Less common diseases such as polyglandular failure, Addison’s disease, and lymphocytic hypophysitis also have an immunologic basis. Common endocrine diseases such as autoimmune thyroid disease and type 1 diabetes mellitus are caused by dysregulation of immune surveillance and tolerance. Cytokines and interleukins (ILs) have profound effects on the functions of the pituitary, adrenal, thyroid, and gonads. The adrenal hormone cortisol is a powerful immunosuppressant. The immune and endocrine systems are also intimately intertwined.
The peripheral nervous system stimulates the adrenal medulla. Through the production of hypothalamic releasing factors, the central nervous system (CNS) exerts a major regulatory influence over pituitary hormone secretion ( Chap. In addition to its traditional synaptic functions, the brain produces a vast array of peptide hormones, and this has led to the discipline of neuroendocrinology. The classic endocrine glands-pituitary, thyroid, parathyroid, pancreatic islets, adrenals, and gonads-communicate broadly with other organs through the nervous system, hormones, cytokines, and growth factors. Unlike many other specialties in medicine, it is not possible to define endocrinology strictly along anatomic lines.
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