The Evolution of Endocrinology

Plenary Lecture at the 12th International Congress of Endocrinology, Lisbon, Portugal, 31 August 2004

Jean D. Wilson


Clin Endocrinol. 2005;62(4):389-396. 

In This Article

What About the Future?

Developments in the past several decades have blurred the concept of endocrinology as a discipline of basic science. Hansson, Skalhegg and Tasken[46] addressed this issue in a provocative essay entitled 'Is basic endocrinology disappearing?'.

To quote their argument: 'Knowledge of the molecular mechanisms through which hormones act is of major importance in trying to understand and solve the problems of clinical endocrinology. However, the elucidation of more detailed molecular aspects, such as the coupling of receptors to intracellular pathways through second messengers and protein phosphorylation cascades, has also posed an important question: is it still meaningful to speak of basic endocrinology, or are all aspects of this discipline now absorbed in the larger field of molecular cell biology?'

The biomedical sciences were separated into individual disciplines when research methods were limited, and such divisions were useful for teaching and research. Uncertainty as whether the basic science will survive as a distinct discipline is not unique to endocrinology and can be viewed as a desirable consequence of advances that breach artificial barriers between the branches of biology. Now, endocrinology involves neural science, immunology, cell and molecular biology and genetics as much as it does hormones per se. Careful thought does need to be given to the appropriate training of both clinical and basic scientists in our field,[47] but there is cause for optimism that endocrinology will survive as a basic as well as a clinical discipline for at least three reasons.

First, a large number of 'orphan' receptors and candidate signalling molecules are known to exist, many of which will turn out to be hormones and hormone receptors that control critical functions. Second, many of the major unresolved issues in the field involve systems or whole animal physiology. Such issues include the control of complex physiological processes such as growth and puberty by multiple hormones; the interaction of biological rhythms with the endocrine system; the integration of the endocrine, neural and immune systems; and the control of complex behavioural and developmental processes such as those involved in sexual differentiation, gender behaviour and reproduction. These problems cannot be solved by genome sequencing or by study of single cell types but will require a renaissance in physiology, a discipline now overshadowed by developments in genetics and molecular biology. The field of endocrinology is appropriately poised to lead such a renaissance. Third, the field continues to be stimulated by clinical problems, the same phenomenon that powered the initial growth explosion in the field at the turn of the twentieth century. Not only are we confronted with many critical unresolved dilemmas about common problems such as obesity, diabetes mellitus, ageing and development, but, in addition, new syndromes and new clinical problems continue to be recognized and to challenge basic as well as clinical scientists. International Congresses of Endocrinology will probably be held in 2104 and beyond, and it is likely that the clinical and basic scientists gathered here today would not feel totally lost in those meetings.


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