KULIAH 1:

ENDOKRINOLOGI
DASAR
Krishna W. Sucipto, dr, SpPD
Divisi Endokrinologi & Metabolisme
Bag./SMF Penyakit Dalam
FK Unsyiah/ RSUZA
Banda Aceh
 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 electro-
chemical signals Releases chemi-
two way traffic ENDOCRINE
cal mediators
NERVOUS
between the SYSTEM into the circu-
SYSTEM
brain and lation for action
peripheral away from their
tissues or sites of origin
between tissues 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 Juxtracrine

H H
H H

H H H R

R H
R H Intracrine Autocrine
Hormon Target Cell
H

Juxtracrine

H
Paracrine
R

Paracrine
R H 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
GROWTH &
REPRODUCTION
DEVELOPMENT

HORMONES

MAINTENANCE OF ENERGY PRODUCTION,

INTERNAL ENVIRONMENT 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 2

Action 1 Action 3 Action 1 Action 3

Hormone 1 Hormone 2

Multi
Hormonal
Process

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

Glucagon,
Insulin 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) Steroids
Complex Intact steroid
polypeptides (LH,CG) nucleus (adrenal
Intermediate-sized & gonadal)
peptides (insulin)
Small peptides (TRH)
Broken steroid
nucleus (Vit. D &
Dipeptides (T3,T4)
Metabolites)
Single amino acids
(actecholamine,
serotonin, histamin)
 Receptors
Lypophilic Hormones
Hormon dengan molekul yang kecil
Masuk kedalam sel dengan difusi
Reseptor dalam inti (nuclear receptor)
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)
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-insulin-glucagon), some
by other hormones ( somatostatin, on insulin
and glucagon ), some by osmolality /
extracellular fluid volume (vasopressin
renin-aldosteron)
Hypothalamus

TRH

The clasic feedback

Pituitary - system:
TSH Control of thyroid
hormone release

Thyroid

T4

rT3 T3
 HYPOTHALAMUS
(releasing factors)

(Portal System)

HYPOPHYSIS ANTERIOR
(trophic hormone)

FSH FSH
ACTH TSH
LH ICSH
+ + + +

ADRENAL TIROID OVARIUM TESTES

cortisol T3 estrogen testosteron
aldosteron T4 progesteron
 HYPOTHALAMUS
(Paraoptic Nuclei)
(HT- HP TRACT)

HYPOPHYSIS POSTERIOR
(Neurohypophyse)

A.D.H (Oxytocine)

Collecting Duct of Kidney

Contraction of uterus
(water reabsorbtion)
 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