第37章内分泌系

The thyroid gland is located in the neck, just below the larynx and in front of the trachea, as shown in Figure 37.16. It is a butterfly-shaped gland with two lobes that are connected by the isthmus. It has a dark red color due to its extensive vascular system. When the thyroid swells due to dysfunction, it can be felt under the skin of the neck.

The thyroid gland is made up of many spherical thyroid follicles, which are lined with a simple cuboidal epithelium. These follicles contain a viscous fluid, called colloid, which stores the glycoprotein thyroglobulin, the precursor to the thyroid hormones. The follicles produce hormones that can be stored in the colloid or released into the surrounding capillary network for transport to the rest of the body via the circulatory system.

Thyroid follicle cells synthesize the hormone thyroxine, which is also known as T₄ because it contains four atoms of iodine, and triiodothyronine, also known as T₃ because it contains three atoms of iodine. Follicle cells are stimulated to release stored T₃ and T₄ by thyroid stimulating hormone (TSH), which is produced by the anterior pituitary. These thyroid hormones increase the rates of mitochondrial ATP production.

A third hormone, calcitonin, is produced by parafollicular cells of the thyroid. Calcitonin release is not controlled by TSH, but instead is released when calcium ion concentrations in the blood rise. Calcitonin functions to help regulate calcium concentrations in body fluids. It acts in the bones to inhibit osteoclast activity and in the kidneys to stimulate excretion of calcium. The combination of these two events lowers body fluid levels of calcium.

Most people have four parathyroid glands; however, the number can vary from two to six. These glands are located on the posterior surface of the thyroid gland, as shown in Figure 37.17. Normally, there is a superior gland and an inferior gland associated with each of the thyroid’s two lobes. Each parathyroid gland is covered by connective tissue and contains many secretory cells that are associated with a capillary network.

The parathyroid glands produce parathyroid hormone (PTH). PTH increases blood calcium concentrations when calcium ion levels fall below normal. PTH (1) enhances reabsorption of Ca²⁺ by the kidneys, (2) stimulates osteoclast activity and inhibits osteoblast activity, and (3) it stimulates synthesis and secretion of calcitriol by the kidneys, which enhances Ca²⁺ absorption by the digestive system. PTH is produced by chief cells of the parathyroid. PTH and calcitonin work in opposition to one another to maintain homeostatic Ca²⁺ levels in body fluids. Another type of cells, oxyphil cells, exist in the parathyroid but their function is not known.

The adrenal glands are associated with the kidneys; one gland is located on top of each kidney as illustrated in Figure 37.18. The adrenal glands consist of an outer adrenal cortex and an inner adrenal medulla. These regions secrete different hormones.

The adrenal cortex is made up of layers of epithelial cells and associated capillary networks. These layers form three distinct regions: an outer zona glomerulosa that produces mineralocorticoids, a middle zona fasciculata that produces glucocorticoids, and an inner zona reticularis that produces androgens.

The main mineralocorticoid is aldosterone, which regulates the concentration of Na⁺ ions in urine, sweat, pancreas, and saliva. Aldosterone release from the adrenal cortex is stimulated by a decrease in blood concentrations of sodium ions, blood volume, or blood pressure, or by an increase in blood potassium levels.

The three main glucocorticoids are cortisol, corticosterone, and cortisone. The glucocorticoids stimulate the synthesis of glucose and gluconeogenesis (converting a non-carbohydrate to glucose) by liver cells and they promote the release of fatty acids from adipose tissue. These hormones increase blood glucose levels to maintain levels within a normal range between meals. These hormones are secreted in response to ACTH and levels are regulated by negative feedback.

The adrenal cortex also produces small amounts of testosterone precursor, although the role of this additional hormone production is not fully understood. Testosterone is a type of androgen that promotes a suite of characteristics such as the growth and development of the testes and penis, increased skeletal and muscular growth, enlargement of the larynx, increased growth and redistribution of body hair, and increased sexual drive. Testosterone secretion is regulated by both the hypothalamus and the anterior pituitary gland. The hypothalamus sends releasing hormones that stimulate the release of gonadotropins from the anterior pituitary gland. Testosterone produced in small amounts in the adrenal cortex may work with sex hormones released from the gonads.