Professional Documents
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Water-soluble
Bersirkulasi secara bebas dalam darah dan
tidak tergantung pada protein
Reseptor & Target
Resepter terdapat didalam sel
Hormon yang termasuk Lipid-Soluble
Termasuk hormon steroid, hormon tiroid
Melawati membran sel melalui difusi pasif dan berikatan
dengan reseptor yang terdapat pada sitoplasma atau
nekleus pada sel target
Reseptor terdapat pada membran sel
Hormon yang termasuk Water-Soluble (hormon protein)
Reseptor terdapat pada membran sel (first mesengger)
cyclic adenosine monophospate (cAMP) (second
mesegger)
Aktivasi enzim untuk mengatur aktivitas intraseluler
Sekresi Hormon
Some hormones are released in response to
variation in the concretrations of specific
substances in body fluids (calcium levels
decline PTH me
Some hormones are released only when the
gland cells receive hormononal instructions
from other endocrine organs (T3 & T4
TSH me)
Some hormones are released in response to
neural stimulaion (epinephrine &
norephrine sympathetic activation)
Pengaturan Sekresi Hormon
Simple feedback
Negative feedback : mekanisme homeostasis,
sekresi fisiologis (e.c insulin, PTH)
Positive feedback :mekanisme peningkatan
(berlebihan) aktivitas organ target (ect : oxytocin)
Complex feedback
Nervous control system
Physiologic rhythms
Simple Feedback
Negative feedback
ex : Parathyroid Hormone (PTH)
Parathyroid Hormon
calcium absorpyion
(intestine)
calcium resorption
(bone)
calcium PTH calcium reabsorption calcium PTH
(kidneys)
calcium excretion
(kidneys)
Simple Feedback
Negative Feedback
e.t Insulin
Simple Feedback
Positive feedback
ex : oxytocin
Complex Feedback
Ultra short
Feedback
loop
physiologic effect
Nervous System Control
Aktivitas beberapa kelenjar endokrin yang
secara langsung dipengaruhi oleh aktivitas
sistem persarafan.
Contoh : nyeri, emosi, stress dapat
menstimulasi sistem saraf untuk merangsang
sekresi hormon
HPA-Axis
Halm, 2009
Rhythms
Mekanisme pengaturan sekresi hormon yang berasal dari
otak
Circadian rhythms (periode 24 jam) : b.d siklus sleep-wake /
dark light cycles :
hormon cortisol (siang meningkat, sore menurun,
meningkat lagi saat tidur dan mencapai puncak pada
pagi hari
Sekresi GH dan prolactin meningkat saat tidur
Sekresi TSH maksimal selama tidur dan menurun 3 jam
setelah bangun pada pagi hari
Ultradian rhythms (periode > 24 jam)
Hormon estrogen, progesteron saat menstruasi
Endocrine Gland Abnormalities
Metabolic Factors
a deficiency in some key substrate needed
to synthesis the hormone.
Physical Damage
Adanya gangguan sirkulasi, inactive
Congenital Disorder
Enable to produce normal amount of
hormones (kelenjar kecil, enzim abnormal,
receptors insensitive)
Endocrine & Neural Regulatory
Abnormalities
Secondary Hypothyroidism
Inadequate TSH production and TRH
secretion
Secondary Hyperthyroidism
Excessive TRH and TSH production
Target Tissue Abnormalities
Presence of abnormal hormonal
receptors in target tissue.
In T2 DM, peripheral cells do not
respond normally to insulin
HYPOTHALAMUS
LOKASI : bagian bawah otak; diatas
kelenjar pituitari dan dibawah thalamus
HYPOTHALAMUS
VASKULARISASI : arteri karotis
FUNGSI HYPOTHALAMUS
1. Production of antidiuretic hormone (ADH) and Oxytocin
2. Production of releasing hormones (also called releasing factors)
that stimulate the secretion of hormones by the anterior pituitary
gland.
3. Regulation of body temperature by promoting responses such as
sweating in a warm environment or shivering in a cold
environment
4. Regulation of food intake;
5. Integration of the functioning of the autonomic nervous system,
which in turn regulates the activity of organs such as the heart,
blood vessels, and intestines.
6. Stimulation of visceral responses during emotional situations.
7. Regulation of body rhythms such as secretion of hormones, sleep
cycles, changes in mood, or mental alertness.
KELENJAR HIPOFISE (PITUITARY)
KELENJAR HIPOFISE (PITUITARY)
Kelenjar hipofise dirangsang oleh hipotalamus;
Mengontrol semua fungsi hormon dan Mengatur
produksi hormon besar dalam tubuh (gonad,
kelenjar adrenal dan kelenjar tiroid;
Kelenjar ini terdiri dari dua bagian yang
menghasilkan hormon-hormon yang berbeda:
Bagian anterior :
Growth Hormone (GH), Adenocorticotropin
Hormone (ACTH), Tyroid Stimulating Hormone (TSH),
Luteinizing Hormone (LH), Folicel Stimulating
Hormone (FSH), Prolactin (PRL)
Bagian posterior :
Oxitocin dan Anti Diuretic Hormone (ADH).
KELENJAR HIPOFISE (PITUITARY)
ANATOMI
KELENJAR HIPOFISE (PITUITARY)
KELENJAR HIPOFISE (PITUITARY)
GROWTH HORMONE
PROLACTIN
Prolactin (PRL), also called luteotropic hormone
(LTH) or luteotropin, a protein hormone produced
by the pitutary gland of mammals that acts with
other hormones to initiate secretion of milk
(lactation) by the mammary glands.
Increased serum concentrations of prolactin during
pregnancy cause enlargement of the mammary
glands of the breasts and prepare for the production
of milk.
Milk production normally starts when the levels of
progesterone fall by the end of pregnancy and a
suckling stimulus is present.
Prolactin
Prolactin, as its name suggests, is responsible for lactation.
More precisely, prolactin initiates and maintains milk production
by the mammary glands.
The regulation of secretion of prolactin is complex, involving both
prolactin-releasing hormone (PRH) and prolactin-inhibiting
hormone (PIH) from the hypothalamus.
The mammary glands must first be acted upon by other
hormones such as estrogen and progesterone which are secreted
in large amounts by the placenta during pregnancy.
Then, after delivery of the baby, prolactin secretion increases and
milk is produced.
If the mother continues to breast-feed, prolactin levels remain
high.
Prolactin
HORMONES OF THE PITUITARY GLAND
(ADENOHYPOPHYSIS)
ADRENO- FOLLICLE-
LUTEINIZING
CORTICOTROPIC STIMULATING
HORMONE
HORMONE HORMONE
THYROID-
GROWTH PROLACTIN STIMULATING
HORMONE
HORMONE
MELATONIN
TRIIODOTHYRONINE
(T3) CALCITONIN
TETRAIODOTHYRONINE (T4)
THYROXINE
PARATHYROID HORMONE
GLUCAGON INSULIN
(GENERAL) (GENERAL)
Promotes movement of glucose Promotes movement of glucose
from storage and out of the blood
into the blood and into the cells
ADRENAL
Kelenjar Adrenal
Kelenjar adrenal terletak pada bagian atas ginjal
(suprarenal glands).
ADRENAL MEDULLA
mensekresi epinephrine and norepinephrine,
(catecholamines & sympathomimetic).
ADRENAL CORTEX
Mensekresi 3 tipe hormon steroid :
mineralocorticoids,
Glucocorticoids (cortisol),
sex hormones.
Adrenocorticotropic Hormone (ACTH)
ACTH menstimulasi sekresi kortisol dan hormon lain dari korteks adrenal.
Sekresi ACTH meningkat akibat adanya corticotropin releasing hormone (CRH) dari
hipotalamus.
CRH diproduksi pada kondisi stress fisiologis (cidera, penyakit, stress & (hypoglikemea)
Kelenjar Adrenal
oKelenjar adrenal atau kelenjar suprs renal yang terletak diatas ginjal.
o Tiap kelenjar adrenal terdiri dari 2 bagian medulla (tengah) dan korteks pada
bagian tepi.
Medulla Adrenal
o Sel pada medulla adrenal mensekresi epinefrin dan norepinefrin (katekolamin)
yang merupakan agen sympathomimetic.
o Sekresi hormon epinefrin dan norepinefrin distimulasi oleh impuls saraf dari
hipotalamus dan berfungsi dalam duplikasi divisi simpatik dari sistem saraf
otonom.
Epinephrine and Norepinephrine
Epinephrine (Adrenalin) and norepinephrine (noradrenalin) disekresi pada
situasi stress dan membantu menyiapkan tubuh untuk menghadapi stressor.
Norepinephrine
Norepinefrin disekresii dalam jumlah yang sedikit dan mempunyai fungsi yang
signifikan yang menyebabkan adanya vasokontriksi pada kulit, organ visera,
muskuloskeletal, dan peningkatan tekanan darah.
BLOOD SUPPLY
Kelenjar adrenal mendapat suplai darah + 5 ml per menit. Suplai darah dilayani oleh 5
cabang arteri untuk masing-masing kelenjar adrenal yang berasal dari aorta, arteri renalis
dan arteria phrenic inferior. Darah dialirkan melalui kanal yang didistribusikan kedalam
sinusoid dan menyuplai kelenjar adrenal bagian medula dan korteks. After supplying the
cortex and medulla, blood collects at the cortico-medullary junction and drains through the
central adrenal vein to the renal vein or directly into the inferior vena cava.
INNERVATION
Korteks adrenal menerima persarafan aferen dan eferen. A direct contact of nerve
terminals with adrenocortical cells has been suggested and chemoreceptors and
baroreceptors present in the adrenal cortex infer efferent innervation. Diurnal variation in
cortisol secretion [9] and compensatory adrenal hypertrophy are influenced by adrenal
innervation. Splanchnic nerve innervation has an effect in the regulation of adrenal steroid
release
IMMUNE CELLS
Macrophages are distributed throughout the adrenal cortex. In addition to their phagocytic
activity, they produce and secrete cytokines (TNFb, IL-1, IL-6) and peptides (VIP), which
interact with adrenocortical cells and influence their functions. Lymphocytes are scattered
in the adrenal cortex (Fig. 5), and have been shown to produce ACTH-like substances. It
has also been shown, that immuno-endocrine interactions between lymphocytes and
adrenal zona reticularis cells can stimulate dehydroepiandrosterone production
Korteks Adrenal
Korteks Adrenal mensekresi 3 jenis hormon steroid
oMineralokortikoid
oGlukokortikoid
oHormon sex
Aldosterone
o Aldosterone merupakan bagian terbanyak dari mineralokortikoid
o Organ target aldosterone adalah ginjal , aldosterone meningkatkan
reabsorpsi sodium dan ekskresi potasium oleh tubulus ginjal. Ion
Sodium kembali ke dalam darah, potasium dikeluarkan melalui
ginjal.
o Aldosterone : mempertahankan kadar sodium normal dalam darah,
pH darah dan tekanan darah.
o Beberapa faktor yang mempnegaruhi sekresi aldosterone :
o Defisiensi sodium, kehilangan darah (dehidrasi), penurunan
tekanan darah dan peningkatan kadar kalium darah.
PHYSIOLOGY
Corticotropin releasing hormone (CRH) is released by
the hypothalamus which stimulates pituitary release of
adrenocorticotropin hormone (ACTH).
ACTH stimulates the release of cortisol from the
adrenal cortex.
Cortisol then invokes a negative feedback mechanism
on CRH and ACTH. An adenoma of the adrenal gland
results in very high circulating cortisol, and low ACTH.
When a pituitary adenoma is present, or too much
CRH is produced, ACTH levels are continuously high
resulting in high cortisol.
These elevated cortisol levels predispose hypertension,
glucose intolerance and increase risk for cardiovascular
disease.
FUNGSI KORTISOL
membantu tubuh untuk mengelola stres
mengkonversi protein menjadi glukosa untuk
meningkatkan kadar gula darah lesu
bekerja sama secara erat dengan hormon insulin
untuk menjaga kadar gula darah konstan
mengurangi peradangan
berkontribusi terhadap pemeliharaan tekanan
darah yang konstan
memberikan kontribusi pada kerja sistem
kekebalan tubuh.
METABOLISME GLUKOSA HEPATIK
Glukokortikoid meningkatkan
glukoneogenesis hepatik dengan
merangsang enzim glukoneogenik yaitu
fosfoenolpiruvat karboksikinase dan
glukosa-6-fosfatase.
Glukokortikoid meningkatkan respons hepar
terhadap hormon glukoneogenik (glukagon,
katekolamin) dan juga mempengaruhi
peningkatan pembesaran substrat dari
jaringan perifer terutama otot.
METABOLISME GLUKOSA PERIFER
Glukokortikoid mempengaruhi
metabolisme karbohidrat dengan jalan
menghalangi ambilan glukosa di perifer
dalam otot dan jaringan adiposa.
Epinephrine
oEpinefrin disekresi dalam jumlah yang banyak
HORMONES OF THE REPRODUCTIVE ORGANS
UTERUS &
TESTES OVARIES
OVARIES
ESTROGEN &
TESTOSTERONE PROSTAGLANDINS
PROGESTERONE