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Chu Z, Zhu L, Zhou Y, Yang F, Hu Z, Luo Y, Li W, Luo F. Targeting Nrf2 by bioactive peptides alleviate inflammation: expanding the role of gut microbiota and metabolites. Crit Rev Food Sci Nutr 2024:1-20. [PMID: 38881345 DOI: 10.1080/10408398.2024.2367570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
Inflammation is a complex process that usually refers to the general response of the body to the harmful stimuli of various pathogens, tissue damage, or exogenous pollutants. Nuclear factor erythroid 2-related factor 2 (Nrf2) is a transcription factor that regulates cellular defense against oxidative damage and toxicity by expressing genes related to oxidative stress response and drug detoxification. In addition to its antioxidant properties, Nrf2 is involved in many other important physiological processes, including inflammation and metabolism. Nrf2 can bind the promoters of antioxidant genes and upregulates their expressions, which alleviate oxidation-induced inflammation. Nrf2 has been shown to upregulate heme oxygenase-1 expression, which promotes NF-κB activation and is closely related with inflammation. Nrf2, as a key factor in antioxidant response, is closely related to the expressions of pro-inflammatory factors, NF-κB pathway and cell metabolism. Bioactive peptides come from a wide range of sources and have many biological functions. Increasing evidence indicates that bioactive peptides have potential anti-inflammatory activities. This article summarized the sources, absorption and utilization of bioactive peptides and their role in alleviating inflammation via Nrf2 pathway. Bioactive peptides can also regulate gut microbiota and alter metabolites, which regulates the Nrf2 pathway through novel pathway and supplement the anti-inflammatory mechanisms of bioactive peptides. This review provides a reference for further study on the anti-inflammatory effect of bioactive peptides and the development and utilization of functional foods.
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Affiliation(s)
- Zhongxing Chu
- Hunan Key Laboratory of Grain-oil Deep Process and Quality Control, Hunan Key Laboratory of Forestry Edible Resources Safety and Processing, Central South University of Forestry and Technology, Changsha, Hunan, China
| | - Lingfeng Zhu
- Hunan Agricultural Product Processing Institute, Hunan Academy of Agricultural Sciences, Changsha, Hunan, China
| | - Yaping Zhou
- Hunan Key Laboratory of Grain-oil Deep Process and Quality Control, Hunan Key Laboratory of Forestry Edible Resources Safety and Processing, Central South University of Forestry and Technology, Changsha, Hunan, China
| | - Feiyan Yang
- Hunan Key Laboratory of Grain-oil Deep Process and Quality Control, Hunan Key Laboratory of Forestry Edible Resources Safety and Processing, Central South University of Forestry and Technology, Changsha, Hunan, China
| | - Zuomin Hu
- Hunan Key Laboratory of Grain-oil Deep Process and Quality Control, Hunan Key Laboratory of Forestry Edible Resources Safety and Processing, Central South University of Forestry and Technology, Changsha, Hunan, China
| | - Yi Luo
- Department of Clinic Medicine, Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Wen Li
- Hunan Key Laboratory of Grain-oil Deep Process and Quality Control, Hunan Key Laboratory of Forestry Edible Resources Safety and Processing, Central South University of Forestry and Technology, Changsha, Hunan, China
| | - Feijun Luo
- Hunan Key Laboratory of Grain-oil Deep Process and Quality Control, Hunan Key Laboratory of Forestry Edible Resources Safety and Processing, Central South University of Forestry and Technology, Changsha, Hunan, China
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Wang F, Deng Y, Yu L, Zhou A, Wang J, Jia J, Li N, Ding F, Lian W, Liu Q, Yang Y, Lin X. A Macrophage Membrane-Polymer Hybrid Biomimetic Nanoplatform for Therapeutic Delivery of Somatostatin Peptide to Chronic Pancreatitis. Pharmaceutics 2022; 14:pharmaceutics14112341. [PMID: 36365160 PMCID: PMC9698601 DOI: 10.3390/pharmaceutics14112341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/23/2022] [Accepted: 10/26/2022] [Indexed: 11/16/2022] Open
Abstract
The clinical translation of therapeutic peptides is generally challenged by multiple issues involving absorption, distribution, metabolism and excretion. In this study, a macrophage membrane-coated poly(lactic-co-glycolic acid) (PLGA) nanodelivery system was developed to enhance the bioavailability of the somatostatin (SST) peptide, which faces the hurdles of short half-life and potential side effects in the treatment of chronic pancreatitis. Using a facile nanoprecipitation strategy, SST was loaded in the nanoparticles with an encapsulation efficiency (EE) and a loading efficiency (LE) of 73.68 ± 3.56% and 1.47 ± 0.07%, respectively. The final formulation of SST-loaded nanoparticles with the camouflage of macrophage membrane (MP-SST) showed a mean diameter of 151 ± 4 nm and an average zeta potential of −29.6 ± 0.3 mV, which were stable long term during storage. With an above 90% cell viability, a hemolysis level of about 2% (<5%) and a preference for being ingested by activated endothelial cells compared to macrophages, the membrane−polymer hybrid nanoparticle showed biocompatibility and targeting capability in vitro. After being intravenously administered to mice with chronic pancreatitis, the MP-SST increased the content of SST in the serum (123.6 ± 13.6 pg/mL) and pancreas (1144.9 ± 206.2 pg/g) compared to the treatment of (Dulbecco’s phosphate-buffered saline) DPBS (61.7 ± 6.0 pg/mL in serum and 740.2 ± 172.4 pg/g in the pancreas). The recovery of SST by MP-SST downregulated the expressions of chronic pancreatitis-related factors and alleviated the histologic severity of the pancreas to the greatest extent compared to other treatment groups. This augmentation of SST therapeutic effects demonstrated the superiority of integrating the synthetic polymer with biological membranes in the design of nanoplatforms for advanced and smart peptide delivery. Other peptides like SST can also be delivered via the membrane−polymer hybrid nanosystem for the treatment of diseases, broadening and promoting the potential clinical applications of peptides as therapeutics.
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Affiliation(s)
- Fang Wang
- College of Pharmaceutical Science, Zhejiang University of Technology, Hangzhou 310014, China
- Key Laboratory of Nanomedical Technology (Education Department of Fujian Province), Nanomedical Technology Research Institute, School of Pharmacy, Fujian Medical University, Fuzhou 350122, China
| | - Yu Deng
- Key Laboratory of Nanomedical Technology (Education Department of Fujian Province), Nanomedical Technology Research Institute, School of Pharmacy, Fujian Medical University, Fuzhou 350122, China
| | - Luying Yu
- Key Laboratory of Nanomedical Technology (Education Department of Fujian Province), Nanomedical Technology Research Institute, School of Pharmacy, Fujian Medical University, Fuzhou 350122, China
| | - Ao Zhou
- Key Laboratory of Nanomedical Technology (Education Department of Fujian Province), Nanomedical Technology Research Institute, School of Pharmacy, Fujian Medical University, Fuzhou 350122, China
| | - Jieting Wang
- Key Laboratory of Nanomedical Technology (Education Department of Fujian Province), Nanomedical Technology Research Institute, School of Pharmacy, Fujian Medical University, Fuzhou 350122, China
| | - Jingyan Jia
- Key Laboratory of Nanomedical Technology (Education Department of Fujian Province), Nanomedical Technology Research Institute, School of Pharmacy, Fujian Medical University, Fuzhou 350122, China
| | - Ning Li
- Key Laboratory of Nanomedical Technology (Education Department of Fujian Province), Nanomedical Technology Research Institute, School of Pharmacy, Fujian Medical University, Fuzhou 350122, China
| | - Fadian Ding
- Center for Reproductive Medicine, 1st Affiliated Hospital, Fujian Medical University, 20 Chazhong Road, Fuzhou 350005, China
| | - Wei Lian
- Center for Reproductive Medicine, 1st Affiliated Hospital, Fujian Medical University, 20 Chazhong Road, Fuzhou 350005, China
| | - Qicai Liu
- Center for Reproductive Medicine, 1st Affiliated Hospital, Fujian Medical University, 20 Chazhong Road, Fuzhou 350005, China
| | - Yu Yang
- Department of Hepatopancreatobiliary Surgery, The Third Affiliated Hospital of Soochow University, Juqian Road 185, Changzhou 213000, China
- Correspondence: (Y.Y.); (X.L.)
| | - Xinhua Lin
- Key Laboratory of Nanomedical Technology (Education Department of Fujian Province), Nanomedical Technology Research Institute, School of Pharmacy, Fujian Medical University, Fuzhou 350122, China
- Correspondence: (Y.Y.); (X.L.)
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Song YH, Yoon J, Lee SH. The role of neuropeptide somatostatin in the brain and its application in treating neurological disorders. Exp Mol Med 2021; 53:328-338. [PMID: 33742131 PMCID: PMC8080805 DOI: 10.1038/s12276-021-00580-4] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/23/2021] [Accepted: 01/25/2021] [Indexed: 02/07/2023] Open
Abstract
Somatostatin (SST) is a well-known neuropeptide that is expressed throughout the brain. In the cortex, SST is expressed in a subset of GABAergic neurons and is known as a protein marker of inhibitory interneurons. Recent studies have identified the key functions of SST in modulating cortical circuits in the brain and cognitive function. Furthermore, reduced expression of SST is a hallmark of various neurological disorders, including Alzheimer's disease and depression. In this review, we summarize the current knowledge on SST expression and function in the brain. In particular, we describe the physiological roles of SST-positive interneurons in the cortex. We further describe the causal relationship between pathophysiological changes in SST function and various neurological disorders, such as Alzheimer's disease. Finally, we discuss potential treatments and possibility of novel drug developments for neurological disorders based on the current knowledge on the function of SST and SST analogs in the brain derived from experimental and clinical studies.
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Affiliation(s)
- You-Hyang Song
- grid.37172.300000 0001 2292 0500Department of Biological Sciences, Korea Advanced Institute of Science and Technology, 291 Daehak-ro, Yuseong-gu, Daejeon 34141 Republic of Korea
| | - Jiwon Yoon
- grid.37172.300000 0001 2292 0500Department of Biological Sciences, Korea Advanced Institute of Science and Technology, 291 Daehak-ro, Yuseong-gu, Daejeon 34141 Republic of Korea
| | - Seung-Hee Lee
- grid.37172.300000 0001 2292 0500Department of Biological Sciences, Korea Advanced Institute of Science and Technology, 291 Daehak-ro, Yuseong-gu, Daejeon 34141 Republic of Korea
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An Z, Lei T, Duan L, Hu P, Gou Z, Zhang L, Durand-Gasselin L, Wang N, Wang Y, Gu F. Efficacy and safety of lanreotide autogel compared with lanreotide 40 mg prolonged release in Chinese patients with active acromegaly: results from a phase 3, prospective, randomized, and open-label study (LANTERN). BMC Endocr Disord 2020; 20:57. [PMID: 32366244 PMCID: PMC7199333 DOI: 10.1186/s12902-020-0524-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 03/23/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Lanreotide autogel is a somatostatin analog (SSA) approved for the treatment of acromegaly in 73 countries worldwide; however, it is not yet approved in China. The aim of this study was to evaluate the efficacy and safety of lanreotide autogel compared with lanreotide 40 mg prolonged release (PR) in Chinese patients with active acromegaly. METHODS LANTERN was a phase 3, randomized, open-label, non-inferiority study. Patients with active acromegaly who had undergone surgery ≥3 months prior, or were unlikely or unable to undergo surgery, were treated with lanreotide autogel 60/90/120 mg (monthly deep subcutaneous injection) or lanreotide 40 mg PR (intramuscular injection every 7, 10, or 14 days) for 32 weeks. Primary endpoint was mean change-from-baseline in age-adjusted insulin-like growth factor-1 (IGF-1) standard deviation scores (SDS) at the end-of-study. Secondary endpoints included: growth hormone (GH) levels ≤2.5 μg/L or ≤ 1.0 μg/L, ≥20% reduction in tumor volume (TV) and safety. RESULTS In total, 128 patients were randomized and received study treatment. Lanreotide autogel was non-inferior to lanreotide 40 mg PR: treatment difference (95% CI) for IGF-1 SDS between groups was - 0.32 (- 0.74, 0.11; per protocol population) and - 0.27 (- 0.63, 0.09; intention-to-treat [ITT] population), respectively. Reductions in IGF-1 (- 6.453 vs - 7.003) and GH levels (- 9.548 μg/L vs - 13.182 μg/L), and the proportion of patients with ≥1 acromegaly symptom (- 20.3% vs - 32.5%) were observed from baseline to end-of-study in lanreotide autogel and lanreotide 40 mg PR groups, respectively. In the lanreotide autogel group, 45.5% (25/55) patients achieved ≥20% reduction in TV compared with 50.9% (25/53) in lanreotide 40 mg PR group (ITT). Safety profiles were similar in both treatment groups. CONCLUSIONS Lanreotide autogel was non-inferior to lanreotide 40 mg PR in Chinese patients with active acromegaly after 32 weeks of treatment. TRIAL REGISTRATION Retrospectively registered on ClinicalTrials.gov: NCT02493517 (9 July 2015); prospectively registered on chinadrugtrials.org.cn: CTR20140698 (24 October 2014).
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Affiliation(s)
- Zhenmei An
- West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ting Lei
- Tongji Hospital, Tongji Medical college of HUST, Wuhan, China
| | - Lian Duan
- Peking Union Medical College Hospital, PUMCH, No.1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing, 100730, China
| | - Pei Hu
- Peking Union Medical College Hospital, PUMCH, No.1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing, 100730, China
| | - Zhongping Gou
- West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lihui Zhang
- The second hospital of Hebei Medical University, Shijiazhuang, China
| | | | | | | | - Feng Gu
- Peking Union Medical College Hospital, PUMCH, No.1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing, 100730, China.
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Wauters L, Arts J, Caenepeel P, Holvoet L, Tack J, Bisschops R, Vanuytsel T. Efficacy and safety of lanreotide in postoperative dumping syndrome: A Phase II randomised and placebo-controlled study. United European Gastroenterol J 2019; 7:1064-1072. [PMID: 31662863 DOI: 10.1177/2050640619862166] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 06/10/2019] [Indexed: 12/11/2022] Open
Abstract
Background Data on the efficacy and safety of the long-acting somatostatin analogue lanreotide (LAN) for postoperative dumping syndrome are lacking. Objective We performed a double-blind, randomised and placebo-controlled crossover study of LAN Autogel® 90 mg in postoperative dumping. Methods Adults with a positive prolonged oral glucose tolerance test or spontaneous hypoglycaemia and total dumping score (DS) ≥ 10 despite dietary measures were treated with three monthly injections of LAN or placebo in a randomised crossover fashion with an eight-week wash-out period. Primary outcome was the effect of LAN on total DS versus placebo. Secondary outcomes were the effect on early and late DS, treatment assessment, quality of life and safety. Results Of 24 included patients (66.7% female; age 49.1 ± 2.1 years), 12 were randomised to LAN first. Pooled DS after three injections were lower compared to baseline after LAN (median=14 (interquartile range (IQR) 11.5-23) vs. median = 22 (IQR 16-27); p = 0.03) but not placebo (median = 20 (IQR 15-27) vs. median = 23 (IQR 13-29); p = 0.15). Improvement of early (median = 7.5 (IQR 4.5-13) vs. median = 12 (IQR 9-16); p = 0.03) but not late (median = 7 (IQR 6-10.3) vs. median = 9 (IQR 6-13); p = 0.26) DS was seen. Overall treatment assessment correlated with change in DS (r = -0.69, p = 0.004). Symptom improvement was not associated with changes in quality of life. Of the 81 reported adverse events, 44 occurred on LAN compared to 37 on placebo (p > 0.05), with seven serious adverse events on LAN. Conclusions LAN is effective for treating early postoperative dumping symptoms, although side effects are common and quality of life is not significantly affected.
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Affiliation(s)
- Lucas Wauters
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
| | - Joris Arts
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium.,Department of Gastroenterology, AZ Sint-Lucas, Brugge, Belgium
| | - Philip Caenepeel
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium.,Department of Gastroenterology, ZOL Genk, Genk, Belgium
| | - Lieselot Holvoet
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
| | - Jan Tack
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
| | - Raf Bisschops
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
| | - Tim Vanuytsel
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
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Pavel M, Borson-Chazot F, Cailleux A, Hörsch D, Lahner H, Pivonello R, Tauchmanova L, Darstein C, Olsson H, Tiberg F, Ferone D. Octreotide SC depot in patients with acromegaly and functioning neuroendocrine tumors: a phase 2, multicenter study. Cancer Chemother Pharmacol 2018; 83:375-385. [DOI: 10.1007/s00280-018-3734-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 11/23/2018] [Indexed: 11/25/2022]
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Progress in the formulation and delivery of somatostatin analogs for acromegaly. Ther Deliv 2017; 8:867-878. [DOI: 10.4155/tde-2017-0064] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
A 14 amino acid cystin bridge containing neuropeptide was discovered in 1973 and designated as growth hormone-inhibiting hormone, in other words, somatostatin. Its discovery led to the synthesis of three analogs which were licensed for the treatment of acromegaly: octreotide, lanreotide and pasireotide. Somatostatin analogs are currently approved only as either subcutaneous or intramuscular long-acting injections. We examine the challenges that must be overcome to create oral formulations of somatostatin analogs and examine selected clinical trial data. While octreotide has low intestinal permeability, similar to almost all other peptides, it has an advantage of being more stable against intestinal peptidases. The development of new oral formulation strategies may eventually allow for the successful oral administration of potent somatostatin analogs with high therapeutic indices.
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Fleseriu M, Hoffman AR, Katznelson L. AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY DISEASE STATE CLINICAL REVIEW: MANAGEMENT OF ACROMEGALY PATIENTS: WHAT IS THE ROLE OF PRE-OPERATIVE MEDICAL THERAPY? Endocr Pract 2016; 21:668-73. [PMID: 26135961 DOI: 10.4158/ep14575.dscr] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Acromegaly is a complex disease characterized by growth hormone (GH) excess originating in most cases from a pituitary tumor. The goals of treatment include removing the tumor or reducing tumor burden, normalizing GH secretion and insulin-like growth factor 1 levels, and preserving normal pituitary function if possible. Surgery by an experienced neurosurgeon is still considered first-line therapy, especially in cases with small tumors. In the last few decades, significant progress in the development of selective pharmacologic agents has greatly facilitated the management of active acromegaly, with agents such as somatostatin-receptor ligands (SRLs), GH-receptor antagonists, and dopamine agonists. In addition to adjuvant treatment, pre-operative medical therapy and primary therapy in de novo patients are increasingly employed. METHODS A United States National Library of Medicine PubMed search (through July 2014) was conducted for the following terms: acromegaly, pre-operative medical therapy, somatostatin-receptor ligands, and somatostatin analogs. Articles not in English and those not in peer-reviewed journals were excluded. In reviewing pertinent articles, focus was placed on biochemical and other postoperative outcomes of medical therapy. RESULTS An analysis of the full effect of pre-operative use of SRLs on surgical outcomes (remission rates and peri-operative complications) is limited by heterogeneity of methodology, low overall surgical cure rates, and different study designs. The assumption that SRL use prior to surgery reduces peri-operative surgical risk has yet to be proven. A variable degree of tumor shrinkage with preoperative SRLs is observed. Likewise, SRL treatment 3 months before surgery may improve surgical remission rates in the short term; however, positive results do not persist in the long term. CONCLUSION We consider that medical therapy before surgery could play a role in carefully selected patients, but treatment should be individualized. Primary medical therapy with a SRL may be considered in patients with macroadenomas without local mass effects on the optic chiasm, as SRLs have been shown to reduce tumor size and control GH hypersecretion. However, the data are insufficient to support general use of a SRL prior to surgery in order to improve post-surgery biochemical outcomes. Theoretically, patients with severe cardiac and respiratory complications due to acromegaly could potentially benefit from pre-operative SRLs in order to reduce peri-operative morbidity. Further investigation and investment in large randomized long-term clinical trials are needed to define the precise role and duration of pre-surgical medical treatment in acromegaly patients.
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Fougner SL, Bollerslev J, Svartberg J, Øksnes M, Cooper J, Carlsen SM. Preoperative octreotide treatment of acromegaly: long-term results of a randomised controlled trial. Eur J Endocrinol 2014; 171:229-35. [PMID: 24866574 DOI: 10.1530/eje-14-0249] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Randomised studies have demonstrated a beneficial effect of pre-surgical treatment with somatostatin analogues (SSA) in acromegaly when evaluated early postoperatively. The objective of this study was to evaluate the long-term surgical cure rates. METHODS Newly diagnosed patients were randomised to direct surgery (n=30) or 6-month pretreatment with octreotide LAR (n=32). The patients were evaluated 1 and 5 years postoperatively. Cure was defined as normal IGF1 levels and by normal IGF1 level combined with nadir GH <2 mU/l in an oral glucose tolerance test, all without additional post-operative treatment. A meta-analysis using the other published randomised study with long-term analyses on preoperative SSA treatment was performed. RESULTS The proportion of patients receiving post-operative acromegaly treatment was equal in the two groups. When using the combined criteria for cure, 10/26 (38%) macroadenomas were cured in the pretreatment group compared with 6/25 (24%) in the direct surgery group 1 year postoperatively (P=0.27), and 9/22 (41%) vs 6/22 (27%) macroadenomas, respectively, 5 years postoperatively (P=0.34). In the meta-analysis, 16/45 (36%) macroadenomas were cured using combined criteria in the pretreatment group vs 8/45 (18%) in the direct surgery group after 6-12 months (P=0.06), and 15/41 (37%) vs 8/42 (19%), respectively, in the long-term (P=0.08). CONCLUSION This study does not prove a beneficial effect of SSA pre-surgical treatment, but in the meta-analysis a trend towards significance can be claimed. A potential favourable, clinically relevant response cannot be excluded.
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Affiliation(s)
- S L Fougner
- Department of EndocrinologyMedical Clinic, St Olavs University Hospital, 7006 Trondheim, NorwaySection of Specialized EndocrinologyDepartment of Endocrinology, Oslo University Hospital, Rikshospitalet, Oslo, NorwayFaculty of MedicineUniversity of Oslo, Oslo, NorwayDivision of Internal MedicineUniversity Hospital of North Norway, Tromsø, NorwayTromsø Endocrine Research GroupInstitute of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, NorwayDepartment of MedicineCentre for Clinical Research, Haukeland University Hospital, Bergen, NorwayDepartment of EndocrinologyStavanger University Hospital, Stavanger, NorwayUnit for Applied Clinical ResearchNorwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - J Bollerslev
- Department of EndocrinologyMedical Clinic, St Olavs University Hospital, 7006 Trondheim, NorwaySection of Specialized EndocrinologyDepartment of Endocrinology, Oslo University Hospital, Rikshospitalet, Oslo, NorwayFaculty of MedicineUniversity of Oslo, Oslo, NorwayDivision of Internal MedicineUniversity Hospital of North Norway, Tromsø, NorwayTromsø Endocrine Research GroupInstitute of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, NorwayDepartment of MedicineCentre for Clinical Research, Haukeland University Hospital, Bergen, NorwayDepartment of EndocrinologyStavanger University Hospital, Stavanger, NorwayUnit for Applied Clinical ResearchNorwegian University of Science and Technology (NTNU), Trondheim, NorwayDepartment of EndocrinologyMedical Clinic, St Olavs University Hospital, 7006 Trondheim, NorwaySection of Specialized EndocrinologyDepartment of Endocrinology, Oslo University Hospital, Rikshospitalet, Oslo, NorwayFaculty of MedicineUniversity of Oslo, Oslo, NorwayDivision of Internal MedicineUniversity Hospital of North Norway, Tromsø, NorwayTromsø Endocrine Research GroupInstitute of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, NorwayDepartment of MedicineCentre for Clinical Research, Haukeland University Hospital, Bergen, NorwayDepartment of EndocrinologyStavanger University Hospital, Stavanger, NorwayUnit for Applied Clinical ResearchNorwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - J Svartberg
- Department of EndocrinologyMedical Clinic, St Olavs University Hospital, 7006 Trondheim, NorwaySection of Specialized EndocrinologyDepartment of Endocrinology, Oslo University Hospital, Rikshospitalet, Oslo, NorwayFaculty of MedicineUniversity of Oslo, Oslo, NorwayDivision of Internal MedicineUniversity Hospital of North Norway, Tromsø, NorwayTromsø Endocrine Research GroupInstitute of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, NorwayDepartment of MedicineCentre for Clinical Research, Haukeland University Hospital, Bergen, NorwayDepartment of EndocrinologyStavanger University Hospital, Stavanger, NorwayUnit for Applied Clinical ResearchNorwegian University of Science and Technology (NTNU), Trondheim, NorwayDepartment of EndocrinologyMedical Clinic, St Olavs University Hospital, 7006 Trondheim, NorwaySection of Specialized EndocrinologyDepartment of Endocrinology, Oslo University Hospital, Rikshospitalet, Oslo, NorwayFaculty of MedicineUniversity of Oslo, Oslo, NorwayDivision of Internal MedicineUniversity Hospital of North Norway, Tromsø, NorwayTromsø Endocrine Research GroupInstitute of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, NorwayDepartment of MedicineCentre for Clinical Research, Haukeland University Hospital, Bergen, NorwayDepartment of EndocrinologyStavanger University Hospital, Stavanger, NorwayUnit for Applied Clinical ResearchNorwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - M Øksnes
- Department of EndocrinologyMedical Clinic, St Olavs University Hospital, 7006 Trondheim, NorwaySection of Specialized EndocrinologyDepartment of Endocrinology, Oslo University Hospital, Rikshospitalet, Oslo, NorwayFaculty of MedicineUniversity of Oslo, Oslo, NorwayDivision of Internal MedicineUniversity Hospital of North Norway, Tromsø, NorwayTromsø Endocrine Research GroupInstitute of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, NorwayDepartment of MedicineCentre for Clinical Research, Haukeland University Hospital, Bergen, NorwayDepartment of EndocrinologyStavanger University Hospital, Stavanger, NorwayUnit for Applied Clinical ResearchNorwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - J Cooper
- Department of EndocrinologyMedical Clinic, St Olavs University Hospital, 7006 Trondheim, NorwaySection of Specialized EndocrinologyDepartment of Endocrinology, Oslo University Hospital, Rikshospitalet, Oslo, NorwayFaculty of MedicineUniversity of Oslo, Oslo, NorwayDivision of Internal MedicineUniversity Hospital of North Norway, Tromsø, NorwayTromsø Endocrine Research GroupInstitute of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, NorwayDepartment of MedicineCentre for Clinical Research, Haukeland University Hospital, Bergen, NorwayDepartment of EndocrinologyStavanger University Hospital, Stavanger, NorwayUnit for Applied Clinical ResearchNorwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - S M Carlsen
- Department of EndocrinologyMedical Clinic, St Olavs University Hospital, 7006 Trondheim, NorwaySection of Specialized EndocrinologyDepartment of Endocrinology, Oslo University Hospital, Rikshospitalet, Oslo, NorwayFaculty of MedicineUniversity of Oslo, Oslo, NorwayDivision of Internal MedicineUniversity Hospital of North Norway, Tromsø, NorwayTromsø Endocrine Research GroupInstitute of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, NorwayDepartment of MedicineCentre for Clinical Research, Haukeland University Hospital, Bergen, NorwayDepartment of EndocrinologyStavanger University Hospital, Stavanger, NorwayUnit for Applied Clinical ResearchNorwegian University of Science and Technology (NTNU), Trondheim, NorwayDepartment of EndocrinologyMedical Clinic, St Olavs University Hospital, 7006 Trondheim, NorwaySection of Specialized EndocrinologyDepartment of Endocrinology, Oslo University Hospital, Rikshospitalet, Oslo, NorwayFaculty of MedicineUniversity of Oslo, Oslo, NorwayDivision of Internal MedicineUniversity Hospital of North Norway, Tromsø, NorwayTromsø Endocrine Research GroupInstitute of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, NorwayDepartment of MedicineCentre for Clinical Research, Haukeland University Hospital, Bergen, NorwayDepartment of EndocrinologyStavanger University Hospital, Stavanger, NorwayUnit for Applied Clinical ResearchNorwegian University of Science and Technology (NTNU), Trondheim, Norway
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Gariani K, Meyer P, Philippe J. Implications of Somatostatin Analogues in the Treatment of Acromegaly. EUROPEAN ENDOCRINOLOGY 2013; 9:132-135. [PMID: 29922369 PMCID: PMC6003582 DOI: 10.17925/ee.2013.09.02.132] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 05/13/2013] [Indexed: 11/24/2022]
Abstract
Octreotide has an important role in the medical management of acromegaly. Its place in the management of acromegaly as an adjuvant therapy after neurosurgery is well established with a well-demonstrated efficacy. It can also be used in certain clinical conditions as a neoadjuvant treatment. Clinicians and patients should be aware of the possible side effects of octreotide treatment.
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Affiliation(s)
| | | | - Jacques Philippe
- Professor, Head, Division of Diabetology, Endocrinology and Hypertension and Nutrition, Geneva University Hospital, Switzerland
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Roemmler J, Schopohl J. Clinical experience with lanreotide for the treatment of acromegaly. Expert Rev Endocrinol Metab 2012; 7:139-149. [PMID: 30764005 DOI: 10.1586/eem.11.93] [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] [Indexed: 11/08/2022]
Abstract
Acromegaly is a rare disease, characterized in adults by its distinctive appearance of facial dysmorphism and swollen fingers. It is caused by an overproduction of growth hormone (GH) in more than 99% of patients and in nearly all cases is due to a pituitary adenoma. If surgical resection of the adenoma is not effective, medical treatment is usually the next treatment option. The most commonly used medications are the somatostatin analogues octreotide and lanreotide. Lanreotide is a synthetic somatostatin analogue and is available as slow-release microparticle (every 7-14 days) and prolonged-release liquid (autogel, every 28-56 days) formulations. Lanreotide autogel is a supersaturated aqueous formulation for deep subcutaneous injection and is sold in a ready-to-use prefilled syringe. This ease of use allows self or partner administration at home. This article reviews the use of lanreotide in the treatment of acromegaly and its advantages and disadvantages compared with other somatostatin analogues.
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Affiliation(s)
- Josefine Roemmler
- b Medizinische Klinik und Poliklinik IV, University of Munich, Ziemssenstr. 1, 80336 München, Germany.
| | - Jochen Schopohl
- a Medizinische Klinik und Poliklinik IV, University of Munich, Ziemssenstr. 1, 80336 München, Germany
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