Celebrating 100^th Anniversary of the Japan Endocrine Society

In cerebration of the 100^th anniversary of the Japan Endocrine Society (JES), I would like to mention about contributions of the JES to the progress of endocrinology in the past, and forecast the future prospects about what the JES can do to combat against diseases and maintain human health.

1. JES during the last 100 years

The concept of endocrine system was first proposed by Ernest Starling at the beginning of the 20^th century. Since then, many hormones have been identified as key players of maintaining homeostasis of the human body via feedback regulation. The last century was a period when most, but probably not all, hormones and receptors were identified, and their mechanisms of action were clarified via identification of the intracellular signaling cascade. Hydrophilic peptide hormones bind to cell-surface receptors and stimulate the second messenger system such as cyclic AMP and calcium ion, which further transduce signals via protein kinases or calmodulin to evoke cellular responses. In contrast, lipophilic hormones such as steroid hormones get into cells and bind to nuclear receptors that regulate transcription of their target genes. By way of these different mechanisms and cascades, hormones act to maintain homeostasis of human body. Thus, when hormone secretion is stimulated by a reduction in its action, the increased circulating hormone enhances its action to maintain homeostasis. Those scientific advances in the field of endocrinology had a great impact in the understanding of other areas/systems, and have been applied to many other fields such as inflammatory cytokines and their signaling systems, and neurotransmitters and their signal reception mechanisms.

Basic and clinical endocrinologists in Japan have contributed greatly to the discovery of hormones, receptors and signal transduction mechanisms, as well as diseases caused by disturbances in the endocrine system, and the JES has played a critical role during the last 100 years in providing a platform for discussion and collaboration to put forth new ideas and hypotheses that led to new discoveries. Now, all the major hormones and their actions are identified, and treatment strategies of many endocrine disorders due to disturbances in those hormonal actions have been established except for some intractable diseases. Many diagnostic criteria and treatment algorithms have been developed by committees in the JES, and are applied to the daily clinical practice. As a result, there is a feeling that not many scientific frontiers are left in the field of endocrinology. Well, I do not think so. There are many important frontiers that await scientific progress in the field of endocrinology to cope with the development of various disorders.

2. JES in the future

With the widespread use of synthetic chemical products, many compounds have been shown to disturb endocrine system. There are several ways for these endocrine disruptors to interfere with the endocrine system: they may directly interact with hormonal receptors, or they may affect the synthesis or metabolism of hormones, or they may interfere with storage, secretion, transport or signaling system of hormones. Most of the hormones affected by endocrine disruptors are nuclear receptor ligands such as estrogen, androgen and thyroid hormone, causing disturbances especially in gonadal function and reproductive systems. These endocrine disruptors cause cancer development, birth defects and other developmental disorders by interfering with the actions of hormones that play essential roles in fertility, developmental processes, and maintenance of normal homeostasis. Especially, endocrine disruptors are thought to play important roles in the development of breast cancer and prostate cancer, and the number of patients affected by these cancers are steadily growing in women and men. Thus, much has to be done to prevent cancer development and protect human reproductive system, and it is the task of endocrinologists to cope with these threatening disruptors of endocrine system.

Tremendous progress has been made in the imaging techniques, and artificial intelligence (AI) has been applied by reading big data of imaging to the development of diagnostic tools. Sooner or later, diagnosis made by AI seems to surpass that made by an experienced physician. In the field of endocrinology, the most common of all the endocrine disorders is diabetes mellitus (DM). Because of the large and still growing number of patients with serious outcomes of its complications, tools using advanced technologies have been applied to the diagnosis and treatment of DM. Continuous monitoring of blood glucose coupled with controlled infusion of insulin via a subcutaneous needle is applied to more and more patients. Less invasive way of blood glucose monitoring over the skin is also under development. What about other life-threatening endocrine disorders? For example, adrenal insufficiency either primary or secondary may cause life-threatening adrenal crisis. Hormone assay system has made a great progress to be able to measure very low concentrations of circulating hormones with high sensitivity in a short period of time. With further progress of assay systems and related technologies, it would be nice if there is a way to monitor blood hormone levels frequently by a less invasive way by those patients themselves, and an alarming system can be implemented to let them know about the problem ahead of time.

Development of immune checkpoint inhibitors (ICI) has provided a marked progress in the treatment of various types of cancers by stimulating immune cell responses against cancer. However, ICI cause various endocrine disorders including hypophysitis, type 1 DM, autoimmune thyroiditis, adrenal insufficiency, etc. in a short period of time. By clarifying the mechanism whereby stimulated immune system causes such endocrine disturbances, we may be able to find out a clue to prevent autoimmune endocrinopathies.

Due to the expansion of the world economy and improvement of daily living in many areas of the world except for some areas with political conflict or instability, a marked increase in the use of fossil fuel causes a steady accumulation of carbon dioxide in the earth’s atmosphere resulting in global warming. These changes in the ecology of the earth are creating many problems not only in environmental disturbances and animal life but also in human health. We should take special care for the development of endocrine disturbances caused by a derangement in homeostatic mechanisms due to those ecological changes. I believe that the JES will and should take a lead to analyze emerging health problems and find out a way to cope with them.

Biographies

Toshio Matsumoto

20^th President/Honorary Member

Professor Emeritus, Tokushima University

Advisor, Fujii Memorial Institute of Medical Sciences, Tokushima University

E-mail: [e-mail]

Careers in JES

2018– Honorary Member

2015– Senior Councilor

2013–2015 20^th President

2011–2013 Vice President

2009–2013 Director (General Affairs)

2007–2009 Director (Public Relations and Collaboration)

2006–2013 President for Shikoku Regional Branch

2003–2007 Director (Education and Career Development)

1990– Councilor

1978– Member

Activities in JES

2011 Chair, 84^th Annual Congress of JES

2004 Chair, 22^nd JES Summer Seminar on Endocrinology & Metabolism

2002 Chair, 2^nd Annual Meeting of JES Shikoku Regional Branch

JES Awards

2008 7^th JES Award

1990 10^th JES Research Award

Contributions to EJ

1999–2005 Editor