ENDOKRINOLOGI DASAR

Krishna W. Sucipto, dr, SpPD

Divisi Endokrinologi & Metabolisme Bag./SMF Penyakit Dalam FK Unsyiah/ RSUZA Banda Aceh

KULIAH 1:

KONSEP DASAR
Ilmu yang mempelajari tentang keadaan klinik yang disebabkan oleh karena gangguan sekresi hormon pada sistim kelenjar endokrin

Content
Function of hormones Interaction Chemical nature of hormones Hormone synthesis,storage,and release Transport Feedback relationship Biorhytme Endocrine pathology Assessment of endocrine function

Systems Of Extracellular Communication

Transmit electrochemical signals two way traffic between the brain and peripheral tissues or between tissues

NERVOUS SYSTEM

ENDOCRINE SYSTEM

Releases chemical mediators into the circulation for action away from their sites of origin

IMMUNE SYSTEM

Protect organism against external And internal threats No Clear distinction between the 3 systems

Blood Circulation

Duct

 PARACRINE HORMONES When hormones act on neighboring non-hormone-producing cells ( Sex Steroid on ovary, Angiotensin II in the Kidney, etc) JUXTACRINE HORMONES Variant from Paracrine Hormones, Peptide hormone can remain in the membrane of one cell and interact with a receptor on a juxtaposed cell (The action of some hemopoietic GF) AUTOCRINE HORMONES Hormone is released and acts on receptors located on the same cell. (hormones to unregulated growth of cancer cells) INTRACRINE HORMONES When hormones act inside the cell without being released (Insulin can inhibit its own release from pancreatic islet B cells)

Endocrine Cell
H H H H H H H Intracrine H Juxtracrine H Paracrine H Juxtracrine

Autocrine

Hormon Target Cell

R R
H

Hormon Target Cell

Up And Down Regulation

DOWN REGULATION Hormone Serum Level Receptor Number

Sensitivity to Hormone (Hormone Resistance)

UP REGULATION Hormone serum level

Receptor Number
Sensitivity to Hormone

Function of Hormones
REPRODUCTION GROWTH & DEVELOPMENT

HORMONES

MAINTENANCE OF INTERNAL ENVIRONMENT

ENERGY PRODUCTION, UTILIZATION & STORAGE

Reproduction
All hormones are present in both sex Sexual dimorphism result of differences in the amounts of individual hormones and their pattern of secretion Sexual reproduction requires a precise genetic programming Hormones regulates gametogenesis Control dimorphic anatomic, functional, and behavioural development of males and females

Growth and Development

Growth and limitation of growth involve interaction hormones of all classes (peptide, steroid, catecholamine, thyroid) Hormones influence growth in several ways (i.e thyroid induced the formation if IGF 1)

Maintenance (and adaptation) of Internal Environment

Regulate the volume and electrolyte content of body fluid Blood pressure and heart Acid base balance Body temperature Mass of bone, muscle, and fat

Energy Production, Utilization, and Storage

Mediators of substrate flux and utilization of food (glucagon and insulin) Oxidation of fatty acid and ketones for maintaining a save level of plasma glucose level to protect CNS function Leptin regulates food intake Thyroid regulates oxygen consumption (BMR)

Action of Hormones. A single hormone may act independently or in concert with other hormones
Action 2
Action 1 Hormone 1 Multi Hormonal Process Action 3 Action 1 Hormone 2

Action 2
Action 3

Action 1

Action 3

Hormone 3

Action 2

One Hormone, Multiple Action

Testosterone effects
Fusion of labioscrotal folds during embryogenesis Induction of male differentiation of Wolfian duct Regression of embryonic breast Growth of the male urogenital tract Control spermatogenesis Growth of bread and body hair Promotion of muscle growth etc. Antiestrogen Anabolic

One Function, Multiple Hormones

Blood Glucose Homeostasis

Insulin

Glucagon, Epinephrin, Cortisol, GH, Thyroxin, etc

Characteristic of Hormones
Low concentration
Steroid and thyroid pmol micromol Peptides 1 pmol/L - 1mol/L

Directed to site of action

By specific mechanisms (receptors that recognize and bind the hormone) Delivered within restricted circulation Direct diffusion Local formation within a tissue from circulating

Concept of target tissue

The Chemical Natures of Hormones

Peptides (Amino acids)
Complex polypeptides (LH,CG) Intermediate-sized peptides (insulin) Small peptides (TRH) Dipeptides (T3,T4) Single amino acids (actecholamine, serotonin, histamin)

Steroids
Intact steroid nucleus (adrenal & gonadal) Broken steroid nucleus (Vit. D & Metabolites)

Receptors
Lypophilic Hormones
Hormon dengan molekul yang kecil Masuk kedalam sel dengan difusi Reseptor dalam inti (nuclear receptor) Berikatan dan memodulasi gene tunggal Yang termasuk: hormon derivat steroid, retinoic acid, tiroid, vitamin D., Cholesterol dan asam lemak

Receptors
Hydrophilic Hormon
Bersifat semipermeabel, tidak dapat menembus membran sel Mempunyai reseptor di membran sel (Membrane Receptor) Ikatan hormon dan membran akan mensintesa mediator intra sel ( 2nd messenger atau intracellular signal transducers) Yang termasuk: hormon derifat Peptida, Growth Factors dan Cytokines

Hormone Synthesis, Storage And Release

Peptide hormones are synthesized as other protein Steroid hormones and catecholamines are synthesized from smaller precursor molecule Synthesizes of some hormones can occur in diverse tissue (i.e hCG in almost every tissue; estrogen can be formed from testosteron and androstenedione in ovary, brain, adipocytes, hair follicle) Thyroid hormone to be restricted to thyroid cells

Fundamental Characteristics Distinguish Endocrine From Nonendocrine Tissues

Rates of synthesizes are greater in the endocrine organ There is an appropriate processing machinery to complete conversion of pro hormones to hormones Contain mechanisms for regulating the release of the hormone into the circulation (specialized vesicle)

Hormone Release
The rate of hormone release is limited by the rate of its synthesizes Only limited quantities of hormones are stored within the body Exceptions to the generalization are T4 and 1,25-idydroxyvitamin D

Transport
Water soluble hormones require no specific transport mechanism (transported in solution) Hormones inasoluble in water require carrier mechanisms (transport protein) Transport protein are two types: albumin an transthyretin (prealbumin)

Feedback Relationship
Hormone produced in peripheral organs feedback on the hypothalamic-pituitary system All hormones are under feedback control, some by the peripheral hormone themselves, some by cations (Ca and PTH), some by metabolites (glucose-insulinglucagon), some by other hormones (somatostatin, on insulin and glucagon), some by osmolality/extracellular fluid volume (vasopressinrenin-aldosteron)

Hypothalamus
TRH

Pituitary TSH

The clasic feedback system: Control of thyroid hormone release

Thyroid T4 rT3 T3

HYPOTHALAMUS
(releasing factors) (Portal System)

HYPOPHYSIS ANTERIOR
(trophic hormone)

ACTH
+ ADRENAL

TSH
+ TIROID

FSH LH + OVARIUM

FSH ICSH + TESTES

cortisol aldosteron

T3 T4

estrogen progesteron

testosteron

HYPOTHALAMUS
(Paraoptic Nuclei) (HT- HP TRACT)

HYPOPHYSIS POSTERIOR
(Neurohypophyse)

A.D.H (Oxytocine)

Collecting Duct of Kidney (water reabsorbtion)

Contraction of uterus

Not Related With Feedback Mechanism

Insulin Glucagon Catecholamines Parathyroid Hormone (P.T.H) Intestinal Hormones
(Secretin Glp, Etc)

Biorhytms
Common feature of all endocrine systems Common cause of endocrine pathology Can vary over minutes, hours, days, weeks, seasonal

Endocrine Pathology
Excess Deficiency
Sub normal production Receptor disorder Abnormalities of transport or metabolism

Tumors of endocrine glands

Functioning Non functioning

Thank You