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Adrenal Medulla

Anatomy and Physiology · NLM MeSH · updated 2026-10-31 · version 1

Citations verified against PubMedNot yet clinician-reviewed10 referencesApproximately 4 min read

The inner portion of the adrenal gland.

Table of Contents

1. Definition2. Research landscape3. Reading the evidence4. Open-access studies5. Key reviews6. References7. About this article

Definition and research guide

This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.

Content available: 4 complete abstracts (676 words), 10 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.

Definition

The inner portion of the adrenal gland. Derived from ectoderm, adrenal medulla consists mainly of chromaffin cells that produces and stores a number of neurotransmitters, mainly adrenaline (epinephrine) and norepinephrine. The activity of the adrenal medulla is regulated by the sympathetic nervous system.

Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.

Also known as: Adrenal Medullas; Medulla, Adrenal; Medullas, Adrenal.

Where it fits in the MeSH classification

Broader topics
Adrenal Glands
Narrower topics
Sympathoadrenal System

Related concepts

  • Ectoderm
  • Chromaffin Cells
  • Neurotransmitters
  • Epinephrine
  • Norepinephrine
  • Sympathetic Nervous System

Research landscape

PubMed indexes 9,671 records tagged with the MeSH heading “Adrenal Medulla” (counts retrieved 2026-10-31). 121 of them (1.3%) were published from 2020 onward, and the busiest period so far is through 1999 with 8,259 records.

Reviews account for 698 records (7.2%) and meta-analyses for 2. Randomized controlled trials number 21 (0.2%) as a share of all records on the topic. Randomized trials make up only a small share of this literature, so much of what is known comes from laboratory, observational or descriptive work.

PubMed records by publication periodthrough 1999: 8,259 records; 2000-2009: 901 records; 2010-2019: 390 records; 2020 onward: 121 records8,259through 19999012000-20093902010-20191212020 onward
Records in PubMed indexed with this heading, by publication period. Real counts from NCBI E-utilities; the final period covers only part of the current year. Volume reflects how much has been published, not how strong the evidence is.
Show the data
PeriodRecords
through 19998,259
2000-2009901
2010-2019390
2020 onward121
Share of records by publication typeReviews: 7.2 percent; Meta-analyses: 0.0 percent; Randomized controlled trials: 0.2 percentReviews7.2% (698)Meta-analyses0.0% (2)Randomized controlled trials0.2% (21)
Share of all PubMed records on this heading that carry each publication type. Types overlap with other records, so the shares do not sum to 100%.
Publication-type chart data
Publication types among 9,671 PubMed records
TypeRecordsShare
Reviews6987.2%
Meta-analyses20.0%
Randomized controlled trials210.2%

Method: PubMed query "Adrenal Medulla"[MeSH Terms] with publication-type and date filters, retrieved 2026-10-31.

Reading the evidence in anatomy and physiology

Anatomy describes how body structures are built and physiology describes how they normally work, so most findings here are descriptive or mechanistic rather than evidence about treatment. Much of what is known comes from dissection, imaging, tissue studies and experiments in animals, and measurements in healthy volunteers can differ from those in people with disease or at different ages. Normal ranges vary between individuals and populations. Check whether a result was measured in people or in another species, the age and health of the participants, and the method used.

Evidence from open-access studies

These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.

Study comparison — selected abstracts, not a systematic review
Study / authorsYearSource label / designEurope PMC citationsLicence / source
Isolation of large dense-core vesicles from bovine adrenal medulla for functional studies
Birinci Y, Preobraschenski J, Ganzella M, Jahn R, Park Y
2020Research article
Design not recorded in structured metadata
26cc by
PMID 32371955 · DOI · PMC7200684
Spatial and activity-dependent catecholamine release in rat adrenal medulla under native neuronal stimulation
Wolf K, Zarkua G, Chan SA, Sridhar A, Smith C
2016Research article
Design not recorded in structured metadata
24cc by
PMID 27597763 · DOI · PMC5027341
Neuropilins guide preganglionic sympathetic axons and chromaffin cell precursors to establish the adrenal medulla
Lumb R, Tata M, Xu X, Joyce A, Marchant C, Harvey N, et al.
2018Research article
Design not recorded in structured metadata
21cc by
PMID 30237243 · DOI · PMC6240312
SOX2+ sustentacular cells are stem cells of the postnatal adrenal medulla
Santambrogio A, Kemkem Y, Willis TL, Berger I, Kastriti ME, Faure L, et al.
2025Research article
Design not recorded in structured metadata
11cc by
PMID 39747853 · DOI · PMC11696870

Isolation of large dense-core vesicles from bovine adrenal medulla for functional studies [1]

Research article Birinci Y, Preobraschenski J, Ganzella M, Jahn R, Park Y · · 2020 · cited 26 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
Large dense-core vesicles (LDCVs) contain a variety of neurotransmitters, proteins, and hormones such as biogenic amines and peptides, together with microRNAs (miRNAs).
Closing excerpt
This protocol can be useful in research on the biological functions of LDCVs.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (143 words)

Large dense-core vesicles (LDCVs) contain a variety of neurotransmitters, proteins, and hormones such as biogenic amines and peptides, together with microRNAs (miRNAs). Isolation of LDCVs is essential for functional studies including vesicle fusion, vesicle acidification, monoamine transport, and the miRNAs stored in LDCVs. Although several methods were reported for purifying LDCVs, the final fractions are significantly contaminated by other organelles, compromising biochemical characterization. Here we isolated LDCVs (chromaffin granules) with high yield and purity from bovine adrenal medulla. The fractionation protocol combines differential and continuous sucrose gradient centrifugation, allowing for reducing major contaminants such as mitochondria. Purified LDCVs show robust acidification by the endogenous V-ATPase and undergo SNARE-mediated fusion with artificial membranes. Interestingly, LDCVs contain specific miRNAs such as miR-375 and miR-375 is stabilized by protein complex against RNase A. This protocol can be useful in research on the biological functions of LDCVs.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 32371955 · DOI · PMC7200684

Spatial and activity-dependent catecholamine release in rat adrenal medulla under native neuronal stimulation [2]

Research article Wolf K, Zarkua G, Chan SA, Sridhar A, Smith C · · 2016 · cited 24 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
Neuroendocrine chromaffin cells of the adrenal medulla in rat receive excitatory synaptic input through anterior and posterior divisions of the sympathetic splanchnic nerve.
Closing excerpt
Our data further show that elimination of either division from stimulation greatly attenuated epinephrine release under elevated stimulation, while either division alone can largely support norepinephrine release.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (245 words)

Neuroendocrine chromaffin cells of the adrenal medulla in rat receive excitatory synaptic input through anterior and posterior divisions of the sympathetic splanchnic nerve. Upon synaptic stimulation, the adrenal medulla releases the catecholamines, epinephrine, and norepinephrine into the suprarenal vein for circulation throughout the body. Under sympathetic tone, catecholamine release is modest. However, upon activation of the sympathoadrenal stress reflex, and increased splanchnic firing, adrenal catecholamine output increases dramatically. Moreover, specific stressors can preferentially increase release of either epinephrine (i.e., hypoglycemia) or norepinephrine (i.e., cold stress). The mechanism for this stressor-dependent segregated release of catecholamine species is not yet fully understood. We tested the hypothesis that stimulation of either division of the splanchnic selects for epinephrine over norepinephrine release. We introduce an ex vivo rat preparation that maintains native splanchnic innervation of the adrenal gland and we document experimental advantages and limitations of this preparation. We utilize fast scanning cyclic voltammetry to detect release of both epinephrine and norepinephrine from the adrenal medulla, and report that epinephrine and norepinephrine release are regulated spatially and in a frequency-dependent manner. We provide data to show that epinephrine is secreted preferentially from the periphery of the medulla and exhibits a higher threshold and steeper stimulus-secretion function than norepinephrine. Elevated stimulation of the whole nerve specifically enhances epinephrine release from the peripheral medulla. Our data further show that elimination of either division from stimulation greatly attenuated epinephrine release under elevated stimulation, while either division alone can largely support norepinephrine release.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 27597763 · DOI · PMC5027341

Neuropilins guide preganglionic sympathetic axons and chromaffin cell precursors to establish the adrenal medulla [3]

Research article Lumb R, Tata M, Xu X, Joyce A, Marchant C, Harvey N, et al. · · 2018 · cited 21 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
The adrenal medulla is composed of neuroendocrine chromaffin cells that secrete adrenaline into the systemic circulation to maintain physiological homeostasis and enable the autonomic stress response.
Closing excerpt
Thus, SEMA3 proteins serve as guidance cues to control formation of the adrenal neuroendocrine system by establishing appropriate connections between preganglionic neurons and adrenal chromaffin cells that regulate the autonomic stress response.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (133 words)

The adrenal medulla is composed of neuroendocrine chromaffin cells that secrete adrenaline into the systemic circulation to maintain physiological homeostasis and enable the autonomic stress response. How chromaffin cell precursors colonise the adrenal medulla and how they become connected to central nervous system-derived preganglionic sympathetic neurons remain largely unknown. By combining lineage tracing, gene expression studies, genetic ablation and the analysis of mouse mutants, we demonstrate that preganglionic axons direct chromaffin cell precursors into the adrenal primordia. We further show that preganglionic axons and chromaffin cell precursors require class 3 semaphorin (SEMA3) signalling through neuropilins (NRP) to target the adrenal medulla. Thus, SEMA3 proteins serve as guidance cues to control formation of the adrenal neuroendocrine system by establishing appropriate connections between preganglionic neurons and adrenal chromaffin cells that regulate the autonomic stress response.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 30237243 · DOI · PMC6240312

SOX2+ sustentacular cells are stem cells of the postnatal adrenal medulla [4]

Research article Santambrogio A, Kemkem Y, Willis TL, Berger I, Kastriti ME, Faure L, et al. · · 2025 · cited 11 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
Renewal of the catecholamine-secreting chromaffin cell population of the adrenal medulla is necessary for physiological homeostasis throughout life.
Closing excerpt
This work identifies SOX2+ cells as a true stem cell for catecholamine-secreting chromaffin cells.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (155 words)

Renewal of the catecholamine-secreting chromaffin cell population of the adrenal medulla is necessary for physiological homeostasis throughout life. Definitive evidence for the presence or absence of an adrenomedullary stem cell has been enigmatic. In this work, we demonstrate that a subset of sustentacular cells endowed with a support role, are in fact adrenomedullary stem cells. Through genetic tracing and comprehensive transcriptomic data of the mouse adrenal medulla, we show that cells expressing Sox2/SOX2 specialise as a unique postnatal population from embryonic Schwann Cell Precursors and are also present in the normal adult human adrenal medulla. Postnatal SOX2+ cells give rise to chromaffin cells of both the adrenaline and noradrenaline lineages in vivo and in vitro. We reveal that SOX2+ stem cells have a second, paracrine role in maintaining adrenal chromaffin cell homeostasis, where they promote proliferation through paracrine secretion of WNT6. This work identifies SOX2+ cells as a true stem cell for catecholamine-secreting chromaffin cells.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 39747853 · DOI · PMC11696870

Key reviews and meta-analyses

The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.

  • Research article Psychological stress reactivity and future health and disease outcomes: A systematic review of prospective evidence [5]
    Turner AI, Smyth N, Hall SJ, Torres SJ, Hussein M, Jayasinghe SU, et al. · Psychoneuroendocrinology · 2020 · cited 329 times (Europe PMC)
  • Research article The composition of adrenal chromaffin granules: an assessment of controversial results [6]
    Winkler H · Neuroscience · 1976 · cited 328 times (Europe PMC)
  • Research article The molecular function of adrenal chromaffin granules: established facts and unresolved topics [7]
    Winkler H, Apps DK, Fischer-Colbrie R · Neuroscience · 1986 · cited 279 times (Europe PMC)
  • Research article Associations between physiological reactivity and children's behavior: advantages of a multisystem approach [8]
    Bauer AM, Quas JA, Boyce WT · J Dev Behav Pediatr · 2002 · cited 231 times (Europe PMC)
  • Research article Calcium control of exocytosis and endocytosis in bovine adrenal medullary cells [9]
    Baker PF, Knight DE · Philos Trans R Soc Lond B Biol Sci · 1981 · cited 176 times (Europe PMC)
  • Research article Molecular control of cell fate in the neural crest: the sympathoadrenal lineage [10]
    Anderson DJ · Annu Rev Neurosci · 1993 · cited 162 times (Europe PMC)

References

  1. Birinci Y, Preobraschenski J, Ganzella M, Jahn R, Park Y. Isolation of large dense-core vesicles from bovine adrenal medulla for functional studies. . 2020. PMID 32371955 · DOI · PMC7200684
  2. Wolf K, Zarkua G, Chan SA, Sridhar A, Smith C. Spatial and activity-dependent catecholamine release in rat adrenal medulla under native neuronal stimulation. . 2016. PMID 27597763 · DOI · PMC5027341
  3. Lumb R, Tata M, Xu X, Joyce A, Marchant C, Harvey N, et al.. Neuropilins guide preganglionic sympathetic axons and chromaffin cell precursors to establish the adrenal medulla. . 2018. PMID 30237243 · DOI · PMC6240312
  4. Santambrogio A, Kemkem Y, Willis TL, Berger I, Kastriti ME, Faure L, et al.. SOX2+ sustentacular cells are stem cells of the postnatal adrenal medulla. . 2025. PMID 39747853 · DOI · PMC11696870
  5. Turner AI, Smyth N, Hall SJ, Torres SJ, Hussein M, Jayasinghe SU, et al.. Psychological stress reactivity and future health and disease outcomes: A systematic review of prospective evidence. Psychoneuroendocrinology. 2020. PMID 32045797 · DOI
  6. Winkler H. The composition of adrenal chromaffin granules: an assessment of controversial results. Neuroscience. 1976. PMID 794758 · DOI
  7. Winkler H, Apps DK, Fischer-Colbrie R. The molecular function of adrenal chromaffin granules: established facts and unresolved topics. Neuroscience. 1986. PMID 2942794 · DOI
  8. Bauer AM, Quas JA, Boyce WT. Associations between physiological reactivity and children's behavior: advantages of a multisystem approach. J Dev Behav Pediatr. 2002. PMID 11943973 · DOI
  9. Baker PF, Knight DE. Calcium control of exocytosis and endocytosis in bovine adrenal medullary cells. Philos Trans R Soc Lond B Biol Sci. 1981. PMID 6121350 · DOI
  10. Anderson DJ. Molecular control of cell fate in the neural crest: the sympathoadrenal lineage. Annu Rev Neurosci. 1993. PMID 8460888 · DOI

About this article

Sources
NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
Verification
Every reference was resolved against PubMed on 2026-10-31; title, year and DOI matched.
Review state
automated source verified; no human expert review has been recorded yet.
Version
1, last updated 2026-10-31.

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At a glance

9,671
PubMed records on this heading
1%
published since 2020
698
review articles
21
randomized trials
10
verified references below

Counts come from PubMed on 2026-10-31; they show how much has been written, not how strong the evidence is.

Related topics See all →

  • Adrenal GlandsAnatomy and Physiology
  • Zona GlomerulosaAnatomy and Physiology
  • Adrenal CortexAnatomy and Physiology
  • Sympathetic Nervous SystemNeuroscience
  • Chromaffin CellsAnatomy and Physiology

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