Adrenal gland in mammals

In mammals, the adrenal glands (also known as suprarenal glands) are endocrine glands that sit at the top of the kidneys; in humans, the right adrenal gland is triangular shaped, while the left adrenal gland is semilunar shaped. [1] They are chiefly responsible for releasing hormones in response to stress through the synthesis of corticosteroids such as cortisol and catecholamines such asadrenaline (epinephrine) and noradrenaline. These endocrine glands also produce androgens in their innermost cortical layer. The adrenal glands affect kidney function through the secretion of aldosterone, and recent data (1998) suggest that adrenocortical cells under pathological as well as under physiological conditions show neuroendocrine properties; within the normal adrenal, this neuroendocrine differentiation seems to be restricted to cells of the zona glomerulosa and might be important for an autocrineregulation of adrenocortical function.[2]

Structure[edit]
The adrenal glands are located in the retroperitoneum superior to the kidneys, they are quadrilaterial in shape and are situated bilaterally. The combined weight of the adrenal glands in an adult human ranges from 7 to 10 grams.[3] They are surrounded by anadipose capsule and renal fascia. Each adrenal gland has two distinct structures, the outer adrenal cortex and the inner medulla, both of which produce hormones. The cortex mainly produces cortisol, aldosterone and androgens, while the medulla chiefly produces adrenaline and noradrenaline. In contrast to the direct innervation of the medulla, the cortex is regulated by neuroendocrine hormones secreted from the pituitary gland which are under the control of the hypothalamus, as well as by the renin-angiotensin system.

Cortex[edit]
Main article: Adrenal cortex The adrenal cortex is devoted to production of corticosteroid and androgen hormones. Specific cortical cells produce particular hormones including aldosterone, cortisol, and androgens such as androstenedione. Under normal unstressed conditions, the human adrenal glands produce the equivalent of 3540 mg of cortisone acetate per day.[4] The adrenal cortex comprises three zones, or layers. This anatomic zonation can be appreciated at the microscopic level, where each zone can be recognized and distinguished from one another based on structural and anatomic characteristics.[5] The adrenal cortex exhibits functional zonation as well: by virtue of the characteristic enzymes present in each zone, the zones produce and secrete distinct hormones.[5]

Zona glomerulosa[edit]
The outermost layer, the zona glomerulosa is the main site for production of aldosterone, a mineralocorticoid, by the action of the enzyme aldosterone synthase (also known as CYP11B2).[6][7] Aldosterone is largely responsible for the longterm regulation of blood pressure.[8] The expression of neuron-specific proteins in the zona glomerulosa cells of human adrenocortical tissues has been predicted and reported by several authors[2][9][10] and it was suggested that the expression of proteins like the neuronal cell adhesion molecule(NCAM) in the cells of the zona glomerulosa reflects the regenerative feature of these cells, which would lose NCAM immunoreactivity after moving to the zona fasciculata.[2][11] However, together with other data on neuroendocrine properties of zona glomerulosa cells, NCAM expression may reflect a neuroendocrine differentiation of these cells. [2]
Paraffin sections of human adrenals immunostained forneuronal cell adhesion molecule (NCAM). Immunohistochemistry was carried out using 4-amino-9-ethylcarbazole(AEC; Dinanova, Hamburg, Germnay) and were counterstained with hematoxylin. Staining for NCAM was restricted to the zona glomerulosa (zg) and the adrenal medulla (m); a: x 20; b: x 200.[2]

Zona fasciculata[edit]
Situated between the glomerulosa and reticularis, the zona fasciculata is responsible for producing glucocorticoids, such as 11-deoxycorticosterone, corticosterone, and cortisol in humans.[12]

Zona reticularis[edit]
The inner most cortical layer, the zona reticularis produces androgens, mainly dehydroepiandrosterone (DHEA),DHEA sulfate (DHEA-S), and androstenedione (the precursor to testosterone) in humans.[12]

Medulla[edit]
The adrenal medulla is the core of the adrenal gland, and is surrounded by the adrenal cortex. It secretes approximately 20% noradrenaline (norepinephrine) and 80% adrenaline (epinephrine).[12] The chromaffin cells of the medulla, named for their characteristic brown staining with chromic acid salts, are the body's main source of the circulating catecholamines adrenaline and noradrenaline. Catecholamines are derived from the amino acid tyrosine and these water-soluble hormones are the major hormones underlying the fight-or-flight response. To carry out its part of this response, the adrenal medulla receives input from the sympathetic nervous system through preganglionic fibers originating in the thoracic spinal cordfrom T5T11.[13] Because it is innervated by preganglionic nerve fibers, the adrenal medulla can be considered as a specialized sympathetic ganglion.[13] Unlike other sympathetic ganglia, however, the adrenal medulla lacks distinct synapses and releases its secretions directly into the blood. Cortisol also promotes adrenaline synthesis in the medulla. Produced in the cortex, cortisol reaches the adrenal medulla and at high levels, the hormone can promote the upregulation of phenylethanolamine N-methyltransferase (PNMT), thereby increasing adrenaline synthesis and secretion.[5]

Blood supply[edit]
Although variations of the blood supply to the adrenal glands (and indeed the kidneys themselves) are common, there are usually three arteries that supply each adrenal gland:

The superior suprarenal artery is provided by the inferior phrenic artery The middle suprarenal artery is provided by the abdominal aorta The inferior suprarenal artery is provided by the renal artery

Venous drainage of the adrenal glands is achieved via the suprarenal veins:

The right suprarenal vein drains into the inferior vena cava The left suprarenal vein drains into the left renal vein or the left inferior phrenic vein.

The suprarenal veins may form anastomoses with the inferior phrenic veins. Since the right supra-renal vein is short and drains directly into the inferior vena cava it is likely to injure the latter during removal of right adrenal for various reasons. The adrenal glands and the thyroid gland are the organs that have the greatest blood supply per gram of tissue. Up to 60 arterioles may enter each adrenal gland.[14] This may be one of the reasons lung cancer commonly metastasizes to the adrenals.

Function[edit]
Aldosterone and mineralocorticoids[edit]
Aldosterone's effects are on the distal convoluted tubule and collecting duct of the kidney where it causes increased reabsorption of sodium and increased excretion of both potassium (by principal cells) and hydrogen ions (by intercalated cells of the collecting duct).[8] Sodium retention is also a response of the distal colon, and sweat glands to aldosterone receptor stimulation. Although sustained production of aldosterone requires persistent calcium entry through low-voltage activated Ca2+ channels, isolated zona glomerulosa cells are considered nonexcitable, with recorded membrane voltages that are too hyperpolarized to permit Ca2+ channels entry.[15] However, mouse zona glomerulosa cells within adrenal slices spontaneously generate membrane potential oscillations of low periodicity; this innate electrical excitability of zona glomerulosa cells provides a platform for the production of a recurrent Ca 2+ channels signal that can be controlled by angiotensin II and extracellular potassium, the 2 major regulators of aldosterone production.[15]Angiotensin II originates from plasmatic angiotensin I after the conversion of angiotensinogen by renin produced by the juxtaglomerular cells of the kidney.[12]

Cortisol and glucocorticoids[edit]

Cortisol is the main glucocorticoid under normal conditions and its actions include mobilization of fats, proteins, and carbohydrates, but it does not increase under starvation conditions.[12] Additionally, cortisol enhances the activity of other hormones including glucagon and catecholamines. The zona fasciculata secretes a basal level of cortisol but can also produce bursts of the hormone in response to adrenocorticotropic hormone (ACTH) from the anterior pituitary.

Androgen production[edit] Adrenaline and noradrenaline[edit]

Clinical significance[edit]

Several adrenal tumors cause symptoms because they result in the over- or underproduction of certain hormones by the adrenal gland. In hyperaldosteronism the adrenal glands produce too much aldosterone. In pheochromocytoma the adrenal glands secretes excessive amounts of catecholamines. In endogenous Cushing's syndrome the adrenal glands produce too much cortisol. Adrenal insufficiency denotes a group of diseases characterized by underproduction of cortisol or aldosterone. They can be caused by problems in the adrenal glands themselves, or by impairment of the pituitary gland or hypothalamus. The ACTH stimulation test may assist in diagnosis. Addison's disease is a rare disorder in which the adrenal glands do not produce sufficient amounts of glucocorticoids (mainly cortisol). This can be caused by an autoimmune reaction, by certain infections or by some other rarer causes. Congenital adrenal hyperplasias are genetic defects of enzymes involved in cortisol production and can affect sex characteristics of affected patients. WaterhouseFriderichsen syndrome is adrenal gland failure due to bleeding into the adrenal glands, caused by severe bacterial infection. Isolated hypoaldosteronism can rarely occur due to aldosterone synthase deficiency Absent adrenal gland, rare congenital condition

Nuclear binding and degradation

When the RNA polymerase reaches the end of mRNA coding genes, the nascent transcript is cleaved and a poly(A) tail is appended to the 3 end of the molecule. A large complex of proteins, the cleavage and polyadenylation machinery, is responsible for the recognition of 3 -processing signals and for cleavage, and an associated poly(A) polymerase (Pap1p) synthesizes the terminal polyadenylate (Buratowski, 2005 and Zhao et al., 1999). The presence of a 3 poly(A) tail is both a signal that the mRNA synthesis is complete and a functional element that will promote export from the nucleus and translation. Its position close to the end of the coding region of the mRNA is also a hallmark of quality, preventing degradation by the quality control system that detects the occurrence of premature stop codons. The size of the poly(A) tail (70100 nt in Saccharomyces cerevisiae) is also crucial, as its shortening in the cytoplasm is the first event committing the transcript to degradation. Poly(A)-binding proteins are required for a readout of the tail functions and to influence its synthesis and length by affecting the processivity of the poly(A) polymerase (Mangus et al., 2003). In S. cerevisiae, two proteins (Pab1p and Nab2p) that recognize the poly(A) tail have been described and extensively studied. Although both proteins shuttle between the nucleus and the cytoplasm, their main subcellular localization is cytoplasmic (Pab1p) and nuclear (Nab2p). While a cytoplasmic role for Pab1p in translation is clearly established, the nuclear role of the two proteins is still a matter of controversy, and it is not clear which one is directly involved in the regulation of poly(A) tail synthesis and its nuclear function(s) ( Dunn et al., 2005 and Hector et al., 2002). Poly(A) tailing is not only instrumental to express the message carried by an RNA, but also to promote maturation or degradation. A different polyadenylation pathway, dependent on an alternative poly(A) polymerase (Trf4p or Trf5p in S. cerevisiae), exists ( Houseley and Tollervey, 2008). This pathway tags a different class of substrates for faster (or more efficient) degradation by the nuclear exosome, a protein complex endowed with both exo- and endonuclease activity ( Lebreton and Seraphin, 2008). In many cases, degradation is halted by stable ribonucleoprotein complexes, and exonuclease trimming results in the production of mature and stable RNAs, as in the case of the small nucleolar RNAs (snoRNAs). It is unclear whether degradative polyadenylation is coupled to the termination of transcription and/or to 3 end processing of the primary transcript or if it occurs posttranscriptionally on substrates that cannot be degraded efficiently by the exosome, for instance due to secondary structures. Importantly, it is also unclear whether the unstructured poly(A) tail is required in vivo to promote more efficient degradation or whether it somehow serves for addressing the exosome to the substrate. Thus, the poly(A) tail can promote very different fates, which raises the important question of what differs in the readout of the same signal. One possibility is that binding of a poly(A)-binding protein (e.g., Pab1p) after cleavage and polyadenylation marks the poly(A) tails that have a cytoplasmic fate while masking at the same time a dangerous degradation signal. A poly(A) tail that would not associate with poly(A)-binding proteins during or shortly after synthesis (as could be the case of a tail added posttranscriptionally by Trf4p) would be exposed to the degradative activity of the exosome. The paper from Bachand and colleagues in this issue of Molecular Cell ( Lemay et al., 2010) challenges to some extent this view and provides a unique perspective on the function of poly(A)-binding proteins. The authors show that deletion of the gene encoding a nuclear poly(A)-binding protein in Schizosaccharomyces pombe, Pab2, leads to stabilization of extended forms of several snoRNAs. Importantly, these precursors to the mature snoRNAs are polyadenylated by a poly(A) polymerase that turns out to be distinct from the S. pombe homolog of Trf4p. The same extended forms are stabilized by deletion of Rrp6p (a nuclear exonuclease that is associated with the exosome), but in a double mutant rrp6 pab2 a further stabilization of the precursors was not observed, suggesting that Rrp6p and Pab2p work in the same pathway. Importantly, Pab2p binds these polyadenylated forms in vivo and interacts directly with Rrp6p, both in vivo and in vitro. This suggests that the binding of Pab2 to the poly(A) tail is required to target these extended transcripts to degradation via the direct interaction between Pab2p and the exosome

( Figure 1). These findings have two important implications: first, they provide evidence that the presence of the poly(A) tail can recruit the exosome (as opposed to favoring its catalytic activity); second, the mere (and presumably early) binding of a poly(A)-binding protein is not sufficient to prevent degradation but actually, in some conditions, promotes it. The authors suggest that this might reveal the existence of an alternative pathway to generate a mature form of snoRNAs: either transcription ends at a proximal site (presumably via the action of a homolog of the S.

cerevisiae Nrd1 complex, involved in termination of independently transcribed snoRNA genes) or it ends at a
downstream site where the nascent transcript is processed by the cleavage and polyadenylation machinery and where it interacts with Pab2b. The presence of Pab2 would lead to the recruitment of the exosome and subsequent trimming of these transcripts to their mature length.

However, there is more to the story. In another recent article (Lemieux and Bachand, 2009), the same group shows that Pab2p also binds cotranscriptionally to mRNAs and that this occurs even before the poly(A) tail synthesis (Figure 1B). In spite of this, no stabilization of the tested mRNAs nor an effect on the length of the poly(A) tail was observed in pab2 cells ( Lemay et al., 2010), suggesting that the presence of Pab2p on the poly(A) tail does not target these transcripts to the nuclear degradation machinery. Rather, Pab2p is found in polysomes, indicating that it remains associated with the mRNA during translation. Therefore, what determines whether RNAs that share the same tail, possibly generated by the same apparatus and with the same protein bound to it, are targeted to the exosome for degradation or to the cytoplasm for translation remains a hot question. It is obviously possible that other proteins, aside from Pab2p, bind differentially to mRNAs and snoRNAs, but it remains unexplained how these species are distinguished in the act of transcription if they are processed by the same 3 end apparatus. One possibility is that their fate is determined kinetically via a take the money and run strategy. If the RNA is not exported fast enough from the nucleus, it is targeted to a default exosome pathway for degradation or processing. If so, the presence of Pab2p on the poly(A) tail might not have a function in the nucleus other than that of a trigger that would determine the threshold above which the nuclear residency time is not compatible with the life of an mRNA.