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Oxford Textbook of Medicine (5 ed.)

Edited by David A. Warrell, Timothy M. Cox, John D. Firth

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Latest update

The November 2012 update sees updates to over 70 chapters, focusing on Neurology and Gastroenterology. This update also incorporates a selection of 29 Case Histories taken from related titles in the Oxford Case Histories series, linked to from related chapters. Each case includes several questions followed by detailed answers and discussion to enhance diagnostic and clinical understanding.

Neurology updates include substantial updates to key chapters and new material on a wide range of topics including spinal cord injury, autonomic nervous system disorders, and inherited neurodegenerative diseases. 

Gastroenterology updates include extensive revisions of key chapters on liver failure and acute pancreatitis and new material on a wide range of matters, ranging from the common to the rare: including surgical treatments for colonic diverticular disease, antibody tests for immune disorders, and a revised treatment algorithm for small bowel bacterial overgrowth.

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Publisher:
Oxford University Press
Print Publication Date:
May 2010
Print ISBN-13:
9780199204854
Published to Oxford Medicine:
May 2012
DOI:
10.1093/med/9780199204854.001.1

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Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up to date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work. Except where otherwise stated, drug dosages and recommendations are for the non-pregnant adult who is not breastfeeding.

Contents

Principles of hormone action

Chapter:
Principles of hormone action
Author(s):

Mark Gurnell,

Jacky Burrin,

V. Krishna Chatterjee

DOI:
10.1093/med/9780199204854.003.1301_update_001

Update:

Minor updates made to table of genetic defects in membrane receptors or signalling and endocrine disorders.

Updated on 30 November 2011. The previous version of this content can be found here.

Hormones, produced by glands or cells, are messengers which act locally or at a distance to coordinate the function of cells and organs. Types of hormone include (1) peptides (e.g hypothalamic releasing factors) and proteins (e.g. insulin, growth hormone)—these generally interact with membrane receptors located on the cell surface, causing activation of downstream signalling pathways leading to alteration in gene transcription or modulation of biochemical pathways to effect a physiological response; (2) steroids (e.g. cortisol, progesterone, testosterone, oestradiol) and other lipophilic substances (e.g. vitamin D, retinoic acid, thyroid hormone)—these act by crossing the plasma membrane to interact with intracellular receptors, with hormone action via nuclear receptors altering cellular gene expression directly.

Hormone synthesis, processing and secretion—production of hormones can be regulated at many levels, including (1) gene transcription; (2) mRNA processing; (3) post-translational modification. Some hormones are not significantly concentrated within cells and are released via Golgi-derived transport vesicles that fuse with the plasma membrane (a ‘constitutive’ pathway of secretion). By contrast, many endocrine cells contain an additional ‘regulated’ secretory pathway, which allows the export of high concentrations of hormone stored in cytoplasmic vesicles. Many hormones are released in a rhythmic or pulsatile manner.

Control of hormone production—the classical mechanism by which hormone-producing glands are controlled is by negative feedback, e.g. tri-iodothyronine (T3) inhibits production of thyrotropin releasing hormone and thyroid stimulating hormone.

Physiological roles of hormones—these are enormously varied and include (1) control of growth and differentiation; (2) maintenance of homeostasis—energy balance, metabolic pathways; fluid, electrolyte and calcium balance; control of blood pressure; and (3) regulation of reproduction.

Clinical features of endocrine disorders—these comprise conditions of either hormone excess or hormone deficiency or hormone resistance, with germ-line or somatic defects in genes mediating hormone synthesis or action causing inherited syndromes or acquired endocrine cellular dysfunction.

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