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Endocrinology of Genitourinary System

Anatomy Renin
Peptide Hormone
Secreted by Kidney from Granular Cells of Juxtaglomerular Apparatus
Secreted in Response to
↓ Arterial Blood Pressure (↓ in Blood Volume)(Detected by Baroreceptor)
↓ NaCl in Ultra-Filtrate of Nephron
(Flow is Measured by Macula Densa of Juxtaglomerular Apparatus)
Sympathetic Nervous System Activity
(also control BP) (act through β1-Adrenergic Receptors)
Human Renin is Secreted by at least 2 Cellular Pathways
Constitutive Pathway Regulated Pathway
Secretion of Prorenin Secretion of Mature Renin
Processes
↓ BP produce a Baroreceptor Resp onse
(↑ Sympathetic Activity)
↓
Secretes ↑ Renin
↓
Renin → Angiotensinogen → Angiotensin I
↓
(Lungs ) by ACE, Angiotensin I → Angiotensin II
↓
Angiotensin II Produces ↑ Aldosterone
↓
Aldosterone Stimulates Reabsorption of Sodium
(Distal Tubule, Collecting Duct)
↓
Cl- (-ve charge) Follow Na+ (+ve charge) Passively
↓
H2O flows them into Blood (Reabsorption) by Osmosis

Erythropoietin (EPO) (Hematopoietin, Hemopoietin)

Glycoprotein Hormone that Controls Erythropoiesis
Is a Cytokine for Erythrocyte Precursors in Bone Marrow
Produced by Peritubular Capillary Endothelial Cells (in Kidney)
(Peritubular Fibroblasts of Renal Cortex)
Small amounts produced in Liver
Biological Functions
1° - Promoting Red Blood Cell Survival (protecting cells from Apoptosis)
Brain’s Response to Neuronal Injury
Wound Healing Process
Erythropoiesis-Stimulating Agent (ESA)
Exogenous EPO is used as a Performan ce-Enhan cing Drug
Regulation
Feedback Mechanism (measuring Blood Oxygenation)
Hypoxia-Inducible Factors (HIFs) (Transcription Factors for EPO)
Hydroxylated, Proteosomally Digested in Presence of Oxygen
Binds to Erythropoietin Receptor (EpoR) on RBC Surface
Activates JAK2 Cascade
Found in (Activate Intracellular Biological Pathways upon binding with Epo)
• Bone Marrow Cells
• Peripheral, Central Nerve Cells
Cooperates with various Growth Factors
(Involved in Development of Precursor Red Cells)
CFU-E BFU-E
(Colony Forming Unit-Erythroid) (Burst Forming Unit-Erythroid)
Completely dependent on Responsive to Erythropoietin
Erythropoietin
Under Hypoxic Con ditions, Kidney will Produce, Secrete Erythropoietin
(↑ Production of RBC by targeting CFU-E)
Actions
Vasoconstriction-Dependent Hypertension
Stimulate Angiogenesis
Induce Proliferation of Smooth Mus cle Fibers
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Male

Reproductive System – Gonads, Reproductive Tract, Accessory Sex Glands Reproductive Endocri nology
Reproduction Cells of Leydig in Testis – Secrete Testosterone
Depends on Union of Male, Female Gametes Testosterone is Secreted in Blood, Carried by Plasma Proteins
Female System – Site of Prenatal Development Reaches Target Cells (Numerous Effe cts)
Primary (1°) Reproductive Organs
Male Female Testosterone - 5 Major Effects
Pair of Testis Pair of Ovaries Masculinises Reproductive Tract, External Genitalia (Fetal Testis)
Spermatozoa Ova Growth, Maturation of Reproductive System (onset of Puberty)
Testosterone Estrogen, Progesterone (Essential for Spermatogenesis, Maintain Male Reproductive Tract)
Reproductive Tract + Accessory Organs (found in Either Sex) Development of Sexual Libido
Unique Secondary (2°) Characteristics are found in Each Sex Maintain Sex Drive (in Adult Male)
(Traits include Differences in) Signals Development of Secondary (2°) Sexual Characteristics
Body Configuration Signaling Protein Anabolism
Distribution of Body Hair (Non-Reprodu ctive Functions)

Spermatogenesis
Spermatogonia
Relatively Undifferentiated Primordial Germ Cells
Diploid
In the Outermost Layer in Walls of Seminiferous Tubules
Functional Sperm Cells (near Lumens of Tub ules) (Released)
Proliferate by Mitotic Division (Produce New Primordial Germ Cells)
(Move toward Lumen through Progressive Stages of Spermatogenesis)
Each Sperm-Forming Daughter Cells form 4 Ident ical Primary Spermatocytes
↓

These Dipl oid Cell s Carry out 1s t Me iotic Divi sion

↓

Each Primary Spermatocyte Forms 2 Secondary Spermatocytes

(Haploid, Double-Stranded Chromosome s)
↓

Each Secondary Spermatocytes forms 2 Spermatids

(Haploid, Single-Stranded Chromosome)
Therefore, Each Primary Spermatocyte Forms 4 Spermatids

Spermiogenesis
Packaging (Remodelling) of Spermatids
Differentiation into 4 Parts – Head, Acrosome, Tail, Midpiece
Through Sperm Cell Maturation
Cells are Intimately associated with Sertoli Cells
(cells are in wall of Seminiferous Tubules)
Tight Junctions between Sertoli Cells (form a Blood-Brain Barrier)
Sertoli Cells
Provide Nourishment for Sperm Cells
Carry out Phagocytosis
Secrete a Seminiferous Tubule Fluid into Lumens of Tubules
Site of Action to Control Spermatogenesis (Signalled by Testosterone, FSH)

Hypothalamus-Pituitary-Gonadal Axis (HPG Axis)

Testosterone – Essential for Mitosis, Meiosis of Germ Cells

FSH – Important for Spermatid Remodelling
Estrogen – Male Reproductive Health
Gonadotropin-releasing Hormone Activity ↑ at Puberty

Male Accessory Sex Glands

Seminal Vesicles Prostate Gland Bulbourethral Glands
Fructose for Energy Alkaline Fluid to Mucus Secretion for
Prostaglandin for Neutralize Acidity of Lubrication
Smooth Muscle Female Reproductive
Contraction in Tract Tract
Provide Clotting
Enzymes
Prostaglandins (Locally-Acting Chemical Messengers)(Fatty Acid Derivatives)
• Promote Sperm Transport
• Promote Bronch odilation
• ↑ Renal Blood Flow
• Inhibit HCl from Stomach
• Enhance Cortisol Secretion
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Female

Reproductive Endocri nology Changes in Uterus

Complex Cycling of Female Sex Hormones Beginning of Menstrual Cycle, there is Sloughing off of Endometrium of Uterus
Ovaries Produce Ova (Due to ↓ Estrogen, Progesterone)
Produce Estrogen, Progesterone Proliferative Phase
Functions of Estrogen In Follicular Phase (↑ Estrogen) cause Thickening in Uterine Lining
Maturation, Maintenance of Female System Uterine Secretory Phase
Establish Female Secondary Sexual Characteristics After Ovulation, Progesterone produce Further Thickening of Uterine Lining
Ova Maturation, Release Suitable for Implantation
Transport of Sperm from Vagina to Site of Fertilization in Oviduct New Ovarian Follicular Phase
Function of Progesterone Degeneration of Corpus Luteum
Prepare a Suitable Environment for Nourishing Developing Embryo, Fetus Menstruation begins

Ovarian Cycle (28 Days) Female Cycle

Cyclical Changes in Cervical Mucous
Fluctuating Estrogen, Progesterone
Puberty changes in Females = Males
GnRH Secretion ↑ (at Onset of Puberty)
GnRH – Stimulate release of Hormones from Anterior Pituitary
Estrogen – Changes in Female Reproductive System, Body Characteristics
Menopause
Mid-Life Hypothalamic Change (cau se Onset of Menopau se)
Characterized by ↑ Irregular Cycles, Dwindling Estrogen Levels
(Has widespread physiological actions)

Hypothalamus-Pituitary-Gonadal Axis (HPG Axis)

Follicular Phase Luteal Phase

1st Half of Cycle Corpus Luteum Left behind in Ovary
Dominated by Maturing Follicles after it loses its sex cell by Ovulation
Granulosa cells of some Primary Corpus Luteum Secretes
Follicles Proliferate • ↑ Progesterone
Oocyte inside each Follicle Enlarges (compared to Follicular Phase)
Theca Cells (in Follicle) • Estrogen
secrete ↑ Estrogen Degenerates after 14 Days of
(Circulate throughout Body) Formation (unless Fertilization,
Rapid Follicular Growth Implantation occur)
↑ FSH signal Ovarian Follicle to If Fertilization, Implantation occur
Secrete ↑ Estrogen Corpus Luteum continue to secrete its
↑ Estrogen Feedback to Inhibit FSH hormones
LH rises (Peaks in Mid-Cycle) (Corpus Luteum of Pregnancy)
Triggers Ovulation Progesterone output Inhibits release
(Estrogen Output ↓) of FSH, LH
(Mature Follicle → Corpus Luteum) With ↓ LH, Corpus Luteum
Degenerates
Ovulation
1 Follicle Grows ↑ Rapidly
Matures about 14 Days after onset of Follicular Development
Follicle Ruptures to release Oocyte (from Ovary)
Released Sex Cell Enters Oviduct (may or may not be Fertilized)
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Hormones Secreted by Placenta Lactation

hCG
Maintain Corpus Luteum of Pregnancy
Estrogen ↑ Estrogen Secretion Progesterone Prolactin
Stimulate Growth of Myometrium (Strengthen it for Parturition) Promotes Extensive Stimulates Mammary Gland
Progesterone Duct Development in Alveolar-Lobular Development
Suppresses Uterine Contractions Breasts Development
Relaxin Lactation
Softens Cervix to prepare it for Cervical Dilation at Parturition Abrupt ↓ in Estrogen, Progesterone
Placental PTHrp Loss of Placenta
↑ Plasma Ca2+ in Maternal Blood Oxytocin Prolactin
Overall, Maternal Body System respond to ↑ Demands of Gestation Induce Milk Ejection Promotes Milk Secretion
Changes Include Breast Feeding (Advantages)
• Uterine Enlargement Infant Mother
• ↑ Amount of Blood Abundance of I mmune Cells Oxytocin
Many Substances Hastens Involution of Uterus
Parturition (Birth) (eg. Lactoferrin)
During Last Trimester, Uterus becomes More Excitable Weaning (Introdu cing Adult Diet, Withdrawal of Mother’s Milk)
Mild Contraction occur Cessation of Production
Cervix begins to Soften (near Parturition)
Fetus Shifts Downwards (Head Contacting Cervix)
Rhythmic contraction (Begin at Onset of Lab or)
(↑ Estrogen)
Oxytocin
Labor Progresses
Powerful Muscle Stimulant