The hormones in the endocrine glands

Among hormonal factors in the development of ulcers become crucial disorder hypophysial-adrenal system (GFS) or, more precisely, of the hypothalamic-pituitary-adrenal axis (GHPS). Experimental evidence suggests that gipofizektomii lowers secretory activity of gastric glands (Backer and Abrams, 1954), and is accompanied by histological changes, manifested by degeneration of the main and obkladochnykh cells (C. M. Lipovskii, etc., 1966). Recently Century M. Mosin (1968) showed that ulcers disturbed function of the pituitary secretion of ACTH in the beginning of the disease is increasing dramatically, and later returning to normal. In patients with long-current disease with frequent relapses blood was deprived of adrenocorticotropic activity.
To date there is no single design solution of the question about the role of steroid hormones in ulceration. Clinical and experimental observations suggest that steroid hormones increase gastric secretion, can change the volume of the gastric mucosa, to break the protective mechanisms of the latter, mucus secretion, and also to create the basis for pathological implementing other effects on the stomach (vagal influence, gastrin and others). It is known that the steroid hormones, are entered in pharmacological doses therapeutic purposes, may cause aggravation and perforation of the former previously and the formation of new ulcers.
Lately all researchers studying the functional state of adrenal cortex in patients with peptic ulcer, came to the conclusion that the spontaneous excretion of 17-hydroxycorticoid-steroids (17 GOKS) and other metabolites steroids with urine ulcers regardless of localization of the ulcer is low and only in some cases the normal (C. M. Mosin, 1966; L. M. Kozlov, 1968; S. L. Litvinov, and A. A. Fischer, 1969). In some patients with duodenal ulcer in the phase of deterioration has increased the response to the introduction of ACTH (20 or 40 U); in other cases, it is normal. In most patients with stomach ulcer, there is a close Hyper-reactivity of the adrenal cortex, with increased excretion of 17-GOKS in 1,5-2 times compared to the original *.
Along with this, some patients with duodenal ulcer noted inadequate response on introduction 1 UNITS ACTH, while the adrenal cortex healthy people on such a dose doesn't react.
Thus, glucocorticoid adrenal function changes in patients with peptic ulcer very peculiar. On the one hand, the depletion of functional ability of these endocrine glands, and on the other hand is inadequately high reactivity of the latter. The reason of such violations and their pathogenetic role remains unclear. Perhaps hypersecretion ACTH over time depletes the functional reserves of natural order, while it increased reactivity remains. Periodic significant release of steroids under the influence of various stressors, certainly affects the mucous membranes of gastroduodenal system. On the other hand, low levels of production of glucocorticoids can cause trophic changes of the mucous membrane, contributing to the formation of ulcers. In patients with peptic ulcer sometimes there is impaired secretion of catecholamines, and if the preparation of adrenaline in most cases rises, the allocation of norepinephrine, on the contrary, decreases. Hyperadrenalism, apparently, is caused by pain syndrome (C. L. Litvinov, and A. A. Fischer, 1969).
Bojanowitz (1950-1967) attached great pathogenetic importance to so-called disharmonize", manifested in the oppression mineralokortikoidna activity on the background of excess production of glucocorticoids. However, the direct determination of aldosterone in the urine of patients with peptic ulcer, spontaneously and after loading hypothiazide found the absence of any abnormalities in the secretion of the hormone, and thus the concept Bojanowitz was not confirmed (C. A. Gorshkov, 1969).
Obviously, in patients with peptic ulcer is a "disharmonic", which appears high and stable allocation of ACTH and low functional activity of cortical layer of the adrenal glands against secretion of glucocorticoids.
Currently, participation GGNS in the development of peptic ulcer disease cannot be limited to a simple, mechanical its inclusion in hormonal path stress to the stomach. Materials of researches of the last years make the new position to discuss this complex issue that cannot be unequivocally resolved, and, obviously, there should be strict analogy between the pharmacological effects of steroids, used as medicines, and their physiological effects of gastroduodenal system. When ulcers is a variant of the functional Central gipokortitizma in which low spontaneous excretion of 17-GOKS with urine combined with normal or elevated in response to exogenous input ACTH, and allocation of endogenous ACTH in the blood remains consistently high.
The question of pathogenetic significance of sex hormones ulcers was widely discussed in connection with the fact that among women it is less common, and during pregnancy there are no cases of acute illness or experience it for the first time. In rats removal of the ovaries increases gastric secretion and increases the number of defects in the creation of experimental model for Schay (C. M. Lipovskii, 1965, 1969). C. X. Vasilenko and others (1967) observed rhythmic changes in acid-forming and periodic motor function of the stomach in different phases of the menstrual cycle. Normal menstrual cycle, strengthening the function of sexual glands during an active sexual activity and pregnancy provides protection against the occurrence of peptic ulcer disease (A. M. of Sarvanov, 1968). The mechanism of protective action remains unclear; it is possible that sex hormones affect trophic processes in the gastroduodenal mucosa of the system. Violations of the sexual cycle, the change of proper balance between the factions of estrogen or total decrease their excretion, and a misbalance between estrogen and glukokortikoidami, can contribute to the development of peptic ulcer disease, especially at a young age (juvenile forms).
At clinicians often gets the impression that in the patients with ulcer is showing signs of hyperthyroidism. To date, however, in the literature there is no evidence of pathogenetic role of thyroid hormones in ulceration. Recent studies Dotevall and others (1967) found that increased activity of the thyroid gland is accompanied by inhibition of gastric secretion, due to the morphological changes of the mucous membrane of the stomach complex Genesis (autoimmunity thyroxin influence, changes in blood mucous).
Initial ideas about the high frequency of peptic ulcers among patients with giperparatireoidizm (Rogers, 1946, 1947) further revised (Ostrow and others, 1960), and currently the role of the impaired function of the parathyroid glands in the formation questioned. Clinical and experimental observations in this area are continuing.
Thus, the considered material allows to assert, that of all endocrine glands only pituitary-adrenal axis and the sex glands take an active part in the development of ulcers, and the question of direct mechanisms of pathological effects of hormones on the gastroduodenal system is not solved yet and requires further research.

* Here and further under the duodenal ulcer and gastric ulcer is meant ulcer in the right location ulcers.