The
endocrine and
nervous systems both function to achieve and maintain the stability of the internal environment. Each system may work alone or they may all work in concert as a single
neuroendocrine system. They perform the same purpose of communication, integration and control and both systems carry out their regulatory function through chemical messengers sent to specific cells. In the nervous system, neurons secrete
neurotransmitters to signal nearby cells that have the appropriate receptor molecules. In the endocrine system, secreting cells send out hormone
(Greek "hormaein" to excite) molecules by way of the blood stream to signal specific target cells throughout the body. Target tissues and target organs are the tissues and organs that contain the endocrine target cells. As with postsynaptic cells, endocrine target cells must have the appropriate receptor to be influenced by the signalling chemical. Many cells have receptors for neurotransmitters and hormones and can be influenced by both. Neurotransmitters are sent over very short distances across the
synaptic junction, but hormones diffuse into the blood to be carried to nearly every point in the body.
The nervous system can control only muscles and glands that are innervated with efferent nerves whereas the
endocrine system can regulate most cells of the body. Neurotransmitters are short lived, but work rapidly. Hormones are slower to act, but the effects last considerably longer. The secretion into the blood is directly from
ductless glands. This distinguishes between
endocrine and
exocrine glands: secretions via ducts.
Neurosecretory cells are modified neurons which secrete chemical messengers into the bloodstream rather than across a synapse. The chemical messenger in this case is called a
hormone rather than a neurotransmitter. When
norepinephrine is released by neurons, it diffuses across the synapse and binds to an
adrenergic receptor in a postsynaptic neuron. In this case norepinephrine is a neurotransmitter. On the other hand it is a hormone when it diffuses into the blood (because there is
no postsynaptic cell present) and binds to a
distant adrenergic receptor in a
distant target cell.
Hormones are classified in various ways and are identified as:
In a chemical sense, steroid hormones are manufactured from cholesterol and there are structural similarities. They are lipid (fat) soluble and so easily pass through phospholipid plasma membrane of the target cell.
Cortisol,
aldosterone,
estrogen,
progesterone and
testosterone are examples of
steroid hormones. Non-steroid hormones mostly come from amino acids though some non-steroid hormone are
protein hormones (or
peptide hormones) and are long, folded chains of amino acids.
Those
protein hormones that have carbohydrate groups attached to amino acid chains are often classified as
non-steroid glycoprotein hormones.
Follicle stimulating hormone (FSH),
luteinising hormone (LH) or
prolactin (LTH: luteotropic hormone),
thyroid stimulating hormone (TSH) and
adrenocorticotropic hormone (ACTH) are all
tropic hormones (peptide hormones) and are produced and secreted by the basophils of the
pars anterior. They have a stimulating effect on the endocrine glands. These hormones stimulate the development of their target glands and tend to stimulate synthesis and secretions of the target hormone.
FSH and
LH are
gonadotropins because they stimulate growth and maintenance of the
gonads (
ovaries and
testes). The
adenohypophysis in childhood releases insignificant amounts then a few years before puberty releases gradually increasing amounts until suddenly the output spurts and gonads are stimulated to develop and begin normal functions. A
pituitary tumour may result in hypersecretion (too much) of tropic hormones. Early secretion of
gonadotropins may lead to abnormally early onset of puberty and
abnormal secretions may disrupt reproduction, kidney function, overall metabolism and other processes: hyposecretion
(too little) and hypersecretion
(too much).
Peptide hormones. Non-steroid category such as
oxytocin (OT) and
antidiuretic hormone (ADH) smaller than
protein hormones and are made from short chain of amino acids. Also,
melanocyte-stimulating hormone (MSH),
somatostatin,
thyrotropin-releasing hormone (TRH),
gonadotropin-releasing hormone (GNRH). A further category of non-steroid hormones consists of the amino-acid derivative hormone. Each is derived from a single amino acid molecule.
There are two major subgroups:
- synthesised by modifying the amino acid tyrosine and are produced by nonsecretory cells (secreted as hormones) and by neurons (secreted as neurotransmitters).
They operate by the lock and key theory and switch on a cell by receptor acceptance. The target cell may have several different receptors and can be affected by many hormones. Different hormones produce a different effect within the same target cell. Chemical reactions within the cell are altered or modified. Some hormone-receptor interactions trigger the activation or inactivation of certain enzymes and others may regulate activity by opening or closing specific ion channels in membranes. Hormones may work together to enhance each other's influence on the target cell. This is synergism. The effect of both working together is greater than each operating individually. They may exhibit permissiveness which is the full effect of a hormone facilitated by the presence of a small amount of another. The first hormone permits the
full action of the second hormone or conversely, by antagonism
lowers the activity of the second hormone. A feedback mechanism is put in place through this effect.
Steroid hormone mode of actionSteroid hormones are lipids and therefore not particularly soluble in the watery plasma of the blood. They are carried in the blood attached to plasma proteins to confer solubility. They are not freely floating molecules and to be effective must free themselves to reach the target cell receptors. Blood carries hormones throughout the body even where target cells are not present so generally the endocrine glands produce more hormones than are necessary to produce the desired effect. Any excess is either excreted by the kidney or broken down (rendered inactive) by metabolic processes. They pass easily through cell membrane as lipid soluble steroid hormones where receptors are normally found (within the cell rather than on the surface). Once the steroid hormone has diffused into the target cell, it passes into the nucleus and binds to a mobile receptor molecule to form a
hormone-receptor complex. Some hormones must be activated by enzymes before they can bind to their receptors. The steroid hormone receptors seem to be free floating in the nucleoplasm so this model has been termed the
mobile-receptor hypothesis. Once formed, the
hormone-receptor complex activates a certain gene sequence to begin transcription of
messenger RNA (mRNA) molecules. These move out of the nucleus into the
cytosol (still within the cell) where they associate with
ribosomes to begin synthesising specific protein molecules. These would not have been made if the hormone had not been present to act as the trigger.
Steroid hormones regulate cells by controlling the production of certain critical proteins, such as enzymes that effect intracellular reactions or membrane proteins that alter the permeability of the cell. The extracellular hormone in effect initiates the synthesis of the key from within the cell to activate a lock to produce the desired effect. The amount of a hormone will determine the amount of
mRNA (via
hormone-receptor complexes) formed and hence the level of transcription to form new proteins. So this amount of hormone determines the magnitude of the target cell's response. The time taken can be from
45 minutes to
several days for the full effects to be seen.
Non-steroid mode of actionThe mechanism of non-steroid hormones is different. This type of hormone typically operates according to the
second messenger hypothesis. A non-steroid hormone initially acts as a
"first messenger" delivering its chemical message to fixed receptors in the target cell's plasma membrane. This message is then passed into the cell where a
"second messenger" triggers the appropriate cellular changes. This concept is called the
fixed-membrane-receptor hypothesis. The formation of the
hormone-receptor complex causes a membrane protein
(G protein) to bind to a nucleotide
(guanosine triphosphate - GTP) in turn activating another membrane protein
(adenyl cyclase). This enzyme cleaves off two phosphate groups from
ATP in the
cytosol leaving
cyclic adenosine monophosphate (cAMP). This is the "second messenger" within the cell and activates (or inactivates) protein kinases, a set of enzymes that activate other enzymes. The target enzymes are switched on and catalyse the cellular reactions that characterise the target cell's response. The
"first messenger" hormone binds to a membrane receptor triggering the formation of an intracellular
"second messenger" which activates a cascade of chemical reactions producing the target cell's response. Although most non-steroid hormones use
cAMP as second messenger, some use
inositol triphosphate (IP3) and
cyclic guanosine monophosphate (cGMP).
Others trigger the opening of
Ca++ channels in the target cell's membrane through activation of a chain of membrane proteins (
G protein and
phosphodiesterase,
PDE2).
Ca++ ions then enter the
cytosol and bind to an intracellular molecule
(calmodulin). This
Ca++ :
calmodulin complex then acts as
"second messenger" influencing the enzymes that produce the target cell's response. The second messenger mechanism produces target cell effects that differ from steroidal hormone effects in two important ways.
- The cascade reactions greatly amplify the effects of the hormone and results in a disproportionate effect compared to the amount of non-steroid hormone present.
- The effect of the steroid hormone is directly proportional to the amount of that hormone present.
The second messenger mechanism also acts very much quicker to reach full effect. Typically
seconds or
minutes after initial binding to target cell instead of
hours or
days for steroid hormones. Not all non-steroid hormones operate through this second messenger model. One notable exception is the pair of thyroid hormones
thyroxine (T4) and
triiodothyronine (T3). These small iodinated amino acids enter the target cell and bind to receptors already associated with a
DNA molecule within the nucleus of the target cell. Formation of the
hormone-receptor complex triggers transcription of
mRNA and the synthesis of new enzymes similar to the steroid mechanism.
Cell sensitivitySensitivity to any particular hormone depends on the number of receptors. These receptors are constantly broken down and replaced with newly synthesised ones as any other cell component. Not only are
"new" cell parts made which work properly, but this also allows their number to change with time. If the synthesis of new receptors outstrips their degradation then greater hormone sensitivity will occur:
up regulation. Conversely,
down regulation leads to less sensitivity. The feedback (endocrine reflex) control the effects of hormones by adjusting levels. The negative feedback loops tend to reverse any deviation of the internal environment away from its stable point. Positive feedback controls the secretion of a hormone. The deviation from the stable point is exaggerated rather than reversed. The simplest mechanism operates when an endocrine cell is sensitive to the physiological changes produced by its target cells.
Parathyroid hormone (PTH) produces responses in its target cells that increase
Ca++ ion concentration in the blood. When this concentration exceeds a set point value,
parathyroid cells sense it and reflexively reduce their output of
PTH. (The parathyroid cell monitors extracellular free calcium concentration via an integral membrane protein that functions as a
calcium-sensing receptor.) Lactation is caused by
prolactin (PRL). This is a lactogenic hormone and, as a
pituitary gland hormone, stimulates lactation in pregnant women and consumes
Ca++. This reduces blood concentration. The
parathyroid glands sense this change and respond by increasing
PTH secretions. This in turn stimulates
osteoclasts in bone to release more
Ca++ from storage in bone tissue into the bloodstream thereby elevating levels. Secretions by many
endocrine glands is regulated by a hormone produced by another gland. The
pituitary gland (specifically the anterior portion) produces
thyroid stimulating hormone (TSH): a
non-steroid glycoprotein hormone. The pituitary gland triggers the thyroid to produce its hormone and the pituitary gland reflexively responds to the altering levels and adjusts accordingly by this negative feedback process. Secretions of the
pituitary gland can also be controlled by secretions from the
hypothalamus (stimulate or inhibit the release of pituitary hormones). A more precise regulation of hormone blood levels is possible by these additional long feedback loops involving the
anterior pituitary and
hypothalamus. The nervous system can also influence hormone secretions. The posterior pituitary is not regulated by releasing hormones, but by direct nervous input from the
hypothalamus. Sympathetic nerve impulses similarly reach the
medulla of the
adrenal glands and trigger the release of
epinephrine and
norepinephrine. Many other glands
(pancreas) are also influenced to some degree by nervous input. The close functional relationship between these two systems is emphasised by the nervous system operating with the hormonal mechanisms to produce endocrine reflexes. Although these long feedback loops tend to minimise wide fluctuations in secretions, the output of several hormones typically rises and falls dramatically within a short period of time.
Insulin concentrations are dependent on blood glucose levels and increases to a high level just after a carbohydrate meal. The
insulin level decreases only after blood glucose settles to its set point value. The non-steroid amino acid hormone
epinephrine (from the
adrenal medulla) can cause a sudden infusion as part of the fight-or-flight response.
Focus on insulinThe
pancreas is a mixed
endocrine and
exocrine gland. Mostly, this involves secretions of
digestive enzymes and
bicarbonate solution. The endocrine part is the
Islet of Langerhans and is
one to
two million clusters
(islets) of cells scattered between the exocrine
acinar cells (acini). Each islet is a collection of several different types of cell, each supposedly secreting a particular pancreatic hormone.
Alpha cells (A) are less numerous, located peripherally and secrete
glucagon. The central
beta cells (
B) are more in number and secrete insulin.
Delta cells (D) cells are more sparse and secrete
somatostatin.
Insulin and
glucagon regulate the metabolism of carbohydrates in tissues and ensure the maintenance of optimal blood glucose levels (normal fasting level between
0-110mg/100ml).
Insulin facilitates the transport of glucose across the cell membrane of mostly muscle tissue
(heart, skeletal and
smooth) and
adipose tissue (fat).
No matter how much glucose is present in the blood, membranes are impermeable to glucose in the absence of insulin. Insulin enhances the availability of glucose in cells and promotes its utilisation and becomes bound to the insulin receptors in the plasma membrane of target cells. Insulin functions as a
hypoglycemic hormone by
decreasing blood sugar.
Glucagon also enhances carbohydrate utilisation by mobilising glucose from liver (stored as) glycogen. This functions as a
hyperglycemic hormone by
increasing blood glucose.
Somatostatin inhibits the secretion of both
insulin and
glucagon, the levels of which are influenced by each other:
glucagon promotes secretion of both
insulin and somatostatin, but
insulin inhibits glucagon secretions. An increase in glucose is detected by the
beta cells (B) and insulin is released and transported to the tissues promoting glucose uptake and utilisation and so lowering blood sugar levels. The interaction between blood glucose and insulin provides another example of simple hormonal regulation by negative feedback with no nervous system involvement.
A signal is generated in the
beta cell (B) resulting in the release of
Ca++ ions which interact with secretory vesicles promoting their fusion with the cell membrane. The resulting
exocytosis releases
insulin into the blood. The
Ca++ ions also promote a longer-lasting response (increased synthesis of insulin) at the cytoplasmic level ensuring insulin is available for prolonged secretion
(hours) until the
hyperglycemia is eliminated. The primary stimulus for
glucagon release is a decrease in level of blood sugar below its normal limit. Glucose detectors in the
alpha cells (A) of the pancreatic islets sense this and release
glucagon, which binds with specific receptors in the membranes of liver cells. This activates the enzyme adenylate cyclase:
cyclic adenosine monophosphate (cAMP). This acts as second messenger initiating a cascade of chemical reactions involving the activation of enzymes, but not their synthesis. The amplification mechanism ensures a rapid
(within seconds) mobilisation of enzymes to break down liver glycogen through
glycogenolysis.
Glucagon also stimulates the synthesis of new glucose from amino acids in the liver
(gluconeogenesis) when glucose is low. This is a slower process and becomes more important in fasting and starvation. The mobilisation of glucose by the action of
glucagon ensures the glucose leaks out into the blood increasing sugar levels and supply for constant users like the brain and heart. Negative feedback on
alpha cells (A) decreases glucagon release until the glucose level falls again due to its constant use. Glucagon release is then initiated again.
Insulin and
glucagon although opposite in their effects:
insulin is
hypoglycemic causing
sugar insufficiency and
glucagon is
hyperglycemic promoting
sugar over-sufficiency. They act in a complementary way to regulate carbohydrate metabolism and provide ample glucose supply for tissues.
Insulin is made up of an
A chain and
B chain peptide connected at two locations by disulphide
(-S-S-) bridging bonds. The
beta cells (B) of the
endoplasmic reticulum synthesise the larger peptide chain
proinsulin but release
insulin into the blood. During packaging in the vesicles of the
Golgi apparatus,
protease (an
enzyme) converts
proinsulin to
insulin by selective peptide hydrolysis. The
C chain is attached to
one end of
A chain and the
other end of the
B chain is cleaved. The disulphide bridges fold the long peptide chain so the long chain is firstly extended then further modified by bridging.
The
C chain can be proposed as a shape assisting
moiety which is then discarded. It brings the
A and
B parts into close proximity for subsequent joining. The two parts (
A+B and
C chain) are transported together within secretor vesicles, although separated, toward the plasma membrane of the
beta cells (B). Near a capillary, the contents of the vesicles are released into the blood by
exocytosis of the vesicles. The fate of the
C chain is uncertain. Muscle cells normally prefer to use glucose for oxidation and cellular energy metabolism. Once inside a muscle cell glucose is oxidised to provide
ATP or is converted to glycogen (rest condition). During activity glycogen is broken down to provide glucose within the cell.
Insulin promotes glucose entry into fat cells of
adipose tissue where it is not used to provide energy for the fat cell. Instead it is metabolised to form two molecules of
glycerol from one glucose unit. Each
glycerol molecule combines with three
fatty acids to form one
triglyceride as the storage form of fat. Fatty acids are usually obtained from the blood (initially from the liver).
Insulin also
inhibits a
lipase enzyme (fat cleavage) which
prevents fat breakdown. The direct action of
insulin on liver cells does not promote increased transport of glucose because liver cells are normally permeable to glucose. Instead by stimulating the synthesis or actions of specific enzymes,
insulin promotes the utilisation of glucose for glycogen, amino acids and proteins and fats, particularly fatty acid, synthesis. These fatty acids are used by
adipose tissue to form
triglycerides.
Insulin does not influence glucose uptake by the brain,
kidney tubules and
intestinal mucosa mainly because these membranes are permeable to glucose passage. This may be an adaptive response because the nervous tissue relies solely on glucose for its energy needs and a constant and plentiful supply is essential. Alterations in
insulin secretions would have major consequences on brain function. A large dose (by injection) of
insulin may result in coma or death by causing
hypoglycemia and starving the brain of glucose as its energy and fuel source. The special transport functions for glucose by the
intestinal mucosa and
kidney tubules ( unrelated to its utilisation for energy) preclude their regulation by
insulin.
Insulin deficiencyThe range of glucose over sufficiency is from between
2-4 times normal (before-after meal). The
hyperglycemia is due to both the
decreased glucose uptake by muscle and
adipose tissue and increased glucose output by liver. As a result, takes
6-8hrs vs
1-2hrs to fall to premeal levels. Muscle cells are deprived of glucose as it remains in the blood and so other sources of energy are used. Fat and protein reserves are utilised for oxidation resulting in muscle wasting, weakness and weight loss. The weight loss is worsened because not only can glucose fail to enter these cells, but also
triglycerides are broken down to form and mobilise
free fatty acids. The
hormone-sensitive lipase is removed. Diabetics are characteristically thin and
fatty acids provide energy for the heart and muscle tissue. Excessive
fatty acids production results in formation of keto acids
(ketone bodies), particularly in the liver. The ketones enter the blood stream causing
ketosis and ketoacidosis, which is a very dangerous condition if left untreated giving rise to
metabolic acidosis. The increased blood acidity suppresses the higher nervous centres (coma). Ultimately, depression of the brain respiratory centres leads to death. These
ketone bodies are excreted in the urine worsening the osmotic diuresis (excess water in urine) caused by the glucose. Normally, as long as the blood sugar level stays below about
170mg/100ml, plasma glucose is filtered by the
Bowman capsule of the
kidney nephron and is completely reabsorbed in the proximal tubules. The extra glucose present in the
hyperglycemic condition spills over into the urine causing
glycosuria (sugar in urine) , a well-recognised sign of
diabetes mellitus and
insulin deficiency. This has the consequences of
polyuria (excess urine production) and
polydipsia (excessive drinking of water) due decreased plasma volume and increased plasma osmolarity. Excessive water loss may lead to severe dehydration and
osmotic shock, conditions that can also result in irreversible brain damage, coma and death.
Diabetes mellitusThis is a spontaneous disease and is of two types:
- Type I
- Juvenile - seen in children and young adults
- Type II
- Maturity onset and usually seen in obese individuals over forty
Type I is associated with the lack or serious deficiency of
insulin and may be an
autoimmune disease probably without genetic or familial traits. If untreated it is often fatal due to
ketoacidosis and dehydration shock. This is remedied by an
insulin injection. Maturity onset
Type II diabetes shows strong familial association and the
insulin deficiency is relative, because the absolute amounts in the blood may be even higher than in normal individuals. Due to prolonged obesity a reduction in the number of
insulin receptors in target cells occurs
(down-regulation), perhaps caused by a steady, but high
insulin production. The available
insulin is not as effective resulting in a signs similar to
insulin deficiency like
hyperglycemia,
glycosuria,
polydipsia and weight loss. Only
ketosis does not occur. Extra
insulin may be corrective but simple weight reduction will frequently ameliorate the diabetic condition. However, for reasons not completely understood if untreated, this may lead to vascular diseases that can cause blindness, atherosclerosis, heart and kidney diseases and gangrene. The use of
exogenous insulin derived from the pancreas of livestock can stop and reverse the pathological chain of events seen in diabetic patients. One complication is that animal
insulin is
antigenic and gradually becomes ineffective as the body makes antibodies
against this foreign protein.
Genetic engineering and new methods of molecular biology are now being researched in order to synthesise human
insulin. Such material is not
antigenic.