and stored in the liver and also in the muscle tissues and in adipose as fat. Insulin also promotes amino acid utilization and cellular protein synthesis.

 

b.   Glucagon:

The threshold for low blood glucose level is 180 mg/dL. The brain relies on blood glucose for its energy. When glucose concentration falls below the threshold value, the brain sends signals (pain/headache, dizziness, etc) indicating low blood sugar level. Our body responds when the alpha cells secrete glucagon that converts stored glycogen in the liver and muscle into glucose and release it to the blood stream. The rising blood glucose level turns off the hormone stimulus. These actions of insulin and glucagon maintain the blood glucose homeostasis.

 

Pineal gland
Melanin and serotonin

Pineal body or gland is located in the third ventricle where it is covered by the meringues of the brain. The size of this pine cone-shaped gland maximum between age 1 and 5 and regresses in adolescent to a mere shrunken fibrous tissue mass. In animals with seasonal breeding, it regulates the breeding cycle and the gonads.

It produces Serotonin by day and converts it to melatonin by night. Melatonin suppresses gonadotropin and removal of pineal gland result in premature sexual maturation. Excessive secretion of melatonin is associated with a delay in onset of puberty. The role of melatonin remains controversial.

Gonads and Placenta
Androgens, estrogens, progesterone

The gonads (testes and ovaries) secrete sex steroids. These include male sex hormones or androgens and female sex hormones- estrogens and progesterone. The principal hormones in each of these categories are testosterone, estradiol-17B and progesterone.

The placenta is the organ responsible for nutrient and waste exchange between the fetus and the mother.  It is also an endocrine gland that secretes large amounts of estrogen and progesterone as well as other peptides.

 

V.  HORMONE DISORDERS

 

There are a few disorders associated with hormones function. A few of the hormones with widespread disorders are examined.

1.       Antidiuretic hormone (ADH)

A severe hyposecretion of ADH may result in diabetes insipidus, a condition characterized by production of excessive quantities (20-30 liters) of dilute urine

 

2.       Thyroid gland disorders: hypersecretion, hyposecretion, iodine deficiencies produce exophthalmic goiter, simple goiter, cretinism, myxedema.

a.      Exophthalmic goiter (Grave’s disease) is a condition that results from hypersecretion of thyroxine (and T3). It is characterized by increased metabolic rate, restlessness, weight loss, bulging eyes and swelling of the thyroid gland

b.     Simple goiter: This is the enlargement of the thyroid gland and result from a deficiency of iodine in the diet. Without iodine, inadequate amount of thyroxine and T3 are produced and the gland enlarges in an attempt to produce more hormones. Goiter can be prevented by inclusion of adequate amount of iodine in diet (e.g. iodized salt) or iodized spices.

c.     Cretinism: this is caused by a severe deficiency of thyroxine and T3 in infants. Without treatment it results in mental and physical retardation. It is characterized by stunted growth, abnormal bone formation, mental retardation and sluggishness.

d.     Myxedema: Caused by severe thyroxine and T3 deficiency in adults and characterized by weight gain, weakness, dry skin, puffiness of the face and sluggishness.

 

3.       Parathyroid hormone:

a.       Hypoparathyroidism:  Insufficient secretion of para- thyroid hormone may result in drastic drop in the concentration of blood calcium ions. Untreated this may produce calcemic tetany (inability of the muscles to contract) thus resulting in death.

b.     Hyperparathyrodism: Excessive secretion of this hormone may result in excessive removal of calcium ions from bones resulting in high blood calcium ions.  Untreated this condition may lead to osteoporosis, kidney stones and bone formation in abnormal areas of the body.

 

4.       Adrenal Cortex

a.  Cushion’s syndrome (cortisol or aldosterone): Hyper secretion of either of these hormones may produce Cushion’s syndrome characterized by high blood pressure, protein loss, osteoporosis, accumulation of fat on the trunk, fatigue, edema, and decreased immunity. A person with this condition tends to have a full rounded face.

c.     Addision’s disease: This condition results from a severe hyposecretion of either cortisol or aldosterone by the adrenal cortex. Low blood pressure, low blood sugar and sodium levels, an increase in potassium level, dehydration, muscle weakness and increased skin pigmentation characterize it. May result in death without treatment.

 

5.       Insulin

a.      Diabetes mellitus: Caused by insufficiency or hypo- secretion of insulin. It is characterized by high level of blood glucose. The hepatocytes are not able to take up glucose therefore such individuals cannot metabolize glucose. They rely on fat for energy. When fat is metabolized as energy it produces keto acids which tends to lower the blood pH (acidosis) thus inactivating enzymes and may be fatal. There are two types of diabetes:

Type I (insulin-dependent) diabetes appears in individuals less than 20 years and persist throughout life. Individuals require frequent insulin injections to counter insulin deficiency. Type II (non-insulin independent) diabetes occurs in individuals over 40 years and overweight. This type of diabetes may be controlled by diet and medication.

          b.   Hypoglycemia:  An extremely low level of blood glucose sometimes within 30min to 60 min after eating. Food craving and lethargy may characterize the condition immediately after eating. It may be caused by hyperactive beta cells of Langerhans that puts out excessive amounts of insulin.

6.       Growth hormone

a.      Acondroplasia (dwarfism): results from inadequate secretion of growth hormone (Somatotropin) during birth. Early detection may remedy the condition by injection of the hormone.

b.      Cachexia: in adults inadequacy of GH produces cachexia (premature aging) caused by tissue atrophy.

c.     Gigantism: oversecretion of GH leads to excessive stimulation of the epiphyseal plates leading to abnormal increase in bone lengths.

d.     Acromegly: In adults hypersecretion leads to softening disfiguring of the bones especially bones of the face, hand and feet.