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Fleseriu M, Christ-Crain M, Langlois F, Gadelha M, Melmed S. Hypopituitarism. Lancet 2024; 403:2632-2648. [PMID: 38735295 DOI: 10.1016/s0140-6736(24)00342-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 02/13/2024] [Accepted: 02/16/2024] [Indexed: 05/14/2024]
Abstract
Partial or complete deficiency of anterior or posterior pituitary hormone production leads to central hypoadrenalism, central hypothyroidism, hypogonadotropic hypogonadism, growth hormone deficiency, or arginine vasopressin deficiency depending on the hormones affected. Hypopituitarism is rare and likely to be underdiagnosed, with an unknown but rising incidence and prevalence. The most common cause is compressive growth or ablation of a pituitary or hypothalamic mass. Less common causes include genetic mutations, hypophysitis (especially in the context of cancer immunotherapy), infiltrative and infectious disease, and traumatic brain injury. Clinical features vary with timing of onset, cause, and number of pituitary axes disrupted. Diagnosis requires measurement of basal circulating hormone concentrations and confirmatory hormone stimulation testing as needed. Treatment is aimed at replacement of deficient hormones. Increased mortality might persist despite treatment, particularly in younger patients, females, and those with arginine vasopressin deficiency. Patients with complex diagnoses, pregnant patients, and adolescent pituitary-deficient patients transitioning to adulthood should ideally be managed at a pituitary tumour centre of excellence.
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Affiliation(s)
- Maria Fleseriu
- Department of Medicine, Division of Endocrinology, Diabetes and Clinical Nutrition, Oregon Health and Science University, Portland, OR, USA; Department of Neurological Surgery, Oregon Health and Science University, Portland, OR, USA; Pituitary Center, Oregon Health and Science University, Portland, OR, USA.
| | - Mirjam Christ-Crain
- Department of Endocrinology, Diabetology and Metabolism, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Fabienne Langlois
- Department of Medicine, Division of Endocrinology, Centre intégré universitaire de santé et de services sociaux de l'Estrie, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Mônica Gadelha
- Endocrine Unit and Neuroendocrinology Research Center, Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Shlomo Melmed
- Department of Medicine and Pituitary Center, Cedars-Sinai Medical Center, Los Angeles, CA, USA
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2
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Liu H, Davis T, Duran-Ortiz S, Martino T, Erdely A, Profio S, Osipov B, Loots GG, Berryman DE, O'Connor PM, Kopchick JJ, Zhu S. Growth hormone-receptor disruption in mice reduces osteoarthritis and chondrocyte hypertrophy. GeroScience 2024:10.1007/s11357-024-01230-z. [PMID: 38831184 DOI: 10.1007/s11357-024-01230-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 05/28/2024] [Indexed: 06/05/2024] Open
Abstract
Excessive growth hormone (GH) has been shown to promote joint degeneration in both preclinical and clinical studies. Little is known about the effect of disrupted GH or GH receptor (GHR) on joint health. The goal of this study is to investigate joint pathology in mice with either germline (GHR-/-) or adult inducible (iGHR-/-) GHR deficiency. Knee joints from male and female GHR-/- and WT mice at 24 months of age were processed for histological analysis. Also, knee joints from male and female iGHR-/- and WT mice at 22 months of age were scanned by micro-CT (μCT) for subchondral bone changes and characterized via histology for cartilage degeneration. Joint sections were also stained for the chondrocyte hypertrophy marker, COLX, and the cartilage degeneration marker, ADAMTS-5, using immunohistochemistry. Compared to WT mice, GHR-/- mice had remarkably smooth articular joint surfaces and an even distribution of proteoglycan with no signs of degeneration. Quantitatively, GHR-/- mice had lower OARSI and Mankin scores compared to WT controls. By contrast, iGHR-/- mice were only moderately protected from developing aging-associated OA. iGHR-/- mice had a significantly lower Mankin score compared to WT. However, Mankin scores were not significantly different between iGHR-/- and WT when males and females were analyzed separately. OARSI scores did not differ significantly between WT and iGHR-/- in either individual or combined sex analyses. Both GHR-/- and iGHR-/- mice had fewer COLX+ hypertrophic chondrocytes compared to WT, while no significant difference was observed in ADAMTS-5 staining. Compared to WT, a significantly lower trabecular thickness in the subchondral bone was observed in the iGHR-/- male mice but not in the female mice. However, there were no significant differences between WT and iGHR-/- mice in the bone volume to total tissue volume (BV/TV), bone mineral density (BMD), and trabecular number in either sex. This study identified that both germline and adult-induced GHR deficiency protected mice from developing aging-associated OA with more effective protection in GHR-/- mice.
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Affiliation(s)
- Huanhuan Liu
- Ohio University Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio, USA
- Department of Biomedical Sciences, Ohio University, Athens, Ohio, USA
- Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University, Athens, Ohio, USA
| | - Trent Davis
- Ohio University Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio, USA
| | - Silvana Duran-Ortiz
- Ohio University Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio, USA
- Edison Biotechnology Institute, Ohio University, Athens, Ohio, USA
- Diabetes Institute, Ohio University, Athens, Ohio, USA
| | - Tom Martino
- Ohio University Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio, USA
| | - Austin Erdely
- Ohio University Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio, USA
| | - Shane Profio
- Ohio University Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio, USA
| | - Benjamin Osipov
- Department of Orthopaedic Surgery, University of California Davis Health, Sacramento, California, USA
| | - Gabriela G Loots
- Department of Orthopaedic Surgery, University of California Davis Health, Sacramento, California, USA
| | - Darlene E Berryman
- Ohio University Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio, USA
- Department of Biomedical Sciences, Ohio University, Athens, Ohio, USA
- Edison Biotechnology Institute, Ohio University, Athens, Ohio, USA
- Diabetes Institute, Ohio University, Athens, Ohio, USA
| | - Patrick M O'Connor
- Ohio University Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio, USA
- Department of Biomedical Sciences, Ohio University, Athens, Ohio, USA
- Ohio Center for Ecological and Evolutionary Studies, Irvine Hall, Athens, Ohio, USA
| | - John J Kopchick
- Ohio University Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio, USA.
- Department of Biomedical Sciences, Ohio University, Athens, Ohio, USA.
- Edison Biotechnology Institute, Ohio University, Athens, Ohio, USA.
- Diabetes Institute, Ohio University, Athens, Ohio, USA.
| | - Shouan Zhu
- Ohio University Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio, USA.
- Department of Biomedical Sciences, Ohio University, Athens, Ohio, USA.
- Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University, Athens, Ohio, USA.
- Diabetes Institute, Ohio University, Athens, Ohio, USA.
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3
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Arosio M, Sciannameo V, Contarino A, Berchialla P, Puglisi S, Pesatori AC, Ferrante E, Filopanti M, Pivonello R, Dassie F, Rochira V, Cannavò S, De Menis E, Pigliaru F, Grottoli S, Cambria V, Faustini-Fustini M, Montini M, Peri A, Ceccato F, Puxeddu E, Borretta G, Bondanelli M, Ferone D, Colao A, Terzolo M, Reimondo G. Disease control of acromegaly does not prevent excess mortality in the long term: results of a nationwide survey in Italy. J Endocrinol Invest 2024; 47:1457-1465. [PMID: 38214852 PMCID: PMC11142937 DOI: 10.1007/s40618-023-02257-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 11/21/2023] [Indexed: 01/13/2024]
Abstract
OBJECTIVE This study aimed to assess the long-term outcome of patients with acromegaly. DESIGN This is a multicenter, retrospective, observational study which extends the mean observation period of a previously reported cohort of Italian patients with acromegaly to 15 years of follow-up. METHODS Only patients from the centers that provided information on the life status of at least 95% of their original cohorts were included. Life status information was collected either from clinical records or from the municipal registry offices. Standardized mortality ratios (SMRs) were computed comparing data with those of the general Italian population. RESULTS A total of 811 patients were included. There were 153 deaths, with 90 expected and an SMR of 1.7 (95% CI 1.4-2.0, p < 0.001). Death occurred after a median of 15 (women) or 16 (men) years from the diagnosis, without gender differences. Mortality remained elevated in the patients with control of disease (SMR 1.3, 95% CI 1.1-1.6). In the multivariable analysis, only older age and high IGF1 concentrations at last available follow-up visit were predictors of mortality. The oncological causes of death outweighed the cardiovascular ones, bordering on statistical significance with respect to the general population. CONCLUSIONS Mortality remains significantly high in patients with acromegaly, irrespectively of disease status, as long as the follow-up is sufficiently long with a low rate of patients lost to follow-up. Therapy strategy including radiotherapy does not have an impact on mortality. Oncological causes of death currently outweigh the cardiovascular causes.
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Affiliation(s)
- M Arosio
- Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - V Sciannameo
- Statistical Unit, Department of Clinical and Biological Sciences, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Italy
| | - A Contarino
- Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122, Milan, Italy.
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
| | - P Berchialla
- Statistical Unit, Department of Clinical and Biological Sciences, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Italy
| | - S Puglisi
- Internal Medicine, Department of Clinical and Biological Sciences, S. Luigi Hospital, University of Turin, Turin, Italy
| | - A C Pesatori
- EPIGET LAB, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - E Ferrante
- Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122, Milan, Italy
| | - M Filopanti
- Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122, Milan, Italy
| | - R Pivonello
- Division of Endocrinology, Department of Clinical Medicine and Surgery, University Federico II Di Napoli, Naples, Italy
| | - F Dassie
- Internal Medicine, Department of Medicine, DIMED, University of Padova, Padua, Italy
| | - V Rochira
- Endocrinology Unit, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Endocrinology Unit, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, 41126, Modena, Italy
| | - S Cannavò
- Department of Human Pathology "G. Barresi", University of Messina, Messina, Italy
| | - E De Menis
- Internal Medicine 2-Endocrine-Metabolic Department, Treviso Hospital, Montebelluna, Treviso, Italy
| | - F Pigliaru
- Endocrinology Unit, AOU Cagliari, Cagliari, Italy
| | - S Grottoli
- Division of Endocrinology, Diabetes and Metabolism, Department of Medical Science, University of Turin, AOU Città della Salute e della Scienza, Turin, Italy
| | - V Cambria
- Division of Endocrinology, Diabetes and Metabolism, Department of Medical Science, University of Turin, AOU Città della Salute e della Scienza, Turin, Italy
| | | | - M Montini
- Ambulatori di Endocrinologia, Humanitas Gavazzeni, Bergamo, Italy
| | - A Peri
- Pituitary Diseases and Sodium Alterations Unit, Endocrinology, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", Careggi University Hospital, University of Florence, Florence, Italy
| | - F Ceccato
- Department of Medicine (DIMED), University of Padova, Padua, Italy
- Endocrinology Unit, Padova University Hospital, Padua, Italy
| | - E Puxeddu
- Department of Medicine and Surgery, Section of Internal Medicine and Endocrine and Metabolic Sciences, University of Perugia, Perugia, Italy
| | - G Borretta
- Division of Endocrinology and Metabolism, Santa Croce and Carle Hospital, Cuneo, Italy
| | - M Bondanelli
- Section of Endocrinology, Geriatrics and Internal Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - D Ferone
- Endocrinology Unit, Department of Internal Medicine and Medical Specialties (DI.M.I.), University of Genoa, Genoa, Italy
- Endocrinology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - A Colao
- Division of Endocrinology, Department of Clinical Medicine and Surgery, University Federico II Di Napoli, Naples, Italy
| | - M Terzolo
- Internal Medicine, Department of Clinical and Biological Sciences, S. Luigi Hospital, University of Turin, Turin, Italy
| | - G Reimondo
- Internal Medicine, Department of Clinical and Biological Sciences, S. Luigi Hospital, University of Turin, Turin, Italy
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Chen J, Xu Y, Yu F, Ma Z, Yu J, Zhang X. NETs: an extracellular DNA network structure with implication for cardiovascular disease and cancer. Hypertens Res 2024; 47:1260-1272. [PMID: 38443616 DOI: 10.1038/s41440-023-01574-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 12/19/2023] [Accepted: 12/20/2023] [Indexed: 03/07/2024]
Abstract
Cardiovascular (CV) diseases and tumors are best known for its high morbidity and mortality worldwide. There is a growing recognition of the association between CV diseases and tumorigenesis. In addition to CV damage caused by anti-tumor drugs and tumor-induced organ dysfunction, CV events themselves and their treatment may also have a role in promoting tumorigenesis. Therefore, Therefore, the diagnosis and treatment of the two kinds of diseases have entered the era of clinical convergence. Emerging evidence indicates significant biologic overlap between cancer and CV diseases, with the recognition of shared biologic mechanisms. Neutrophil extracellular traps (NETs) represent an immune mechanism of neutrophils promoting the development of tumors and their metastasis. It has been recently demonstrated that NETs exist in various stages of hypertension and heart failure, exacerbating disease progression. At present, most studies focus on the biological role of NETs in CV diseases and tumor respectively, and there are relatively few studies on the specific regulatory mechanisms and effects of NETs in cardiovascular diseases associated with tumors. In this narrative review, we summarize some recent basic and clinical findings on how NETs are involved in the pathogenesis of cardiovascular diseases associated with tumors. We also highlight that the development of treatments targeting NETs may be one of the effective ways to prevent and treat cardiovascular diseases associated with tumors.
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Affiliation(s)
- Jianshu Chen
- Lanzhou University Second Hospital, Lanzhou, 730030, China
| | - Yuansheng Xu
- Lanzhou University Second Hospital, Lanzhou, 730030, China
| | - Fei Yu
- Lanzhou University Second Hospital, Lanzhou, 730030, China
| | - Zhengke Ma
- Lanzhou University Second Hospital, Lanzhou, 730030, China
| | - Jing Yu
- Lanzhou University Second Hospital, Lanzhou, 730030, China
- Lanzhou University Second College of Clinical Medicine, Lanzhou, 730030, China
| | - Xiaowei Zhang
- Lanzhou University Second Hospital, Lanzhou, 730030, China.
- Lanzhou University Second College of Clinical Medicine, Lanzhou, 730030, China.
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5
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Eroğlu İ, Iremli BG, Idilman IS, Yuce D, Lay I, Akata D, Erbas T. Nonalcoholic Fatty Liver Disease, Liver Fibrosis, and Utility of Noninvasive Scores in Patients With Acromegaly. J Clin Endocrinol Metab 2023; 109:e119-e129. [PMID: 37590020 PMCID: PMC10735300 DOI: 10.1210/clinem/dgad490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 05/19/2023] [Accepted: 08/16/2023] [Indexed: 08/18/2023]
Abstract
CONTEXT Nonalcoholic fatty liver disease (NAFLD) is a metabolical disorder and can lead to liver fibrosis. Because it is commonly seen, several noninvasive scores (NS) have been validated to identify high-risk patients. Patients with NAFLD have been shown to have higher serum angiopoietin-like protein-8 (ANGPTL-8) levels. OBJECTIVE The risk of NAFLD is known insufficiently in acromegaly. Moreover, the utility of the NS and the link between NAFLD and ANGPTL-8 in acromegaly is unknown. METHODS Thirty-two patients with acromegaly (n = 15, active [AA] and n = 17, controlled acromegaly [CA]) and 19 healthy controls were included. Magnetic resonance imaging (MRI)-proton density fat fraction (PDFF) was used to evaluate hepatic steatosis, and magnetic resonance elastography to evaluate liver stiffness measurement. ANGPTL-8 levels were measured with ELISA. RESULTS Median liver MRI-PDFF and NAFLD prevalence in AA were lower than in CA (P = .026 and P < .001, respectively). Median magnetic resonance elastography-liver stiffness measurement were similar across groups. Of the NS, visceral adiposity index, fatty liver index, hepatic steatosis index, and triglyceride-glucose index (TyG) all showed positive correlation with the liver MRI-PDFF in the control group. However, only TyG significantly correlated with liver fat in the AA and CA groups. There was no correlation between traditional NAFLD risk factors (body mass index, waist circumference, C-reactive protein, homeostasis model assessment for insulin resistance, visceral adipose tissue) and liver MRI-PDFF in the AA and CA. Patients with acromegaly with NAFLD had lower GH, IGF-1, and ANGPTL-8 levels than in those without NAFLD (P = .025, P = .011, and P = .036, respectively). CONCLUSION Active acromegaly may protect from NAFLD because of high GH. In patients with acromegaly, NAFLD risk cannot be explained with classical risk factors; hence, additional risk factors must be identified. TyG is the best score to evaluate NAFLD risk. Lower ANGPTL-8 in patients with acromegaly and NAFLD implies this hormone may be raised because of insulin resistance rather than being a cause for NAFLD.
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Affiliation(s)
- İmdat Eroğlu
- Department of Internal Medicine, Hacettepe University, School of Medicine, 06230, Ankara, Turkey
| | - Burcin Gonul Iremli
- Department of Internal Medicine, Hacettepe University, School of Medicine, 06230, Ankara, Turkey
- Department of Endocrinology and Metabolism, Hacettepe University, School of Medicine, 06230, Ankara, Turkey
| | - Ilkay S Idilman
- Department of Radiology, Hacettepe University, School of Medicine, 06230, Ankara, Turkey
| | - Deniz Yuce
- Department of Preventive Oncology, Hacettepe University, School of Medicine, 06230, Ankara, Turkey
| | - Incilay Lay
- Department of Biochemistry, Hacettepe University, School of Medicine, 06230, Ankara, Turkey
| | - Deniz Akata
- Department of Radiology, Hacettepe University, School of Medicine, 06230, Ankara, Turkey
| | - Tomris Erbas
- Department of Internal Medicine, Hacettepe University, School of Medicine, 06230, Ankara, Turkey
- Department of Endocrinology and Metabolism, Hacettepe University, School of Medicine, 06230, Ankara, Turkey
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Apaydin T, Zonis S, Zhou C, Valencia CW, Barrett R, Strous GJ, Mol JA, Chesnokova V, Melmed S. WIP1 is a novel specific target for growth hormone action. iScience 2023; 26:108117. [PMID: 37876819 PMCID: PMC10590974 DOI: 10.1016/j.isci.2023.108117] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 08/22/2023] [Accepted: 09/29/2023] [Indexed: 10/26/2023] Open
Abstract
DNA damage repair (DDR) is mediated by phosphorylating effectors ATM kinase, CHK2, p53, and γH2AX. We showed earlier that GH suppresses DDR by suppressing pATM, resulting in DNA damage accumulation. Here, we show GH acting through GH receptor (GHR) inducing wild-type p53-inducible phosphatase 1 (WIP1), which dephosphorylated ATM and its effectors in normal human colon cells and three-dimensional human intestinal organoids. Mice bearing GH-secreting xenografts exhibited induced colon WIP1 with suppressed pATM and γH2AX. WIP1 was also induced in buffy coats derived from patients with elevated GH from somatotroph adenomas. In contrast, decreased colon WIP1 was observed in GHR-/- mice. WIP1 inhibition restored ATM phosphorylation and reversed GH-induced DNA damage. We elucidated a novel GH signaling pathway activating Src/AMPK to trigger HIPK2 nuclear-cytoplasmic relocation and suppressing WIP1 ubiquitination. Concordantly, blocking either AMPK or Src abolished GH-induced WIP1. We identify WIP1 as a specific target for GH-mediated epithelial DNA damage accumulation.
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Affiliation(s)
- Tugce Apaydin
- Department of Medicine, Pituitary Center, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Svetlana Zonis
- Department of Medicine, Pituitary Center, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Cuiqi Zhou
- Department of Medicine, Pituitary Center, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Christian Wong Valencia
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Robert Barrett
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Ger J. Strous
- Center for Molecular Medicine, University Medical Center Utrecht, Institute of Biomembranes, Utrecht University, Utrecht, the Netherlands
| | - Jan A. Mol
- Department of Clinical Sciences of Companion Animals, Utrecht University, Utrecht, the Netherlands
| | - Vera Chesnokova
- Department of Medicine, Pituitary Center, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Shlomo Melmed
- Department of Medicine, Pituitary Center, Cedars-Sinai Medical Center, Los Angeles, CA, USA
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7
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Yoshida N, Maeda-Minami A, Ishikawa H, Mutoh M, Kanno Y, Tomita Y, Hirose R, Dohi O, Itoh Y, Mano Y. Analysis of the development of gastric cancer after resecting colorectal lesions using large-scale health insurance claims data. J Gastroenterol 2023; 58:1105-1113. [PMID: 37646980 DOI: 10.1007/s00535-023-02035-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 08/15/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Colorectal endoscopic resection (C-ER) is spreading due to the increase of colorectal cancer (CRC) in Japan. Gastric cancer (GC) sometimes occurs after C-ER. We aimed to analyze the status of GC after C-ER using large-scale data. METHODS We retrospectively used commercially anonymized health insurance claims data of 5.71 million patients from 2005 to 2018, and extracted 62,392 patients ≥ 50 years old who received C-ER. The incidence and risk factors of GC were analyzed. Additionally, subjects were divided into ≥ 2 cm group and < 2 cm group and risks of GC were analyzed. RESULTS The median age (range) was 58 (50-75) years and the overall rate of GC was 0.68% (423/62,392). Multivariate analysis showed that significant risk factors for GC [odds rates (OR), 95% confidence interval (CI)] were colorectal lesion size ≥ 2 cm (1.75, 1.24-2.47, p = 0.002), age ≥ 65 y.o. (1.65, 1.31-2.07, p < 0.001), male (2.35, 1. 76-3.13, p < 0.001), diabetes mellitus (1.40, 1.02-1.92, p = 0.035), liver disease (1.54, 1.06-2.24, p = 0.025), Helicobacter pylori infection (2.10, 1.65-2.67, p < 0.001), chronic atrophic gastritis (1.58, 1.14-2.18, p = 0.006), and CRC (1.72, 1.10-2.68, p = 0.017). The rate of GC in the ≥ 2 cm was significantly higher than that in < 2 cm groups (1.17% and 0.65%, p < 0.001). According to the number of significant risk factors, the rates of GC and the hazard ratios of GC (95%CI) were 0.64% and 3.64 (2.20-6.02) and 1.95% and 11.17 (6.57-19.00) for patient with 1-2 and ≥ 3 risk factors, compared with patients without risk factors. CONCLUSIONS Using large-scale data, risk factors for GC, including colorecal lesions ≥ 2 cm after C-ER could be investigated.
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Affiliation(s)
- Naohisa Yoshida
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-Cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
| | - Ayako Maeda-Minami
- Department of Clinical Drug Informatics, Faculty of Pharmaceutical Sciences, Tokyo University of Science, Chiba, Japan
| | - Hideki Ishikawa
- Department of Molecular-Targeting Prevention, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Michihiro Mutoh
- Department of Molecular-Targeting Prevention, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yui Kanno
- Department of Clinical Drug Informatics, Faculty of Pharmaceutical Sciences, Tokyo University of Science, Chiba, Japan
| | - Yuri Tomita
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-Cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Ryohei Hirose
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-Cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Osamu Dohi
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-Cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Yoshito Itoh
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-Cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Yasunari Mano
- Department of Clinical Drug Informatics, Faculty of Pharmaceutical Sciences, Tokyo University of Science, Chiba, Japan
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Ratku B, Sebestyén V, Szelesné Árokszállási A, Erdei A, Berta E, Szabó Z, Bodor M, Nagy VE, Somodi S. [Unfavourable cardiovascular consequences of adult growth hormone deficiency]. Orv Hetil 2023; 164:1616-1627. [PMID: 37987695 DOI: 10.1556/650.2023.32890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 08/14/2023] [Indexed: 11/22/2023]
Abstract
The growth hormone-insulin-like growth factor-1 (GH-IGF-1) axis plays a crucial role in maintaining the normal function of the cardiovascular system. Results of the last decades demonstrated that GH-IGF-1 takes part in regulating peripheral resistance and contributes to preserving physiological cardiac mass and left ventricular function. Vasculoprotective functions of the GH-IGF-1 axis are believed to counteract atherosclerosis. Unlike in childhood, when GH-deficiency results in growth retardation, GH deficiency does not cause specific symptoms in adults. Adult growth hormone deficiency (AGHD) is characterized by a clustering of cardiometabolic risk factors resulting in a clinical picture similar to the metabolic syndrome. Besides visceral obesity, dyslipidemia and insulin resistance, novel cardiovascular risk factors, such as chronic low-grade inflammation, oxidative stress and prothrombotic state have also been reported in AGHD and may contribute to the increased cardiometabolic risk. Based on a growing body of evidence, long-term GH-replacement improves lipid profile significantly and has a favorable impact on body composition, endothelial function, left ventricular mass as well as the novel, non-traditional cardiometabolic risk factors. Increased mortality associated with the disease is now considered to be multicausal and as such cannot be solely attributed to the GH-deficiency. The etiology of GH-deficiency, treatment of the underlying pathology as well as the inadequate treatment of coexisting hormonal deficiencies might also be responsible for the increased mortality. Nevertheless, in hypopituitarism, adequate replacement therapy including GH-substitution may result in a mortality that is comparable to the general population. Orv Hetil. 2023; 164(41): 1616-1627.
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Affiliation(s)
- Balázs Ratku
- 1 Debreceni Egyetem, Egészségtudományi Kar, Sürgősségi és Oxiológiai Tanszék Nyíregyháza Magyarország
- 2 Debreceni Egyetem, Általános Orvostudományi Kar, Sürgősségi Orvostani Tanszék Debrecen, Nagyerdei krt. 98., 4032 Magyarország
- 3 Debreceni Egyetem, Általános Orvostudományi Kar, Egészségtudományok Doktori Iskola Debrecen Magyarország
| | - Veronika Sebestyén
- 2 Debreceni Egyetem, Általános Orvostudományi Kar, Sürgősségi Orvostani Tanszék Debrecen, Nagyerdei krt. 98., 4032 Magyarország
- 3 Debreceni Egyetem, Általános Orvostudományi Kar, Egészségtudományok Doktori Iskola Debrecen Magyarország
| | | | - Annamária Erdei
- 4 Debreceni Egyetem, Klinikai Központ, Belgyógyászati Intézet, Endokrinológiai Részleg Debrecen Magyarország
| | - Eszter Berta
- 4 Debreceni Egyetem, Klinikai Központ, Belgyógyászati Intézet, Endokrinológiai Részleg Debrecen Magyarország
| | - Zoltán Szabó
- 2 Debreceni Egyetem, Általános Orvostudományi Kar, Sürgősségi Orvostani Tanszék Debrecen, Nagyerdei krt. 98., 4032 Magyarország
| | - Miklós Bodor
- 4 Debreceni Egyetem, Klinikai Központ, Belgyógyászati Intézet, Endokrinológiai Részleg Debrecen Magyarország
| | - V Endre Nagy
- 4 Debreceni Egyetem, Klinikai Központ, Belgyógyászati Intézet, Endokrinológiai Részleg Debrecen Magyarország
| | - Sándor Somodi
- 2 Debreceni Egyetem, Általános Orvostudományi Kar, Sürgősségi Orvostani Tanszék Debrecen, Nagyerdei krt. 98., 4032 Magyarország
- 4 Debreceni Egyetem, Klinikai Központ, Belgyógyászati Intézet, Endokrinológiai Részleg Debrecen Magyarország
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9
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Wang Y, Kim M, Buckley C, Maynard HD, Langley RJ, Perry JK. Growth hormone receptor agonists and antagonists: From protein expression and purification to long-acting formulations. Protein Sci 2023; 32:e4727. [PMID: 37428391 PMCID: PMC10443362 DOI: 10.1002/pro.4727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 07/06/2023] [Accepted: 07/07/2023] [Indexed: 07/11/2023]
Abstract
Recombinant human growth hormone (rhGH) and GH receptor antagonists (GHAs) are used clinically to treat a range of disorders associated with GH deficiency or hypersecretion, respectively. However, these biotherapeutics can be difficult and expensive to manufacture with multiple challenges from recombinant protein generation through to the development of long-acting formulations required to improve the circulating half-life of the drug. In this review, we summarize methodologies and approaches used for making and purifying recombinant GH and GHA proteins, and strategies to improve pharmacokinetic and pharmacodynamic properties, including PEGylation and fusion proteins. Therapeutics that are in clinical use or are currently under development are also discussed.
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Affiliation(s)
- Yue Wang
- Liggins Institute, University of AucklandAucklandNew Zealand
- Maurice Wilkins Centre for Molecular BiodiscoveryAucklandNew Zealand
| | - Minah Kim
- Liggins Institute, University of AucklandAucklandNew Zealand
| | - Chantal Buckley
- Liggins Institute, University of AucklandAucklandNew Zealand
| | - Heather D. Maynard
- Department of Chemistry and Biochemistry and the California NanoSystems InstituteUniversity of CaliforniaLos AngelesCaliforniaUSA
| | - Ries J. Langley
- Maurice Wilkins Centre for Molecular BiodiscoveryAucklandNew Zealand
- Department of Molecular Medicine and PathologyUniversity of AucklandAucklandNew Zealand
| | - Jo K. Perry
- Liggins Institute, University of AucklandAucklandNew Zealand
- Maurice Wilkins Centre for Molecular BiodiscoveryAucklandNew Zealand
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10
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Basu R, Brody R, Sandbhor U, Kulkarni P, Davis E, Swegan D, Caggiano LJ, Brenya E, Neggers S, Kopchick JJ. Structure and function of a dual antagonist of the human growth hormone and prolactin receptors with site-specific PEG conjugates. J Biol Chem 2023; 299:105030. [PMID: 37442239 PMCID: PMC10410519 DOI: 10.1016/j.jbc.2023.105030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 06/06/2023] [Accepted: 06/08/2023] [Indexed: 07/15/2023] Open
Abstract
Human growth hormone (hGH) is a pituitary-derived endocrine protein that regulates several critical postnatal physiologic processes including growth, organ development, and metabolism. Following adulthood, GH is also a regulator of multiple pathologies like fibrosis, cancer, and diabetes. Therefore, there is a significant pharmaceutical interest in developing antagonists of hGH action. Currently, there is a single FDA-approved antagonist of the hGH receptor (hGHR) prescribed for treating patients with acromegaly and discovered in our laboratory almost 3 decades ago. Here, we present the first data on the structure and function of a new set of protein antagonists with the full range of hGH actions-dual antagonists of hGH binding to the GHR as well as that of hGH binding to the prolactin receptor. We describe the site-specific PEG conjugation, purification, and subsequent characterization using MALDI-TOF, size-exclusion chromatography, thermostability, and biochemical activity in terms of ELISA-based binding affinities with GHR and prolactin receptor. Moreover, these novel hGHR antagonists display distinct antagonism of GH-induced GHR intracellular signaling in vitro and marked reduction in hepatic insulin-like growth factor 1 output in vivo. Lastly, we observed potent anticancer biological efficacies of these novel hGHR antagonists against human cancer cell lines. In conclusion, we propose that these new GHR antagonists have potential for development towards multiple clinical applications related to GH-associated pathologies.
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Affiliation(s)
- Reetobrata Basu
- Edison Biotechnology Institute, Ohio University, Athens, Ohio, USA
| | | | | | - Prateek Kulkarni
- Edison Biotechnology Institute, Ohio University, Athens, Ohio, USA; Molecular and Cellular Biology Program, Ohio University, Athens, Ohio, USA; Department of Biological Sciences, Ohio University, Athens, Ohio, USA
| | - Emily Davis
- Edison Biotechnology Institute, Ohio University, Athens, Ohio, USA; Molecular and Cellular Biology Program, Ohio University, Athens, Ohio, USA; Department of Biological Sciences, Ohio University, Athens, Ohio, USA
| | - Deborah Swegan
- Edison Biotechnology Institute, Ohio University, Athens, Ohio, USA; Department of Biological Sciences, Ohio University, Athens, Ohio, USA
| | - Lydia J Caggiano
- Edison Biotechnology Institute, Ohio University, Athens, Ohio, USA; Honors Tutorial College, Ohio University, Athens, Ohio, USA
| | - Edward Brenya
- Edison Biotechnology Institute, Ohio University, Athens, Ohio, USA; Department of Biological Sciences, Ohio University, Athens, Ohio, USA
| | - Sebastian Neggers
- Department of Medicine, Endocrinology, Erasmus Medical Centre, Rotterdam, Netherlands
| | - John J Kopchick
- Edison Biotechnology Institute, Ohio University, Athens, Ohio, USA; Molecular and Cellular Biology Program, Ohio University, Athens, Ohio, USA; Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio, USA.
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11
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Bell S, Young JA, List EO, Basu R, Geitgey DK, Lach G, Lee K, Swegan D, Caggiano LJ, Okada S, Kopchick JJ, Berryman DE. Increased Fibrosis in White Adipose Tissue of Male and Female bGH Transgenic Mice Appears Independent of TGF-β Action. Endocrinology 2023; 164:7069260. [PMID: 36869769 DOI: 10.1210/endocr/bqad038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 02/21/2023] [Accepted: 02/24/2023] [Indexed: 03/05/2023]
Abstract
Fibrosis is a pathological state caused by excess deposition of extracellular matrix proteins in a tissue. Male bovine growth hormone (bGH) transgenic mice experience metabolic dysfunction with a marked decrease in lifespan and with increased fibrosis in several tissues including white adipose tissue (WAT), which is more pronounced in the subcutaneous (Sc) depot. The current study expanded on these initial findings to evaluate WAT fibrosis in female bGH mice and the role of transforming growth factor (TGF)-β in the development of WAT fibrosis. Our findings established that female bGH mice, like males, experience a depot-dependent increase in WAT fibrosis, and bGH mice of both sexes have elevated circulating levels of several markers of collagen turnover. Using various methods, TGF-β signaling was found unchanged or decreased-as opposed to an expected increase-despite the marked fibrosis in WAT of bGH mice. However, acute GH treatments in vivo, in vitro, or ex vivo did elicit a modest increase in TGF-β signaling in some experimental systems. Finally, single nucleus RNA sequencing confirmed no perturbation in TGF-β or its receptor gene expression in any WAT cell subpopulations of Sc bGH WAT; however, a striking increase in B lymphocyte infiltration in bGH WAT was observed. Overall, these data suggest that bGH WAT fibrosis is independent of the action of TGF-β and reveals an intriguing shift in immune cells in bGH WAT that should be further explored considering the increasing importance of B cell-mediated WAT fibrosis and pathology.
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Affiliation(s)
- Stephen Bell
- Heritage College of Osteopathic Medicine, Ohio University, Athens, OH 45701, USA
- Edison Biotechnology Institute, Ohio University, Athens, OH 45701, USA
| | - Jonathan A Young
- Heritage College of Osteopathic Medicine, Ohio University, Athens, OH 45701, USA
- Edison Biotechnology Institute, Ohio University, Athens, OH 45701, USA
| | - Edward O List
- Edison Biotechnology Institute, Ohio University, Athens, OH 45701, USA
| | - Reetobrata Basu
- Edison Biotechnology Institute, Ohio University, Athens, OH 45701, USA
| | | | - Grace Lach
- Heritage College of Osteopathic Medicine, Ohio University, Athens, OH 45701, USA
- Edison Biotechnology Institute, Ohio University, Athens, OH 45701, USA
| | - Kevin Lee
- Heritage College of Osteopathic Medicine, Ohio University, Athens, OH 45701, USA
- Diabetes Institute, Ohio University, Athens, OH 45701, USA
| | - Deborah Swegan
- College of Arts and Sciences, Ohio University, Athens, OH 45701, USA
| | | | - Shigeru Okada
- Heritage College of Osteopathic Medicine, Ohio University, Athens, OH 45701, USA
- Edison Biotechnology Institute, Ohio University, Athens, OH 45701, USA
| | - John J Kopchick
- Heritage College of Osteopathic Medicine, Ohio University, Athens, OH 45701, USA
- Edison Biotechnology Institute, Ohio University, Athens, OH 45701, USA
- Diabetes Institute, Ohio University, Athens, OH 45701, USA
| | - Darlene E Berryman
- Heritage College of Osteopathic Medicine, Ohio University, Athens, OH 45701, USA
- Edison Biotechnology Institute, Ohio University, Athens, OH 45701, USA
- Diabetes Institute, Ohio University, Athens, OH 45701, USA
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12
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Falch CM, Arlien-Søborg MC, Dal J, Sundaram AYM, Michelsen AE, Ueland T, Olsen LG, Heck A, Bollerslev J, Jørgensen JOL, Olarescu NC. Gene expression profiling of subcutaneous adipose tissue reveals new biomarkers in acromegaly. Eur J Endocrinol 2023; 188:7075007. [PMID: 36895180 DOI: 10.1093/ejendo/lvad031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/17/2023] [Accepted: 03/08/2023] [Indexed: 03/11/2023]
Abstract
CONTEXT Active acromegaly is characterized by lipolysis-induced insulin resistance, which suggests adipose tissue (AT) as a primary driver of metabolic aberrations. OBJECTIVE To study the gene expression landscape in AT in patients with acromegaly before and after disease control in order to understand the changes and to identify disease-specific biomarkers. METHODS RNA sequencing was performed on paired subcutaneous adipose tissue (SAT) biopsies from six patients with acromegaly at time of diagnosis and after curative surgery. Clustering and pathway analyses were performed in order to identify disease activity-dependent genes. In a larger patient cohort (n = 23), the corresponding proteins were measured in serum by immunoassay. Correlations between growth hormone (GH), insulin-like growth factor I (IGF-I), visceral AT (VAT), SAT, total AT, and serum proteins were analyzed. RESULTS 743 genes were significantly differentially expressed (P-adjusted < .05) in SAT before and after disease control. The patients clustered according to disease activity. Pathways related to inflammation, cell adhesion and extracellular matrix, GH and insulin signaling, and fatty acid oxidation were differentially expressed.Serum levels of HTRA1, METRNL, S100A8/A9, and PDGFD significantly increased after disease control (P < .05). VAT correlated with HTRA1 (R = 0.73) and S100A8/A9 (R = 0.55) (P < .05 for both). CONCLUSION AT in active acromegaly is associated with a gene expression profile of fibrosis and inflammation, which may corroborate the hyper-metabolic state and provide a means for identifying novel biomarkers.
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Affiliation(s)
- Camilla M Falch
- Section of Specialized Endocrinology, Oslo University Hospital (OUS), Postboks 4950 Nydalen, 0424 Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo (UIO), Postboks 1171 Blindern, 0318 Oslo, Norway
- Research Institute of Internal Medicine, Oslo University Hospital (OUS), Postboks 4950 Nydalen, 0424 Oslo, Norway
| | - Mai Christiansen Arlien-Søborg
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital (AUH), Palle Juul Jensens Boulevard 99, 8200 Aarhus N, Denmark
- Medical Research Laboratory, Department of Clinical Medicine, Aarhus University Hospital (AUH), Palle Juul Jensens Boulevard 99, 8200 Aarhus N, Denmark
| | - Jakob Dal
- Department of Endocrinology and Internal Medicine, Aalborg University Hospital (AAUH), Hobrovej 18-22, 9000 Aalborg, Denmark
- Steno Diabetes Center North Jutland, Aalborg University Hospital, Søndre Skovvej 3E, 9000 Aalborg, Denmark
| | - Arvind Y M Sundaram
- Department of Medical Genetics, University of Oslo, Oslo University Hospital, Kirkeveien 166, 0450 Oslo, Norway
| | - Annika E Michelsen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo (UIO), Postboks 1171 Blindern, 0318 Oslo, Norway
- Research Institute of Internal Medicine, Oslo University Hospital (OUS), Postboks 4950 Nydalen, 0424 Oslo, Norway
| | - Thor Ueland
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo (UIO), Postboks 1171 Blindern, 0318 Oslo, Norway
| | - Linn Guro Olsen
- Section of Specialized Endocrinology, Oslo University Hospital (OUS), Postboks 4950 Nydalen, 0424 Oslo, Norway
| | - Ansgar Heck
- Section of Specialized Endocrinology, Oslo University Hospital (OUS), Postboks 4950 Nydalen, 0424 Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo (UIO), Postboks 1171 Blindern, 0318 Oslo, Norway
| | - Jens Bollerslev
- Section of Specialized Endocrinology, Oslo University Hospital (OUS), Postboks 4950 Nydalen, 0424 Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo (UIO), Postboks 1171 Blindern, 0318 Oslo, Norway
| | - Jens Otto L Jørgensen
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital (AUH), Palle Juul Jensens Boulevard 99, 8200 Aarhus N, Denmark
| | - Nicoleta C Olarescu
- Section of Specialized Endocrinology, Oslo University Hospital (OUS), Postboks 4950 Nydalen, 0424 Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo (UIO), Postboks 1171 Blindern, 0318 Oslo, Norway
- Research Institute of Internal Medicine, Oslo University Hospital (OUS), Postboks 4950 Nydalen, 0424 Oslo, Norway
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13
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Growth Hormone Alters Circulating Levels of Glycine and Hydroxyproline in Mice. Metabolites 2023; 13:metabo13020191. [PMID: 36837810 PMCID: PMC9959592 DOI: 10.3390/metabo13020191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/20/2023] [Accepted: 01/24/2023] [Indexed: 01/31/2023] Open
Abstract
Growth hormone (GH) has established effects on protein metabolism, such as increasing protein synthesis and decreasing amino acid degradation, but its effects on circulating amino acid levels are less studied. To investigate this relationship, metabolomic analyses were used to measure amino acid concentrations in plasma and feces of mice with alterations to the GH axis, namely bovine GH transgenic (bGH; increased GH action) and GH receptor knockout (GHRKO; GH resistant) mice. To determine the effects of acute GH treatment, GH-injected GH knockout (GHKO) mice were used to measure serum glycine. Furthermore, liver gene expression of glycine metabolism genes was assessed in bGH, GHRKO, and GH-injected GHKO mice. bGH mice had significantly decreased plasma glycine and increased hydroxyproline in both sexes, while GHRKO mice had increased plasma glycine in both sexes and decreased hydroxyproline in males. Glycine synthesis gene expression was decreased in bGH mice (Shmt1 in females and Shmt2 in males) and increased in GHRKO mice (Shmt2 in males). Acute GH treatment of GHKO mice caused decreased liver Shmt1 and Shmt2 expression and decreased serum glycine. In conclusion, GH alters circulating glycine and hydroxyproline levels in opposing directions, with the glycine changes at least partially driven by decreased glycine synthesis.
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The Potential of Pharmaceutical Hydrogels in the Formulation of Topical Administration Hormone Drugs. Polymers (Basel) 2022; 14:polym14163307. [PMID: 36015564 PMCID: PMC9413899 DOI: 10.3390/polym14163307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/12/2022] [Accepted: 08/12/2022] [Indexed: 11/16/2022] Open
Abstract
Hormones have attracted considerable interest in recent years due to their potential use in treatment of many diseases. Their ability to have a multidirectional effect leads to searching for new and increasingly effective drugs and therapies. Limitations in formulating drug forms containing hormones are mainly due to their low enzymatic stability, short half-life and limited bioavailability. One of the solutions may be to develop a hydrogel as a potential hormone carrier, for epidermal and transdermal application. This review discusses the main research directions in developing this drug formulation. The factors determining the action of hormones as drugs are presented. An analysis of hydrogel substrates and permeation enhancers that have the potential to enhance the efficacy of hormones applied to the skin is reviewed.
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Osorio RC, Oh JY, Choudhary N, Lad M, Savastano L, Aghi MK. Pituitary adenomas and cerebrovascular disease: A review on pathophysiology, prevalence, and treatment. Front Endocrinol (Lausanne) 2022; 13:1064216. [PMID: 36578965 PMCID: PMC9791098 DOI: 10.3389/fendo.2022.1064216] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 11/28/2022] [Indexed: 12/14/2022] Open
Abstract
Pituitary adenomas (PAs) have been shown to cause excess cardiovascular disease comorbidity and mortality. Cerebrovascular disease (CeVD) is a small subset of cardiovascular disease with high morbidity, and its risk in patients with pituitary adenomas has been sparingly explored. In this review, we examine what is known about the prevalence of cerebrovascular disease in patients with PAs, from its initial discovery in 1970 to present. An abundance of literature describes increased cerebrovascular mortality in patients with acromegaly, while research on other PA subtypes is less frequent but shows a similarly elevated CeVD mortality relative to healthy populations. We also review how cerebrovascular risk changes after PAs are treated, with PA treatment appearing to prevent further accumulation of cerebrovascular risk without reversing prior elevations. While acromegaly-associated CeVD appears to be caused by elevated growth hormone (GH) levels and Cushing disease's elevated glucocorticoids similarly cause durable alterations in cerebrovascular structure and function, less is known about the mechanisms behind CeVD in other PA subpopulations. Proposed pathophysiologies include growth hormone deficiency inducing vessel wall damage or other hormone deficits causing increased atherosclerotic disease. Early diagnosis and treatment of PAs may be the key to minimizing lifetime CeVD risk elevations. More research is needed to better understand the mechanisms behind the increased CeVD seen in patients with PAs. Physicians caring for PA patients must remain vigilant for signs and symptoms of cerebrovascular disease in this patient population.
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