Endocrinology

For the academic journal, see Endocrinology (journal).

Endocrinology (from Greek , endon, within";
, krn, to separate"; and -, -logia) is
a branch of biology and medicine dealing with the
endocrine system, its diseases, and its specic secretions
known as hormones. It is also concerned with the integra- Triiodothyronine
tion of developmental events proliferation, growth, and Examples of amine hormones
dierentiation, and the psychological or behavioral activO
OH
ities of metabolism, growth and development, tissue funcHO
OH
tion, sleep, digestion, respiration, excretion, mood, stress,
H
lactation, movement, reproduction, and sensory percepH
H
tion caused by hormones. Specializations include behavioral endocrinology[1][2][3] and comparative endocrinol- O
ogy.
Cortisol
The endocrine system consists of several glands, all in different parts of the body, that secrete hormones directly
into the blood rather than into a duct system. Hormones
have many dierent functions and modes of action; one
hormone may have several eects on dierent target organs, and, conversely, one target organ may be aected
by more than one hormone.
In the original 1902 denition by Bayliss and Starling (see
below), they specied that, to be classied as a hormone,
a chemical must be produced by an organ, be released (in
small amounts) into the blood, and be transported by the
blood to a distant organ to exert its specic function. This
denition holds for most classical hormones, but there
are also paracrine mechanisms (chemical communication
between cells within a tissue or organ), autocrine signals
(a chemical that acts on the same cell), and intracrine
signals (a chemical that acts within the same cell).[4] A
neuroendocrine signal is a classical hormone that is released into the blood by a neurosecretory neuron (see article on neuroendocrinology).A disease of the endocrine
system that many adults have is diabeates.

Vitamin D3
Examples of steroid hormones
Grin and Ojeda identify three dierent classes of hormone based on their chemical composition:[5]

1.1 Amines
Amines, such as norepinephrine, epinephrine, and
dopamine, are derived from single amino acids, in
this case tyrosine. Thyroid hormones such as 3,5,3triiodothyronine (T3) and 3,5,3,5-tetraiodothyronine
(thyroxine, T4) make up a subset of this class because
they derive from the combination of two iodinated tyrosine amino acid residues.

Chemical classes of hormones

1.2 Peptide and protein

OH
(R)

NH2

Peptide hormones and protein hormones consist of three

(in the case of thyrotropin-releasing hormone) to more
than 200 (in the case of follicle-stimulating hormone)
amino acid residues and can have a molecular mass as

HO
OH

Norepinephrine
1

2 HISTORY AND KEY DISCOVERIES

large as 30,000 grams per mole. All hormones secreted

by the pituitary gland are peptide hormones, as are leptin
from adipocytes, ghrelin from the stomach, and insulin
from the pancreas.

1.3

Steroid

Steroid hormones are converted from their parent compound, cholesterol. Mammalian steroid hormones can be
grouped into ve groups by the receptors to which they
bind: glucocorticoids, mineralocorticoids, androgens,
estrogens, and progestogens. Some forms of vitamin D,
such as calcitriol, are steroid-like and bind to homologous
receptors, but lack the characteristic fused ring structure
of true steroids.

History and key discoveries

humoral approach to understanding biological function and disease was favoured by the ancient Greek
and Roman thinkers such as Aristotle, Hippocrates,
Lucretius, Celsus, and Galen, according to Freeman et
al.,[7] and these theories held sway until the advent of
germ theory, physiology, and organ basis of pathology
in the 19th century.
In 1849, Arnold Berthold noted that castrated cockerels
did not develop combs and wattles or exhibit overtly male
behaviour.[8] He found that replacement of testes back
into the abdominal cavity of the same bird or another
castrated bird resulted in normal behavioural and morphological development, and he concluded (erroneously)
that the testes secreted a substance that conditioned the
blood that, in turn, acted on the body of the cockerel.
In fact, one of two other things could have been true:
that the testes modied or activated a constituent of the
blood or that the testes removed an inhibitory factor from
the blood. It was not proven that the testes released a
substance that engenders male characteristics until it was
shown that the extract of testes could replace their function in castrated animals. Pure, crystalline testosterone
was isolated in 1935.[9]
The Graves disease was named after Irish doctor Robert
James Graves,[10] who described a case of goiter with
exophthalmos in 1835. The German Karl Adolph von
Basedow also independently reported the same constellation of symptoms in 1840, while earlier reports of the
disease were also published by the Italians Giuseppe Flajani and Antonio Giuseppe Testa, in 1802 and 1810
respectively,[11] and by the English physician Caleb
Hillier Parry (a friend of Edward Jenner) in the late
18th century.[12] Thomas Addison was rst to describe
Addisons disease in 1849.[13]

Arnold Berthold is known as a pioneer in endocrinology.

The earliest study of endocrinology began in China.[6]

The Chinese were isolating sex and pituitary hormones
from human urine and using them for medicinal purposes by 200 BCE.[6] They used many complex methods, such as sublimation of steroid hormones.[6] Another
method specied by Chinese textsthe earliest dating
to 1110specied the use of saponin (from the beans
of Gleditschia sinensis) to extract hormones, but gypsum
(containing calcium sulfate) was also known to have been
used.[6]

In 1902 William Bayliss and Ernest Starling performed

an experiment in which they observed that acid instilled
into the duodenum caused the pancreas to begin secretion, even after they had removed all nervous connections
between the two.[14] The same response could be produced by injecting extract of jejunum mucosa into the
jugular vein, showing that some factor in the mucosa was
responsible. They named this substance "secretin" and
coined the term hormone for chemicals that act in this
way.
Joseph von Mering and Oskar Minkowski made the observation in 1889 that removing the pancreas surgically
led to an increase in blood sugar, followed by a coma
and eventual deathsymptoms of diabetes mellitus. In
1922, Banting and Best realized that homogenizing the
pancreas and injecting the derived extract reversed this
condition.[15] The hormone responsible, insulin, was not
discovered until Frederick Sanger sequenced it in 1953.

Neurohormones were rst identied by Otto Loewi in

1921.[16] He incubated a frogs heart (innervated with its
vagus nerve attached) in a saline bath, and left in the soAlthough most of the relevant tissues and endocrine
lution for some time. The solution was then used to bathe
glands had been identied by early anatomists, a more

3
endocrinology.[17]

3 Endocrinology as a profession
Although every organ system secretes and responds to
hormones (including the brain, lungs, heart, intestine,
skin, and the kidney), the clinical specialty of endocrinology focuses primarily on the endocrine organs, meaning
the organs whose primary function is hormone secretion.
These organs include the pituitary, thyroid, adrenals,
ovaries, testes, and pancreas.
An endocrinologist is a physician who specializes in treating disorders of the endocrine system, such as diabetes,
hyperthyroidism, and many others (see list of diseases below).

3.1 Work
The medical specialty of endocrinology involves the diagnostic evaluation of a wide variety of symptoms and
variations and the long-term management of disorders of
a non-innervated second heart. If the vagus nerve on the deciency or excess of one or more hormones.
rst heart was stimulated, negative inotropic (beat am- The diagnosis and treatment of endocrine diseases are
plitude) and chronotropic (beat rate) activity were seen guided by laboratory tests to a greater extent than for most
in both hearts. This did not occur in either heart if specialties. Many diseases are investigated through excithe vagus nerve was not stimulated. The vagus nerve tation/stimulation or inhibition/suppression testing. This
was adding something to the saline solution. The ef- might involve injection with a stimulating agent to test
fect could be blocked using atropine, a known inhibitor the function of an endocrine organ. Blood is then samto heart vagal nerve stimulation. Clearly, something was pled to assess the changes of the relevant hormones or
being secreted by the vagus nerve and aecting the heart. metabolites. An endocrinologist needs extensive knowlThe vagusstu (as Loewi called it) causing the my- edge of clinical chemistry and biochemistry to understand
otropic (muscle enhancing) eects was later identied to the uses and limitations of the investigations.
be acetylcholine and norepinephrine. Loewi won the NoA second important aspect of the practice of endocrinolbel Prize for his discovery.
ogy is distinguishing human variation from disease.
Recent work in endocrinology focuses on the molecu- Atypical patterns of physical development and abnormal
lar mechanisms responsible for triggering the eects of test results must be assessed as indicative of disease or
hormones. The rst example of such work being done not. Diagnostic imaging of endocrine organs may reveal
was in 1962 by Earl Sutherland. Sutherland investigated incidental ndings called incidentalomas, which may or
whether hormones enter cells to evoke action, or stayed may not represent disease.
outside of cells. He studied norepinephrine, which acts
on the liver to convert glycogen into glucose via the ac- Endocrinology involves caring for the person as well
tivation of the phosphorylase enzyme. He homogenized as the disease. Most endocrine disorders are chronic
the liver into a membrane fraction and soluble fraction diseases that need lifelong care. Some of the most
(phosphorylase is soluble), added norepinephrine to the common endocrine diseases include diabetes mellitus,
membrane fraction, extracted its soluble products, and hypothyroidism and the metabolic syndrome. Care of
added them to the rst soluble fraction. Phosphorylase diabetes, obesity and other chronic diseases necessitates
activated, indicating that norepinephrines target recep- understanding the patient at the personal and social level
tor was on the cell membrane, not located intracellu- as well as the molecular, and the physicianpatient relalarly. He later identied the compound as cyclic AMP tionship can be an important therapeutic process.
(cAMP) and with his discovery created the concept of Apart from treating patients, many endocrinologists
second-messenger-mediated pathways. He, like Loewi, are involved in clinical science and medical research,
won the Nobel Prize for his groundbreaking work in teaching, and hospital management.
Thomas Addison

3.2

Training

3.3

Professional organizations

REFERENCES

A disease due to a disorder of the endocrine system is

often called a hormone imbalance, but is technically
Endocrinologists are specialists of internal medicine or known as an endocrinopathy or endocrinosis. Such dispediatrics. Reproductive endocrinologists deal primarily ease can be treated by increasing or reducing the hormone
with problems of fertility and menstrual functionoften which has become imbalanced.
training rst in obstetrics. Most qualify as an internist,
pediatrician, or gynecologist for a few years before specializing, depending on the local training system. In the 6 See also
U.S. and Canada, training for board certication in internal medicine, pediatrics, or gynecology after medical
Pediatric endocrinology
school is called residency. Further formal training to subspecialize in adult, pediatric, or reproductive endocrinol Neuroendocrinology
ogy is called a fellowship. Typical training for a North
Reproductive endocrinology and infertility
American endocrinologist involves 4 years of college, 4
years of medical school, 3 years of residency, and 2 years
Hormone
of fellowship. Adult endocrinologists are board certied
by the American Board of Internal Medicine (ABIM) or
Hormone replacement therapy
the American Osteopathic Board of Internal Medicine
(AOBIM) in Endocrinology, Diabetes and Metabolism.
Endocrine disease
Comparative Endocrinology

In North America the principal professional organizations of endocrinologists include The Endocrine
Society,[18] the American Association of Clinical Endocrinologists,[19] the American Diabetes
Association,[20] the Lawson Wilkins Pediatric Endocrine
Society,[21] and the American Thyroid Association.[22]
In the United Kingdom, the Society for Endocrinology[23]
and the British Society for Paediatric Endocrinology and
Diabetes[24] are the main professional organisations. The
European Society for Paediatric Endocrinology[25] is the
largest international professional association dedicated
solely to paediatric endocrinology. There are numerous
similar associations around the world.

Patient education

Because endocrinology encompasses so many conditions

and diseases, there are many organizations that provide
education to patients and the public. The Hormone Foundation is the public education aliate of The Endocrine
Society and provides information on all endocrine-related
conditions. Other educational organizations that focus
on one or more endocrine-related conditions include the
American Diabetes Association, National Osteoporosis Foundation, Human Growth Foundation, American
Menopause Foundation, Inc., and Thyroid Foundation of
America.

Diseases
See main article at Endocrine diseases

7 References
[1] Nelson, R. J. 2005. An Introduction to Behavioral Endocrinology, Fourth Edition. Sinauer Associates, Sunderland, MA.
[2] Introduction to Behavioral Endocrinology
[3] Behavioral Endocrinology
[4] Nussey S; Whitehead S (2001). Endocrinology: An Integrated Approach. Oxford: Bios Scientic Publ. ISBN
1-85996-252-1.
[5] Ojeda, Sergio R.; Grin, James Bennett (2000). Textbook
of endocrine physiology (4th ed.). Oxford [Oxfordshire]:
Oxford University Press. ISBN 0-19-513541-5.
[6] Temple, Robert (2007) [1986]. The genius of China:
3,000 years of science, discovery & invention (3rd ed.).
London: Andre Deutsch. pp. 141145. ISBN 978-0233-00202-6.
[7] Freeman ER; Bloom DA; McGuire EJ (2001). A
brief history of testosterone. J. Urol. 165 (2): 371
3. doi:10.1097/00005392-200102000-00004. PMID
11176375.
[8] Berthold AA (1849). Transplantation der Hoden. Arch.
Anat. Phsiol. Wiss. Med. 16: 426.
[9] David K; Dingemanse E; Freud J et al. (1935). Uber
krystallinisches mannliches Hormon aus Hoden (Testosteron) wirksamer als aus harn oder aus Cholesterin bereitetes Androsteron. Hoppe Seylers Z Physiol Chem 233
(56): 281. doi:10.1515/bchm2.1935.233.5-6.281.
[10] Robert James Graves at Who Named It?
[11] Giuseppe Flajani at Who Named It?

8.1

Societies and associations

[12] Hull G (1998). Caleb Hillier Parry 1755-1822: a notable provincial physician. Journal of the Royal Society of
Medicine 91 (6): 3358. PMC 1296785. PMID 9771526.
[13] Ten S; New M; Maclaren N (2001). Clinical review 130:
Addisons disease 2001. J. Clin. Endocrinol. Metab.
86 (7): 290922. doi:10.1210/jc.86.7.2909. PMID
11443143.
[14] Bayliss WM, Starling EH. The mechanism of pancreatic
secretion. J Physiol 1902;28:325352.
[15] Bliss M (1989). J. J. R. Macleod and the discovery of
insulin. Q J Exp Physiol 74 (2): 8796. PMID 2657840.
[16] Loewi, O. Uebertragbarkeit der Herznervenwirkung.
Pugers Arch. ges Physiol. 1921;189:239-42.
[17] Sutherland EW (1972).
Studies on the mechanism of hormone action.
Science 177
(4047):
4018.
Bibcode:1972Sci...177..401S.
doi:10.1126/science.177.4047.401. PMID 4339614.
[18] The Endocrine Society
[19] American Association of Clinical Endocrinologists
[20] American Diabetes Association
[21] Lawson Wilkins Pediatric Endocrine Society
[22] American Thyroid Association
[23] Society for Endocrinology
[24] British Society for Paediatric Endocrinology and Diabetes
[25] European Society for Paediatric Endocrinology

External links
Endocrinology (British online textbook)
Endotext (American online textbook)
Endocrinology at the US National Library of
Medicine Medical Subject Headings (MeSH)
The Hormone Foundation

8.1

Societies and associations

Endocrine Society
American Association of Clinical Endocrinologists
American Diabetes Association
Lawson Wilkins Pediatric Endocrine Society
Society for Endocrinology
Society for Behavioral Neuroendocrinology
British Society for Paediatric Endocrinology & Diabetes

9 TEXT AND IMAGE SOURCES, CONTRIBUTORS, AND LICENSES

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Endocrinology Source: http://en.wikipedia.org/wiki/Endocrinology?oldid=660570858 Contributors: Kpjas, Mav, Bryan Derksen, Malcolm Farmer, Ben-Zin~enwiki, Sgall, Bernfarr, Edward, Steve Rawlinson, Gabbe, Karada, Ellywa, Marumari, JWSchmidt, Scott, Emperorbma, Charles Matthews, JorgeGG, Robbot, Bryce, Diberri, Smjg, Gtrmp, Wolfkeeper, Everyking, Jfdwol, Ianmc, Gadum, Alteripse,
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