Integrated Endocrinology E-Book

John Laycock

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 634

Veröffentlichungsjahr: 2012

Beschreibung

This innovative textbook provides a readable, contemporary and fully integrated introduction to endocrine glands, their hormones and how their function relates to homeostasis. It explores the pathology of endocrine disease by relating the underpinning science through a wealth of clinical scenarios and examples. The book integrates basic and clinical aspects for a range of endocrine glands and their hormones and includes a number of specialist chapters that also address areas of intense research and clinical interest including the regulation of salt, appetite and endocrine-immune interactions.

• Provides a fully-integrated, scientific and clinical introduction to endocrinology.
• Includes a wealth of colour illustrations to reinforce key concepts.
• Introduces clinical scenarios and  leading questions to engage interest and illustrate the relevance of  the underpinning science.
• Includes key references and suggestions for further reading at the end of each chapter.

Written by a highly respected and experienced author team this new textbook will prove invaluable to students needing an original, integrated introduction to the subject across a variety of disciplines including biomedical science, pharmacology , bioengineering and pre-clinical medicine.

Leseprobe

Table of Contents

Title Page

Copyright

Preface

Chapter 1: The Molecular Basis of Hormones

Hormones versus Neurotransmitters

Synthesis of Hormones

Storage of Hormones

Release of Hormones

Transport of Hormones in the Circulation

Hormone Receptors

Mechanisms of Action

Feedback Control

Summary

Conclusion

Reference

Chapter 2: The Hypothalamus and the Concept of Neurosecretion

The Hypothalamus

Hypothalamic Neurosecretions: Neurotransmitters and Hormones

Physiological Role of the Hypothalamus

Chapter 3: The Pituitary Gland (1): The Anterior Lobe (Adenohypophysis)

Introduction

Embryological Derivation

General Structure

The Anterior Pituitary and its Link to the Hypothalamus

Hypothalamic Neurones and Their Hormones

Pituitary Tumours and the Optic Chiasma

The Adenohypophysial Hormones

The Adenohypophysial Protein Hormones

The Glycoproteins

Further Reading

Chapter 4: The Pituitary Gland (2): The Posterior Lobe (Neurohypophysis)

Embryological Derivation and General Structure

Synthesis, Storage, Release and Transport of Neurohypophysial Hormones

Vasopressin (VP)

Oxytocin (OT)

Further Reading

Chapter 5: Diseases of the Pituitary Gland

The Anterior Pituitary (Adenohypophysis)

Individual Adenohypophysial Hormone Deficiencies

Hyperprolactinaemia

Anterior Pituitary Hypofunction (Panhypopituitarism)

Tumour Size Matters

Anterior Pituitary Hyperfunction (Hyperpituitarism)

The Posterior Pituitary Gland (Neurohypophysis)

Appendix: Clinical Cases

Answers to Clinical Scenario 5.1

Answers to Clinical Scenario 5.2

Further Reading

Chapter 6: The Gonads (1): Testes

Introduction

The Embryonic Development of the Testes

The Genetic Basis of Spermatozoon Production

The Endocrine Basis for Phenotype Differentiation

The Anatomy and Structure of the Testes

The Testicular Hormones and Their Receptors

Control of Testicular Function

Coitus and Penile Erection

Diseases of the Testis

Further Reading

Chapter 7: The Gonads (2): Ovaries

Introduction

Embryonic Development of the Ovaries

The Genetic Basis of Ovum Production

The Anatomy and Structure of the Ovaries and Related Structures

The Menstrual Cycle

The Ovarian Hormones

Control of the Menstrual Cycle

Clinical Conditions

Appendix: Clinical Cases

Further Reading

Chapter 8: The Endocrine Control of Puberty

Introduction

Pubertal Changes

Adrenarche

The Endocrine Basis for the Pubertal Changes

What is the Signal for the Onset for Puberty?

The Regulation of GnRH Neurones

The Kiss Gene and Its Products

Further Reading

Chapter 9: The Hormones of Pregnancy, Parturition and Lactation

Introduction

Fertilisation

Implantation and Creation of the Placenta

Hormones of Pregnancy

Parturition

Lactation

Chapter 10: The Adrenal Glands (1): Adrenal Cortex

Introduction

Adrenal Embryology and General Structure

Synthesis, Storage, Release and Transport of the Adrenocortical Hormones

Corticosteroid Receptors and Mechanisms of Action

Physiological Actions of Corticosteroids

Regulation of Corticosteroid Production

Adrenocortical Disorders

Appendix: Clinical Scenarios

Answers to Clinical Scenario 10.1

Answers to Clinical Scenario 10.2

Further Reading

Chapter 11: The Adrenal Glands (2): Adrenal Medulla

Introduction

Synthesis, Storage, Release and Transport of Adrenal Medullary Hormones

Catecholamine Receptors

Physiological Actions

Control of Release

Adrenal Medullary Disorders

Appendix: Clinical Case

Answers to Clinical Scenario 11.1

Reference

Chapter 12: The Endocrine Control of Salt and Water Balance

Introduction

Salt and Water Regulation and the Human Body

Regulatory Mechanisms

Central Regulation

Clinical Correlates

Conclusion

Chapter 13: The Thyroid Gland and Its Iodothyronine Hormones

Introduction

Embryological Derivation, General Structure and Histology

Synthesis, Storage and Release of Iodothyronines

Transport of Iodothyronines in the Blood

The Iodothyronine Receptors and Mechanism(s) of Action

Physiological Actions

Regulation of Thyroid Iodothyronine Hormones

Diseases of the Thyroid Gland

Thyroid Failure

Overactivity of the Thyroid Gland

Management of a Non-Functioning Thyroid Lump

Appendix: Clinical Scenario

Answers to Clinical Scenario 13.1

Reference

Further Reading

Chapter 14: The Islets of Langerhans and Their Hormones

Introduction

The Pancreatic Islets of Langerhans: Anatomy and Structure

The β (beta) Cells and Insulin

The α (alpha) Cells and Glucagon

The δ (delta) Cells and Somatostatin

The γ (gamma) Cells and Pancreatic Polypeptide (PP)

Clinical Conditions Associated with Glucose Metabolism Disturbances

Further Reading

Chapter 15: Diabetes Mellitus

Introduction

Type 1 Diabetes (Insulin-Dependent Diabetes)

Type 2 Diabetes (Non-Insulin-Dependent Diabetes)

Clinical Presentation of Patients with Diabetes Mellitus

Clinical Presentation of Type 2 Diabetes Mellitus

Treatment of Type 1 Diabetes

Treatment of Type 2 Diabetes

Long-Term Complications of Diabetes Mellitus

Appendix: Clinical Scenario

Answers to Clinical Scenario 15.1

Reference

Further Reading

Chapter 16: The Gut–Brain Axis

Introduction

Neuropeptide Y (NPY)

Glucagon and Glucagon-Like Peptide-1 (GLP-1)

Oxyntomodulin

Leptin

Orexins

The Combined Effects of Different Gut Hormones in Patients with Gastric Bypass Surgery

References

Further Reading

Chapter 17: Hormones, Endocrine Tumours and the Gut

Introduction

Insulinomas

Secretin

Gastrin and Gastrinomas

VIPomas

Glucagonoma

Somatostatinomas

Further Reading

Chapter 18: The Parathyroids, the Endocrine Kidney and Calcium Regulation

Introduction

Parathormone, or Parathyroid Hormone (PTH)

Calcitriol (1,25 (OH)2-Cholecalciferol)

Calcitonin

Phosphate Regulation and Fibroblast Growth Factor-23

Diseases of the Parathyroids, the Endocrine Kidney and Calcium Disorders

Appendix: Clinical Scenario

Answers to Clinical Scenario 18.1

Further Reading

Chapter 19: The Genetics of Endocrine Tumours

Multiple Endocrine Neoplasia Types 1 and 2, and Von Hippel Lindau Disease

Pancreatic Tumours

Pituitary Tumours

Further Reading

Chapter 20: Future Prospects

Introduction

Neuroendocrinology

The Genome

Stem Cells

Organ Replacement

Technical Advances

Index

This edition first published 2013 © 2013 by John Wiley & Sons, Ltd

Wiley-Blackwell is an imprint of John Wiley & Sons, formed by the merger of Wiley's global Scientific, Technical and Medical business with Blackwell Publishing.

Registered office: John Wiley & Sons, Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK

Editorial offices: 9600 Garsington Road, Oxford, OX4 2DQ, UK

The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK

111 River Street, Hoboken, NJ 07030-5774, USA

For details of our global editorial offices, for customer services and for information about how to apply for permission to reuse the copyright material in this book please see our website at www.wiley.com/wiley-blackwell.

The right of the author to be identified as the author of this work has been asserted in accordance with the UK Copyright, Designs and Patents Act 1988.

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by the UK Copyright, Designs and Patents Act 1988, without the prior permission of the publisher.

Designations used by companies to distinguish their products are often claimed as trademarks. All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners. The publisher is not associated with any product or vendor mentioned in this book. This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold on the understanding that the publisher is not engaged in rendering professional services. If professional advice or other expert assistance is required, the services of a competent professional should be sought.

Library of Congress Cataloging-in-Publication Data has been applied for

ISBN 978-0-4706-8813-7 (hardback) – 978-0-4706-8812-0 (paperback)

A catalogue record for this book is available from the British Library.

Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books.

First Impression 2013

Preface

Both of us have always been inspired by the interest shown by our students in the subject of endocrinology, and we are grateful to them for enhancing our desire to produce a readable textbook covering the main aspects of the subject. Because the understanding of endocrinology is enhanced by a consideration of the clinical conditions associated with diminished or excessive production of individual hormones, we hope that the integration we have attempted between basic and clinical aspects is successful. In addition we are grateful to our wives and families, who have given us their continual support, and to our colleagues, in particular Waljit Dhillo and Gareth Leng who gave us many suggestions for improvement in those chapters which they read for us.

John Laycock and Karim Meeran

Chapter 1

The Molecular Basis of Hormones

Endocrine Glands and Their Hormones

Introduction

In 1849 Claude Bernard postulated that the internal environment of the cells in the body (the milieu intérieur) is constantly regulated. In 1855 he also proposed that substances can be synthesised and secreted internally, within the body, by demonstrating the production and release of glucose from the liver. In these ways, perhaps he can be considered to be the ‘father’ of endocrinology even though we would not nowadays consider glucose to be a hormone.

While there are descriptions clearly relating to what we now know as endocrine glands going back at least 2000–3000 years in various parts of the world, it is interesting to note that endocrine glands were first classified as such only from the early 1900s. Initially, there were certain accepted methodologies which were used to ascertain whether or not tissues and organs had a true endocrine function. For example, since hormones are released into the bloodstream, certainly according to the original definition (see section ‘What is a hormone?’), it is not surprising to find that endocrine glands in general have a very high blood flow per gram of tissue compared to most other organs. When assays were sufficiently developed to estimate, and later to measure, hormone levels in the blood, the concentration of a hormone would be expected to be greater in the venous effluent from an endocrine gland than in its arterial affluent. Nowadays, this general principle can be used to precisely locate the presence of an endocrine tumour.

Furthermore, removal of the endocrine gland being studied would be expected to result in observable changes to some aspect of the body's physiology. For example, one classic observation by Berthold, also in 1849, linking the testes (male sex glands) with a specific feature, was the disappearance of the comb on the head of a cockerel—a male characteristic in this species—when the testes were removed. Indeed, transplantation of the testes to another part of the body with an adequate blood circulation apparently restored the cock's comb. Likewise, the appropriate administration of an extract from the suspected endocrine gland should restore that physiological function, following the gland's removal. Clearly, such determining studies as these were essential in identifying what we can now call the ‘classical’ endocrine glands including the thyroid, the parathyroids, the gonads and the adrenals. However, nowadays we also recognise the much more disparate sources of hormones, from tissues not instinctively considered to have an endocrine function. For instance, the heart, lungs, kidneys and liver are better known for their other better described physiological functions than for the production of hormones, and yet this is undoubtedly one of their roles. Clearly the removal of such an organ would be problematic with regard to determining its endocrine function!

What is an Endocrine Gland (or Tissue)?

An endocrine gland (or tissue) is usually defined as a group of cells which synthesises a chemical that is released into the surrounding medium, essentially into the blood. An endocrine gland is most easily recognised if it consists of cells with clearly identifiable, intracellular secretory machinery allowing for the expulsion of synthesised molecules out of that cell into the surrounding medium (blood). This is in contrast to an exocrine gland, such as a salivary gland or the main part of the pancreas, which secretes molecules into a duct leading to the exterior of the body. Nowadays, we know of various endocrine glands and tissues in the body which do not quite so readily fit the description given here; indeed, many of them are better known for other physiological actions. A general classification of endocrine glands would now have to include the following categories.

‘Classic’ Endocrine Glands

Various clearly defined glands have been identified as having an endocrine function and these can be classified as the ‘classic’ endocrine glands. They include the gonads, the thyroid, the adrenals, the parathyroids, the pancreatic islets of Langerhans and the pituitary. Each of these glands produces one or more different hormones. Only those glands producing amino acid–derived (e.g. amine, polypeptide and protein) hormones would contain secretory granules.