Adrenal medulla

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Adrenal medulla
Gray1185.png
Medulla labeled at bottom right.
Details
Precursor Neural crest
Part of Adrenal gland
Artery superior suprarenal artery, middle suprarenal artery, Inferior suprarenal artery
Vein suprarenal veins
Nerve celiac plexus, renal plexus
Lymph lumbar glands
Identifiers
MeSH D000313
TA98 A11.5.00.008
TA2 3882
FMA 15633
Anatomical terminology
In H&E staining, the adrenal medulla (on the pointer) stains lighter than the adrenal cortex. Adrenal gland (medulla).JPG
In H&E staining, the adrenal medulla (on the pointer) stains lighter than the adrenal cortex.

The adrenal medulla (Latin : medulla glandulae suprarenalis) is the inner part of the adrenal gland. [1] It is located at the center of the gland, being surrounded by the adrenal cortex. [1] It is the innermost part of the adrenal gland, consisting of chromaffin cells that secrete catecholamines, including epinephrine (adrenaline), norepinephrine (noradrenaline), and a small amount of dopamine, in response to stimulation by sympathetic preganglionic neurons. [1] [2]

Contents

Structure

The adrenal medulla consists of irregularly shaped cells grouped around blood vessels. These cells are intimately connected with the sympathetic division of the autonomic nervous system (ANS). These adrenal medullary cells are modified postganglionic neurons, and preganglionic autonomic nerve fibers lead to them directly from the central nervous system. The adrenal medulla affects energy availability, heart rate, and basal metabolic rate. Recent research indicates that the adrenal medulla may receive input from higher-order cognitive centers in the prefrontal cortex as well as the sensory and motor cortices, providing credence to the idea that there are psychosomatic illnesses. [3]

Development

Chromaffin cells are derived from the embryonic neural crest, and are modified postganglionic sympathetic neurons. [1] They are modified postganglionic sympathetic neurons of the autonomic nervous system that have lost their axons and dendrites, receiving innervation from corresponding preganglionic fibers. The cells form clusters around fenestrated capillaries where they release norepinephrine and epinephrine into the blood.

As a cluster of neuron cell bodies, the adrenal medulla is considered a modified ganglion of the sympathetic nervous system. [2]

Function

Rather than releasing a neurotransmitter, the cells of the adrenal medulla secrete hormones. [1]

The adrenal medulla is the principal site of the conversion of the amino acid tyrosine into the catecholamines; epinephrine, norepinephrine, and dopamine.

Because the ANS, specifically the sympathetic division, exerts direct control over the chromaffin cells, the hormone release can occur rather quickly. [2] In response to stressors, such as exercise or imminent danger, medullary cells release the catecholamines adrenaline and noradrenaline into the blood. Adrenaline composes about 85% of the released catecholamines, and noradrenaline the other 15%. [4]

Notable effects of adrenaline (epinephrine) and noradrenaline (norepinephrine) include increased heart rate and blood pressure, blood vessel constriction in the skin and gastrointestinal tract, smooth muscle (bronchiole and capillary) dilation, and increased metabolism, all of which are characteristic of the fight-or-flight response. [1] Release of catecholamines is stimulated by nerve impulses, and receptors for catecholamines are widely distributed throughout the body.

Clinical significance

Neoplasms include:


The adrenal medulla may be poorly formed or absent in cases of absent adrenal gland. The deficiency in circulating catecholamines is mildly symptomatic due to compensation by the autonomous nervous system, except in episodes of hypoglycemia where glycogenolysis cannot be stimulated by circulating epinephrine . [5]

In dopamine beta hydroxylase deficiency, the entire body cannot efficiently produce epinephrine and norepinephrine from dopamine, this results in severe dysautonomia but most crucially due to autonomous nervous system failure which requires epinephrine and norepinephrine as neurotransmitters, dopamine being used in this pathology as an inadequate substitute. [5] [7]

See also

Related Research Articles

<span class="mw-page-title-main">Adrenal gland</span> Endocrine gland

The adrenal glands are endocrine glands that produce a variety of hormones including adrenaline and the steroids aldosterone and cortisol. They are found above the kidneys. Each gland has an outer cortex which produces steroid hormones and an inner medulla. The adrenal cortex itself is divided into three main zones: the zona glomerulosa, the zona fasciculata and the zona reticularis.

<span class="mw-page-title-main">Catecholamine</span> Class of chemical compounds

A catecholamine is a monoamine neurotransmitter, an organic compound that has a catechol and a side-chain amine.

<span class="mw-page-title-main">Autonomic nervous system</span> Division of the nervous system supplying internal organs, smooth muscle and glands

The autonomic nervous system (ANS), formerly referred to as the vegetative nervous system, is a division of the nervous system that operates internal organs, smooth muscle and glands. The autonomic nervous system is a control system that acts largely unconsciously and regulates bodily functions, such as the heart rate, its force of contraction, digestion, respiratory rate, pupillary response, urination, and sexual arousal. This system is the primary mechanism in control of the fight-or-flight response.

<span class="mw-page-title-main">Sympathetic nervous system</span> Part of the autonomic nervous system which stimulates fight-or-flight responses

The sympathetic nervous system (SNS) is one of the three divisions of the autonomic nervous system, the others being the parasympathetic nervous system and the enteric nervous system. The enteric nervous system is sometimes considered part of the autonomic nervous system, and sometimes considered an independent system.

<span class="mw-page-title-main">Fight-or-flight response</span> Physiological reaction to a perceived threat or harmful event

The fight-or-flight or the fight-flight-freeze-or-fawn is a physiological reaction that occurs in response to a perceived harmful event, attack, or threat to survival. It was first described by Walter Bradford Cannon. His theory states that animals react to threats with a general discharge of the sympathetic nervous system, preparing the animal for fighting or fleeing. More specifically, the adrenal medulla produces a hormonal cascade that results in the secretion of catecholamines, especially norepinephrine and epinephrine. The hormones estrogen, testosterone, and cortisol, as well as the neurotransmitters dopamine and serotonin, also affect how organisms react to stress. The hormone osteocalcin might also play a part.

<span class="mw-page-title-main">Chromaffin cell</span> Neuroendocrine cells found in adrenal medulla in mammals

Chromaffin cells, also called pheochromocytes, are neuroendocrine cells found mostly in the medulla of the adrenal glands in mammals. These cells serve a variety of functions such as serving as a response to stress, monitoring carbon dioxide and oxygen concentrations in the body, maintenance of respiration and the regulation of blood pressure. They are in close proximity to pre-synaptic sympathetic ganglia of the sympathetic nervous system, with which they communicate, and structurally they are similar to post-synaptic sympathetic neurons. In order to activate chromaffin cells, the splanchnic nerve of the sympathetic nervous system releases acetylcholine, which then binds to nicotinic acetylcholine receptors on the adrenal medulla. This causes the release of catecholamines. The chromaffin cells release catecholamines: ~80% of adrenaline (epinephrine) and ~20% of noradrenaline (norepinephrine) into systemic circulation for systemic effects on multiple organs, and can also send paracrine signals. Hence they are called neuroendocrine cells.

<span class="mw-page-title-main">Muscarinic acetylcholine receptor</span> Acetylcholine receptors named for their selective binding of muscarine

Muscarinic acetylcholine receptors, or mAChRs, are acetylcholine receptors that form G protein-coupled receptor complexes in the cell membranes of certain neurons and other cells. They play several roles, including acting as the main end-receptor stimulated by acetylcholine released from postganglionic fibers in the parasympathetic nervous system.

A neurohormone is any hormone produced and released by neuroendocrine cells into the blood. By definition of being hormones, they are secreted into the circulation for systemic effect, but they can also have a role of neurotransmitter or other roles such as autocrine (self) or paracrine (local) messenger.

<span class="mw-page-title-main">Postganglionic nerve fibers</span> Fibers from the ganglion to the effector organ

In the autonomic nervous system, nerve fibers from the ganglion to the effector organ are called postganglionic nerve fibers.

<span class="mw-page-title-main">Lateral grey column</span>

The lateral grey column is one of the three grey columns of the spinal cord ; the others being the anterior and posterior grey columns. The lateral grey column is primarily involved with activity in the sympathetic division of the autonomic motor system. It projects to the side as a triangular field in the thoracic and upper lumbar regions of the postero-lateral part of the anterior grey column.

Small intensely fluorescent cells are the interneurons of the sympathetic ganglia of the Sympathetic division of the autonomic nervous system (ANS). The neurotransmitter for these cells is dopamine. They are a neural crest derivative and share a common sympathoadrenal precursor cell with sympathetic neurons and chromaffin cells.

<span class="mw-page-title-main">Vanillylmandelic acid</span> Chemical compound

Vanillylmandelic acid (VMA) is a chemical intermediate in the synthesis of artificial vanilla flavorings and is an end-stage metabolite of the catecholamines. It is produced via intermediary metabolites.

<span class="mw-page-title-main">Paraganglion</span>

A paraganglion is a group of non-neuronal cells derived of the neural crest. They are named for being generally in close proximity to sympathetic ganglia. They are essentially of two types: (1) chromaffin or sympathetic paraganglia made of chromaffin cells and (2) nonchromaffin or parasympathetic paraganglia made of glomus cells. They are neuroendocrine cells, the former with primary endocrine functions and the latter with primary chemoreceptor functions.

<span class="mw-page-title-main">Phenylethanolamine N-methyltransferase</span> Mammalian protein found in Homo sapiens

Phenylethanolamine N-methyltransferase (PNMT) is an enzyme found primarily in the adrenal medulla that converts norepinephrine (noradrenaline) to epinephrine (adrenaline). It is also expressed in small groups of neurons in the human brain and in selected populations of cardiomyocytes.

<span class="mw-page-title-main">Norepinephrine</span> Catecholamine hormone and neurotransmitter

Norepinephrine (NE), also called noradrenaline (NA) or noradrenalin, is an organic chemical in the catecholamine family that functions in the brain and body as a hormone, neurotransmitter and neuromodulator. The name "noradrenaline" is more commonly used in the United Kingdom, whereas "norepinephrine" is usually preferred in the United States. "Norepinephrine" is also the international nonproprietary name given to the drug. Regardless of which name is used for the substance itself, parts of the body that produce or are affected by it are referred to as noradrenergic.

<span class="mw-page-title-main">Adrenal tumor</span> Medical condition

An adrenal tumor or adrenal mass is any benign or malignant neoplasms of the adrenal gland, several of which are notable for their tendency to overproduce endocrine hormones. Adrenal cancer is the presence of malignant adrenal tumors, and includes neuroblastoma, adrenocortical carcinoma and some adrenal pheochromocytomas. Most adrenal pheochromocytomas and all adrenocortical adenomas are benign tumors, which do not metastasize or invade nearby tissues, but may cause significant health problems by unbalancing hormones.

<span class="mw-page-title-main">Iobenguane</span> Chemical compound

Iobenguane, or MIBG, is an aralkylguanidine analog of the adrenergic neurotransmitter norepinephrine (noradrenaline), typically used as a radiopharmaceutical. It acts as a blocking agent for adrenergic neurons. When radiolabeled, it can be used in nuclear medicinal diagnostic and therapy techniques as well as in neuroendocrine chemotherapy treatments.

<span class="mw-page-title-main">Adrenaline</span> Hormone and medication

Adrenaline, also known as epinephrine, is a hormone and medication which is involved in regulating visceral functions. It appears as a white microcrystalline granule. Adrenaline is normally produced by the adrenal glands and by a small number of neurons in the medulla oblongata. It plays an essential role in the fight-or-flight response by increasing blood flow to muscles, heart output by acting on the SA node, pupil dilation response, and blood sugar level. It does this by binding to alpha and beta receptors. It is found in many animals, including humans, and some single-celled organisms. It has also been isolated from the plant Scoparia dulcis found in Northern Vietnam.

<span class="mw-page-title-main">Sympathoadrenal system</span>

The sympathoadrenal system is a physiological connection between the sympathetic nervous system and the adrenal medulla and is crucial in an organism's physiological response to outside stimuli. When the body receives sensory information, the sympathetic nervous system sends a signal to preganglionic nerve fibers, which activate the adrenal medulla through acetylcholine. Once activated, norepinephrine and epinephrine are released directly into the blood by adrenomedullary cells where they act as the bodily mechanism for "fight-or-flight" responses. Because of this, the sympathoadrenal system plays a large role in maintaining glucose levels, sodium levels, blood pressure, and various other metabolic pathways that couple with bodily responses to the environment. During numerous diseased states, such as hypoglycemia or even stress, the body's metabolic processes are skewed. The sympathoadrenal system works to return the body to homeostasis through the activation or inactivation of the adrenal gland. However, more severe disorders of the sympathoadrenal system such as pheochromocytoma can affect the body's ability to maintain a homeostatic state. In these cases, curative agents such as adrenergic agonists and antagonists are used to modify epinephrine and norepinephrine levels released by the adrenal medulla.

<span class="mw-page-title-main">History of catecholamine research</span>

The catecholamines are a group of neurotransmitters composed of the endogenous substances dopamine, noradrenaline (norepinephrine), and adrenaline (epinephrine), as well as numerous artificially synthesized compounds such as isoprenaline - an anti-bradycardiac medication. Their investigation constitutes a major chapter in the history of physiology, biochemistry, and pharmacology. Adrenaline was the first hormone extracted from an endocrine gland and obtained in pure form, before the word hormone was coined. Adrenaline was also the first hormone whose structure and biosynthesis was discovered. Second to acetylcholine, adrenaline and noradrenaline were some of the first neurotransmitters discovered, and the first intercellular biochemical signals to be found in intracellular vesicles. The β-adrenoceptor gene was the first G protein-coupled receptor to be cloned.

References

  1. 1 2 3 4 5 6 7 Carmichael, Stephen W. (1997-01-01), Bittar, E. Edward; Bittar, Neville (eds.), "Chapter 8 - The Adrenal Medulla", Principles of Medical Biology, Molecular and Cellular Endocrinology, Elsevier, 10: 207–225, doi:10.1016/s1569-2582(97)80035-9, ISBN   9781559388153 , retrieved 2020-12-17
  2. 1 2 3 Hinson, Joy; Raven, Peter; Chew, Shern (2010-01-01), Hinson, Joy; Raven, Peter; Chew, Shern (eds.), "The Adrenal Glands Part I", The Endocrine System (Second Edition), Churchill Livingstone, pp. 53–60, doi:10.1016/b978-0-7020-3372-8.00005-7, ISBN   978-0-7020-3372-8 , retrieved 2020-12-17
  3. Dum, Richard (2016). "Motor, cognitive, and affective areas of the cerebral cortex influence the adrenal medulla". Proceedings of the National Academy of Sciences of the United States of America. 113 (35): 9922–9927. doi: 10.1073/pnas.1605044113 . PMC   5024624 . PMID   27528671.
  4. Introduction to Autonomics, Part 2 - Page 5 of 12 anatomy module at med.umich.edu
  5. 1 2 3 4 5 Fung, M. M.; Viveros, O. H.; O’Connor, D. T. (16 November 2007). "Diseases of the adrenal medulla". Acta Physiologica. 192 (2): 325–335. doi:10.1111/j.1748-1716.2007.01809.x. PMC   2576282 . PMID   18021328.
  6. Därr, Roland; Lenders, Jacques W.M.; Hofbauer, Lorenz C.; Naumann, Bernd; Bornstein, Stefan R.; Eisenhofer, Graeme (February 2012). "Pheochromocytoma – update on disease management". Therapeutic Advances in Endocrinology and Metabolism. 3 (1): 11–26. doi:10.1177/2042018812437356. PMC   3474647 . PMID   23148191.
  7. Robertson, D; Haile, V; Perry, SE; Robertson, RM; Phillips JA, 3rd; Biaggioni, I (July 1991). "Dopamine beta-hydroxylase deficiency. A genetic disorder of cardiovascular regulation". Hypertension. 18 (1): 1–8. doi: 10.1161/01.hyp.18.1.1 . PMID   1677640.{{cite journal}}: CS1 maint: numeric names: authors list (link)