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Soejima Y, Yamamoto K, Nakano Y, Suyama A, Iwata N, Otsuka F. Functional interaction of Clock genes and bone morphogenetic proteins in the adrenal cortex. VITAMINS AND HORMONES 2023; 124:429-447. [PMID: 38408807 DOI: 10.1016/bs.vh.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
The bone morphogenetic protein (BMP) system in the adrenal cortex plays modulatory roles in the control of adrenocortical steroidogenesis. BMP-6 enhances aldosterone production by modulating angiotensin (Ang) II-mitogen-activated protein kinase (MAPK) signaling, whereas activin regulates the adrenocorticotropin (ACTH)-cAMP cascade in adrenocortical cells. A peripheral clock system in the adrenal cortex was discovered and it has been shown to have functional roles in the adjustment of adrenocortical steroidogenesis by interacting with the BMP system. It was found that follistatin, a binding protein of activin, increased Clock mRNA levels, indicating an endogenous function of activin in the regulation of Clock mRNA expression. Elucidation of the interrelationships among the circadian clock system, the BMP system and adrenocortical steroidogenesis regulated by the hypothalamic-pituitary-adrenal (HPA) axis would lead to an understanding of the pathophysiology of adrenal disorders and metabolic disorders and the establishment of better medical treatment from the viewpoint of pharmacokinetics.
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Affiliation(s)
- Yoshiaki Soejima
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Shikata-cho, Kitaku, Okayama, Japan
| | - Koichiro Yamamoto
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Shikata-cho, Kitaku, Okayama, Japan
| | - Yasuhiro Nakano
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Shikata-cho, Kitaku, Okayama, Japan
| | - Atsuhito Suyama
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Shikata-cho, Kitaku, Okayama, Japan
| | - Nahoko Iwata
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Shikata-cho, Kitaku, Okayama, Japan
| | - Fumio Otsuka
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Shikata-cho, Kitaku, Okayama, Japan.
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Fu Y, Sun S, Bi J, Kong C. Construction of a risk signature for adrenocortical carcinoma using immune-related genes. Transl Androl Urol 2020; 9:1920-1930. [PMID: 33209656 PMCID: PMC7658150 DOI: 10.21037/tau-20-485] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background Adrenocortical carcinoma (ACC) is considered a rare tumor with a dismal prognosis. Expression of immune-related genes (IRGs) in ACC and correlations between IRGs and ACC prognosis were assessed using The Cancer Genome Atlas (TCGA) and Genotype-Tissue Expression (GTEx) databases. Methods To preliminarily predict immune cell infiltration, an immune score was calculated using ESTIMATE. Differentially expressed IRGs were screened, and potential biological functions were investigated. We then performed univariate Cox regression to identify IRGs associated with survival, and the regulatory mechanisms of IRGs associated with survival were predicted. We built a risk signature through multivariate Cox regression to evaluate patient overall survival (OS). Results A high immune score predicted a good prognosis and an early clinical stage in ACC. We identified 30 IRGs associated with survival and then predicted associated regulatory mechanisms via protein-protein interaction (PPI) and transcription factor (TF) regulatory networks. The risk signature established by multivariate Cox regression correlated significantly with prognosis in ACC. Conclusions The vital roles of IRGs in ACC were assessed, and the risk signature obtained based on IRGs associated with survival independently predicted ACC prognosis.
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Affiliation(s)
- Yang Fu
- Department of Urology, The First Hospital of China Medical University, Shenyang, China
| | - Shanshan Sun
- Department of Pharmacy, The First Hospital of China Medical University, Shenyang, China
| | - Jianbin Bi
- Department of Urology, The First Hospital of China Medical University, Shenyang, China
| | - Chuize Kong
- Department of Urology, The First Hospital of China Medical University, Shenyang, China
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A phase II study of the orally administered negative enantiomer of gossypol (AT-101), a BH3 mimetic, in patients with advanced adrenal cortical carcinoma. Invest New Drugs 2019; 37:755-762. [PMID: 31172443 DOI: 10.1007/s10637-019-00797-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 05/22/2019] [Indexed: 02/06/2023]
Abstract
Background Adrenal cortical carcinoma (ACC) is a rare cancer with treatment options of limited efficacy, and poor prognosis if metastatic. AT-101 is a more potent inhibitor of B cell lymphoma 2 family apoptosis-related proteins than its racemic form, gossypol, which showed preliminary clinical activity in ACC. We thus evaluated the efficacy of AT-101 in patients with advanced ACC. Methods Patients with histologically confirmed metastatic, recurrent, or primarily unresectable ACC were treated with AT-101 (20 mg/day orally, 21 days out of 28-day cycles) until disease progression and/or prohibitive toxicity. The primary endpoint was objective response rate, wherein a Response Evaluation Criteria In Solid Tumors (RECIST) partial response rate of 25% would be considered promising and 10% not, with a Type I error of 10% and 90% power. In a 2-stage design, 2 responses were required of the first 21 assessable subjects to warrant complete accrual of 44 patients. Secondary endpoints included safety, progression-free survival and overall survival. Results This study accrued 29 patients between 2009 and 2011; median number of cycles was 2. Seven percent experienced grade 4 toxicity including cardiac troponin elevations and hypokalemia. None of the first 21 patients attained RECIST partial response; accordingly, study therapy was deemed ineffective and the trial was permanently closed. Conclusions AT-101 had no meaningful clinical activity in this study in patients with advanced ACC, but demonstrated feasibility of prospective therapeutic clinical trials in this rare cancer.
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Chen TY, Syu JS, Lin TC, Cheng HL, Lu FL, Wang CY. Chloroquine alleviates etoposide-induced centrosome amplification by inhibiting CDK2 in adrenocortical tumor cells. Oncogenesis 2015; 4:e180. [PMID: 26690546 PMCID: PMC4688395 DOI: 10.1038/oncsis.2015.37] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 09/25/2015] [Accepted: 10/21/2015] [Indexed: 12/26/2022] Open
Abstract
The antitumor drug etoposide (ETO) is widely used in treating several cancers, including adrenocortical tumor (ACT). However, when used at sublethal doses, tumor cells still survive and are more susceptible to the recurring tumor due to centrosome amplification. Here, we checked the effect of sublethal dose of ETO in ACT cells. Sublethal dose of ETO treatment did not induce cell death but arrested the ACT cells in G2/M phase. This resulted in centrosome amplification and aberrant mitotic spindle formation leading to genomic instability and cellular senescence. Under such conditions, Chk2, cyclin A/CDK2 and ERK1/2 were aberrantly activated. Pharmacological inactivation of Chk2, CDK2 or ERK1/2 or depletion of CDK2 or Chk2 inhibited the centrosome amplification in ETO-treated ACT cells. In addition, autophagy was activated by ETO and was required for ACT cell survival. Chloroquine, the autophagy inhibitor, reduced ACT cell growth and inhibited ETO-induced centrosome amplification. Chloroquine alleviated CDK2 and ERK, but not Chk2, activation and thus inhibited centrosome amplification in either ETO- or hydroxyurea-treated ACT cells. In addition, chloroquine also inhibited centrosome amplification in osteosarcoma U2OS cell lines when treated with ETO or hydroxyurea. In summary, we have demonstrated that chloroquine inhibited ACT cell growth and alleviated DNA damage-induced centrosome amplification by inhibiting CDK2 and ERK activity, thus preventing genomic instability and recurrence of ACT.
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Affiliation(s)
- T-Y Chen
- Department of Cell Biology and Anatomy, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - J-S Syu
- Department of Cell Biology and Anatomy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - T-C Lin
- Department of Cell Biology and Anatomy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - H-L Cheng
- Department of Cell Biology and Anatomy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - F-L Lu
- Institute of Biotechnology, College of Bioscience and Biotechnology, National Cheng Kung University, Tainan, Taiwan.,Department of Biotechnology and Bioindustry Sciences, College of Bioscience and Biotechnology, National Cheng Kung University, Tainan, Taiwan
| | - C-Y Wang
- Department of Cell Biology and Anatomy, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Hara T, Otsuka F, Tsukamoto-Yamauchi N, Inagaki K, Hosoya T, Nakamura E, Terasaka T, Komatsubara M, Makino H. Mutual effects of melatonin and activin on induction of aldosterone production by human adrenocortical cells. J Steroid Biochem Mol Biol 2015; 152:8-15. [PMID: 25889901 DOI: 10.1016/j.jsbmb.2015.04.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 03/18/2015] [Accepted: 04/10/2015] [Indexed: 11/30/2022]
Abstract
Melatonin has been reported to suppress adrenocorticotropin (ACTH) secretion in the anterior pituitary and cortisol production in the adrenal by different mechanisms. However, the effect of melatonin on aldosterone production has remained unknown. In this study, we investigated the role of melatonin in the regulation of aldosterone production using human adrenocortical H295R cells by focusing on the activin system expressed in the adrenal. Melatonin receptor MT1 mRNA and protein were expressed in H295R cells and the expression levels of MT1 were increased by activin treatment. Activin increased ACTH-induced, but not angiotensin II (Ang II)-induced, aldosterone production. Melatonin alone did not affect basal synthesis of either aldosterone or cortisol. However, melatonin effectively enhanced aldosterone production induced by co-treatment with ACTH and activin, although melatonin had no effect on aldosterone production induced by Ang II in combination with activin. These changes in steroidogenesis became apparent when the steroid production was evaluated by the ratio of aldosterone/cortisol. Melatonin also enhanced dibutyryl-AMP-induced aldosterone/cortisol levels in the presence of activin, suggesting a functional link to the cAMP-PKA pathway for induction of aldosterone production by melatonin and activin. In accordance with the data for steroids, ACTH-induced, but not Ang II-induced, cAMP synthesis was also amplified by co-treatment with melatonin and activin. Furthermore, the ratio of ACTH-induced mRNA level of CYP11B2 compared with that of CYP17 was amplified in the condition of treatment with both melatonin and activin. In addition, melatonin increased expression of the activin type-I receptor ALK-4 but suppressed expression of inhibitory Smads6/7, leading to the enhancement of Smad2 phosphorylation. Collectively, the results showed that melatonin facilitated aldosterone production induced by ACTH and activin via the cAMP-PKA pathway. The results also suggested that mutual enhancement of melatonin and activin receptor signaling is involved in the induction of aldosterone output by adrenocortical cells.
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Affiliation(s)
- Takayuki Hara
- Department of Medicine and Clinical Science, 2-5-1 Shikata-cho, Kitaku, Okayama 700-8558, Japan
| | - Fumio Otsuka
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kitaku, Okayama 700-8558, Japan.
| | | | - Kenichi Inagaki
- Department of Medicine and Clinical Science, 2-5-1 Shikata-cho, Kitaku, Okayama 700-8558, Japan
| | - Takeshi Hosoya
- Department of Medicine and Clinical Science, 2-5-1 Shikata-cho, Kitaku, Okayama 700-8558, Japan
| | - Eri Nakamura
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kitaku, Okayama 700-8558, Japan
| | - Tomohiro Terasaka
- Department of Medicine and Clinical Science, 2-5-1 Shikata-cho, Kitaku, Okayama 700-8558, Japan
| | - Motoshi Komatsubara
- Department of Medicine and Clinical Science, 2-5-1 Shikata-cho, Kitaku, Okayama 700-8558, Japan
| | - Hirofumi Makino
- Okayama University Hospital, 2-5-1 Shikata-cho, Kitaku, Okayama 700-8558, Japan
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Ramanjaneya M, Tan BK, Rucinski M, Kawan M, Hu J, Kaur J, Patel VH, Malendowicz LK, Komarowska H, Lehnert H, Randeva HS. Nesfatin-1 inhibits proliferation and enhances apoptosis of human adrenocortical H295R cells. J Endocrinol 2015; 226:1-11. [PMID: 25869615 DOI: 10.1530/joe-14-0496] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/30/2015] [Indexed: 11/08/2022]
Abstract
NUCB2/nesfatin and its proteolytically cleaved product nesfatin-1 are recently discovered anorexigenic hypothalamic neuroproteins involved in energy homeostasis. It is expressed both centrally and in peripheral tissues, and appears to have potent metabolic actions. NUCB2/nesfatin neurons are activated in response to stress. Central nesfatin-1 administration elevates circulating ACTH and corticosterone levels. Bilateral adrenalectomy increased NUCB2/nesfatin mRNA levels in rat paraventricular nuclei. To date, studies have not assessed the effects of nesfatin-1 stimulation on human adrenocortical cells. Therefore, we investigated the expression and effects of nesfatin-1 in a human adrenocortical cell model (H295R). Our findings demonstrate that NUCB2 and nesfatin-1 are expressed in human adrenal gland and human adrenocortical cells (H295R). Stimulation with nesfatin-1 inhibits the growth of H295R cells and promotes apoptosis, potentially via the involvement of Bax, BCL-XL and BCL-2 genes as well as ERK1/2, p38 and JNK1/2 signalling cascades. This has implications for understanding the role of NUCB2/nesfatin in adrenal zonal development. NUCB2/nesfatin may also be a therapeutic target for adrenal cancer. However, further studies using in vivo models are needed to clarify these concepts.
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Affiliation(s)
- Manjunath Ramanjaneya
- Warwick Medical SchoolUniversity of Warwick, Coventry CV4 7AL, UKInterim Translational Research InstituteAcademic Health System, Hamad Medical Corporation, Doha, QatarDepartment of Obstetrics and GynaecologyBirmingham Heartlands Hospital, Heart of England NHS Foundation Trust, Birmingham, UKDepartment of Histology and EmbryologyPoznan University of Medical Sciences, Poznan, PolandDepartment of EndocrinologyMetabolism and Internal Medicine, University of Medical Sciences, 16 Karol Marcinkowski, Poznan, Poland1st Medical DepartmentUniversity of Lübeck Medical School, Lübeck, GermanyDepartment of DiabetesEndocrinology and Metabolism, University Hospital, Coventry CV2 2DX, UKAston Medical Research InstituteSchool of Life and Health Sciences, Aston University, Birmingham, UK Warwick Medical SchoolUniversity of Warwick, Coventry CV4 7AL, UKInterim Translational Research InstituteAcademic Health System, Hamad Medical Corporation, Doha, QatarDepartment of Obstetrics and GynaecologyBirmingham Heartlands Hospital, Heart of England NHS Foundation Trust, Birmingham, UKDepartment of Histology and EmbryologyPoznan University of Medical Sciences, Poznan, PolandDepartment of EndocrinologyMetabolism and Internal Medicine, University of Medical Sciences, 16 Karol Marcinkowski, Poznan, Poland1st Medical DepartmentUniversity of Lübeck Medical School, Lübeck, GermanyDepartment of DiabetesEndocrinology and Metabolism, University Hospital, Coventry CV2 2DX, UKAston Medical Research InstituteSchool of Life and Health Sciences, Aston University, Birmingham, UK
| | - Bee K Tan
- Warwick Medical SchoolUniversity of Warwick, Coventry CV4 7AL, UKInterim Translational Research InstituteAcademic Health System, Hamad Medical Corporation, Doha, QatarDepartment of Obstetrics and GynaecologyBirmingham Heartlands Hospital, Heart of England NHS Foundation Trust, Birmingham, UKDepartment of Histology and EmbryologyPoznan University of Medical Sciences, Poznan, PolandDepartment of EndocrinologyMetabolism and Internal Medicine, University of Medical Sciences, 16 Karol Marcinkowski, Poznan, Poland1st Medical DepartmentUniversity of Lübeck Medical School, Lübeck, GermanyDepartment of DiabetesEndocrinology and Metabolism, University Hospital, Coventry CV2 2DX, UKAston Medical Research InstituteSchool of Life and Health Sciences, Aston University, Birmingham, UK Warwick Medical SchoolUniversity of Warwick, Coventry CV4 7AL, UKInterim Translational Research InstituteAcademic Health System, Hamad Medical Corporation, Doha, QatarDepartment of Obstetrics and GynaecologyBirmingham Heartlands Hospital, Heart of England NHS Foundation Trust, Birmingham, UKDepartment of Histology and EmbryologyPoznan University of Medical Sciences, Poznan, PolandDepartment of EndocrinologyMetabolism and Internal Medicine, University of Medical Sciences, 16 Karol Marcinkowski, Poznan, Poland1st Medical DepartmentUniversity of Lübeck Medical School, Lübeck, GermanyDepartment of DiabetesEndocrinology and Metabolism, University Hospital, Coventry CV2 2DX, UKAston Medical Research InstituteSchool of Life and Health Sciences, Aston University, Birmingham, UK
| | - Marcin Rucinski
- Warwick Medical SchoolUniversity of Warwick, Coventry CV4 7AL, UKInterim Translational Research InstituteAcademic Health System, Hamad Medical Corporation, Doha, QatarDepartment of Obstetrics and GynaecologyBirmingham Heartlands Hospital, Heart of England NHS Foundation Trust, Birmingham, UKDepartment of Histology and EmbryologyPoznan University of Medical Sciences, Poznan, PolandDepartment of EndocrinologyMetabolism and Internal Medicine, University of Medical Sciences, 16 Karol Marcinkowski, Poznan, Poland1st Medical DepartmentUniversity of Lübeck Medical School, Lübeck, GermanyDepartment of DiabetesEndocrinology and Metabolism, University Hospital, Coventry CV2 2DX, UKAston Medical Research InstituteSchool of Life and Health Sciences, Aston University, Birmingham, UK
| | - Mohamed Kawan
- Warwick Medical SchoolUniversity of Warwick, Coventry CV4 7AL, UKInterim Translational Research InstituteAcademic Health System, Hamad Medical Corporation, Doha, QatarDepartment of Obstetrics and GynaecologyBirmingham Heartlands Hospital, Heart of England NHS Foundation Trust, Birmingham, UKDepartment of Histology and EmbryologyPoznan University of Medical Sciences, Poznan, PolandDepartment of EndocrinologyMetabolism and Internal Medicine, University of Medical Sciences, 16 Karol Marcinkowski, Poznan, Poland1st Medical DepartmentUniversity of Lübeck Medical School, Lübeck, GermanyDepartment of DiabetesEndocrinology and Metabolism, University Hospital, Coventry CV2 2DX, UKAston Medical Research InstituteSchool of Life and Health Sciences, Aston University, Birmingham, UK
| | - Jiamiao Hu
- Warwick Medical SchoolUniversity of Warwick, Coventry CV4 7AL, UKInterim Translational Research InstituteAcademic Health System, Hamad Medical Corporation, Doha, QatarDepartment of Obstetrics and GynaecologyBirmingham Heartlands Hospital, Heart of England NHS Foundation Trust, Birmingham, UKDepartment of Histology and EmbryologyPoznan University of Medical Sciences, Poznan, PolandDepartment of EndocrinologyMetabolism and Internal Medicine, University of Medical Sciences, 16 Karol Marcinkowski, Poznan, Poland1st Medical DepartmentUniversity of Lübeck Medical School, Lübeck, GermanyDepartment of DiabetesEndocrinology and Metabolism, University Hospital, Coventry CV2 2DX, UKAston Medical Research InstituteSchool of Life and Health Sciences, Aston University, Birmingham, UK
| | - Jaspreet Kaur
- Warwick Medical SchoolUniversity of Warwick, Coventry CV4 7AL, UKInterim Translational Research InstituteAcademic Health System, Hamad Medical Corporation, Doha, QatarDepartment of Obstetrics and GynaecologyBirmingham Heartlands Hospital, Heart of England NHS Foundation Trust, Birmingham, UKDepartment of Histology and EmbryologyPoznan University of Medical Sciences, Poznan, PolandDepartment of EndocrinologyMetabolism and Internal Medicine, University of Medical Sciences, 16 Karol Marcinkowski, Poznan, Poland1st Medical DepartmentUniversity of Lübeck Medical School, Lübeck, GermanyDepartment of DiabetesEndocrinology and Metabolism, University Hospital, Coventry CV2 2DX, UKAston Medical Research InstituteSchool of Life and Health Sciences, Aston University, Birmingham, UK
| | - Vanlata H Patel
- Warwick Medical SchoolUniversity of Warwick, Coventry CV4 7AL, UKInterim Translational Research InstituteAcademic Health System, Hamad Medical Corporation, Doha, QatarDepartment of Obstetrics and GynaecologyBirmingham Heartlands Hospital, Heart of England NHS Foundation Trust, Birmingham, UKDepartment of Histology and EmbryologyPoznan University of Medical Sciences, Poznan, PolandDepartment of EndocrinologyMetabolism and Internal Medicine, University of Medical Sciences, 16 Karol Marcinkowski, Poznan, Poland1st Medical DepartmentUniversity of Lübeck Medical School, Lübeck, GermanyDepartment of DiabetesEndocrinology and Metabolism, University Hospital, Coventry CV2 2DX, UKAston Medical Research InstituteSchool of Life and Health Sciences, Aston University, Birmingham, UK
| | - Ludwik K Malendowicz
- Warwick Medical SchoolUniversity of Warwick, Coventry CV4 7AL, UKInterim Translational Research InstituteAcademic Health System, Hamad Medical Corporation, Doha, QatarDepartment of Obstetrics and GynaecologyBirmingham Heartlands Hospital, Heart of England NHS Foundation Trust, Birmingham, UKDepartment of Histology and EmbryologyPoznan University of Medical Sciences, Poznan, PolandDepartment of EndocrinologyMetabolism and Internal Medicine, University of Medical Sciences, 16 Karol Marcinkowski, Poznan, Poland1st Medical DepartmentUniversity of Lübeck Medical School, Lübeck, GermanyDepartment of DiabetesEndocrinology and Metabolism, University Hospital, Coventry CV2 2DX, UKAston Medical Research InstituteSchool of Life and Health Sciences, Aston University, Birmingham, UK
| | - Hanna Komarowska
- Warwick Medical SchoolUniversity of Warwick, Coventry CV4 7AL, UKInterim Translational Research InstituteAcademic Health System, Hamad Medical Corporation, Doha, QatarDepartment of Obstetrics and GynaecologyBirmingham Heartlands Hospital, Heart of England NHS Foundation Trust, Birmingham, UKDepartment of Histology and EmbryologyPoznan University of Medical Sciences, Poznan, PolandDepartment of EndocrinologyMetabolism and Internal Medicine, University of Medical Sciences, 16 Karol Marcinkowski, Poznan, Poland1st Medical DepartmentUniversity of Lübeck Medical School, Lübeck, GermanyDepartment of DiabetesEndocrinology and Metabolism, University Hospital, Coventry CV2 2DX, UKAston Medical Research InstituteSchool of Life and Health Sciences, Aston University, Birmingham, UK
| | - Hendrik Lehnert
- Warwick Medical SchoolUniversity of Warwick, Coventry CV4 7AL, UKInterim Translational Research InstituteAcademic Health System, Hamad Medical Corporation, Doha, QatarDepartment of Obstetrics and GynaecologyBirmingham Heartlands Hospital, Heart of England NHS Foundation Trust, Birmingham, UKDepartment of Histology and EmbryologyPoznan University of Medical Sciences, Poznan, PolandDepartment of EndocrinologyMetabolism and Internal Medicine, University of Medical Sciences, 16 Karol Marcinkowski, Poznan, Poland1st Medical DepartmentUniversity of Lübeck Medical School, Lübeck, GermanyDepartment of DiabetesEndocrinology and Metabolism, University Hospital, Coventry CV2 2DX, UKAston Medical Research InstituteSchool of Life and Health Sciences, Aston University, Birmingham, UK Warwick Medical SchoolUniversity of Warwick, Coventry CV4 7AL, UKInterim Translational Research InstituteAcademic Health System, Hamad Medical Corporation, Doha, QatarDepartment of Obstetrics and GynaecologyBirmingham Heartlands Hospital, Heart of England NHS Foundation Trust, Birmingham, UKDepartment of Histology and EmbryologyPoznan University of Medical Sciences, Poznan, PolandDepartment of EndocrinologyMetabolism and Internal Medicine, University of Medical Sciences, 16 Karol Marcinkowski, Poznan, Poland1st Medical DepartmentUniversity of Lübeck Medical School, Lübeck, GermanyDepartment of DiabetesEndocrinology and Metabolism, University Hospital, Coventry CV2 2DX, UKAston Medical Research InstituteSchool of Life and Health Sciences, Aston University, Birmingham, UK
| | - Harpal S Randeva
- Warwick Medical SchoolUniversity of Warwick, Coventry CV4 7AL, UKInterim Translational Research InstituteAcademic Health System, Hamad Medical Corporation, Doha, QatarDepartment of Obstetrics and GynaecologyBirmingham Heartlands Hospital, Heart of England NHS Foundation Trust, Birmingham, UKDepartment of Histology and EmbryologyPoznan University of Medical Sciences, Poznan, PolandDepartment of EndocrinologyMetabolism and Internal Medicine, University of Medical Sciences, 16 Karol Marcinkowski, Poznan, Poland1st Medical DepartmentUniversity of Lübeck Medical School, Lübeck, GermanyDepartment of DiabetesEndocrinology and Metabolism, University Hospital, Coventry CV2 2DX, UKAston Medical Research InstituteSchool of Life and Health Sciences, Aston University, Birmingham, UK Warwick Medical SchoolUniversity of Warwick, Coventry CV4 7AL, UKInterim Translational Research InstituteAcademic Health System, Hamad Medical Corporation, Doha, QatarDepartment of Obstetrics and GynaecologyBirmingham Heartlands Hospital, Heart of England NHS Foundation Trust, Birmingham, UKDepartment of Histology and EmbryologyPoznan University of Medical Sciences, Poznan, PolandDepartment of EndocrinologyMetabolism and Internal Medicine, University of Medical Sciences, 16 Karol Marcinkowski, Poznan, Poland1st Medical DepartmentUniversity of Lübeck Medical School, Lübeck, GermanyDepartment of DiabetesEndocrinology and Metabolism, University Hospital, Coventry CV2 2DX, UKAston Medical Research InstituteSchool of Life and Health Sciences, Aston University, Birmingham, UK Warwick Medical SchoolUniversity of Warwick, Coventry CV4 7AL, UKInterim Translational Research InstituteAcademic Health System, Hamad Medical Corporation, Doha, QatarDepartment of Obstetrics and GynaecologyBirmingham Heartlands Hospital, Heart of England NHS Foundation Trust, Birmingham, UKDepartment of Histology and EmbryologyPoznan University of Medical Sciences, Poznan, PolandDepartment of EndocrinologyMetabolism and Internal
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Zhang B, Xu ZW, Wang KH, Lu TC, Du Y. Complex Regulatory Network of MicroRNAs, Transcription Factors, Gene Alterations in Adrenocortical Cancer. Asian Pac J Cancer Prev 2013; 14:2265-8. [DOI: 10.7314/apjcp.2013.14.4.2265] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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The insulin and igf-I pathway in endocrine glands carcinogenesis. JOURNAL OF ONCOLOGY 2012; 2012:635614. [PMID: 22927847 PMCID: PMC3423951 DOI: 10.1155/2012/635614] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2012] [Accepted: 06/20/2012] [Indexed: 12/26/2022]
Abstract
Endocrine cancers are a heterogeneous group of diseases that may arise from endocrine cells in any gland of the endocrine system. These malignancies may show an aggressive behavior and resistance to the common anticancer therapies. The etiopathogenesis of these tumors remains mostly unknown. The normal embryological development and differentiation of several endocrine glands are regulated by specific pituitary tropins, which, in adult life, control the function and trophism of the endocrine gland. Pituitary tropins act in concert with peptide growth factors, including the insulin-like growth factors (IGFs), which are considered key regulators of cell growth, proliferation, and apoptosis. While pituitary TSH is regarded as tumor-promoting factor for metastatic thyroid cancer, the role of other pituitary hormones in endocrine cancers is uncertain. However, multiple molecular abnormalities of the IGF system frequently occur in endocrine cancers and may have a role in tumorigenesis as well as in tumor progression and resistance to therapies. Herein, we will review studies indicating a role of IGF system dysregulation in endocrine cancers and will discuss the possible implications of these findings for tumor prevention and treatment, with a major focus on cancers from the thyroid, adrenal, and ovary, which are the most extensively studied.
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Heaton JH, Wood MA, Kim AC, Lima LO, Barlaskar FM, Almeida MQ, Fragoso MCBV, Kuick R, Lerario AM, Simon DP, Soares IC, Starnes E, Thomas DG, Latronico AC, Giordano TJ, Hammer GD. Progression to adrenocortical tumorigenesis in mice and humans through insulin-like growth factor 2 and β-catenin. THE AMERICAN JOURNAL OF PATHOLOGY 2012; 181:1017-33. [PMID: 22800756 DOI: 10.1016/j.ajpath.2012.05.026] [Citation(s) in RCA: 128] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 01/19/2012] [Revised: 04/27/2012] [Accepted: 05/08/2012] [Indexed: 11/28/2022]
Abstract
Dysregulation of the WNT and insulin-like growth factor 2 (IGF2) signaling pathways has been implicated in sporadic and syndromic forms of adrenocortical carcinoma (ACC). Abnormal β-catenin staining and CTNNB1 mutations are reported to be common in both adrenocortical adenoma and ACC, whereas elevated IGF2 expression is associated primarily with ACC. To better understand the contribution of these pathways in the tumorigenesis of ACC, we examined clinicopathological and molecular data and used mouse models. Evaluation of adrenal tumors from 118 adult patients demonstrated an increase in CTNNB1 mutations and abnormal β-catenin accumulation in both adrenocortical adenoma and ACC. In ACC, these features were adversely associated with survival. Mice with stabilized β-catenin exhibited a temporal progression of increased adrenocortical hyperplasia, with subsequent microscopic and macroscopic adenoma formation. Elevated Igf2 expression alone did not cause hyperplasia. With the combination of stabilized β-catenin and elevated Igf2 expression, adrenal glands were larger, displayed earlier onset of hyperplasia, and developed more frequent macroscopic adenomas (as well as one carcinoma). Our results are consistent with a model in which dysregulation of one pathway may result in adrenal hyperplasia, but accumulation of a second or multiple alterations is necessary for tumorigenesis.
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Affiliation(s)
- Joanne H Heaton
- Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, University of Michigan, Ann Arbor, USA
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Mariniello B, Finco I, Sartorato P, Patalano A, Iacobone M, Guzzardo V, Fassina A, Mantero F. Somatostatin receptor expression in adrenocortical tumors and effect of a new somatostatin analog SOM230 on hormone secretion in vitro and in ex vivo adrenal cells. J Endocrinol Invest 2011; 34:e131-8. [PMID: 21042045 DOI: 10.1007/bf03346721] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Somatostatin is a widely distributed polypeptide that modulates endocrine and exocrine secretion, cell proliferation, and apoptosis by 5 somatostatin receptors (SSTR1-5). The inhibitory effects of somatostatin on tumor growth may be the result of its suppressing the synthesis and/or secretion of growth factors and growth-promoting hormones. AIM Very little information is available on the effect of somatostatin analogs on adrenal tumors, so we examined SSTR expression in adrenocortical tumors and studied the effect of a somatostatin analog (SOM230) on hormone secretion and cell viability in adrenal cells. MATERIAL/SUBJECTS AND METHODS SSTR expression was analyzed by real-time PCR in 13 adrenocortical carcinomas (ACC), 24 aldosterone-producing adenomas (APA), 11 cortisol-producing adenomas (CPA), and 7 normal adrenals (NA), and verified by immunohistochemistry (IHC) in 14 samples. The effect of SOM230 on cortisol or aldosterone secretion in H295R and primary cell cultures was determined by radioimmunoassay, and its effect on viability in H295R and SW13 using the MTT test. RESULTS SSTR1 and SSTR2 mRNA was expressed in 100% of adrenal tumors. Compared to NA, ACC revealed an increase in almost all SSTR, while only some APA over-expressed SSTR3 and SSTR1. CPA expressed SSTR similar to NA. IHC confirmed the mRNA expression data. At nanomolar concentrations, SOM230 inhibited hormone secretion in primary adrenal cultures and H295R cells, but had no evident effect on cell viability. CONCLUSIONS The evidence of SSTR over-expression (particularly in ACC) and of hormone secretion being inhibited by SOM230 suggests a potential therapeutic role for this broad-spectrum somatostatin analog in adrenal tumors.
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Affiliation(s)
- B Mariniello
- Endocrinology Division, University of Padua, Via Ospedale 105, 35128 Padua, Italy.
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11
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Epidermal growth factor receptor in adrenocortical tumors: analysis of gene sequence, protein expression and correlation with clinical outcome. Mod Pathol 2010; 23:1596-604. [PMID: 20693985 DOI: 10.1038/modpathol.2010.153] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Adrenocortical carcinoma is a rare but highly malignant neoplasm with still limited treatment options. Epidermal growth factor receptor (EGFR) has been shown to be overexpressed in many solid tumors, but its expression in adrenocortical carcinoma has been studied only in a limited number of cases. Therefore, we analyzed the expression of EGFR in 169 adrenocortical carcinoma samples and compared it with 31 adrenocortical adenomas. Additionally, in 30 cases of adrenocortical carcinoma, exons 18-21 of the EGFR gene were cloned and sequenced. EGFR expression was found in 128 of 169 adrenocortical carcinoma samples (76%), and in 60 of these samples (=36%) strong membrane staining was detected. However, there was no significant correlation with clinical outcome. In addition, all 30 sequenced cases revealed unmutated EGFR genes. In contrast, only 1 out of 31 adrenocortical adenomas weakly expressed the EGFR (3%). In summary, EGFR was overexpressed in more than three-quarters of adrenocortical carcinoma cases of this series. However, no mutations of the EGFR gene were found and EGFR expression was not of prognostic relevance. As EGFR is hardly expressed in adrenocortical adenomas, our results suggest that its expression in adrenocortical tumors indicates a malignant phenotype, which may be used in the differential diagnosis between adrenocortical adenomas and carcinomas.
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12
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13
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Weismann D, Briese J, Niemann J, Grüneberger M, Adam P, Hahner S, Johanssen S, Liu W, Ezzat S, Saeger W, Bamberger AM, Fassnacht M, Schulte HM, Asa SL, Allolio B, Bamberger CM. Osteopontin stimulates invasion of NCI-h295 cells but is not associated with survival in adrenocortical carcinoma. J Pathol 2009; 218:232-40. [PMID: 19326399 DOI: 10.1002/path.2528] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Gene array studies indicated that osteopontin (OPN) mRNA is highly expressed in adrenocortical carcinomas (ACCs). OPN enhances invasiveness, proliferation, and metastasis formation, and is associated with poor survival in some malignant diseases. Integrin alphavbeta3 has been shown to mediate OPN effects on invasion. In this study, we demonstrated OPN and integrin alphavbeta3 expression in normal adrenal glands and benign adenomas, with staining seen exclusively in adrenocortical cells as well as even stronger staining in ACC. Western blot analysis confirmed overexpression of OPN in ACC (p < 0.01). With Matrigel invasion assays, we have shown that OPN greatly stimulates the invasiveness of NCI-h295 cells (>six-fold increase, p < 0.001). Transfection with integrin alphavbeta3 further increased invasiveness after OPN stimulation (p < 0.001). This increase was reversed by the addition of an anti-integrin beta3 antibody, indicating a functional relationship of OPN and integrin alphavbeta3 in ACC. With tissue arrays, we confirmed high OPN expression in 147 ACC samples. However, no association with survival was seen in Kaplan-Meier analysis including 111 patients with primary tumours graded for OPN staining and follow-up data available. In conclusion, our in vitro data indicate that OPN and integrin alphavbeta3 may act as a functional complex facilitating the invasiveness of adrenocortical tumours. This relationship remains of relevance to our understanding of carcinogenesis, but further studies are needed to address the physiological and pathological function of OPN in adrenal tissue.
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Affiliation(s)
- Dirk Weismann
- University Hospital of Würzburg, Department of Internal Medicine I, Endocrine and Diabetes Unit, Würzburg, Germany.
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14
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Bielinska M, Parviainen H, Kiiveri S, Heikinheimo M, Wilson DB. Review paper: origin and molecular pathology of adrenocortical neoplasms. Vet Pathol 2009; 46:194-210. [PMID: 19261630 DOI: 10.1354/vp.46-2-194] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Neoplastic adrenocortical lesions are common in humans and several species of domestic animals. Although there are unanswered questions about the origin and evolution of adrenocortical neoplasms, analysis of human tumor specimens and animal models indicates that adrenocortical tumorigenesis involves both genetic and epigenetic alterations. Chromosomal changes accumulate during tumor progression, and aberrant telomere function is one of the key mechanisms underlying chromosome instability during this process. Epigenetic changes serve to expand the size of the uncommitted adrenal progenitor population, modulate their phenotypic plasticity (i.e., responsiveness to extracellular signals), and increase the likelihood of subsequent genetic alterations. Analyses of heritable and spontaneous types of human adrenocortical tumors documented alterations in either cell surface receptors or their downstream effectors that impact neoplastic transformation. Many of the mutations associated with benign human adrenocortical tumors result in dysregulated cyclic adenosine monophosphate signaling, whereas key factors and/or signaling pathways associated with adrenocortical carcinomas include dysregulated expression of the IGF2 gene cluster, activation of the Wnt/beta-catenin pathway, and inactivation of the p53 tumor suppressor. A better understanding of the factors and signaling pathways involved in adrenal tumorigenesis is necessary to develop targeted pharmacologic and genetic therapies.
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Affiliation(s)
- M Bielinska
- Box 8208, Washington University School of Medicine, 660 S. Euclid Ave, St. Louis, MO 63110, USA.
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15
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Soon PSH, McDonald KL, Robinson BG, Sidhu SB. Molecular markers and the pathogenesis of adrenocortical cancer. Oncologist 2008; 13:548-61. [PMID: 18515740 DOI: 10.1634/theoncologist.2007-0243] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Adrenal tumors are common, with an estimated incidence of 7.3% in autopsy cases, while adrenocortical carcinomas (ACCs) are rare, with an estimated prevalence of 4-12 per million population. Because the prognoses for adrenocortical adenomas (ACAs) and ACCs are vastly different, it is important to be able to accurately differentiate the two tumor types. Advancement in the understanding of the pathophysiology of ACCs is essential for the development of more sensitive means of diagnosis and treatment, resulting in better clinical outcome. Adrenocortical tumors (ACTs) occur as a component of several hereditary tumor syndromes, which include the Li-Fraumeni syndrome, Beckwith-Wiedemann syndrome, multiple endocrine neoplasia 1, Carney complex, and congenital adrenal hyperplasia. The genes involved in these syndromes have also been shown to play a role in the pathogenesis of sporadic ACTs. The adrenocorticotropic hormone-cAMP-protein kinase A and Wnt pathways are also implicated in adrenocortical tumorigenesis. The aim of this review is to summarize the current knowledge on the molecular mechanisms involved in adrenocortical tumorigenesis, including results of comparative genomic hybridization, loss of heterozygosity, and microarray gene-expression profiling studies.
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Affiliation(s)
- Patsy S H Soon
- Cancer Genetics, Kolling Institute of Medical Research, University of Sydney, Sydney, Australia
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16
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Affiliation(s)
- Ferdous M Barlaskar
- Cellular & Molecular Biology Graduate Program, University of Michigan, BSRB 1502, Ann Arbor, MI 48109-2200, USA
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17
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van Koetsveld PM, Vitale G, de Herder WW, Feelders RA, van der Wansem K, Waaijers M, van Eijck CHJ, Speel EJM, Croze E, van der Lely AJ, Lamberts SWJ, Hofland LJ. Potent inhibitory effects of type I interferons on human adrenocortical carcinoma cell growth. J Clin Endocrinol Metab 2006; 91:4537-43. [PMID: 16912135 DOI: 10.1210/jc.2006-0620] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
CONTEXT Adrenocortical carcinoma (ACC) is a rare tumor with a poor prognosis. Despite efforts to develop new therapeutic regimens for metastatic ACC, surgery remains the mainstay of treatment. Interferons are known to exert tumor-suppressive effects in several types of human cancer. DESIGN We evaluated the tumor-suppressive effects of type I interferons (IFN)-alpha2b and IFNbeta on the H295 and SW13 human ACC cell lines. RESULTS As determined by quantitative RT-PCR analysis and immunocytochemistry, H295 and SW13 cells expressed the active type I IFN receptor (IFNAR) mRNA and protein (IFNAR-1 and IFNAR-2c subunits). Both IFNalpha2b and IFNbeta1a significantly inhibited ACC cell growth in a dose-dependent manner, but the effect of IFNbeta1a (IC50 5 IU/ml, maximal inhibition 96% in H295; IC50 18 IU/ml, maximal inhibition 85% in SW13) was significantly more potent, compared with that of IFNalpha2b (IC50 57 IU/ml, maximal inhibition 35% in H295; IC50 221 IU/ml, maximal inhibition 60% in SW13). Whereas in H295 cells both IFNs induced apoptosis and accumulation of the cells in S phase, the antitumor mechanism in SW13 cells involved cell cycle arrest only. Inhibitors of caspase-3, caspase-8, and caspase-9 counteracted the apoptosis-inducing effect by IFNbeta1a in H295 cells. In H295 cells, IFNbeta1a, but not IFNalpha2b, also strongly suppressed the IGF-II mRNA expression, an important growth factor and hallmark in ACC. CONCLUSIONS IFNbeta1a is much more potent than IFNalpha2b to suppress ACC cell proliferation in vitro by induction of apoptosis and cell cycle arrest. Further studies are required to evaluate the potency of IFNbeta1a to inhibit tumor growth in vivo.
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Affiliation(s)
- Peter M van Koetsveld
- Department of Internal Medicine, Erasmus Medical Center, 3015 GE Rotterdam, The Netherlands
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18
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Abstract
CONTEXT Adrenocortical carcinoma (ACC) is a rare and heterogeneous malignancy with incompletely understood pathogenesis and poor prognosis. Patients present with hormone excess (e.g. virilization, Cushing's syndrome) or a local mass effect (median tumor size at diagnosis > 10 cm). This paper reviews current diagnostic and therapeutic strategies in ACC. EVIDENCE ACQUISITION Original articles and reviews were identified using a PubMed search strategy (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi) covering the time period up until November 2005. The following search terms were used in varying combinations: adrenal, adrenocortical, cancer, carcinoma, tumor, diagnosis, imaging, treatment, radiotherapy, mitotane, cytotoxic, surgery. EVIDENCE SYNTHESIS Tumors typically appear inhomogeneous in both computerized tomography and magnetic resonance imaging with necroses and irregular borders and differ from benign adenomas by their low fat content. Hormonal analysis reveals evidence of steroid hormone secretion by the tumor in the majority of cases, even in seemingly hormonally inactive lesions. Histopathology is crucial for the diagnosis of malignancy and may also provide important prognostic information. In stages I-III open surgery by an expert surgeon aiming at an R0 resection is the treatment of choice. Local recurrence is frequent, particularly after violation of the tumor capsule. Surgery also plays a role in local tumor recurrence and metastatic disease. In patients not amenable to surgery, mitotane (alone or in combination with cytotoxic drugs) remains the treatment of choice. Monitoring of drug levels (therapeutic range 14-20 mg/liter) is mandatory for optimum results. In advanced disease, the most promising therapeutic options (etoposide, doxorubicin, cisplatin plus mitotane, and streptozotocin plus mitotane) are currently being compared in an international phase III trial (www.firm-act.org). Adjuvant treatment options after complete tumor removal (e.g. mitotane, radiotherapy) are urgently needed because postoperative disease-free survival at 5 yr is only around 30%, but options have still not been convincingly established. National registries, international cooperations, and trials provide important new structures for patients but also for researchers aiming at systematic and continuous progress in ACC. However, future advances in the management of ACC will mainly depend on a better understanding of the molecular pathogenesis facilitating the use of modern cancer treatments (e.g. tyrosine kinase inhibitors).
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Affiliation(s)
- Bruno Allolio
- Endocrinology and Diabetes Unit, Department of Medicine I, University Hospital Wuerzburg, Josef-Schneider-Str. 2, 97080 Wuerzburg, Germany.
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19
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Rodriguez-Galindo C, Figueiredo BC, Zambetti GP, Ribeiro RC. Biology, clinical characteristics, and management of adrenocortical tumors in children. Pediatr Blood Cancer 2005; 45:265-73. [PMID: 15747338 DOI: 10.1002/pbc.20318] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Childhood adrenocortical tumors (ACT) are very aggressive endocrine neoplasms whose incidence is quite low. Little is known about their pathogenesis, clinical presentation, and optimal treatment. In recent years, however, new information has been derived from the International Pediatric Adrenocortical Tumor Registry (IPACTR), and new clues to its pathogenesis have emerged. To provide an overview of the available data that may apply to pediatric ACT, we reviewed the epidemiology, pathogenesis, and treatment of ACT in adults and in children. Germline TP53 mutation is almost always the predisposing factor in childhood ACT. A unique germline mutation (TP53-R337H) has been described in Southern Brazil, where the incidence of ACT is 10-15 times the general incidence. Childhood ACT typically present during the first 5 years of life and has female predominance. Hormone hyperproduction is almost universal, and most patients present with virilization. Two-thirds of patients have resectable tumors. Surgery is the definitive treatment for ACT, and a curative complete resection should always be attempted. Cisplatin-based chemotherapy with mitotane is indicated for unresectable or metastatic disease, although its impact on overall outcome is slight. In childhood ACT, age, tumor size, and tumor resectability are the most important prognostic indicators. Outcome is stage-dependent; patients with small, resectable tumors have survival rates in excess of 80%, whereas the outcome for patients with unresectable disease is dismal. Patients with large, resectable tumors have an intermediate outcome. Childhood ACT are rare, but their unique epidemiology appear to implicate novel oncogenic pathways that are unique to the pediatric population. Multi-institutional and prospective studies are necessary to further our understanding of the pathogenesis and to improve outcomes.
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Affiliation(s)
- Carlos Rodriguez-Galindo
- Department of Hematology-Oncology, St. Jude Children's Research Hospital, 332 N. Lauderdale, Memphis, TN 38105-2794, USA.
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20
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Abstract
Hereditary origin of a tumor helps toward early discovery of its mutated gene; for example, it supports the compilation of a DNA panel from index cases to identify that gene by finding mutations in it. The gene for a hereditary tumor may contribute also to common tumors. For some syndromes, such as hereditary paraganglioma, several genes can cause a similar syndrome. For other syndromes, such as multiple endocrine neoplasia 2, one gene supports variants of a syndrome. Onset usually begins earlier and in more locations with hereditary than sporadic tumors. Mono- or oligoclonal ("clonal") tumor usually implies a postnatal delay, albeit less delay than for sporadic tumor, to onset and potential for cancer. Hormone excess from a polyclonal tissue shows onset at birth and no benefit from subtotal ablation of the secreting organ. Genes can cause neoplasms through stepwise loss of function, gain of function, or combinations of these. Polyclonal hormonal excess reflects abnormal gene dosage or effect, such as activation or haploinsufficiency. Polyclonal hyperplasia can cause the main endpoint of clinical expression in some syndromes or can be a precursor to clonal progression in others. Gene discovery is usually the first step toward clarifying the molecule and pathway mutated in a syndrome. Most mutated pathways in hormone excess states are only partly understood. The bases for tissue specificity of hormone excess syndromes are usually uncertain. In a few syndromes, tissue selectivity arises from mutation in the open reading frame of a regulatory gene (CASR, TSHR) with selective expression driven by its promoter. Polyclonal excess of a hormone is usually from a defect in the sensor system for an extracellular ligand (e.g., calcium, glucose, TSH). The final connections of any of these polyclonal or clonal pathways to hormone secretion have not been identified. In many cases, monoclonal proliferation causes hormone excess, probably as a secondary consequence of accumulation of cells with coincidental hormone-secretory ability.
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Affiliation(s)
- Stephen J Marx
- Metabolic Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases/NIH, Building 10, Room 9C-101, 10 Center Drive, MSC 1802, Bethesda, MD 20892-1802, USA.
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21
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Leu SF, Chien CH, Tseng CY, Kuo YM, Huang BM. The in Vivo Effect of Cordyceps sinensis Mycelium on Plasma Corticosterone Level in Male Mouse. Biol Pharm Bull 2005; 28:1722-5. [PMID: 16141547 DOI: 10.1248/bpb.28.1722] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Cordyceps sinensis (CS), an Ascomycetes fungus parasitic to Lepidoptera larvae, has been traditionally used as nutritious food for the enhancement in immuno-modulation in Chinese society for a long time. Previous report has demonstrated the CS water extract stimulates in vitro corticosterone production in rat primary adrenal cells. In the present studies, we determined the in vivo effects of CS and its fractions on plasma corticosterone production in mouse. Different concentrations of CS and CS fractions dissolved in water (0.02 and 0.2 mg/g body weight) were fed to immature and mature mice from 1, 3 or 7 d. The plasma levels of corticosterone were determined by radioimmunoassay (RIA), and the weight of adrenal gland and body weight were also evaluated. Results illustrated that plasma corticosterone levels were significantly induced by F2 at 0.02 mg/g body weight with 7 d feeding in immature mice, and by CS at 0.02 mg/g body weight with 3 d feeding and F3 at 0.02 mg/g body weight for 7 d feeding in mature mice, respectively (p < 0.05). There were no differences of adrenal gland weight except there was significant stimulation by CS at 0.2 mg/g body weight with 3 d feeding in mature mice (p < 0.05) and there were significant inhibitions by both dosages of F3 for 3 d feeding in immature mice and F2 for 7 d feeding in mature mice (p < 0.05), respectively. Concerning body weight, the stimulatory effects were observed with CS feeding at 0.2 mg/g body weight for 7 d and F3 feeding at 0.02 mg/g body weight for 3 and 7 d in mature mice. Whereas, the inhibitory effect were observed in F2 feeding at 0.2 mg/g body weight for 7 d in immature mice and at both dosages for 7 d in mature mice, respectively. Taken together, these studies illustrate that CS and its fractions stimulated mouse in vivo corticosterone production. However, CS and its fractions didn't have constant stimulatory or inhibitory effects on the weights of body and adrenal glands.
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Affiliation(s)
- Sew-Fen Leu
- National Laboratory Animal Breeding and Research Center, National Science Council, Taipei, Taiwan, Republic of China
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22
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Mongiat-Artus P, Miquel C, Meria P, Hernigou A, Duclos JM. [Adrenocortical secretory tumors]. ACTA ACUST UNITED AC 2004; 38:148-72. [PMID: 15485155 DOI: 10.1016/j.anuro.2004.05.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Adrenocortical tumors are rare and mostly non-secreting; their discovery is incidental. When secreting, they produce steroid excess and result in a clinical presentation such as the Cushing syndrome, primary aldosteronism, virilization or feminization syndrome. Such tumors are mostly sporadic but can belong to hereditary syndromes predisposing to tumors. The diagnosis of secreting adrenocortical tumors is based upon clinical presentation and biological data associated with specific biological assessments. Adrenal imaging has been considerably improved with the development of CT scan, which can be completed by MRI if necessary. Most of adrenocortical tumors are adenoma, nevertheless some of them can be malignant and the prognosis of such carcinomas is poor. Management of secreting adrenocortical tumors requires surgery in most of the cases and laparoscopic access is now widely used and provides good results in the treatment of benign tumors.
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Affiliation(s)
- P Mongiat-Artus
- Service d'urologie, hôpital Saint-Louis, Université Paris VII, 1, avenue Claude-Vellefaux, 75010 Paris, France.
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Mignogna MD, Fedele S, Lo Russo L, Lo Muzio L, Bucci E. Immune activation and chronic inflammation as the cause of malignancy in oral lichen planus: is there any evidence ? Oral Oncol 2004; 40:120-30. [PMID: 14693234 DOI: 10.1016/j.oraloncology.2003.08.001] [Citation(s) in RCA: 159] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The association of chronic inflammation with a variety of epithelial malignancies has been recognised for centuries. Well established examples include, among many others, oesophageal adenocarcinoma associated with chronic oesophagitis and bowel cancer associated with chronic inflammatory bowel diseases. By now no data, other than clinical observation, have been available in understanding the pathogenesis of these inflammation-related tumours. However, recent molecular studies on the relationship between solid malignancies and the surrounding stroma have given new insights. There is now enough evidence to accept that the chronic inflammatory process per se is able to provide a cytokine-based microenvironment which is able to influence cell survival, growth, proliferation, differentiation and movement, hence contributing to cancer initiation, progression, invasion and metastasis. Here it is discussed whether also oral lichen planus (OLP), being a chronic inflammatory autoimmune disease which has been clinically associated with development of oral squamous cell carcinoma, might be categorised among these disorders. With this aim, we critically reviewed and detailed the presence, in OLP subepithelial infiltrate, of inflammatory cells and cytokine networks that might act to promote squamous tumorigenesis.
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Affiliation(s)
- Michele D Mignogna
- Section of Oral Medicine, Department of Odontostomatological and Maxillofacial Sciences, University Federico II, Naples, Italy.
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Abstract
Adrenocortical carcinoma (ACC) is a rare neoplasm with poor prognosis. Patients present with signs of steroid hormone excess (e.g. Cushing's syndrome, virilization) or an abdominal mass. Tumour size at presentation (mean diameter at diagnosis > 10 cm) is the most important indicator of malignancy. In addition, computed tomography (CT) typically demonstrates an inhomogeneous adrenal lesion with irregular margins and variable enhancement of solid components after intravenous contrast media. Magnetic resonance imaging (MRI) is equally effective as CT and is particularly helpful to visualize invasion into large vessels. Complete tumour removal (R0 resection) offers by far the best chance for long-term survival and therefore surgery is the treatment of choice in stage I-III ACC. Despite tumour resection for cure most patients will eventually develop local recurrence or distant metastases. Thus adjuvant treatment options need to be evaluated in high-risk patients (e.g. radiation therapy of the tumour bed and/or chemotherapy). In tumour recurrence re-operation should always be considered. In metastatic disease (stage IV ACC) not amenable to surgery mitotane (o,p'DDD) remains the first-line therapy. Drug monitoring is needed for effective treatment aiming at concentrations between 14 and 20 mg/l. Patients not responding to mitotane may benefit from cytotoxic chemotherapy (23% partial remissions, 4% complete remissions). Only large prospective multicentre trials comparing different treatment options will allow to make systematic progress in the management of ACC.
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Affiliation(s)
- Bruno Allolio
- Endocrinology and Diabetes Unit, Department of Medicine, University of Wurzburg, Germany.
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25
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Suzuki J, Otsuka F, Inagaki K, Takeda M, Ogura T, Makino H. Novel action of activin and bone morphogenetic protein in regulating aldosterone production by human adrenocortical cells. Endocrinology 2004; 145:639-49. [PMID: 14592955 DOI: 10.1210/en.2003-0968] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
We have uncovered a functional bone morphogenetic protein (BMP) and activin system complete with ligands (BMP-6 and activin betaA/betaB), receptors (activin receptor-like kinase receptors 2, 3, and 4; activin type-II receptor; and BMP type-II receptor), and the binding protein follistatin in the human adrenocortical cell line H295R. Administration of activin and BMP-6 to cultures of H295R cells caused concentration-responsive increases in aldosterone production. The mRNA levels of steroidogenic acute regulatory protein or P450 steroid side-chain cleavage enzyme, the rate-limiting steps of adrenocortical steroidogenesis, were enhanced by activin and BMP-6. Activin and BMP-6 also activated the transcription of steroidogenic acute regulatory protein as well as the late-step steriodogenic enzyme CYP11B2. Activin enhanced ACTH-, forskolin-, or dibutyryl-cAMP- but not angiotensin II (Ang II)-induced aldosterone production, whereas BMP-6 specifically augmented Ang II-induced aldosterone production. Activin and ACTH but not BMP-6 increased cAMP production. Follistatin, which inhibits activin actions by binding, suppressed basal and ACTH-induced aldosterone secretion but failed to affect the Ang II-induced aldosterone level. Furthermore, MAPK signaling appeared to be involved in aldosterone production induced by Ang II and BMP-6 because an inhibitor of MAPK activation, U0126, reduced the level of aldosterone synthesis stimulated by Ang II and BMP-6 but not activin. In addition, Ang II reduced the expression levels of BMP-6 but increased that of activin betaB, whereas ACTH had no effect on these levels. Collectively, the present data suggest that activin acts to regulate adrenal aldosterone synthesis predominantly by modulating the ACTH-cAMP-protein kinase A signaling cascade, whereas BMP-6 works primarily by modulating the Ang II-MAPK cascade in human adrenal cortex in an autocrine/paracrine fashion.
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Affiliation(s)
- Jiro Suzuki
- Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine and Dentistry, 2-5-1 Shikata-cho, Okayama City 700-8558, Japan
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27
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Bielinska M, Parviainen H, Porter-Tinge SB, Kiiveri S, Genova E, Rahman N, Huhtaniemi IT, Muglia LJ, Heikinheimo M, Wilson DB. Mouse strain susceptibility to gonadectomy-induced adrenocortical tumor formation correlates with the expression of GATA-4 and luteinizing hormone receptor. Endocrinology 2003; 144:4123-33. [PMID: 12933687 DOI: 10.1210/en.2003-0126] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Certain inbred strains of mice, including DBA/2J, develop adrenocortical tumors in response to gonadectomy. Spindle-shaped cells with limited steroidogenic capacity, termed A cells, appear in the subcapsular region of the adrenal gland, followed by sex steroid-producing cells known as B cells. These changes result from unopposed gonadotropin production by the pituitary, but the adrenocortical factors involved in tumorigenesis have not been characterized. GATA-4, a transcription factor normally expressed in fetal, but not adult, adrenocortical cells, was found in neoplastic cells that proliferate in the adrenal cortex of gonadectomized DBA/2J mice. GATA-4 mRNA was detected in the adrenal glands of female mice 0.5 months after ovariectomy and reached a maximum by 4 months. Castrated male mice developed adrenocortical tumors more slowly than gonadectomized females, and the onset of GATA-4 expression in the adrenal was delayed. In situ hybridization and immunohistochemistry revealed GATA-4 mRNA and protein in A and B cells, but not in normal adrenocortical cells. mRNA encoding another factor associated with adrenocortical tumorigenesis, LH receptor (LHR), was detected in A and B cells. In addition, transcripts for P450 17 alpha-hydroxylase/C17-C20 lyase, an enzyme essential for the production of sex steroids, and inhibin-alpha were found in B cells. Unilateral ovarian regeneration, a phenomenon known to occur in gonadectomized mice, was observed in a subset of DBA/2J mice undergoing complete ovariectomy. In these animals, adrenocortical tumor progression was arrested; A cells and GATA-4 expression were evident, but there was no expression of LHR or P450 17 alpha-hydroxylase/C17-C20 lyase. Strain susceptibility to adrenocortical tumorigenesis (DBA/2J >> FVB/N) correlated with the expression of GATA-4 and LHR, implicating these factors in the process of adrenocortical neoplasia in response to continuous gonadotropin stimulation.
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Affiliation(s)
- Malgorzata Bielinska
- Department of Pediatrics, Washington University School of Medicine, St. Louis Children's Hospital, St. Louis, Missouri 63110, USA
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