单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,Principles of Endocrinology,Department of Endocrinology,First Affiliated Hospital,Sun Yet-sen University,Cao Xiaopei,Endocrine,hormones from specialized cells in glands or tissue are secrected and transported in the blood to a distant site of action(classic“endocrine effect),or act directly upon nearby cells which is called“paracrine activity.,Exocrine,products from glands are secrected externally or into a lumen,such as the gastrointestinal tract.,Metabolism,organ function,growth,development reproduction,Maintainance of homostasis of internal environment,Effects of Endocrine System,Hormone,Chemical messengers produced by a variety of specialized secretory cells,Chemical signals secreted into the blood stream that act on distant tissues,usually in a regulatory fashion,Sources of Hormones,Hormone secretory cells (found around human body),Endocrine glands,Tissues or cells of endocrine function:,neurosecretory cel,ls in hypothalamus,hormone secretory cells/organ cells with endocrine function in GI tract,kidney,heart,lung,etc,Classification of Hormone,Amino acid derivatives:dopamine,catecholamines,thyroid hormone(TH),Small neuropeptides:gonadotropin-releasing hormone(GnRH),thyrotropin-releasing hormone(TRH),somatostatin,vasoprssin,Large proteins:insulin,luteinizing hormone(LH),parathyroid hormone(PTH),Steroid hormones:cortisol,estrogen,Vitamin derivatives:retinoid(VitA),vitamin D,a variety of peptide growth factors,Synthesis,Storage and Release of Hormones,Peptide hormones:,Neural or endocrine stimulation,transcription from DNA,mRNA ,peptide product,posttranslational protein processing,intracellular sorting,membrane integration,storage or secretion,.,Synthesis and Processing of Insulin,Synthesis,Storage and Release of Hormones,Steroid hormone:,Synthesis of most steroid hormones is based on modifications of the precursor and cholesterol.,Multiple regulated enzymatic steps are required for the synthesis of testosterone,estradiol,cortisol and vitamin D.,Modes of hormone action,Endocrine,Paracrine,Autocrine,Intracrine,neurocrine,Plasma Transport of Hormones,Hormone,Binding protein(s),Thyroxine(T4),Thyroxine-binding globulin(TBG),Thyroxine-binding prealbumin(TBPA),Albumin,Triiodothyronine(T3)(less bound than T4),Thyroxine-binding globulin(TBG)Albumin,Testosterone,estradiol,Sex hormone-binding globulin(SHBG),Insulin-like growth factor-I(IGF-l),IGF-binding proteins(mainly IGF-BP3),Cortisol,Cortisol-binding globulin(CBG),Hormones,their receptors and pathways,Degradation of Hormones,Hormone transport and degradation dictate the rapidity with which a hormonal signal decays.Some hormonal signals are evanescent(),whereas others are longer lived(e.g.TSH),Most hormones are deactivated in live,kidney or peripheral tissues.Thus it must be noted that hepatic insufficiency or renal insufficiency may result in prolonged half life of some hormones,Patterns of secretion,Hormone secretion is continuous(e.g.thyroid hormone)or intermittent(e.g.LH,FSH).,Biological rhythms-Circadian,Circadian means changes over the 24 hours of the day-night cycle and is best shown for the pituitary-adrenal axis.,Plasma cortisol levels during a 24-hour period,Hormonal and follicular changes during the normal menstrual cycle,The menstrual cycle is the best example of a longer and more complex(28-day)biological rhythm.,Patterns of secretion,Other regulatory factors,Stress,Sleep,Feeding and fasting,Patterns of secretion,Clinical significance of recognising rhythms of hormonal secretion:,1.,Testing the hormone concentration,2.,Hormonal replacement therapy,Endocrine System,Elements of endocrine system:,Endocrine organs,APUD system,Hormonal secrentory cells,Major endocrine organs and common endocrine problems,Hormones involved in Hypothalamus-Pituitary axis and their function,O,ther endocrine sites,Islet：insulincell、glucagoncell,somatostatin、VIP,Mucosa in GI tract：,gastrin、cholecystokinin、secretin、VIP,Kidney:1,25-(OH)2D3,Renin，EP，PG,Lung：APUD,Heart：natriuretic peptide,Endothelial cell：endothelin,Feedback,Hypothalamus Pituitary-target gland axis,Hypothalamus Pituitary thyroid axis,Hypothalamus Pituitary adrenal axis,Hypothalamus Pituitary gonad axis,Endocrine and metabolism,Insulin vs glucose,PTH vs calcium,ADH vs plasma osmotic pressure,Hypothalamus Pituitary thyroid axis,Hypothalamus Pituitary adrenals axis,Hypothalamus Pituitary gonad axis,Insulin and blood glucose,Classification of endocrine disease,1.primary endocrine disorder,2.secondary to other disease,3.ectopic endocrine disorder,4.due to receptor dysfunction,5.heredity abnormal hormones,6.iatrogenic,Clinical picture,history,、,symptom,、,sign,Lab findings,evidence of metabolic disturbance:,target tissue or/and organs function,evidence of inappropriate hormone,：,hormones or their metabolite of,endocrine function test,immunology,Diagnosis,Imageology,X,ray,，,CT，B ultrasound,，,isotope,Histology and cytology,Cytogenetics,Diagnosis,Typical features in endocrine dise