kuliah hormon manusia blok4

7/29/2019 Kuliah Hormon Manusia Blok4

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FAAL ENDOKRIN MANUSIA

dr. Erma Sulistyaningsih, M.Si


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What are hormones?

chemical substances created by the body thatcontrol numerous body functions. They actuallyact as "messengers" to coordinate functions ofvarious body parts.

Functions controlled by hormones include:1. activities of entire organs

2. growth and development

3. reproduction

4. sexual characteristics5. usage and storage of energy

6. levels of fluid, salt, and sugar in the blood


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Hypothalamus

The hypothalamus is not a gland It sends signals to the adrenal glands :

epinephrine and norepinephrine.

It also produces : antidiuretic hormone (ADH),

oxytocin, and regulatory hormones. Regulatory hormones : releasing hormones (RH)

and inhibiting hormones (IH) control therelease of hormones by the pituitary gland.

The hypothalamus functions as a monitoring andcontrol station for many body activities.


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The pituitary gland

2 lobes : the anterior pituitary and the posteriorpituitary

The anterior pituitary produces and secretes sixhormones : GH, TSH, ACTH and three

gonadotropic hormones stimulate or "turn on"other endocrine glands tropic hormones.

The posterior pituitary secretes two hormones, butdoes not produce them : antidiuretic hormone and

oxytocin control other bodily functions. . Because the pituitary's secretions control andregulate the secretions of other endocrine glands, itis often called the "master gland" of the endocrinesystem.


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GROWTH HORMONE (GH)

Function:

stimulates overall body growth by spurring target cells to grow in sizeand divide.

increases the rate at which those cells take in and utilize proteins

also causes fats to be broken down and used by the cells for energydevelopment of muscles and bones, especially in children.

The release of GH is controlled by : GHRH & GHIH.

GHRH stimulates the pituitary to release GH :

- during exercise

- when blood sugar levels are low

- when amino acid levels in the blood are high- when the body in under stress.

When the body is returned to a state of homeostasis or when blood sugarlevels are high the hypothalamus secretes GHIH thepituitary stops releasing GH.


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Gangguan sekresi GH

1.Acromegaly and gigantism

the anterior pituitary produces too muchgrowth hormone (GH) an increasedgrowth in bone and soft tissue, especiallyin the extremitiesnose, jaw, fingers,and toes.

In children who have not yet fullydeveloped the exceptional growthof the long bones gigantism

Caused by a noncancerous tumor thatdevelops within the pituitary (90%)

the anterior pituitary ignore GHIH

GH is thus secreted without a stoppingmechanism.


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2. Dwarfism

- Defisiensi sekresi

pituitari anterior saat

anak-anak

- Kecepatan

perkembangansangat menurun.


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THYROID-STIMULATING HORMONE

(TSH)

influences the growth and activity of the thyroidprompts the thyroid to release thyroxine, whichstimulates the cells in the body to increase theirmetabolism and intake of oxygen.

When the body's metabolic rate decreases.

A releasing hormone from the hypothalamus signalsthe pituitary to secrete TSH

Effect : sintesis thyroglobulin, iodide trapping, iodinasityrosin, proses coupling, ukuran & aktivitas sel kelenjar,peningkatan jumlah sel kel thyroid


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ADRENOCORTICOTROPIC

HORMONE (ACTH)

ACTH stimulates the adrenal cortex to secrete

cortisol and other hormones.

Any stressful situation such as injury, low bloodsugar levels, and exercise

hypothalamus secretes a releasing hormone

that triggers the pituitary to release ACTH.


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GONADOTROPIC HORMONES

affect the gonads or reproductive organs.

3 macam: prolactin, FSH and LH.

In females, prolactin stimulates the development ofmammary glands in breasts and their secretion of milk.

FSH stimulates the development of follicles in the ovariesof female, stimulates the secretion of estrogen by thefollicle cells.

LH stimulates ovulation (the release of an egg from anovary) and the release of estrogens and progesterone

from the ovaries in females.

In males, FSH begins the productions of sperm in thetestes.

LH stimulates the testes to produce testosterone.


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ANTIDIURETIC HORMONE (ADH)

ADH causes the kidneys to reabsorb water fromthe urine that is being formed transportedinto the bloodstream, maintaining bloodpressure.

When too much water is lost from the body(sweating, diarrhea, or any type of dehydration)

the hypothalamus detects an increased amount

of "salt" in the blood

triggers the posterior pituitary to release ADH.


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OXYTOCIN

Oxytocin plays an important role in childbirth.

When a woman goes into labor, the uterus begins tostretch and nerve impulses hypothalamusstimulates the posterior pituitary to release oxytocin

uterus. Function:

- triggers strong contractions of the uterine muscles,helping to bring about delivery of the baby.

- After birth, oxytocin promotes the release of milk fromthe mammary glands stimulates the contraction ofthe muscle cells around the mammary ducts, causing theejection of milk through the nipple.


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Thyroid gland Two lobes, deep red in color.

The thyroid gland is composed ofthyroid follicles thyroxine andcalcitonin.

Thyroxine regulates the rate of metabolismand in children, affects growth.

Calcitonin decreases calcium levels in theblood.

Thyroxine : the body's major metabolichormone stimulates energy productionin cells in the body, increasing the rate atwhich they consume oxygen and utilize

carbohydrates, fats, and proteins. In children : the normal development of themuscular, nervous, and skeletal systems.

In adult : continued tissue growth anddevelopment.

Iodine is an important component of thyroxine.


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Biosintesis hormon tiroid


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Biosintesis dan sekresi T3 dan T4

Step One: Follicle cells actively (using ATP) take upiodide (I-) from the blood.

Step Two: Follicle cells "oxidize" iodide (I-) to iodine (I).

Step Three: Iodine is attached to tyrosine (Tyr) to give

mono-iodotyrosine (MIT) and di-iodotyrosine (DIT). Step Four: MIT's and DIT's are joined together to formT3 (tri-iodothyronine) and T4 (thyroxine).

Step Five : Endocytosis vesikel koloid oleh sel folikel ,aktivasi enzim proteolitik lysosom dan pelepasan molekul

T3 (10%) dan T4 (90%) ke sirkulasi.

T3 dan T4 berikatan dengan protein di sirkulasi.

Bentuk aktif di sirkulsi : T3


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Efek Hormon Thyroid di perifer

1. Elevate oxygen consumption and energy consumption

rate; in children, may cause a rise in body temperature

2. Increase heart rate and force of contraction; generally

cause a rise in blood pressure3. Increase sensitivity to sympathetic stimulation

4. Maintain normal sensitivity of respiratory centers to

changes in oxygen and carbon dioxide concentrations

5. Stimulate formation of red blood cells and therebyenhance oxygen delivery

6. Stimulate activity of other endocrine tissues

7. Accelerate turnover of minerals in bone


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Hyperthyroidism

a tumor of the thyroid.

an autoimmune disorder in which antibodies bind to thethyroid cells, forcing them to produce excessiveamounts of thyroxine Graves' disease.

symptoms:

- weight loss with increased appetite

- shortness of breath

- nervousness and anxiety- rapid heart beat

- weak muscles

- intolerance of heat

- difficulty relaxing and sleeping

- the eyes may bulge

- the thyroid may be visibly enlarged (goiter).

Treatment :

1. surgical removal of the thyroid tumor

2. radioactive iodine may be administered to destroy thehormone-producing cells and shrink the enlarged gland.

3. Medications to decrease the production of thyroxine


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Hypothyroidism Symptoms :

fatigue, decreased heart rate, weight gain,depression, muscle pain or weakness, dry skin,extreme sensitivity to pain, and puffiness of the face.

early childhood cretinism dwarfism:

the head and trunk, which should be about the samelength as the legs, grow about one-and-a-half timeslarger.

Cretins have scanty hair and very dry skin. mentallyretarded.

The symptoms ofadults hypothyroidism myxedema:

subcutaneous swelling, dry skin, hair loss, low body

temperature, muscular weakness, and slowedreflexes. lethargic and unable to tolerate coldtemperatures

- Synthetic or man-made thyroid hormonemedications are also given to adults to treathypothyroidism.


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Hashimoto's disease the body'sdefense attacks the thyroid gland and

sometimes the gland is destroyed.

Infections caused by viruses andbacteria and a diet lacking iodine can

also bring about hypothyroidism.


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Calcitonin (CT)

Produced by the C (clear) cells, orparafollicular cellsa second population of endocrine cells lies sandwichedbetween the cuboidal follicle cells and their basementmembrane.

Calcitonin aids in the regulation of Ca2+ concentrationsin body fluids.

The net effect : a drop in the Ca2+ concentration in bodyfluids.

This reduction is accomplished by

(1) the inhibition of osteoclasts, which slows the rate ofCa2+ release from bone

(2) the stimulation of Ca2+ excretion at the kidneys.


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THE PARATHYROID GLANDS

Two pairs, embedded in the posterior surfaces of the thyroid gland.

4 parathyroid glands weigh a mere 1.6 g

The chief cells produce parathyroid hormone; the functions of the

other cells, called oxyphils, are unknown.


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The net result of PTH secretion is an increase

in Ca2+ concentration in body fluids 3 major effect :

1. Stimu lat ing os teoc las t ac tiv ityand

enhancing the recycling of minerals by

osteocytes.

2. Increas ing the rate of in tes t inal absorp t ion

of ca lc ium ionsby enhancing the action of

calcitriol.3. Decreas ing the rate of excret ion of calc ium

ions at the kidneys.


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Figure 1. The proper allocation of calcium within the body is

absolutely necessary for our survival. Macroevolution would appear

to be insufficient in explaining how this occurred in a functioning

multi-system organism with a complex body plan.


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hypoparathyroidism

Inadequate parathyroid hormone production, leads tolow Ca2+ concentrations in body fluids.

The most obvious symptoms involve neural and muscletissues.

The nervous system becomes more excitable

hypocalcemic tetany, prolonged muscle spasms. Hypoparathyroidism with hypocalcemia after neck

surgery, especially a thyroidectomy, if the blood supplyto the parathyroid glands is restricted.

Treatment is difficult because at present PTH can be

obtained only by extraction from the blood of individualswith normal PTH levels.

Alternative : a dietary combination of vitamin D andcalcium.


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hyperparathyroidism

Ca2+ concentrations become abnormally high.

a tumor of the parathyroid gland.

Simptoms :

1. Calcium salts in the skeleton are mobilized, and bones areweakened. Bones grow thin and brittle.

2. Muscle function deteriorates, and skeletal musclesbecome weak.

3. Calcium deposits may produce masses called kidneystones.

4. CNS function is depressed, thinking slows, memory is

impaired, and experiences emotional swings and depression.5. Nausea and vomiting

6. In severe cases, the patient may become comatose

- Treatment : the surgical removal of the overactive tissue


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The adrenal glands

Kuning, berbentuk pyramid, berat + 7.5 g

Kelenjar suprarenal, banyak vascularisasi

Kelenjar adrenal dibagi 2 bagian:

cortex adrenal di permukaan adrenocortical steroid,

(corticosteroid)

medulla adrenal di lapisan dalam epinefrin & NE


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Cortex adrenal

3 Zones cortex

adrenal :

1. zona

glomerulosa, diluar

2. zona fasciculata,

di tengah

3. zona reticularis,

di dalam

R i / H ( ) T t H l Eff t R l t C t l


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Region/

Zone

Hormone(s) Target Hormonal Effects Regulatory Control

Cortex

Zona

glomerulosa

Mineralocorticoid

s (MC), primarilyaldosterone

Kidney Increase renal reabsorption

of Na+

and water (especiallyin the presence of ADH) and

accelerate urinary loss of K+

Stimulated by

angiotensin II;inhibited by ANP

Zona

fasciculata

Glucocorticoids

(GC): cortisol

(hydrocortisone),

corticosterone,cortisone

Most

cells

Release of amino acids

from skeletal muscles, and

lipids from adipose tissues;

promote liver formation;promote peripheral

glycogen utilization of lipids;

anti-inflammatory effects

Stimulated by ACTH

from anterior

pituitary gland

Zona

reticularis

Androgens Uncertain significance under

normal conditions

Stimulated by

ACTH; significance

uncertain

Medulla Epinephrine,

norepinephrine

Most

cells

Increase cardiac activity,

blood pressure, glycogen

breakdown, blood glucose

levels; release of lipids by

adipose tissue

Stimulated during

sympathetic

activation by

sympathetic

preganglionic fibers


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hypoaldosteronism

Gagal memproduksi aldosterone dalam

jumlah cukup.

Kehilangan sejumlah besar air dan Na+

Mengubah konsentrasi elektrolit

transmembrane potentials,

Gangguan jaringan neural dan otot


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Hyperaldosteronisme

Ditandai dengan Hipertensi danHipokalemi

Macam :

Primer : Sindroma Conn Sekunder

Stenosis arteri renalis

Sirosis Payah jantung

Sindrom nefrotik


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Glucocorticoids

Meningkatkan synthesis glucose dan membentukglycogen terutama di hepar gluco se- spar ing.

Anti-inflammatory effect :

menghambat aktifitas sel leukosit dan komponen sistem

imun lain memperlambat migrasi sel phagocytic dan

menyebabkan kurang aktif

berkurangnya pelepasan histamine dan bahan lainnya

dari mast cells yang menyebabkan inflamasi. Hasilnya,pembengkaan dan irritasi dapat dihilangkan

Kerugiannya : kecepatan penyembuhan luka menurun,dan kerusakan pertahanannya akan mempermudahinfeksi.


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Cushing's syndrome

a hormonal disorder caused by prolongedexposure of the body's tissues to high levels ofthe hormone cortisol hypercortisolism

Penyebab:

1. take glucocorticoid hormones such asprednisone forasthma, rheumatoid arthritis,lupus or other inflammatory diseases

2. overproduction of cortisol by the body :

Pituitary Adenomas , Ectopic ACTH Syndrome ,Adrenal Tumors
http://www.mold-survivor.com/asthma.finnishstudy.htmlhttp://www.mold-survivor.com/arthritis.htmlhttp://www.mold-survivor.com/lupus.htmlhttp://www.mold-survivor.com/lupus.htmlhttp://www.mold-survivor.com/arthritis.htmlhttp://www.mold-survivor.com/asthma.finnishstudy.html


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Symptoms :

upper body obesity, rounded face (moon face),increased fat around the neck, and thinningarms and legs.

Children tend to be obese with slowed growthrates.

skin becomes fragile and thin. Purplish pinkstretch marks on the abdomen, thighs,buttocks, arms and breasts.

The bones are weakened.

Most people have severe fatigue, weakmuscles, high blood pressure and high bloodsugar. Irritability, anxiety and depression.

Women : excess hair growth on their faces,necks, chests, abdomens, and thighs. Irregularor stop menstrual periods.

Men : decreased fertility with diminished orabsent desire for sex.

Treatment : surgical removal of either thepituitary tumor or the adrenal tumor and drugsthat help decrease cortisol production.
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Addison's disease

a disorder in which the adrenal cortex

produces too little cortisol and aldosterone,resulting in the disruption of numerous bodilyfunctions

cause : destruction or shrinking of the adrenalcortex an autoimmune disorde

a gradual, slowly developing disease. Symptoms :

fatigue and loss of energy, decreased appetite, nausea,vomiting, diarrhea, abdominal pain, muscle weakness,dizziness when standing, and dehydration.

Unusual areas of darkened skin and dark freckling.Women : stop having normal menstrual periods.

Disease progresses : abnormal heart rhythms,uncontrollable nausea and vomiting, a drastic drop inblood pressure, kidney failure, and unconsciousness.

Treatment : steroid medications that replace cortisol

and aldosterone in the body.
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Medulla Adrenal

berwarna coklat kemerahan- kaya pembuluh darah

aktifitas sekresi dikontrol oleh divisi sympathetic darisaraf otonom

medulla adrenal mengandung dua kelompok sel

sekretory:

epinephrine (adrenaline)

norepinephrine (noradrenaline). Sekresinya dikemas dalam vesicles

exocytosis

Rangsangan sympatis merangsang peningkatanexocytosis dan pelepasan hormon secara dramatis

E i h i d N i h i


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Epinephrine dan Norepinephrine

Epinephrine 75-80 ; sisanya norepinephrine

Stimulasi reseptor 1 dan 1. When an individual is (or feels) threatened physically or emotionally,

the hypothalamus readies the body to "fight" or "take flight" bysending impulses to the adrenal medulla the medulla secretesnorepinephrine (NE) and epinephrine (E).

NE blood vessels in the skin and skeletal muscles to constrict,

raising blood pressure. Epinephrine :

- an increase in heart rate and contraction

- stimulates the liver to change glycogen to glucose for use asenergy by the cells

- stimulates fatty tissue to break down and release stored fats foruse as energy by the cells

Net effect increased levels of oxygen and glucose in the bloodand a faster circulation of blood to the body organs, especially thebrain, muscles, and heart.


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Kelainan MedullaeAdrenal

Overproduksi epinephrine oleh medullaadrenal

Pheochromocytoma

Tumor yang memproduksi catecholamin >> The most dangerous symptoms are rapid and

irregular heartbeat and high blood pressure;

Other symptoms include uneasiness,

sweating, blurred vision, and headaches. Surgical removal of the tumor is the most

effective treatment.


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The pancreas

- The pancreas is a soft, pink, triangular-shaped gland, 15 cm.

- Primarily a digestive organ, secretes pancreatic juice into the duodenum

helps break down carbohydrates, fats, and proteins in the small intestine.

-The pancreas (endocrine system) producing hormones that maintain

blood glucose (sugar) levels.


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Structure/Cells Hormone Primary Targets Hormonal Effects Regulatory Control


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Pancreatic islets

Alpha cells Glucagon Liver, adipose tissues Mobilizes lipid reserves;

promotes glucose

synthesis and glycogen

breakdown in liver;

elevates blood glucose

concentrations

Stimulated by low blood

glucose concentrations;

inhibited by somatostatin

from delta cells

Beta cells Insulin Most cells Facilitates uptake of

glucose by target cells;

stimulates lipid and

glycogen formation and

storage

Stimulated by high blood

glucose concentrations,

parasympathetic

stimulation, and high

levels of some amino

acids; inhibited by

somatostatin from deltacells and by sympathetic

activation

Delta cells Somatostatin (GH-IH) Other islet cells,

digestive epithelium

Inhibits insulin and

glucagon secretion;

slows rates of nutrient

absorption and enzyme

secretion along digestivetract

Stimulated by protein-

rich meal; mechanism

uncertain

F cells Pancreatic polypeptide Digestive organs Inhibits gallbladder

contraction; regulates

production of pancreatic

enzymes; influences rate

of nutrient absorption by

digestive tract

Stimulated by protein-

rich meal and by

parasympathetic

stimulation


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INSULIN

Peptide hormone, released by beta cells when glucoselevels rise above normal levels (70 -110 mg/dl).

Insulin secretion is also stimulated by elevated levels ofsome amino acids, including arginine and leucine.

Binds to receptor proteins on the cell membrane. Insulinreceptors are present in most cell membranesinsul in-dependent

Cells in the brain and kidneys, cells in the lining of thedigestive tract, and red blood cells lack insulin receptors insul in- independent

One of the most important effects is the enhancement ofglucose absorption and utilization

Insulin is the only hormone that decreases blood glucoselevels and is absolutely necessary in order for the cellsto utilize glucose.


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- S S - - S SS S -

Glucose

Cell membrane

Tyrosine

kinase

Tyrosine

kinase

Phosphorylation of enzymes

Transport Sintesis Sintesis Sintesis Pertumbuhan

Glucose Protein lemak Glucose & Ekspresi Gen

Insulin

Reseptor

insulin


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The effects of insulin on its target cells

Acceleration of glucose uptake (all targetcells).

Acceleration of glucose utilization (all target

cells) and enhanced ATP production. Stimulation of glycogen formation (skeletal

muscles and liver cells).

Stimulation of amino acid absorption and

protein synthesis.

Stimulation of triglyceride formation in

adipose tissues.


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Homeostasis glukosa plasma

usus hepar

Glukosa plasma70 mg/dl

ginjal otak Jar.lemak Otot & jar lain

diet AA gliserol

laktat

Urine, jika glukosa plasma >180mg/dl


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GLUCAGON

secreted by alpha cell in response to low bloodglucose levels.

The primary effects of glucagon :

1. Stimulation of glycogen breakdown in skeletal

muscle and liver cells.2. Stimulation of triglyceride breakdown inadipose tissues.

3. Stimulation of glucose production at the liver

and secrete it into the bloodstream for use bythe cells for energy production


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Diabetes mellitus (DM)

a disorder in which the cells of thebody cannot absorb glucose, eitherbecause the pancreas no longerproduces enough insulin or becausethe cells do not respond to theeffects of the insulin that is produced.

Symptoms : frequent urination,excessive thirst, tiredness, weightloss, hunger, and slow woundhealing.

The long-term effects : loss of vision,

decreased blood supply to the handsand feet, and pain kidney failure,heart disease, stroke, coma, anddeath.


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2 types of DM : Type I and Type II

Type I diabetes (juvenile diabetes), begins mostcommonly in childhood or adolescence. Thepancreas produces little or no insulin a virus ormicroorganism that trigger's an autoimmune.

Type II diabetes (adult-onset diabetes), is themore common. It occurs most often in peoplewho are overweight and who do not exercise.The pancreas may produce enough insulin, butthe body's cells have become resistant to the

effects of insulin. The symptoms : so gradually that a person maynot know they suffer from the disorder.

Gangguan Homeostasis glukosa plasma pada


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Gangguan Homeostasis glukosa plasma pada

defisiensi insulin

usus hepar

Glukosa plasma300 mg/dl

ginjal otak Jar.lemak Otot & jar lain

diet AA gliserol

laktat

Urine glycosuria

kuliah hormon manusia blok4

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