More than the sum of its parts

Endocrinology. Fourth Editionedited by Leslie J. DeGroot and J. Larry Jameson. Saunders, 2001. US$495.00 [xxx (civ index) + 2621 pages, 3 volumes] ISBN 0721678408This welcome new edition of one of our reference standards in the discipline is an impressive collection of 194 chapters written by more than 300 authors. In addition to more than 60 completely new chapters, those from the previous edition have been completely rewritten. As the editors note in their preface: ‘The changes buffeting endocrinology have accelerated in the five years between the third edition and this, the fourth edition of Endocrinology. New hormones and factors abound…whole groups of factors…interleukins, chemokines, and others…have been characterized but are yet to be fully integrated into the structure of endocrinology as it is generally conceived.’ Thus, the latest edition of this book contains new sections on ‘Growth and Maturation’, ‘Immunology and Endocrinology’, ‘Obesity, Anorexia Nevosa and Nutrition in Endocrinology’, ‘Endocrinology of the Breast’, and two additional ‘minibooks’ on ‘Endocrine Testing’ and ‘Drugs and Hormones Used in Endocrinology’. In light of the rapid accumulation of facts and attendant conceptual developments that are of potential importance to physicians, scientists and students working in endocrinology, I am happy to report that the editors and authors of Endocrinology are to be commended for providing us with another topical edition of this well-known resource.Particularly significant is the guidance provided by section coeditors and chapter authors, who have not only constructed useful contexts for readers of diverse backgrounds to ‘personalize’ the content, but have also identified particular subject areas that will be ‘filled in’ during the next few years. This makes Endocrinology a useful resource for the present and a guide for the future, clearly an appropriate approach in several developing areas of which our current understanding is incomplete. The sectional organization and coeditorial responsibilities for the book also create a consistency of quality between the 300 contributing authors.Beginning with the two editors-in-chief and their individual sectional responsibilities, we have: L.J. DeGroot – ‘Immunology and Endocrinology’ and ‘Thyroid Gland’ (subdivided into basic physiology and clinical disorders); and J.L. Jameson – ‘Principles of Hormone Action and Endocrine Tumor Syndromes’. The seven coeditors have the following responsibilities: H.G. Burger – ‘Male Reproduction’ (basic and clinical); D.L. Loriaux – ‘Adrenal Gland and Glucocorticoids’ (basic and clinical); J.C. Marshall – ‘Obesity, Anorexia Nervosa and Nutrition in Endocrinology’, ‘Female Reproduction’ (basic and clinical) and ‘Endocrinology of Breast’; S. Melmed – ‘Neuroendocrinology and Pituitary Gland’ (basic and clinical) and ‘Growth and Maturation’ (basic and clinical); W.D. Odell – ‘Reproductive Endocrinology and Sexual Development’ (basic and clinical), ‘Endocrinology of Pregnancy’ (basic and clinical), and two ‘minibooks’ on ‘Endocrine Testing and Treatment’; J.T. Potts – ‘Parathyroid Gland, Calciotropic Hormones and Bone Metabolism’ (basic physiology and clinical); A.H. Rubenstein – ‘Diabetes Mellitus, Carbohydrate Metabolism, and Lipid Disorders’ (basic and clinical).Prospective readers of this book will want to know something about content. I will expand upon some of the sections that summarize the approach to several ‘emerging frontiers of knowledge’. The section entitled ‘Principles of Hormone Actions’ contains 11 chapters, giving a total of over 150 pages. The chapters emphasize all thematic aspects of the section title, beginning with ‘Hormones and Gene Expression: Basic Principles’ and followed by several chapters on different types of receptors and related signal-transduction pathways. The section concludes with chapters on the ‘Nuclear Receptor Superfamily’ and ‘Applications of Molecular Biology and Genetics in Endocrinology’. All of the chapters in this section are clearly written, enabling most readers to recognize and understand recent advances that rely on the use of recombinant DNA methods, cellular biochemistry and cell biology. A recurring theme throughout the book is ‘the synergism derived by combining information from traditional studies of pathophysiology with new insights from molecular biology’.In addition to the chapters from the previous edition that have been rewritten, the most intellectually satisfying sections of the current edition of Endocrinology, for their incorporation of new information into rapidly developing bodies of knowledge, are found in the new sections presented in the first volume (‘Immunology and Endocrinology’; ‘Growth and Maturation’; and ‘Obesity, Anorexia Nervosa, and Nutrition in Endocrinology’). Although most of the subject matter one might expect to find in these sections is present in the other major standard textbooks of endocrinology, its integration into emerging bodies of knowledge in this edition of Endocrinology as separate, consolidated sections, is notable.For example, in the section on ‘Immunology and Endocrinology’, the chapter titles and summaries of their content illustrate the potential utility of this approach. The chapter on ‘Immunologic Mechanisms Causing Autoimmune Endocrine Disease’ includes a thorough, lucid account of the basic processes that control the immune response and the relationship of these pathways to the pathogenesis of autoimmune endocrine diseases. There is a primer (that will be necessary for some readers) on immune cell types, processes and mechanisms, followed by how failure of these elements and/or processes results in disease (e.g. autoimmune responses), possible roles for ‘molecular mimicry’ and potential treatment by immune modulation. The chapter entitled ‘Interactions of the Endocrine and Immune Systems’ focuses on the organization of the hypothalamic–pituitary–adrenal (HPA) axis, related coordination of central autonomic control, and the adrenomedullary system. This focus is then used as a background to the introduction of Hans Selye's ‘general adaptation’ or ‘stress syndrome’, considering the role of cytokines in stress, ‘sickness behavior’ and related adaptive behavioral and physiological changes. There is also a separate section on sympathetic innervation of lymphoid organs (vascular smooth muscle and gland parenchyma), in addition to sensory innervation. These neural substrates are described in relation to their function and their potential involvement with the HPA axis and the sympathetic nervous system in immune function and the sequelae of inflammation (both pro- and anti-inflammatory processes). Finally, the authors have added a nice overview of our current understanding of proinflammatory actions of corticotrophin releasing hormone (CRH) and its known role in vasodilation.This type of integrated information, bringing together neural, neuroendocrine and immune contributions, is long overdue. These new sections in the fourth edition of Endocrinology also offer a glimpse into the future of this discipline by presenting a ‘broad perspective of regulating mechanisms with great attention to detail at several levels of biological organization’.There are many other superbly rewritten chapters containing the latest in basic and clinical knowledge of individual endocrine glands and related diseases, although with respect to diseases, there is (appropriately) less cross-disciplinary consideration. Most of these chapters are well written and up-to-date. My major criticism is that some of the chapters are long on print and references, and short on illustrations. I suppose that it could be argued that figures and other types of illustration tend to take space from written text. However, illustrations not only invite attention, but they often speak louder than words.In conclusion, I recommend this three-volume set to all those seriously interested in endocrinology: clinical and basic scientists, practitioners and students alike. It will serve you well in years to come and like other ‘standards’ of a biblical nature for the discipline, I predict that in the future you will collect several further editions of Endocrinology on your shelves.