ENDOCRINE GLAND

HORMONES PRODUCED

PRINCIPAL ACTION

COMMENTS

SITE OF ACTION/ TARGET ORGAN

ADRENAL GLAND 1. These glands are paired suprarenal glands situated atop the kidneys; right gland is triangular, left is pear-shaped 2. These glands are highly vascularized 3. There are two portions: (2)

a.

Adrenal cortex (outer) -Produces steroid hormones derived from cholesterol which it can synthesize and take up from the circulation The common biosynthetic pathway from cholesterol is via the stem precursor for the three (3) major groups of adrenal steroids pregnenolone

For all steroid hormones: carbohydrate, protein and fat metabolism salt and water balance inflammation resistance to infection hypersensitivity Steroid hormones: 1. Mineralocorticoids: aldosterone a.) Aldosterone is the major mineralocorticoids of clinical significance - Aldosterone production is regulated to a great extent by the Renin-Angiotensin system and to much a lesser extent by the ACTH concentration. -Its effect is the promotion of sodium ion reabsorption by the kidney to maintain an appropriate sodium-potassium hydrogen ion balance. This reabsorption process also affects water retention by the body causes hypertension due to water and sodium retention leads to severe water and electrolyte abnormalities

General body tissues

This region is subdivided into three (3) regions: a. Outer Zone zona glomerulosa secreting mineralocorticoids b. Middle zone zona fasciculate secreting glucocorticoids Inner zone zona reticularis synthesizing sex hormones

2.

Glucocorticoids : cortisol and cortisone a.) Cortisol - a glucocorticoid that is most significant physiologically. - 75% is bound to transcortin by the corticosteroid-binding globulin (CBG), an alpha-2globulin; 15%is bound to albumin and is 10% is free. ACTH stimulates the adrenocortical production and secretion of cortisol and to a lesser extent, androgen, but has no such effect on aldosterone. -Its major role in metabolic control is the enhancement of glucose production from proteins and amino acids. It acts as an insulin antagonist. -Cortisol is the only adrenal hormone to inhibit the anterior pituitary secretion of ACTH by negative feedback. The plasma concentration of cortisol closely follows the diurnal variation pattern (circardian rhythm) of ACTH and is highest in the early morning hours and lowest at night -carbohydrate, fat and protein metabolism, Water and electrolyte balance. Suppress inflammatory and allergic reactions

Regulated by ACTH. Diurnal variation P.M values in Cushings syndrome In Addisons disease

c.

b.) Cortisone

* Glucocorticoids also stimulate lipolysis, provides resistance to stress and depress immune responses. The urinary metabolite of cortisol and cortisone is known as 17-hydroxydehydrocorticosterone.

3.

Sex/ Androgenic steroid: estrogen, progesterone, androgen a. Estrogen Three (3) major estrogen: o Estradiol o

-plays an important role in the regulation of menstrual cycle. - clinical significance only during pregnancy

Estriol

o Estrone

- clinical significance only during pregnancy

b. Progesterone

-Stimulates the uterus to undergo the changes that prepares it for the implantation of the fertilized ovum, and suppresses ovulation and secretion of the pituitary luteinizing hormone. In this site the primary role of the progesterone is to furnish a precursor for formation of other steroids.

c.

Androgens The major androgens are: o Testosterone

-the primary function of testosterone is to facilitate development of secondary male characteristics and spermatogenesis.

o Androstenedione has a weak biochemical activity

o Dehydroepiandroster one - has a weak biochemical activity *Adrenal androgens also assist in the prepubertal growth spurt and early development axillary and pubic hair in boys and girls and maintenance of libido.

b.

Adrenal medulla (inner) -Consists of hormoneproducing cells called chromaffin cells (so named because of its high affinity to chromium salts) which surround large blood vessels. -Chromaffin cells of adrenal medulla are stimulated by acetycholine to secrete catecholamines from tyrosine. -

The two (2) principal hormone synthesized by the adrenal medulla are: Catecholamines: 1.) Epinephrine also called adrenalin and is derived from tyrosine via dopamine. -10% Epinephrine -Epinephrine is the predominant fraction because N-methyl transferase is confined to the adrenal medulla

For both Epinephrine and Norepinephrine: - Mimic sympathetic receptor glycogenesis (liver & muscle) release of lipids - mobilize energy stores and prepare the body for muscular activity- increased heart rate and blood pressure, increased blood sugar, etc. -These hormones are so potent physiologically that only small amount are needed to obtain their effects. -Their action transitory because of rapid inactivation of a liver enzyme, Catechol-O-methyl transferase (COMT). - The predominant urinary metabolic is Vanillylmandelic Acid (VMA). The most preferable test to assess adrenomedullary function is VMA test. -Cathecolamines cause blood pressure and its measurement is of value to uncover the possible presence of tumor of the adrenal medulla that is a cause of hypertension known as pheochromocytoma. Pheochromocytoma is a benign chromaffin tissue tumor of the adrenal glands and manifested by hypertension accompanied by anxiety, sweating, throbbing headache and either facial pallor e or flushing during the attack. There is excessive secretion of catecholamines. N o -An often fatal malignant condition in children in which cancer of the r nervous system causes excess production of e norepinephrine (neuroblastoma), may secrete dopamine and its p metabolite, chromovanillic acid (HVA). i n e Fight or flight syndrome Stimulation of sympathetic nerve system Sympathetic receptor Adipose body tissues

2.) Norepinephrine - also called noradrenalin and is derived from tyrosine via dopamine. - 30% norepinephirne - Extramedullary sources like postganglionic sympathetic nerves secrete mainly norepinephrine Epinephrin

A. 1. 2. 3. 4. 5. 6. 7.

Related Diseases / Disorders Aldosteronism = hypersecretion of aldosterone Addisons Disease = hypersecretion of glucocorticoids and aldosterone Cushings Syndrome = hypersecretion of glucocorticoids Virilism or Hirsutism = elevated plasma testosterone in women as a result of ovarian or adrenal tumor (virilizing adenoma) Gynecomastia = excessive growth (benign) of the male mammary glands due to an adrenal tumor (feminizing adenoma) which secretes feminizing hormone (estrogen) Pheochromocytoma = tumor of the adrenal medulla that is a cause of hypertension Neuroblastoma = fatal malignant condition in children in which cancer of the nervous system causes excess production of norepinephrine

A. Metabolites 1. Vanillylmandelic acid predominating metabolite of the catecholamines 2. Hormovanillic acid- end product of dopamine metabolism 3. 17- hydroxycorticosteroid (17-OCHS) urinary metabolite of glucocorticoids 4. 17- ketosteroid (17-KS) B. Laboratory Assays 1. Porter- Silber Fluorometric method: 17- OHCS 2. Zimmerman reaction: 17-KS 3. Kober reaction: urine estrogen 4. Dexmethasone Suppression Test (DST): cortisol test in depression 5. Radioimmunoassay (RIA): cortisol 6. Flourscent Polarization Immunoassay (FPIA): cortisol 7. Gas Chromatography: catecholamines 8. High Performance Liquid Chromatography (HPLC) : catecholamines