Endocrine pathophysiology. Doc. MUDr. Ing. RNDr. Peter Celec, DrSc., MPH
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1 Endocrine pathophysiology Doc. MUDr. Ing. RNDr. Peter Celec, DrSc., MPH
2 Cell-cell communicabon Neurocrine (neurotransmiders) Endocrine (hormones) Paracrine (cytokines) Autocrine (various)
3 Hormones Proteins / pepbdes Preprohormone (ER, GA, secrebon granules) Steroids Cholesterol Amines Tyrosine
4 Endocrine regulabon NegaBve feedback PosiBve feedback ProducBon (endocrine gland) Transport (binding proteins in plasma) Target Bssue (receptors on cells)
5 Endocrine glands
6
7 Endocrine disorders Physiology & OverproducBon Insufficiency Resistance
8 Hypothalamus Neural regulabon of the autonomic nervous system - adrenal medulla ProducBon of ADH and oxytocin RegulaBon of the pituitary
9 Hypothalamus Liberins CRH (ACTH), TRH (TSH), GHRH (GH), GnRH (LH, FSH), Salsolinol (PRL) StaBns SomatostaBn (GH), Dopamine (PRL)
10 Hypothalamus Hypothalamic - pituitary axis Control of the producbon and release of pituitary hormones Pulse secrebon Specific membrane receptors Second messenger AutoregulaBon
11 Pituitary Anterior pituitary Adenohypophysis ACTH, TSH, FSH, LH, PRL, GH, MSH Endocrine regulabon Posterior pituitary Neurohypophysis ADH, Oxytocin Neural regulabon of hormone release
12
13 Hypopituitarism General SelecBve InfecBons, infarcbons, cysts, tumors, injuries, iatrogenic, Sheehan syndrome FerBlity, Growth... Therapy - supplementabon
14 GH disorders GH overproducbon GiganBsm Before puberty Acromegaly AXer puberty
15
16 GH disorders GH insufficiency Nanism Before puberty GH insufficiency syndrome AXer puberty Somatopause
17 ADH disorders ADH insufficiency Diabetes insipidus Polydipsia, polyuria OverproducBon ADH Syndrome of IADH Hypoosmolarity of plasma, hyponatriemia, oliguria
18 Thyroid gland physiology AcBons of the thyroid Controls body temperature How body burns calories Controls how fast food moves through digesbve tract Muscle strength Thyroid hormones T4-thyroxine T3-triiodothyronine Calcitonin
19 Specifics Iodine is rare Ubiquitary receptors Highly potent acbon Very common disorders 5% women 0,5% men
20 Iodine intake 150 ug daily intake of iodine 125 ug taken up by the thyroid gland Iodine in the soil region dependent Iodide supplementabon of salt
21 T4:T3 15:1 TBG Peripheral conversion T4 receptor... T3:T4 15:1 5mg T4 per gland InflammaBon and trauma lead to thyreotoxicosis
22 AcBon Increase of number and size of mitochondria Synthesis of respiratory chain enzymes Na+ K+ ATPase Uncloupling proteins Increase in resbng metabolic acbvity
23
24 Grave s disease Grave s Basedow trias Goiter Exophtalmus Hyperthyroidism Autoimmune disease AnB-TSH receptor
25 Calcitonin Parafollicular C cells in the thyroid gland Unknown physiological funcbons Inhibits absorpbon from the gut Inhibits osteoclasts Inhibits food intake (sabety hormone?) Inhibits phosphate reabsorpbon Procalcitonin Marker of sepsis
26 Parathyroid glands
27 Parathyroid glands Parathyroid hormone An antagonist of calcitonin Increase in plasma Ca 2+
28 Hyperparathyroidism Primary (4/100000; women; age>45) Parathyroid glands Secondary Kidneys TerBary From secondary autonomy of the parathyroid glands Bone resorpbon
29 Adrenal glands Cortex Zona glomerulosa (mineralocorbcoids) Zona fasciculata (glucocorbcoids) Zona rebcularis (androgens) Medulla catecholamines
30
31
32 Disorders of the adrenal glands Insufficiency Primary Addison's disease Autoimmune, tuberculosis, hemorrhage (Waterhouse- Friderichsen syndrome in meningococcal infecbons) Secondary pituitary disorders, disconbnuabon of glucocorbcoid therapy
33 Addison's disease Aldosterone insufficiency Hypotension, hyponatremia, hyperkalemia Skin pigmentabon Pro-Opio-Melano-CorBco-Tropin ACTH increased (dif-dg secondary adrenal insufficiency)
34 Conn's disease Primary hyperaldosteronism Mostly unilateral endocrine acbve tumor Hypertension Hypernatremia Hypokalemia
35 Cushing's syndrome HypercorBsolism Primary Adrenal adenoma Secondary Cushing's disease - overproducbon of ACTH Ectopic producbon - lung ca Iatrogenic
36 Cushing's syndrome Central obesity Hypertension Osteoporosis Reduced growth Mental changes HirsuBsm, acne, oligomenorrhea
37 Models Surgical models Pharmacological models ImmunizaBon Hormonal subsbtubon Receptor gene ko mice
38 Tasks What is the cause of PCOS? How to treat acute hypercalcemia? What are the symptoms of oxytocin insufficiency? What are the consequences of GnRH modulabon?
39
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