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Sampedro-Nuñez M, Herrera-Martínez AD, Ibáñez-Costa A, Rivero-Cortés E, Venegas E, Robledo M, Martínez-Hernández R, García-Martínez A, Gil J, Jordà M, López-Fernández J, Gavilán I, Maraver S, Marqués-Pamies M, Cámara R, Fajardo-Montañana C, Valassi E, Dios E, Aulinas A, Biagetti B, Álvarez Escola C, Araujo-Castro M, Blanco C, de Miguel P, Villar-Taibo R, Álvarez CV, Gaztambide S, Webb SM, Castaño L, Bernabéu I, Picó A, Gálvez MÁ, Soto-Moreno A, Puig-Domingo M, Castaño JP, Marazuela M, Luque RM. Integrative Clinical, Hormonal and Molecular Data associate with Invasiveness in Acromegaly: REMAH Study. Eur J Endocrinol 2024:lvae045. [PMID: 38701338 DOI: 10.1093/ejendo/lvae045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 02/18/2024] [Accepted: 03/04/2024] [Indexed: 05/05/2024]
Abstract
INTRODUCTION Growth-hormone (GH)-secreting pituitary-tumors (GHomas) are the most common acromegaly cause. At diagnosis, most of them are macroadenomas, and up to 56% display cavernous sinus invasion. Biomarkers assessment associated with tumor-growth and invasion are important to optimize their management. OBJECTIVES To identify clinical/hormonal/molecular-biomarkers associated with tumor-size and invasiveness in GHomas, and to analyze the influence of pre-treatment with somatostatin-analogs or dopamine-agonists in key molecular biomarkers expression. METHODS Clinical/analytical/radiological-variables were evaluated in 192 patients from the REMAH-study (ambispective multicenter post-surgery study of the Spanish Society of Endocrinology and Nutrition). Expression of somatostatin/ghrelin/dopamine-systems components, and key pituitary/proliferation-markers were evaluated in GHomas after the first surgery. Univariate/multivariate regression studies were performed to identify association between variables. RESULTS 80% of patients harbor macroadenomas (63.8% with extrasellar-growth). Associations between larger and more invasive GHomas with younger age, visual-abnormalities, higher IGF1-levels, extrasellar/suprasellar-growth and/or cavernous-sinus invasion were found. Higher GH1 and lower PRL/POMC/CGA/AVPR1B/DRD2T/DRD2L expression levels (p<0.05) were associated to tumor invasiveness. LASSO´s penalized regression identified combinations of clinical and molecular features with AUCs between 0.67-0.82. Preoperative therapy with dopamine-agonist or somatostatin-analogs did not alter the expression of any of the markers analyzed except for DRD1/AVPR1B (up-regulated with dopamine-agonist), and FSHB/CRHR1 (down-regulated with somatostatin-analogs). CONCLUSIONS A specific combination of clinical/analytical/molecular variables was found to be associated with tumor invasiveness and growth capacity in GHomas. Pre-treatment with first-line drugs for acromegaly did not significantly modify the expression of the most relevant biomarkers in our association model. These findings provide valuable insights for risk stratification and personalized management of GHomas.
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Affiliation(s)
- Miguel Sampedro-Nuñez
- Hospital Universitario de la Princesa, Department of Endocrinology and Nutrition; Instituto de Investigación del Hospital de La Princesa, Mechanisms and mediators of endocrine diseases, Madrid, Spain
| | - Aura Dulcinea Herrera-Martínez
- Endocrinology and Nutrition Service, Reina Sofia University Hospital; Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Córboba, Spain
| | - Alejandro Ibáñez-Costa
- Maimonides Biomedical Research Institute of Córdoba (IMIBIC); Department of Cell Biology, Physiology, and Immunology, University of Córdoba; CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn); Reina Sofia University Hospital, Córdoba, Spain
| | - Esther Rivero-Cortés
- Maimonides Biomedical Research Institute of Córdoba (IMIBIC); Reina Sofia University Hospital, Córdoba, Spain
| | - Eva Venegas
- Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Mercedes Robledo
- Hereditary Endocrine Cancer Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - Rebeca Martínez-Hernández
- Hospital Universitario de la Princesa, Department of Endocrinology; Instituto de Investigación del Hospital de La Princesa, Mechanisms and mediators of endocrine diseases Madrid, Spain
| | - Araceli García-Martínez
- Alicante General University Hospital-Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Joan Gil
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Department of Endocrinology and Nutrition, Barcelona, Spain
| | - Mireia Jordà
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Department of Endocrinology and Nutrition, Barcelona, Spain
| | - Judith López-Fernández
- Servicio de Endocrinología y Nutrición, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain
| | - Inmaculada Gavilán
- Hospital Universitario Puerta del Mar de Cádiz, Department of Endocrinology, Cádiz, Spain
| | - Silvia Maraver
- Servicio de Endocrinología y Nutrición, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | | | - Rosa Cámara
- Hospital Universitari i Politecnic La Fe, Department of Endocrinology, Valencia, Spain
| | | | - Elena Valassi
- Hospital Universitari Germans Trias i Pujol, Department of Endocrinology and Nutrition, Barcelona, Spain
| | - Elena Dios
- Virgen del Rocio University Hospital, Department of Endocrinology, Sevilla, Spain
| | - Anna Aulinas
- Hospital de la Santa Creu i Sant Pau, Department of Endocrinology, IIB-Sant Pau, CIBER de Enfermedades Raras (CIBER-ER), University of Vic-Central University of Catalonia, Barcelona, Spain
| | - Betina Biagetti
- Hospital Vall d'Hebron, Department of Endocrinology, Barcelona, Spain
| | | | | | - Concepción Blanco
- Hospital Universitario Principe de Asturias, Department of Endocrinology, Alcalá de Henares, Madrid, Spain
| | - Paz de Miguel
- Hospital Clinico San Carlos, Department of Endocrinology, Madrid, Spain
| | - Rocío Villar-Taibo
- Complejo Hospitalario Universitario de Santiago de Compostela, Department of Endocrinology, La Coruña, Spain
| | - Clara V Álvarez
- Centro de Investigación en Medicina Molecular y Enfermedades Crónicas (CIMUS), University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Sonia Gaztambide
- Biobizkaia Health Research Institute, Hospital Universitario Cruces, University of the Basque Country (UPV/EHU), CIBERDEM, CIBERER, EndoERN, Barakaldo, Bizkaia, Spain
| | - Susan M Webb
- Hospital de la Santa Creu i Sant Pau, Department of Endocrinology, IIB-Sant Pau, Research Center for Pituitary Diseases, CIBERER, Univ Autonoma Barcelona, Bracelona, Spain
| | - Luis Castaño
- Biobizkaia Health Research Institute, Hospital Universitario Cruces, University of the Basque Country (UPV/EHU), CIBERDEM, CIBERER, EndoERN, Barakaldo, Bizkaia, Spain
| | - Ignacio Bernabéu
- Complejo Hospitalario Universitario de Santiago de Compostela, Department of Endocrinology, Santiago de Compostela, A Coruña, Spain
| | - Antonio Picó
- Department of Endocrinology and Nutrition, Alicante General University Hospital. Institute for Health and Biomedical Research (ISABIAL). University Miguel Hernandez, CIBERER Alicante, Spain
| | - María-Ángeles Gálvez
- Endocrinology and Nutrition Service, Reina Sofia University Hospital; Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Córboba, Spain
| | - Alfonso Soto-Moreno
- Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Manel Puig-Domingo
- Department of Endocrinology and Nutrition, Department of Medicine, Germans Trias i Pujol Research Institute and Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Justo P Castaño
- Maimonides Biomedical Research Institute of Córdoba (IMIBIC); Department of Cell Biology, Physiology, and Immunology, University of Córdoba; CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn); Reina Sofia University Hospital, Córdoba, Spain
| | - Mónica Marazuela
- Hospital Universitario de la Princesa, Department of Endocrinology and Nutrition; Instituto de Investigación del Hospital de La Princesa, Mechanisms and mediators of endocrine diseases, Madrid, Spain
| | - Raúl M Luque
- Maimonides Biomedical Research Institute of Córdoba (IMIBIC); Department of Cell Biology, Physiology, and Immunology, University of Córdoba; CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn); Reina Sofia University Hospital, Córdoba, Spain
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Soto-Moreno A, Díaz-Calvillo P, Arias-Santiago S. Kounis syndrome, mast cells beyond the skin. Actas Dermosifiliogr 2024:S0001-7310(24)00260-6. [PMID: 38554752 DOI: 10.1016/j.ad.2023.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 07/27/2023] [Accepted: 08/08/2023] [Indexed: 04/02/2024] Open
Affiliation(s)
- A Soto-Moreno
- Hospital Universitario Virgen de las Nieves (Granada, España). Departamento de Dermatología, Unidad de Tricología, España.
| | - P Díaz-Calvillo
- Hospital Universitario Virgen de las Nieves (Granada, España). Departamento de Dermatología, Unidad de Tricología, España
| | - S Arias-Santiago
- Hospital Universitario Virgen de las Nieves (Granada, España). Departamento de Dermatología, Unidad de Tricología, España; TECe19-Dermatología Clínica y Traslacional, Instituto de Investigación Biosanitaria de Granada, Granada, España
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Soto-Moreno A, Ureña-Paniego C, Montero-Vílchez T, Sánchez-Díaz M, Díaz-Calvillo P, Rodríguez-Pozo JA, Molina-Leyva A, Martínez-López A, Buendía-Eisman A, Arias-Santiago S. Quality of Professional Life Among Dermatologists: Impact of the COVID-19 Pandemic and Suggestions for Improvement. Actas Dermosifiliogr 2024; 115:231-236. [PMID: 37884261 DOI: 10.1016/j.ad.2023.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 09/28/2023] [Accepted: 10/09/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Quality of professional life (QPL) is defined as a sense of well-being derived from a balance between the challenges of work and the resources available to deal with them. Impaired QPL can contribute to burnout. The aim of this study was to evaluate QPL in Spanish dermatologists using a validated questionnaire. MATERIAL AND METHODS We designed a cross-sectional study in which Spanish dermatologists were invited to complete an online questionnaire sent out by messaging applications. The dermatologists were asked to provide sociodemographic information, answer 3 open questions, and complete the 35-item Spanish QPL questionnaire (Spanish abbreviation, CVP-35). RESULTS We analyzed the information submitted by 106 dermatologists (62 women, 58%) with a mean age of 41 years (95% CI, 43.3-38.8 years). Women and department heads scored significantly higher in the workload domain of the questionnaire (P=.02 and P=.005, respectively). A heavy caseload was mentioned as the main factor contributing to impaired QPL and the main change in the wake of the COVID-19 pandemic. CONCLUSIONS Female dermatologists reported heavier workloads. Heavy caseloads and more remote work were the main changes identified after the COVID-19 pandemic. Heavy caseloads have a significant impact on the QPL of dermatologists in Spain. Reducing caseloads would improve general job satisfaction and quality of care provision.
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Affiliation(s)
- A Soto-Moreno
- Servicio de Dermatología, Hospital Universitario Virgen de Las Nieves, Granada, España
| | - C Ureña-Paniego
- Servicio de Dermatología, Hospital Universitario Virgen de Las Nieves, Granada, España
| | - T Montero-Vílchez
- Servicio de Dermatología, Hospital Universitario Virgen de Las Nieves, Granada, España
| | - M Sánchez-Díaz
- Servicio de Dermatología, Hospital Universitario Virgen de Las Nieves, Granada, España
| | - P Díaz-Calvillo
- Servicio de Dermatología, Hospital Universitario Virgen de Las Nieves, Granada, España
| | - J A Rodríguez-Pozo
- Servicio de Dermatología, Hospital Universitario Virgen de Las Nieves, Granada, España
| | - A Molina-Leyva
- Servicio de Dermatología, Hospital Universitario Virgen de Las Nieves, Granada, España
| | - A Martínez-López
- Servicio de Dermatología, Hospital Universitario Virgen de Las Nieves, Granada, España.
| | - A Buendía-Eisman
- Departamento de Medicina, Facultad de Medicina, Universidad de Granada, Granada, España
| | - S Arias-Santiago
- Servicio de Dermatología, Hospital Universitario Virgen de Las Nieves, Granada, España; Instituto de Investigación Biosanitaria de Granada, Granada, España; Departamento de Medicina, Facultad de Medicina, Universidad de Granada, Granada, España
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Soto-Moreno A, Ureña-Paniego C, Montero-Vílchez T, Sánchez-Díaz M, Díaz-Calvillo P, Rodríguez-Pozo JA, Molina-Leyva A, Martínez-López A, Buendía-Eisman A, Arias-Santiago S. [Translated article] Quality of Professional Life Among Dermatologists: Impact of the COVID-19 Pandemic and Suggestions for Improvement. Actas Dermosifiliogr 2024; 115:T231-T236. [PMID: 38242430 DOI: 10.1016/j.ad.2024.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 10/09/2023] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND AND OBJECTIVE Quality of professional life (QPL) is defined as a sense of well-being derived from a balance between the challenges of work and the resources available to deal with them. Impaired QPL can contribute to burnout. The aim of this study was to evaluate QPL in Spanish dermatologists using a validated questionnaire. MATERIAL AND METHODS We designed a cross-sectional study in which Spanish dermatologists were invited to complete an online questionnaire sent out by messaging applications. The dermatologists were asked to provide sociodemographic information, answer 3 open questions, and complete the 35-item Spanish QPL questionnaire (Spanish abbreviation, CVP-35). RESULTS We analyzed the information submitted by 106 dermatologists (62 women, 58%) with a mean age of 41 years (95% CI, 43.3-38.8 years). Women and department heads scored significantly higher in the workload domain of the questionnaire (P=.02 and P=.005, respectively). A heavy caseload was mentioned as the main factor contributing to impaired QPL and the main change in the wake of the COVID-19 pandemic. CONCLUSIONS Female dermatologists reported heavier workloads. Heavy caseloads and more remote work were the main changes identified after the COVID-19 pandemic. Heavy caseloads have a significant impact on the QPL of dermatologists in Spain. Reducing caseloads would improve general job satisfaction and quality of care provision.
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Affiliation(s)
- A Soto-Moreno
- Servicio de Dermatología, Hospital Universitario Virgen de Las Nieves, Granada, Spain
| | - C Ureña-Paniego
- Servicio de Dermatología, Hospital Universitario Virgen de Las Nieves, Granada, Spain
| | - T Montero-Vílchez
- Servicio de Dermatología, Hospital Universitario Virgen de Las Nieves, Granada, Spain
| | - M Sánchez-Díaz
- Servicio de Dermatología, Hospital Universitario Virgen de Las Nieves, Granada, Spain
| | - P Díaz-Calvillo
- Servicio de Dermatología, Hospital Universitario Virgen de Las Nieves, Granada, Spain
| | - J A Rodríguez-Pozo
- Servicio de Dermatología, Hospital Universitario Virgen de Las Nieves, Granada, Spain
| | - A Molina-Leyva
- Servicio de Dermatología, Hospital Universitario Virgen de Las Nieves, Granada, Spain
| | - A Martínez-López
- Servicio de Dermatología, Hospital Universitario Virgen de Las Nieves, Granada, Spain.
| | - A Buendía-Eisman
- Departamento de Medicina, Facultad de Medicina, Universidad de Granada, Granada, Spain
| | - S Arias-Santiago
- Servicio de Dermatología, Hospital Universitario Virgen de Las Nieves, Granada, Spain; Instituto de Investigación Biosanitaria de Granada, Granada, Spain; Departamento de Medicina, Facultad de Medicina, Universidad de Granada, Granada, Spain
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Ureña-Paniego C, Haselgruber S, Soto-Moreno A, Cuenca-Barrales C, Arias-Santiago S, Molina-Leyva A. Eligibility in a cohort of patients with hidradenitis suppurativa treated with bimekizumab: Lessons and pitfalls in a real-world setting. J Eur Acad Dermatol Venereol 2024. [PMID: 38411288 DOI: 10.1111/jdv.19921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 02/15/2024] [Indexed: 02/28/2024]
Affiliation(s)
- C Ureña-Paniego
- Dermatology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - S Haselgruber
- Dermatology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - A Soto-Moreno
- Dermatology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - C Cuenca-Barrales
- Dermatology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
- Hidradenitis Suppurativa Clinic, Hospital Universitario Virgen de las Nieves, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - S Arias-Santiago
- Dermatology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - A Molina-Leyva
- Dermatology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
- Hidradenitis Suppurativa Clinic, Hospital Universitario Virgen de las Nieves, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- European Hidradenitis Suppurativa Foundation, Dessau-Roßlau, Germany
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Soto-Moreno A, Martínez-López A, Sánchez-Díaz M, Martínez-García E, Buendía-Eisman A, Arias-Santiago S. Burnout and professional quality of life in dermatologists. J Eur Acad Dermatol Venereol 2024. [PMID: 38400518 DOI: 10.1111/jdv.19896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 02/09/2024] [Indexed: 02/25/2024]
Affiliation(s)
- A Soto-Moreno
- Dermatology Department, Virgen de Las Nieves University Hospital, Granada, Spain
| | - A Martínez-López
- Dermatology Department, Virgen de Las Nieves University Hospital, Granada, Spain
- Group of Epidemiology and Health Promotion in Dermatology, Spanish Association of Dermatology and Venereology, Madrid, Spain
- TECe19-Clinical and Translational Dermatology, Institute for Biosanitary Research of Granada, Ibs.Granada, Granada, Spain
| | - M Sánchez-Díaz
- Dermatology Department, Virgen de Las Nieves University Hospital, Granada, Spain
| | - E Martínez-García
- Group of Epidemiology and Health Promotion in Dermatology, Spanish Association of Dermatology and Venereology, Madrid, Spain
| | - A Buendía-Eisman
- Group of Epidemiology and Health Promotion in Dermatology, Spanish Association of Dermatology and Venereology, Madrid, Spain
- TECe19-Clinical and Translational Dermatology, Institute for Biosanitary Research of Granada, Ibs.Granada, Granada, Spain
- Department of Dermatology, Faculty of Medicine, University of Granada, Granada, Spain
| | - S Arias-Santiago
- Dermatology Department, Virgen de Las Nieves University Hospital, Granada, Spain
- Group of Epidemiology and Health Promotion in Dermatology, Spanish Association of Dermatology and Venereology, Madrid, Spain
- TECe19-Clinical and Translational Dermatology, Institute for Biosanitary Research of Granada, Ibs.Granada, Granada, Spain
- Department of Dermatology, Faculty of Medicine, University of Granada, Granada, Spain
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Ureña-Paniego C, Soto-Moreno A, Haselgruber S, Tercedor-Sánchez J. [Translated article] Surgical Treatment of Chronic Lip Fissure with Z-plasty Repair. Actas Dermosifiliogr 2023; 114:T725-T727. [PMID: 37453545 DOI: 10.1016/j.ad.2023.04.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 04/10/2023] [Indexed: 07/18/2023] Open
Affiliation(s)
- C Ureña-Paniego
- Servicio de Dermatología, Hospital Universitario Virgen de las Nieves, Granada, Spain.
| | - A Soto-Moreno
- Servicio de Dermatología, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - S Haselgruber
- Servicio de Dermatología, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - J Tercedor-Sánchez
- Servicio de Dermatología, Hospital Universitario Virgen de las Nieves, Granada, Spain
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Ureña-Paniego C, Soto-Moreno A, Haselgruber S, Tercedor-Sánchez J. Surgical Treatment of Chronic Lip Fissure with Z-Plasty Repair. Actas Dermosifiliogr 2023; 114:725-727. [PMID: 37105271 DOI: 10.1016/j.ad.2023.04.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/25/2023] [Accepted: 04/10/2023] [Indexed: 04/29/2023] Open
Affiliation(s)
- C Ureña-Paniego
- Servicio de Dermatología, Hospital Universitario Virgen de las Nieves, Granada, España.
| | - A Soto-Moreno
- Servicio de Dermatología, Hospital Universitario Virgen de las Nieves, Granada, España
| | - S Haselgruber
- Servicio de Dermatología, Hospital Universitario Virgen de las Nieves, Granada, España
| | - J Tercedor-Sánchez
- Servicio de Dermatología, Hospital Universitario Virgen de las Nieves, Granada, España
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Piñar-Gutiérrez A, Gros-Herguido N, Losada-Viñau F, Farfán-Díaz F, Enríquez-Macías M, Pérez-Morales A, González-Navarro I, Acosta-Delgado D, Guerrero-Vázquez R, Martínez-Ortega AJ, Pumar-López A, Mangas-Cruz MÁ, Bataller-de Juan E, Tallón-Aguilar L, Soto-Moreno A. Outcomes of a multidisciplinary Diabetic Foot Day Unit. ENDOCRINOL DIAB NUTR 2023; 70:381-388. [PMID: 37356875 DOI: 10.1016/j.endien.2022.11.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 12/29/2021] [Indexed: 06/27/2023]
Abstract
OBJECTIVE To analyse the main characteristics of patients and the health outcomes obtained and to evaluate the impact of peripheral artery disease (PAD) in patients treated in our multidisciplinary Diabetic Foot Unit. RESEARCH DESIGN AND METHODS Observational prospective study. 273 patients from two different populations (with and without PAD - classified according to the presence of distal pulses) treated over a 14-month period in the multidisciplinary Diabetic Foot Unit were included. The data on patient characteristics and outcomes were analysed for the purpose of comparison. For the inference study, a comparison of medians with the non-parametric test for independent samples for the quantitative variables and a χ2 test for the comparison of proportions in qualitative variables were performed. RESULTS Patients with PAD ulcers were older (60 (54-67) vs. 64 (75-81), p=0.000) and had a higher macrovascular burden (8.1% vs. 29% for ischaemic heart disease history, p=0.000; 6.7% vs. 18.1% for cerebrovascular disease history, p=0.004). Their Texas Score was higher (p=0.000) and their major amputation rate was higher (1.4% vs. 12.3%, p=0.001). They had less background of previous ulcers (52.6% vs. 26.8%, p=0.000), their episode duration was shorter (4 (0-10) vs. 0 (0-3) weeks, p=0.000), and their proportional need for antibiotic therapy was lower (64.4% vs. 51.4%, p=0.03). CONCLUSIONS The differences found between ulcers with and without vascular involvement support the need for a different approach and for the inclusion of vascular surgeons on the team. The multidisciplinary care model for diabetic foot patients could be effective and improve health outcomes.
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Affiliation(s)
- Ana Piñar-Gutiérrez
- UGC Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Sevilla, Spain.
| | - Noelia Gros-Herguido
- UGC Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Fernando Losada-Viñau
- UGC Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Fátima Farfán-Díaz
- UGC Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | | | - Ana Pérez-Morales
- UGC Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | | | | | | | | | - Alfonso Pumar-López
- UGC Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | | | | | - Luis Tallón-Aguilar
- UGC Cirugía General, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Alfonso Soto-Moreno
- UGC Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Sevilla, Spain
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Piñar-Gutiérrez A, Dios Fuentes E, Benítez-Ávila R, de Ana-Lobato L, Bueno-Delgado MDA, Soto-Moreno A, Venegas-Moreno E. Maternal-fetal outcomes of pregnancies in women treated at an inborn errors of metabolism unit. ENDOCRINOL DIAB NUTR 2023; 70:98-106. [PMID: 36870805 DOI: 10.1016/j.endien.2022.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 09/08/2022] [Indexed: 03/06/2023]
Abstract
INTRODUCTION Intermediate Inborn Errors of Metabolism (IEM) are a group of inherited diseases that include phenylketonuria (PKU), tyrosinemia II (TSII), organic acidaemias and ornithine transcarbamylase deficiency (OTCD), among others. They are increasingly more common in adults due to improved management. This has allowed more affected women to consider having children with good prospects. However, pregnancy may worsen metabolic control and/or increase maternal-fetal complications. The objective is to analyse the characteristics and outcomes of pregnancies of our patients with IEM. METHODS Retrospective descriptive study. Pregnancies of women with IEM attended to at the adult IEM referral unit of the Hospital Universitario Virgen del Rocío were included. The qualitative variables were described as n(%) and the quantitative as P50 (P25-P75). RESULTS 24 pregnancies were recorded: 12 newborns were healthy, 1 inherited their mother's disease, 2 had maternal phenylketonuria syndrome, 1 was stillborn (gestational week 31 + 5), 5 were spontaneous abortions and 3 were voluntarily terminated. The gestations were divided into metabolically controlled and uncontrolled. CONCLUSIONS Pregnancy planning and multidisciplinary management through to postpartum is essential to ensure maternal and fetal health. The basis of treatment in PKU and TSII is a strict protein-limited diet. Events that increase protein catabolism in organic acidaemias and DOTC should be avoided. Further investigation of pregnancy outcomes in women with IEM is needed.
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Affiliation(s)
- Ana Piñar-Gutiérrez
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Sevilla, Spain.
| | - Elena Dios Fuentes
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Rosa Benítez-Ávila
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Laura de Ana-Lobato
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - María Del Amor Bueno-Delgado
- Unidad de Metabolopatías, Unidad de Gestión Clínica de Pediatría, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Alfonso Soto-Moreno
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Eva Venegas-Moreno
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Sevilla, Spain
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Piñar-Gutiérrez A, Dios Fuentes E, Benítez-Ávila R, de Ana-Lobato L, Bueno-Delgado MDA, Soto-Moreno A, Venegas-Moreno E. Resultados materno-fetales de las gestaciones de mujeres atendidas en una unidad de errores innatos del metabolismo. ENDOCRINOL DIAB NUTR 2022. [DOI: 10.1016/j.endinu.2022.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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12
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Piñar-Gutiérrez A, Remón-Ruiz P, Soto-Moreno A. Reply. Med Clin (Barc) 2022; 159:e12. [PMID: 35676116 PMCID: PMC9552192 DOI: 10.1016/j.medcli.2022.02.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 02/25/2022] [Accepted: 02/28/2022] [Indexed: 12/02/2022]
Affiliation(s)
- Ana Piñar-Gutiérrez
- Endocrinology and Nutrition Unit, Virgen del Rocío Universitary Hospital, Sevilla, Spain.
| | - Pablo Remón-Ruiz
- Endocrinology and Nutrition Unit, Virgen del Rocío Universitary Hospital, Sevilla, Spain
| | - Alfonso Soto-Moreno
- Endocrinology and Nutrition Unit, Virgen del Rocío Universitary Hospital, Sevilla, Spain
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Moreno-Moreno P, Ibáñez-Costa A, Venegas-Moreno E, Fuentes-Fayos AC, Alhambra-Expósito MR, Fajardo-Montañana C, García-Martínez A, Dios E, Vázquez-Borrego MC, Remón-Ruiz P, Cámara R, Lamas C, Carlos Padillo-Cuenca J, Solivera J, Cano DA, Gahete MD, Herrera-Martínez AD, Picó A, Soto-Moreno A, Gálvez-Moreno MÁ, Castaño JP, Luque RM. Integrative Clinical, Radiological, and Molecular Analysis for Predicting Remission and Recurrence of Cushing Disease. J Clin Endocrinol Metab 2022; 107:e2938-e2951. [PMID: 35312002 DOI: 10.1210/clinem/dgac172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT Adrenocorticotropin (ACTH)-secreting pituitary tumors (ACTHomas) are associated with severe comorbidities and increased mortality. Current treatments mainly focus on remission and prevention of persistent disease and recurrence. However, there are still no useful biomarkers to accurately predict the clinical outcome after surgery, long-term remission, or disease relapse. OBJECTIVES This work aimed to identify clinical, biochemical, and molecular markers for predicting long-term clinical outcome and remission in ACTHomas. METHODS A retrospective multicenter study was performed with 60 ACTHomas patients diagnosed between 2004 and 2018 with at least 2 years' follow-up. Clinical/biochemical variables were evaluated yearly. Molecular expression profile of the somatostatin/ghrelin/dopamine regulatory systems components and of key pituitary factors and proliferation markers were evaluated in tumor samples after the first surgery. RESULTS Clinical variables including tumor size, time until diagnosis/first surgery, serum prolactin, and postsurgery cortisol levels were associated with tumor remission and relapsed disease. The molecular markers analyzed were distinctly expressed in ACTHomas, with some components (ie, SSTR1, CRHR1, and MKI67) showing instructive associations with recurrence and/or remission. Notably, an integrative model including selected clinical variables (tumor size/postsurgery serum cortisol), and molecular markers (SSTR1/CRHR1) can accurately predict the clinical evolution and remission of patients with ACTHomas, generating a receiver operating characteristic curve with an area under the curve of 1 (P < .001). CONCLUSION This study demonstrates that the combination of a set of clinical and molecular biomarkers in ACTHomas is able to accurately predict the clinical evolution and remission of patients. Consequently, the postsurgery molecular profile represents a valuable tool for clinical evaluation and follow-up of patients with ACTHomas.
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Affiliation(s)
- Paloma Moreno-Moreno
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain
- Reina Sofia University Hospital (HURS), 14004 Cordoba, Spain
- Service of Endocrinology and Nutrition, IMIBIC, HURS, 14004 Cordoba, Spain
| | - Alejandro Ibáñez-Costa
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain
- Reina Sofia University Hospital (HURS), 14004 Cordoba, Spain
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, 14004 Cordoba, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), 14004 Cordoba, Spain
| | - Eva Venegas-Moreno
- Unidad de Gestión de Endocrinología y Nutrición. Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, 41013 Sevilla, Spain
| | - Antonio C Fuentes-Fayos
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain
- Reina Sofia University Hospital (HURS), 14004 Cordoba, Spain
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, 14004 Cordoba, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), 14004 Cordoba, Spain
| | - María R Alhambra-Expósito
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain
- Reina Sofia University Hospital (HURS), 14004 Cordoba, Spain
- Service of Endocrinology and Nutrition, IMIBIC, HURS, 14004 Cordoba, Spain
| | - Carmen Fajardo-Montañana
- Department of Endocrinology, Hospital Universitario de La Ribera, Alzira, 46600, Valencia, Spain
| | - Araceli García-Martínez
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain
- Reina Sofia University Hospital (HURS), 14004 Cordoba, Spain
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, 14004 Cordoba, Spain
| | - Elena Dios
- Unidad de Gestión de Endocrinología y Nutrición. Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, 41013 Sevilla, Spain
| | - Mari C Vázquez-Borrego
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain
- Reina Sofia University Hospital (HURS), 14004 Cordoba, Spain
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, 14004 Cordoba, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), 14004 Cordoba, Spain
| | - Pablo Remón-Ruiz
- Unidad de Gestión de Endocrinología y Nutrición. Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, 41013 Sevilla, Spain
| | - Rosa Cámara
- Department of Endocrinology and Nutrition, Polytechnic University Hospital La Fe, 46026, Valencia, Spain
| | - Cristina Lamas
- Department of Endocrinology and Nutrition, Albacete University Hospital, 02006, Albacete, Spain
| | - José Carlos Padillo-Cuenca
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain
- Reina Sofia University Hospital (HURS), 14004 Cordoba, Spain
- Service of Endocrinology and Nutrition, IMIBIC, HURS, 14004 Cordoba, Spain
| | | | - David A Cano
- Unidad de Gestión de Endocrinología y Nutrición. Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, 41013 Sevilla, Spain
| | - Manuel D Gahete
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain
- Reina Sofia University Hospital (HURS), 14004 Cordoba, Spain
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, 14004 Cordoba, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), 14004 Cordoba, Spain
| | - Aura D Herrera-Martínez
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain
- Reina Sofia University Hospital (HURS), 14004 Cordoba, Spain
- Service of Endocrinology and Nutrition, IMIBIC, HURS, 14004 Cordoba, Spain
| | - Antonio Picó
- Department of Endocrinology and Nutrition, Alicante General University Hospital. Institute for Health and Biomedical Research (ISABIAL). University Miguel Hernandez, CIBER Rare Diseases, 03010, Alicante, Spain
| | - Alfonso Soto-Moreno
- Unidad de Gestión de Endocrinología y Nutrición. Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, 41013 Sevilla, Spain
| | - María Ángeles Gálvez-Moreno
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain
- Reina Sofia University Hospital (HURS), 14004 Cordoba, Spain
- Service of Endocrinology and Nutrition, IMIBIC, HURS, 14004 Cordoba, Spain
| | - Justo P Castaño
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain
- Reina Sofia University Hospital (HURS), 14004 Cordoba, Spain
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, 14004 Cordoba, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), 14004 Cordoba, Spain
| | - Raúl M Luque
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain
- Reina Sofia University Hospital (HURS), 14004 Cordoba, Spain
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, 14004 Cordoba, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), 14004 Cordoba, Spain
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Piñar-Gutiérrez A, Remón-Ruiz P, Soto-Moreno A. Case report: Pituitary apoplexy after COVID-19 vaccination. Med Clin (Barc) 2022; 158:498-499. [PMID: 34895747 PMCID: PMC8590494 DOI: 10.1016/j.medcli.2021.09.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/20/2021] [Accepted: 09/21/2021] [Indexed: 12/25/2022]
Affiliation(s)
- Ana Piñar-Gutiérrez
- Endocrinology and Nutrition Unit, Virgen del Rocío Universitary Hospital, Sevilla, Spain.
| | - Pablo Remón-Ruiz
- Endocrinology and Nutrition Unit, Virgen del Rocío Universitary Hospital, Sevilla, Spain
| | - Alfonso Soto-Moreno
- Endocrinology and Nutrition Unit, Virgen del Rocío Universitary Hospital, Sevilla, Spain
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15
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Affiliation(s)
- Ana Piñar-Gutiérrez
- Endocrinology and Nutrition Unit, Virgen del Rocío Universitary Hospital, Sevilla, Spain
| | - Pablo Remón-Ruiz
- Endocrinology and Nutrition Unit, Virgen del Rocío Universitary Hospital, Sevilla, Spain
| | - Alfonso Soto-Moreno
- Endocrinology and Nutrition Unit, Virgen del Rocío Universitary Hospital, Sevilla, Spain
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16
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Martínez-Ortega A, Flores-Martinez Á, Venegas-Moreno E, Dios E, Del Can D, Rivas E, Kaen A, Cárdenas Ruiz-Valdepeñas E, Fajardo E, Roldán F, González-Rivera N, Oliva R, Fernández-Peña JI, Soto-Moreno A, Cano DA. Sex Hormone Receptor Expression in Craniopharyngiomas and Association with Tumor Aggressiveness Characteristics. J Clin Med 2022; 11:jcm11010281. [PMID: 35012020 PMCID: PMC8746083 DOI: 10.3390/jcm11010281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 12/29/2021] [Accepted: 01/03/2022] [Indexed: 02/01/2023] Open
Abstract
Craniopharyngiomas (CPs) are rare tumors of the sellar and suprasellar regions of embryonic origin. The primary treatment for CPs is surgery but it is often unsuccessful. Although CPs are considered benign tumors, they display a relatively high recurrence rate that might compromise quality of life. Previous studies have reported that CPs express sex hormone receptors, including estrogen and progesterone receptors. Here, we systematically analyzed estrogen receptor α (ERα) and progesterone receptor (PR) expression by immunohistochemistry in a well-characterized series of patients with CP (n = 41) and analyzed their potential association with tumor aggressiveness features. A substantial proportion of CPs displayed a marked expression of PR. However, most CPs expressed low levels of ERα. No major association between PR and ERα expression and clinical aggressiveness features was observed in CPs. Additionally, in our series, β-catenin accumulation was not related to tumor recurrence.
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Affiliation(s)
- Antonio Martínez-Ortega
- Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, 41013 Sevilla, Spain; (A.M.-O.); (Á.F.-M.); (E.V.-M.); (E.D.); (D.D.C.)
| | - Álvaro Flores-Martinez
- Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, 41013 Sevilla, Spain; (A.M.-O.); (Á.F.-M.); (E.V.-M.); (E.D.); (D.D.C.)
| | - Eva Venegas-Moreno
- Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, 41013 Sevilla, Spain; (A.M.-O.); (Á.F.-M.); (E.V.-M.); (E.D.); (D.D.C.)
| | - Elena Dios
- Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, 41013 Sevilla, Spain; (A.M.-O.); (Á.F.-M.); (E.V.-M.); (E.D.); (D.D.C.)
| | - Diego Del Can
- Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, 41013 Sevilla, Spain; (A.M.-O.); (Á.F.-M.); (E.V.-M.); (E.D.); (D.D.C.)
| | - Eloy Rivas
- Unidad de Gestión de Anatomía Patológica, Unidad de Neuropatología, Hospital Universitario Virgen del Rocío, 41013 Sevilla, Spain;
| | - Ariel Kaen
- Servicio de Neurocirugía, Hospital Universitario Virgen del Rocío, 41013 Sevilla, Spain; (A.K.); (E.C.R.-V.)
| | | | - Elena Fajardo
- Servicio de Radiología, Hospital Universitario Virgen del Rocío, 41013 Sevilla, Spain; (E.F.); (F.R.)
| | - Florinda Roldán
- Servicio de Radiología, Hospital Universitario Virgen del Rocío, 41013 Sevilla, Spain; (E.F.); (F.R.)
| | - Natividad González-Rivera
- Unidad de Gestión de Endocrinología y Nutrición, Hospital Universitario Virgen Macarena, 41009 Sevilla, Spain; (N.G.-R.); (R.O.)
| | - Rosario Oliva
- Unidad de Gestión de Endocrinología y Nutrición, Hospital Universitario Virgen Macarena, 41009 Sevilla, Spain; (N.G.-R.); (R.O.)
| | | | - Alfonso Soto-Moreno
- Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, 41013 Sevilla, Spain; (A.M.-O.); (Á.F.-M.); (E.V.-M.); (E.D.); (D.D.C.)
- Correspondence: (A.S.-M.); (D.A.C.)
| | - David A. Cano
- Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, 41013 Sevilla, Spain; (A.M.-O.); (Á.F.-M.); (E.V.-M.); (E.D.); (D.D.C.)
- Correspondence: (A.S.-M.); (D.A.C.)
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Rodríguez de Vera-Gómez P, Piñar-Gutiérrez A, Guerrero-Vázquez R, Bellido V, Morales-Portillo C, Sancho-Márquez MP, Espejo-García P, Gros-Herguido N, López-Gallardo G, Martínez-Brocca MA, Soto-Moreno A. Flash Glucose Monitoring and Diabetes Mellitus Induced by Immune Checkpoint Inhibitors: An Approach to Clinical Practice. J Diabetes Res 2022; 2022:4508633. [PMID: 36387939 PMCID: PMC9652069 DOI: 10.1155/2022/4508633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 09/01/2022] [Accepted: 10/19/2022] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES The aim of this study is to investigate in depth diabetes mellitus associated with immune checkpoint inhibitors (DM-ICIs) by analysing a case series. We also evaluated the clinical impact of flash glucose monitoring (FGM) systems in the management of this entity. METHODS We conducted an observational cohort study of DM-ICIs diagnosed in two hospitals in Seville (Spain). Patients with a new diagnosis of diabetes mellitus (DM) or with sudden worsening of preexisting DM after starting treatment with ICIs, with a random 5 hour-postprandial C-peptide value of <0.6 nmol/L and without possibility of subsequent withdrawal of insulin treatment, were included. RESULTS A total of 7 cases were identified, mostly males (n = 6; 85.7%), with a mean age of 64.9 years. The mean glycated hemoglobin (HbA1c) upon diagnosis was 8.1%, with diabetic ketoacidosis (DKA) observed in 6 cases (85.7%). Subcutaneous flash glucose monitoring (FGM) systems were used in six cases, with a mean follow-up period of 42.7 weeks. During the first 90 days of use, mean average glucose was 167.5 mg/dL, with a coefficient of variation (CV) of 34.6%. The mean time in the range 70-180 mg/dL (TIR) was 59.7%, with a mean time above range (TAR) 181-250 mg/dL of 27.8% and a mean TAR > 250 mg/dL of 10.2%. The mean time below range (TBR) 54-69 mg/dL was 2%, while the mean TBR < 54 mg/dL was 0.3%. The mean glucose management indicator (GMI) was 7.3%. No significant differences were observed in FGM values for the following 90 days of follow-up. A progressive improvement in all parameters of glycaemic control was observed between the first month of FGM use and the sixth month of FGM use. Of note, there was a decrease in mean CV (40.6% to 34.1%, p = 0.25), mean TAR 181-250 (30.3% to 26%, p = 0.49), mean TAR > 250 mg/dL (16.3% to 7.7%, p = 0.09), mean TBR 54-69 mg/dL (5.2% to 2%, p = 0.16), and mean TBR < 54 mg/dL (1.8% to 0.2%, p = 0.31), along with an increase in mean values of TIR 70-180 mg/dL (46.5% to 60.5%, p = 0.09). The lack of statistical significance in the differences observed in the mean FGM values over the follow-up period may be related to the small sample size. CONCLUSION DM-ICI is recognised by a state of sudden-onset insulinopenia, often associated with DKA. The use of FGM systems may be a valid option for the effective management of DM-ICIs and for the prevention of severe hyperglycaemic and hypoglycaemic episodes in this condition.
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Affiliation(s)
| | - Ana Piñar-Gutiérrez
- Endocrinology and Nutrition Department, Hospital Universitario Virgen del Rocío, Seville, Spain
| | - Raquel Guerrero-Vázquez
- Endocrinology and Nutrition Department, Hospital Universitario Virgen Macarena, Seville, Spain
| | - Virginia Bellido
- Endocrinology and Nutrition Department, Hospital Universitario Virgen del Rocío, Seville, Spain
| | | | | | | | - Noelia Gros-Herguido
- Endocrinology and Nutrition Department, Hospital Universitario Virgen del Rocío, Seville, Spain
| | - Gema López-Gallardo
- Endocrinology and Nutrition Department, Hospital Universitario Virgen del Rocío, Seville, Spain
| | | | - Alfonso Soto-Moreno
- Endocrinology and Nutrition Department, Hospital Universitario Virgen del Rocío, Seville, Spain
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Piñar-Gutiérrez A, Dios-Fuentes E, Remón-Ruiz P, Del Can-Sánchez D, Vázquez-Morejón A, López-Narbona M, Dastis-Rodríguez de Guzmán J, Venegas-Moreno E, Soto-Moreno A. Description of characteristics and outcomes of a cohort of patients with severe and enduring eating disorders (SE-ED). J Eat Disord 2021; 9:135. [PMID: 34670625 PMCID: PMC8529819 DOI: 10.1186/s40337-021-00492-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 10/10/2021] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To describe the characteristics of the patients, as well as the treatment outcomes for the people treated in an Endocrinology and Nutrition unit with a diagnosis of SE-ED (> 7 years evolution despite evidence-based conventional treatment). METHODS A descriptive observational study was conducted. Patients with a diagnosis of SE-ED (anorexia nervosa and bulimia nervosa) treated in the Endocrinology and Nutrition service of the Virgen del Rocío University Hospital between 2014 and 2019 were included. RESULTS 67 patients were contacted and accepted to participate in the study. 95.5% were women. 67.2% were diagnosed with AN (anorexia nervosa) and 32.8% with BN (bulimia nervosa). Their median ages (years) at the onset of symptoms, beginning of follow-up and at present were 17, 32 and 42.5 respectively. Their median time of follow-up was 9 years. 73.1% had mental comorbitidy and AN patients had more osteoporosis (48.9% vs 22.7%, p = 0.04) and hypogonadotropic hypogonadism (31.1% vs. 4.5%, p = 0.014). DISCUSSION The SE-ED patients in our sample began treatment years after the onset of symptoms, which may have led to their chronification. This emphasizes the importance of an early diagnosis in eating disorders. They presented with a high rate of physical complications and mental comorbidity. In the current sample, it was determined that patients with AN presented with higher rates of osteoporosis and hypogonadotropic hypogonadism than patients with BN. LEVEL OF EVIDENCE Level III: Evidence obtained from well-designed cohort or case-control analytic studies. At present, the criteria for severe and enduring eating disorders (SE-ED) are not sufficiently clearly defined. It has been calculated that approximately 20% of patients with anorexia nervosa (AN) and 10% of patients with bulimia nervosa (BN) suffer a chronification. We evaluated the characteristics of the patients, as well as the treatment outcomes for the people treated in an Endocrinology and Nutrition unit with a diagnosis of SE-ED (which was made based on an evolution greater than 7 years despite conventional treatment). The SE-ED patients in our sample began treatment years after the onset of symptoms, which may have led to their chronification. They presented with a high rate of physical complications and mental comorbidity. In the current sample, it was determined that patients with AN presented with higher rates of osteoporosis (health condition that weakens bones, making them fragile and more likely to break) and hypogonadotropic hypogonadism (illness in which testes or ovaries produce little or no sex hormones due to a problem in the pituitary gland) than patients with BN.
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Affiliation(s)
- Ana Piñar-Gutiérrez
- Endocrinology and Nutrition Department, Virgen del Rocío University Hospital, Sevilla, Spain. .,Centro de Diagnóstico Y Tratamiento, Planta Baja: Endocrinología Y Nutrición, Av Manuel Siurot sn, CP 41013, Sevilla, Andalucía, Spain.
| | - Elena Dios-Fuentes
- Endocrinology and Nutrition Department, Virgen del Rocío University Hospital, Sevilla, Spain
| | - Pablo Remón-Ruiz
- Endocrinology and Nutrition Department, Virgen del Rocío University Hospital, Sevilla, Spain
| | - Diego Del Can-Sánchez
- Endocrinology and Nutrition Department, Virgen del Rocío University Hospital, Sevilla, Spain
| | | | - Marta López-Narbona
- Mental Health Department, Virgen del Rocío University Hospital, Sevilla, Spain
| | | | - Eva Venegas-Moreno
- Endocrinology and Nutrition Department, Virgen del Rocío University Hospital, Sevilla, Spain
| | - Alfonso Soto-Moreno
- Endocrinology and Nutrition Department, Virgen del Rocío University Hospital, Sevilla, Spain
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19
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Pedraza-Arevalo S, Ibáñez-Costa A, Blázquez-Encinas R, Branco MR, Vázquez-Borrego MC, Herrera-Martínez AD, Venegas-Moreno E, Serrano-Blanch R, Arjona-Sánchez Á, Gálvez-Moreno MA, Korbonits M, Soto-Moreno A, Gahete MD, Charalambous M, Luque RM, Castaño JP. Epigenetic and post-transcriptional regulation of somatostatin receptor subtype 5 (SST 5 ) in pituitary and pancreatic neuroendocrine tumors. Mol Oncol 2021; 16:764-779. [PMID: 34601790 PMCID: PMC8807362 DOI: 10.1002/1878-0261.13107] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 08/19/2021] [Accepted: 09/06/2021] [Indexed: 12/17/2022] Open
Abstract
Somatostatin receptor subtype 5 (SST5) is an emerging biomarker and actionable target in pituitary (PitNETs) and pancreatic (PanNETs) neuroendocrine tumors. Transcriptional and epigenetic regulation of SSTR5 gene expression and mRNA biogenesis is poorly understood. Recently, an overlapping natural antisense transcript, SSTR5‐AS1, potentially regulating SSTR5 expression, was identified. We aimed to elucidate whether epigenetic processes contribute to the regulation of SSTR5 expression in PitNETs (somatotropinomas) and PanNETs. We analyzed the SSTR5/SSTR5‐AS1 human locus in silico to identify CpG islands. SSTR5 and SSTR5‐AS1 expression was assessed by quantitative real‐time PCR (qPCR) in 27 somatotropinomas, 11 normal pituitaries (NPs), and 15 PanNETs/paired adjacent (control) samples. We evaluated methylation grade in four CpG islands in the SSTR5/SSTR5‐AS1 genes. Results revealed that SSTR5 and SSTR5‐AS1 were directly correlated in NP, somatotropinoma, and PanNET samples. Interestingly, selected CpG islands were differentially methylated in somatotropinomas compared with NPs. In PanNETs cell lines, SSTR5‐AS1 silencing downregulated SSTR5 expression, altered aggressiveness features, and influenced pasireotide response. These results provide evidence that SSTR5 expression in PitNETs and PanNETs can be epigenetically regulated by the SSTR5‐AS1 antisense transcript and, indirectly, by DNA methylation, which may thereby impact tumor behavior and treatment response.
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Affiliation(s)
- Sergio Pedraza-Arevalo
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), Córdoba, Spain.,Department of Cell Biology, Physiology, and Immunology, University of Córdoba, Córdoba, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Córdoba, Spain.,Reina Sofia University Hospital, Córdoba, Spain
| | - Alejandro Ibáñez-Costa
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), Córdoba, Spain.,Department of Cell Biology, Physiology, and Immunology, University of Córdoba, Córdoba, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Córdoba, Spain.,Reina Sofia University Hospital, Córdoba, Spain
| | - Ricardo Blázquez-Encinas
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), Córdoba, Spain.,Department of Cell Biology, Physiology, and Immunology, University of Córdoba, Córdoba, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Córdoba, Spain.,Reina Sofia University Hospital, Córdoba, Spain
| | - Miguel R Branco
- Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Mari C Vázquez-Borrego
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), Córdoba, Spain.,Department of Cell Biology, Physiology, and Immunology, University of Córdoba, Córdoba, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Córdoba, Spain.,Reina Sofia University Hospital, Córdoba, Spain
| | - Aura D Herrera-Martínez
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), Córdoba, Spain.,Endocrinology and Nutrition Service, Reina Sofia University Hospital, Córdoba, Spain
| | - Eva Venegas-Moreno
- Metabolism and Nutrition Unit, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS), Sevilla, Spain
| | - Raquel Serrano-Blanch
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), Córdoba, Spain.,Medical Oncology Service, Reina Sofia University Hospital, Córdoba, Spain
| | - Álvaro Arjona-Sánchez
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), Córdoba, Spain.,Surgery Service, Reina Sofia University Hospital, Córdoba, Spain
| | - María A Gálvez-Moreno
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), Córdoba, Spain.,Endocrinology and Nutrition Service, Reina Sofia University Hospital, Córdoba, Spain
| | - Marta Korbonits
- Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Alfonso Soto-Moreno
- Metabolism and Nutrition Unit, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS), Sevilla, Spain
| | - Manuel D Gahete
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), Córdoba, Spain.,Department of Cell Biology, Physiology, and Immunology, University of Córdoba, Córdoba, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Córdoba, Spain.,Reina Sofia University Hospital, Córdoba, Spain
| | - Marika Charalambous
- Developmental Epigenetics group, Department of Medical and Molecular Genetics, King's College of London, London, UK
| | - Raúl M Luque
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), Córdoba, Spain.,Department of Cell Biology, Physiology, and Immunology, University of Córdoba, Córdoba, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Córdoba, Spain.,Reina Sofia University Hospital, Córdoba, Spain
| | - Justo P Castaño
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), Córdoba, Spain.,Department of Cell Biology, Physiology, and Immunology, University of Córdoba, Córdoba, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Córdoba, Spain.,Reina Sofia University Hospital, Córdoba, Spain
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20
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Del Can-Sanchez DJ, Sanchez DJDC, Martínez-Ortega AJ, Flores-Martínez A, Venegas-Moreno E, Dios-Fuentes ME, Madrazo-Atutxa A, Valdepeñas ECR, Kaen AM, Márquez-Rivas FJ, Roldán-Lora AF, Fajardo-Picó E, Cano-González D, Soto-Moreno A. Markers of Aggressiveness in Craniopharyngiomas. J Endocr Soc 2021. [PMCID: PMC8090695 DOI: 10.1210/jendso/bvab048.1317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Craniopharyngiomas (CP) are rare tumors that may be locally aggressive. The presence of functional estrogen receptors (ER) has been reported in CP and might be related to risk of recurrence. Our aim is to ascertain if the expression estrogen and progesterone receptor (PR) might be associated with to recurrence in CP. Material and Methods: Descriptive retrospective observational study of patients with confirmed histology of CP and tissue sample available admitted to Virgen Del Rocio University Hospital (Seville, Spain) from January 1967 to October 2020 were included. Estrogen and progesterone receptor expression was analyzed by Immunohistochemistry. Ki-67 levels were also analyzed. Two CP groups were considereded according to Ki67 levels: Group A (Ki67<10%) and group B (Ki67>10%). As all variables followed a non-parametric distribution, U Mann Whitney, Chi-Square, and Z-test with Benjamini-Hochberg correction were used when needed. Results: Our study population includes 80 patients (46 male and 34 female), with a median age at diagnosis of 34 years [10-50.00]. Twenty-six patients were under 18 years old (children) with a median age of 7 years [4.5-10.00], and 54 were adults (aged 18 and above) with a median age of 45 years [33-58.50]. Our data shows higher recurrence rates when Ki67 levels staining were higher than 10%: 8/14 (57.2%) in comparison with Ki67<10% (6/14, 42.9%, p=0.018). In children we found 6 samples with Ki67<10% and 6 samples with Ki67 >10%; recurrences were observed in 2/6 (33,3%) in the first group and in 6/6 (100%) in the second, respectively (p= 0,199). In adults, we found 9 and 3 patients for high and low Ki67 levels, respectively. Recurrences were observed in 4/9 (44,4%) in the group A and in 2/3 (66,7%) in the group B, respectively (p= 0,28). There were no differences between age groups. In patients with positive ER, we observed an increased rate of recurrence: 12/23 (52.17%) versus 2/13 (15,38%) in patients with negative ER stain but it was no significant. (p=0,21). No association between PR and recurrence was observed. Conclusions: In our series, patients with CP with high Ki67 levels are more likely to recur. No clear association between ER, PR expression and recurrence was observed. These findings support the use of Ki67 as a marker of recurrence in CP. Sources of Research Support: Spanish Ministry of Health, ISCIII co-funded with Fondos FEDER (PI16/00175) and Novartis Oncology Spain.
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21
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Remón-Ruiz P, Venegas-Moreno E, Dios-Fuentes E, Moreno JMC, Fernandez Peña I, Garcia MA, Japón-Rodriguez MA, Roldán F, Fajardo E, Kaen A, Ruiz-Valdepeñas EC, Cano D, Soto-Moreno A. A Silent Corticotroph Pituitary Carcinoma: Lessons From an Exceptional Case Report. Front Endocrinol (Lausanne) 2021; 12:784889. [PMID: 34992581 PMCID: PMC8725817 DOI: 10.3389/fendo.2021.784889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 11/30/2021] [Indexed: 11/22/2022] Open
Abstract
Nowadays, neither imaging nor pathology evaluation can accurately predict the aggressiveness or treatment resistance of pituitary tumors at diagnosis. However, histological examination can provide useful information that might alert clinicians about the nature of pituitary tumors. Here, we describe our experience with a silent corticothoph tumor with unusual pathology, aggressive local invasion and metastatic dissemination during follow-up. We present a 61-year-old man with third cranial nerve palsy at presentation due to invasive pituitary tumor. Subtotal surgical approach was performed with a diagnosis of silent corticotroph tumor but with unusual histological features (nuclear atypia, frequent multinucleation and mitotic figures, and Ki-67 labeling index up to 70%). After a rapid regrowth, a second surgical intervention achieved successful debulking. Temozolomide treatment followed by stereotactic fractionated radiotherapy associated with temozolomide successfully managed the primary tumor. However, sacral metastasis showed up 6 months after radiotherapy treatment. Due to aggressive distant behavior, a carboplatine-etoposide scheme was decided but the patient died of urinary sepsis 31 months after the first symptoms. Our case report shows how the presentation of a pituitary tumor with aggressive features should raise a suspicion of malignancy and the need of follow up by multidisciplinary team with experience in its management. Metastases may occur even if the primary tumor is well controlled.
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Affiliation(s)
- Pablo Remón-Ruiz
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBiS), Virgen del Rocio University Hospital/Centro Superior de Investigaciones Científicas (CSIC)/University of Seville, Seville, Spain
- *Correspondence: Pablo Remón-Ruiz, ; orcid.org/0000-0002-4551-8159
| | - Eva Venegas-Moreno
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBiS), Virgen del Rocio University Hospital/Centro Superior de Investigaciones Científicas (CSIC)/University of Seville, Seville, Spain
| | - Elena Dios-Fuentes
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBiS), Virgen del Rocio University Hospital/Centro Superior de Investigaciones Científicas (CSIC)/University of Seville, Seville, Spain
| | - Juan Manuel Canelo Moreno
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBiS), Virgen del Rocio University Hospital/Centro Superior de Investigaciones Científicas (CSIC)/University of Seville, Seville, Spain
| | - Ignacio Fernandez Peña
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Virgen de Valme University Hospital, Seville, Spain
| | - Miriam Alonso Garcia
- Unidad de Gestión Clínica de Oncología médica, Oncología Radioterápica y Radiofísica Hospitalaria, Virgen del Rocio University Hospital, Seville, Spain
| | | | - Florinda Roldán
- Unidad de Gestión de Radiodiagnóstico, Virgen del Rocio University Hospital, Seville, Spain
| | - Elena Fajardo
- Unidad de Gestión de Radiodiagnóstico, Virgen del Rocio University Hospital, Seville, Spain
| | - Ariel Kaen
- Unidad de Gestión Clínica de Neurocirugía, Virgen del Rocío University Hospital, Seville, Spain
| | | | - David Cano
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBiS), Virgen del Rocio University Hospital/Centro Superior de Investigaciones Científicas (CSIC)/University of Seville, Seville, Spain
| | - Alfonso Soto-Moreno
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBiS), Virgen del Rocio University Hospital/Centro Superior de Investigaciones Científicas (CSIC)/University of Seville, Seville, Spain
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22
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Iglesias P, Nocete I, Moure Rodríguez MD, Venegas-Moreno E, Ares J, Biagetti B, Rodríguez Berrocal V, Guerrero-Pérez F, Vicente A, Villar-Taibo R, Cordido F, Paja M, Glerean M, González Rivera N, Dios Fuentes E, Blanco C, Alvaréz-Escolá C, Martín T, Webb SM, Bernabéu I, Villabona C, Soto-Moreno A, Gaztambide S, Díez JJ. Craniopharyngioma in the Elderly: A Multicenter and Nationwide Study in Spain. Neuroendocrinology 2021; 111:925-936. [PMID: 33040060 DOI: 10.1159/000512161] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 10/03/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Craniopharyngioma (CP) is a rare tumor in the elderly whose clinical features and prognosis are not well known in this population. AIM To evaluate the clinicopathological features and therapeutic outcomes of CP diagnosed in the elderly. PATIENTS AND METHODS This was a retrospective, multicenter, national study of CP patients diagnosed over the age of 65 years and surgically treated. RESULTS From a total of 384 adult CP patients, we selected 53 (13.8%) patients (27 women [50.9%], mean age 72.3 ± 5.1 years [range 65-83 years]) diagnosed after the age of 65 years. The most common clinical symptoms were visual field defects (71.2%) followed by headache (45.3%). The maximum tumor diameter was 2.9 ± 1.1 cm. In most patients, the tumor was suprasellar (96.2%) and mixed (solid-cystic) (58.5%). The surgical approach most commonly used was transcranial surgery (52.8%), and more than half of the patients (54.7%) underwent subtotal resection (STR). Adamantinomatous CP and papillary CP were present in 51 and 45.1%, respectively, with mixed forms in the remaining. Surgery was accompanied by an improvement in visual field defects and in headaches; however, pituitary hormonal hypofunction increased, mainly at the expense of an increase in the prevalence of diabetes insipidus (DI) (from 3.9 to 69.2%). Near-total resection (NTR) was associated with a higher prevalence of DI compared with subtotal resection (87.5 vs. 53.6%, p = 0.008). Patients were followed for 46.7 ± 40.8 months. The mortality rate was 39.6% with a median survival time of 88 (95% CI: 57-118) months. DI at last visit was associated with a lower survival. CONCLUSION CP diagnosed in the elderly shows a similar distribution by sex and histologic forms than that diagnosed at younger ages. At presentation, visual field alterations and headaches are the main clinical symptoms which improve substantially with surgery. However, surgery, mainly NTR, is accompanied by worsening of pituitary function, especially DI, which seems to be a predictor of mortality in this population.
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Affiliation(s)
- Pedro Iglesias
- Department of Endocrinology, Hospital Universitario Puerta de Hierro Majadahonda, Instituto de Investigación Sanitaria Puerta de Hierro Segovia de Arana (IDIPHISA), Madrid, Spain,
| | - Ignacio Nocete
- Department of Endocrinology, Hospital Universitario Puerta de Hierro Majadahonda, Instituto de Investigación Sanitaria Puerta de Hierro Segovia de Arana (IDIPHISA), Madrid, Spain
| | - María Dolores Moure Rodríguez
- Department of Endocrinology, Hospital Universitario Cruces, Biocruces Bizkaia, EndoERN, Cruces Barakaldo.Bizkaia, Barakaldo, Spain
| | - Eva Venegas-Moreno
- Department of Endocrinology, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Jessica Ares
- Department of Endocrinology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Betina Biagetti
- Department of Endocrinology, Universitari Vall d'Hebron, Barcelona, Spain
| | | | - Fernando Guerrero-Pérez
- Department of Endocrinology, Hospital de Bellvitge (L'Hospitalet de Llobregat), Barcelona, Spain
| | - Almudena Vicente
- Department of Endocrinology, Hospital Virgen de la Salud, Toledo, Spain
| | - Rocío Villar-Taibo
- Department of Endocrinology, Complexo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Fernando Cordido
- Department of Endocrinology, Complejo Hospitalario Universitario A Coruña, A Coruña, Spain
- Facultad de Ciencias de la Salud, Universidad de A Coruña, A Coruña, Spain
| | - Miguel Paja
- Department of Endocrinology, Hospital Universitario de Basurto, Bilbao, Spain
| | - Mariela Glerean
- Department of Endocrinology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
- Department of Endocrinology, Hospital Sant Pau, Department of Medicine/Endocrinology, IIB-Sant Pau, Research Center for Pituitary Diseases, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, Unidad 747), ISCIII, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Elena Dios Fuentes
- Department of Endocrinology, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Concepción Blanco
- Department of Endocrinology, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
| | | | - Tomás Martín
- Department of Endocrinology, Hospital Universitario Virgen de la Macarena, Sevilla, Spain
| | - Susan M Webb
- Department of Endocrinology, Hospital Sant Pau, Department of Medicine/Endocrinology, IIB-Sant Pau, Research Center for Pituitary Diseases, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, Unidad 747), ISCIII, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ignacio Bernabéu
- Department of Endocrinology, Complexo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Carles Villabona
- Department of Endocrinology, Hospital de Bellvitge (L'Hospitalet de Llobregat), Barcelona, Spain
| | - Alfonso Soto-Moreno
- Department of Endocrinology, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Sonia Gaztambide
- Department of Endocrinology, Hospital Universitario Cruces, Biocruces Bizkaia, EndoERN, Cruces Barakaldo.Bizkaia, Barakaldo, Spain
- UPV-EHU, CIBERDEM, CIBERER, Barakaldo, Spain
| | - Juan J Díez
- Department of Endocrinology, Hospital Universitario Puerta de Hierro Majadahonda, Instituto de Investigación Sanitaria Puerta de Hierro Segovia de Arana (IDIPHISA), Madrid, Spain
- Department of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
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23
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Flores-Martinez Á, Venegas-Moreno E, Dios E, Remón-Ruiz P, Gros-Herguido N, Vázquez-Borrego MC, Madrazo-Atutxa A, Japón MA, Kaen A, Cárdenas-Valdepeñas E, Roldán F, Castaño JP, Luque RM, Cano DA, Soto-Moreno A. Quantitative Analysis of Somatostatin and Dopamine Receptors Gene Expression Levels in Non-functioning Pituitary Tumors and Association with Clinical and Molecular Aggressiveness Features. J Clin Med 2020; 9:jcm9093052. [PMID: 32971845 PMCID: PMC7565399 DOI: 10.3390/jcm9093052] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 09/03/2020] [Accepted: 09/07/2020] [Indexed: 01/11/2023] Open
Abstract
The primary treatment for non-functioning pituitary tumors (NFPTs) is surgery, but it is often unsuccessful. Previous studies have reported that NFPTs express receptors for somatostatin (SST1-5) and dopamine (DRDs) providing a rationale for the use of dopamine agonists and somatostatin analogues. Here, we systematically assessed SST1-5 and DRDs expression by real-time quantitative PCR (RT-qPCR) in a large group of patients with NFPTs (n = 113) and analyzed their potential association with clinical and molecular aggressiveness features. SST1-5 expression was also evaluated by immunohistochemistry. SST3 was the predominant SST subtype detected, followed by SST2, SST5, and SST1. DRD2 was the dominant DRD subtype, followed by DRD4, DRD5, and DRD1. A substantial proportion of NFPTs displayed marked expression of SST2 and SST5. No major association between SSTs and DRDs expression and clinical and molecular aggressiveness features was observed in NFPTs.
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Affiliation(s)
- Álvaro Flores-Martinez
- Unidad de Gestión de Endocrinología y Nutrición. Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, 41013 Sevilla, Spain; (Á.F.-M.); (E.V.-M.); (E.D.); (P.R.-R.); (N.G.-H.); (A.M.-A.)
| | - Eva Venegas-Moreno
- Unidad de Gestión de Endocrinología y Nutrición. Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, 41013 Sevilla, Spain; (Á.F.-M.); (E.V.-M.); (E.D.); (P.R.-R.); (N.G.-H.); (A.M.-A.)
| | - Elena Dios
- Unidad de Gestión de Endocrinología y Nutrición. Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, 41013 Sevilla, Spain; (Á.F.-M.); (E.V.-M.); (E.D.); (P.R.-R.); (N.G.-H.); (A.M.-A.)
| | - Pablo Remón-Ruiz
- Unidad de Gestión de Endocrinología y Nutrición. Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, 41013 Sevilla, Spain; (Á.F.-M.); (E.V.-M.); (E.D.); (P.R.-R.); (N.G.-H.); (A.M.-A.)
| | - Noelia Gros-Herguido
- Unidad de Gestión de Endocrinología y Nutrición. Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, 41013 Sevilla, Spain; (Á.F.-M.); (E.V.-M.); (E.D.); (P.R.-R.); (N.G.-H.); (A.M.-A.)
| | - M. Carmen Vázquez-Borrego
- Maimonides Institute for Biomedical Research of Córdoba (IMIBIC), 14004 Córdoba, Spain; (M.C.V.-B.); (J.P.C.); (R.M.L.)
- Department of Cell Biology, Physiology and Immunology, University of Córdoba, 14004 Córdoba, Spain
- Hospital Universitario Reina Sofía, 14004 Córdoba, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), 14004 Córdoba, Spain
| | - Ainara Madrazo-Atutxa
- Unidad de Gestión de Endocrinología y Nutrición. Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, 41013 Sevilla, Spain; (Á.F.-M.); (E.V.-M.); (E.D.); (P.R.-R.); (N.G.-H.); (A.M.-A.)
| | - Miguel A. Japón
- Department of Pathology, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, 41013 Sevilla, Spain;
| | - Ariel Kaen
- Servicio de Neurocirugía, Hospital Universitario Virgen del Rocío, 41013 Sevilla, Spain; (A.K.); (E.C.-V.)
| | | | - Florinda Roldán
- Servicio de Radiología, Hospital Universitario Virgen del Rocío, 41013 Sevilla, Spain;
| | - Justo P. Castaño
- Maimonides Institute for Biomedical Research of Córdoba (IMIBIC), 14004 Córdoba, Spain; (M.C.V.-B.); (J.P.C.); (R.M.L.)
- Department of Cell Biology, Physiology and Immunology, University of Córdoba, 14004 Córdoba, Spain
- Hospital Universitario Reina Sofía, 14004 Córdoba, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), 14004 Córdoba, Spain
| | - Raúl M. Luque
- Maimonides Institute for Biomedical Research of Córdoba (IMIBIC), 14004 Córdoba, Spain; (M.C.V.-B.); (J.P.C.); (R.M.L.)
- Department of Cell Biology, Physiology and Immunology, University of Córdoba, 14004 Córdoba, Spain
- Hospital Universitario Reina Sofía, 14004 Córdoba, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), 14004 Córdoba, Spain
| | - David A. Cano
- Unidad de Gestión de Endocrinología y Nutrición. Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, 41013 Sevilla, Spain; (Á.F.-M.); (E.V.-M.); (E.D.); (P.R.-R.); (N.G.-H.); (A.M.-A.)
- Correspondence: (D.A.C.); (A.S.-M.)
| | - Alfonso Soto-Moreno
- Unidad de Gestión de Endocrinología y Nutrición. Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, 41013 Sevilla, Spain; (Á.F.-M.); (E.V.-M.); (E.D.); (P.R.-R.); (N.G.-H.); (A.M.-A.)
- Correspondence: (D.A.C.); (A.S.-M.)
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Remón-Ruiz P, Venegas-Moreno E, Dios Fuentes E, Matias Kaen A, Cardenas Ruiz-Valdepeñas E, Martin-Schrader I, Roldán F, Fajardo E, Cano D, Soto-Moreno A. Our experience in prolactinomas larger than 60mm. ACTA ACUST UNITED AC 2020; 68:3-10. [PMID: 32861621 DOI: 10.1016/j.endinu.2020.03.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 03/11/2020] [Accepted: 03/14/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Giant prolactinomas (tumor size larger than 40mm) are a rare entity of benign nature. Prolactinomas larger than 60mm are usually underrepresented in published studies and their clinical presentation, outcomes and management might be different from smaller giant prolactinomas. PATIENTS AND METHODS We retrospective collected data from patients with prolactinomas larger than 60mm in maximum diameter and prolactin (PRL) serum levels higher than 21,200μIU/mL in our series of prolactinomas (283). Data were collected from January 2012 to December 2017. We included three patients with prolactinomas larger than 60mm. RESULTS At diagnosis, two patients presented neurological symptoms and one nasal protrusion. All patients received medical treatment with dopamine agonists. No surgical procedure was performed. Median prolactin levels at diagnosis was 108,180 [52,594-514,984]μIU/mL. Medical treatment achieved a marked reduction (>99%) in prolactin levels in all cases. Tumor size reduction (higher than 33%) was observed in all cases. In one patient cerebrospinal fluid (CSF) leak was observed after tumor shrinkage. CONCLUSIONS Dopamine agonists appear to be an effective and safe first-line treatment in prolactinomas larger than 60mm even in life-threatening situations. More studies with a higher number of patients are necessary to obtain enough data to make major recommendations.
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Affiliation(s)
- Pablo Remón-Ruiz
- Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBiS), Virgen del Rocio University Hospital/CSIC/University of Seville, Spain.
| | - Eva Venegas-Moreno
- Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBiS), Virgen del Rocio University Hospital/CSIC/University of Seville, Spain
| | - Elena Dios Fuentes
- Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBiS), Virgen del Rocio University Hospital/CSIC/University of Seville, Spain
| | - Ariel Matias Kaen
- Neurosurgery Department, Virgen del Rocío University Hospital, Sevilla, Spain
| | | | | | - Florinda Roldán
- Unidad de Gestión de Radiodiagnóstico, Virgen del Rocio University Hospital, Spain
| | - Elena Fajardo
- Unidad de Gestión de Radiodiagnóstico, Virgen del Rocio University Hospital, Spain
| | - David Cano
- Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBiS), Virgen del Rocio University Hospital/CSIC/University of Seville, Spain
| | - Alfonso Soto-Moreno
- Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBiS), Virgen del Rocio University Hospital/CSIC/University of Seville, Spain
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Vázquez-Borrego MC, Gupta V, Ibáñez-Costa A, Gahete MD, Venegas-Moreno E, Toledano-Delgado Á, Cano DA, Blanco-Acevedo C, Ortega-Salas R, Japón MA, Barrera-Martín A, Vasiljevic A, Hill J, Zhang S, Halem H, Solivera J, Raverot G, Gálvez MA, Soto-Moreno A, Paez-Pereda M, Culler MD, Castaño JP, Luque RM. A Somatostatin Receptor Subtype-3 (SST 3) Peptide Agonist Shows Antitumor Effects in Experimental Models of Nonfunctioning Pituitary Tumors. Clin Cancer Res 2020; 26:957-969. [PMID: 31624102 DOI: 10.1158/1078-0432.ccr-19-2154] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 09/08/2019] [Accepted: 10/14/2019] [Indexed: 11/16/2022]
Abstract
PURPOSE Somatostatin analogues (SSA) are efficacious and safe treatments for a variety of neuroendocrine tumors, especially pituitary neuroendocrine tumors (PitNET). Their therapeutic effects are mainly mediated by somatostatin receptors SST2 and SST5. Most SSAs, such as octreotide/lanreotide/pasireotide, are either nonselective or activate mainly SST2. However, nonfunctioning pituitary tumors (NFPTs), the most common PitNET type, mainly express SST3 and finding peptides that activate this particular somatostatin receptor has been very challenging. Therefore, the main objective of this study was to identify SST3-agonists and characterize their effects on experimental NFPT models. EXPERIMENTAL DESIGN Binding to SSTs and cAMP level determinations were used to screen a peptide library and identify SST3-agonists. Key functional parameters (cell viability/caspase activity/chromogranin-A secretion/mRNA expression/intracellular signaling pathways) were assessed on NFPT primary cell cultures in response to SST3-agonists. Tumor growth was assessed in a preclinical PitNET mouse model treated with a SST3-agonist. RESULTS We successfully identified the first SST3-agonist peptides. SST3-agonists lowered cell viability and chromogranin-A secretion, increased apoptosis in vitro, and reduced tumor growth in a preclinical PitNET model. As expected, inhibition of cell viability in response to SST3-agonists defined two NFPT populations: responsive and unresponsive, wherein responsive NFPTs expressed more SST3 than unresponsive NFPTs and exhibited a profound reduction of MAPK, PI3K-AKT/mTOR, and JAK/STAT signaling pathways upon SST3-agonist treatments. Concurrently, SSTR3 silencing increased cell viability in a subset of NFPTs. CONCLUSIONS This study demonstrates that SST3-agonists activate signaling mechanisms that reduce NFPT cell viability and inhibit pituitary tumor growth in experimental models that expresses SST3, suggesting that targeting this receptor could be an efficacious treatment for NFPTs.
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Affiliation(s)
- Mari C Vázquez-Borrego
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain.,Department of Cell Biology, Physiology and Immunology, University of Cordoba, Cordoba, Spain.,Reina Sofia University Hospital (HURS), Cordoba, Spain.,CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Cordoba, Spain
| | | | - Alejandro Ibáñez-Costa
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain.,Department of Cell Biology, Physiology and Immunology, University of Cordoba, Cordoba, Spain.,Reina Sofia University Hospital (HURS), Cordoba, Spain.,CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Cordoba, Spain
| | - Manuel D Gahete
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain.,Department of Cell Biology, Physiology and Immunology, University of Cordoba, Cordoba, Spain.,Reina Sofia University Hospital (HURS), Cordoba, Spain.,CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Cordoba, Spain
| | - Eva Venegas-Moreno
- Metabolism and Nutrition Unit, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS), Sevilla, Spain
| | - Álvaro Toledano-Delgado
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain.,Reina Sofia University Hospital (HURS), Cordoba, Spain.,Service of Neurosurgery, HURS, Cordoba, Spain
| | - David A Cano
- Metabolism and Nutrition Unit, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS), Sevilla, Spain
| | - Cristóbal Blanco-Acevedo
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain.,Reina Sofia University Hospital (HURS), Cordoba, Spain.,Service of Neurosurgery, HURS, Cordoba, Spain
| | - Rosa Ortega-Salas
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain.,Reina Sofia University Hospital (HURS), Cordoba, Spain.,Anatomical Pathology Service, HURS, Cordoba, Spain
| | - Miguel A Japón
- Department of Pathology, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Ana Barrera-Martín
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain.,Reina Sofia University Hospital (HURS), Cordoba, Spain.,Service of Endocrinology and Nutrition, IMIBIC, HURS, Cordoba, Spain
| | - Alexandre Vasiljevic
- Faculté de Médecine Lyon Est, Université Lyon 1, Lyon, France.,INSERM U1052, CNRS UMR5286, Cancer Research Centre of Lyon, Lyon, France.,Centre de Pathologie et de Biologie, Groupement Hospitalier Est, Hospices Civils de Lyon, Lyon, France
| | - Jason Hill
- IPSEN Bioscience, Cambridge, Massachusetts
| | | | | | - Juan Solivera
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain.,Reina Sofia University Hospital (HURS), Cordoba, Spain.,Service of Neurosurgery, HURS, Cordoba, Spain
| | - Gérald Raverot
- Faculté de Médecine Lyon Est, Université Lyon 1, Lyon, France.,INSERM U1052, CNRS UMR5286, Cancer Research Centre of Lyon, Lyon, France.,Fédération d'endocrinologie, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France
| | - María A Gálvez
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain.,Reina Sofia University Hospital (HURS), Cordoba, Spain.,Service of Endocrinology and Nutrition, IMIBIC, HURS, Cordoba, Spain
| | - Alfonso Soto-Moreno
- Metabolism and Nutrition Unit, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS), Sevilla, Spain
| | | | | | - Justo P Castaño
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain. .,Department of Cell Biology, Physiology and Immunology, University of Cordoba, Cordoba, Spain.,Reina Sofia University Hospital (HURS), Cordoba, Spain.,CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Cordoba, Spain
| | - Raúl M Luque
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain. .,Department of Cell Biology, Physiology and Immunology, University of Cordoba, Cordoba, Spain.,Reina Sofia University Hospital (HURS), Cordoba, Spain.,CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Cordoba, Spain
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Vázquez-Borrego MC, L-López F, Gálvez-Moreno MA, Fuentes-Fayos AC, Venegas-Moreno E, Herrera-Martínez AD, Blanco-Acevedo C, Solivera J, Landsman T, Gahete MD, Soto-Moreno A, Culler MD, Castaño JP, Luque RM. A New Generation Somatostatin-Dopamine Analogue Exerts Potent Antitumoral Actions on Pituitary Neuroendocrine Tumor Cells. Neuroendocrinology 2020; 110:70-82. [PMID: 31272096 DOI: 10.1159/000500812] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 05/03/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Pituitary neuroendocrine tumors (PitNETs) represent approximately 15% of all intracranial tumors and usually are associated with severe comorbidities. Unfortunately, a relevant number of patients do not respond to currently available pharmacological treatments, that is, somatostatin analogs (SSAs) or dopamine-agonists (DA). Thus, novel, chimeric somatostatin/dopamine compounds (dopastatins) that could improve medical treatment of PitNETs have been designed. OBJECTIVE This study aims to determine the direct therapeutic effects of a new-generation dopastatin, BIM-065, on primary cell cultures from different PitNETs subtypes. METHODS Thirty-one PitNET-derived cell cultures (9 corticotropinomas, 9 somatotropinomas, 11 nonfunctioning pituitary adenomas [NFPAs], and 2 prolactinomas), were treated with BIM-065, and key functional endpoints were assessed (cell viability, apoptosis, hormone secretion, expression levels of key genes, free cytosolic [Ca2+]i dynamics, etc.). AtT-20 cell line was used to evaluate signaling pathways in response to BIM-065. RESULTS This chimeric compound decreased cell viability in all corticotropinomas and somatotropinomas tested, but not in NFPAs. BIM-065 reduced ACTH, GH, chromogranin-A and PRL secretion, and increased apoptosis in corticotropinomas, somatotropinomas, and NFPAs. These effects were possibly mediated through modulation of pivotal signaling cascades like [Ca2+]i kinetic and Akt- or ERK1/2-phosphorylation. CONCLUSIONS Our results unveil a robust antitumoral effect in vitro of the novel chimeric compound BIM-065 on the main PitNET subtypes, inform on the mechanisms involved, and suggest that BIM-065 could be an efficacious therapeutic option to be considered in the treatment of PitNETs.
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Affiliation(s)
- Mari C Vázquez-Borrego
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, Cordoba, Spain
- Reina Sofia University Hospital (HURS), Cordoba, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Cordoba, Spain
| | - Fernando L-López
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, Cordoba, Spain
- Reina Sofia University Hospital (HURS), Cordoba, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Cordoba, Spain
| | - María A Gálvez-Moreno
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, Cordoba, Spain
- Reina Sofia University Hospital (HURS), Cordoba, Spain
- Service of Endocrinology and Nutrition, IMIBIC, HURS, Cordoba, Spain
| | - Antonio C Fuentes-Fayos
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, Cordoba, Spain
- Reina Sofia University Hospital (HURS), Cordoba, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Cordoba, Spain
| | - Eva Venegas-Moreno
- Metabolism and Nutrition Unit, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS), Sevilla, Spain
| | - Aura D Herrera-Martínez
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain
- Reina Sofia University Hospital (HURS), Cordoba, Spain
- Service of Endocrinology and Nutrition, IMIBIC, HURS, Cordoba, Spain
| | - Cristóbal Blanco-Acevedo
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain
- Reina Sofia University Hospital (HURS), Cordoba, Spain
- Service of Neurosurgery, HURS, Cordoba, Spain
| | - Juan Solivera
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain
- Reina Sofia University Hospital (HURS), Cordoba, Spain
- Service of Neurosurgery, HURS, Cordoba, Spain
| | | | - Manuel D Gahete
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, Cordoba, Spain
- Reina Sofia University Hospital (HURS), Cordoba, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Cordoba, Spain
| | - Alfonso Soto-Moreno
- Metabolism and Nutrition Unit, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS), Sevilla, Spain
| | | | - Justo P Castaño
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, Cordoba, Spain
- Reina Sofia University Hospital (HURS), Cordoba, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Cordoba, Spain
| | - Raúl M Luque
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain,
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, Cordoba, Spain,
- Reina Sofia University Hospital (HURS), Cordoba, Spain,
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Cordoba, Spain,
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Vázquez-Borrego MC, Fuentes-Fayos AC, Herrera-Martínez AD, Venegas-Moreno E, L-López F, Fanciulli A, Moreno-Moreno P, Alhambra-Expósito MR, Barrera-Martín A, Dios E, Blanco-Acevedo C, Solivera J, Granata R, Kineman RD, Gahete MD, Soto-Moreno A, Gálvez-Moreno MA, Castaño JP, Luque RM. Statins Directly Regulate Pituitary Cell Function and Exert Antitumor Effects in Pituitary Tumors. Neuroendocrinology 2020; 110:1028-1041. [PMID: 31940630 DOI: 10.1159/000505923] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 01/11/2020] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Pituitary neuroendocrine tumors (PitNETs), the most abundant of all intracranial tumors, entail severe comorbidities. First-line therapy is transsphenoidal surgery, but subsequent pharmacological therapy is often required. Unfortunately, many patients are/become unresponsive to available drugs (somatostatin analogues [SSAs]/dopamine agonists), underscoring the need for new therapies. Statins are well-known drugs commonly prescribed to treat hyperlipidemia/cardiovascular diseases, but can convey additional beneficial effects, including antitumor actions. The direct effects of statins on normal human pituitary or PitNETs are poorly known. Thus, we aimed to explore the direct effects of statins, especially simvastatin, on key functional parameters in normal and tumoral pituitary cells, and to evaluate the combined effects of simvastatin with metformin (MF) or SSAs. METHODS Effects of statins in cell proliferation/viability, hormone secretion, and signaling pathways were evaluated in normal pituitary cells from a primate model (Papio anubis), tumor cells from corticotropinomas, somatotropinomas, nonfunctioning pituitary tumors, and PitNET cell-lines (AtT20/GH3-cells). RESULTS All statins decreased AtT20-cell proliferation, simvastatin showing stronger effects. Indeed, simvastatin reduced cell viability and/or hormone secretion in all PitNETs subtypes and cell-lines, and ACTH/GH/PRL/FSH/LH secretion (but not expression), in primate cell cultures, by modulating MAPK/PI3K/mTOR pathways and expression of key receptors (GH-releasing hormone-receptor/ghrelin-R/Kiss1-R) regulating pituitary function. Addition of MF or SSAs did not enhance simvastatin antitumor effects. CONCLUSION Our data reveal direct antitumor effects of simvastatin on PitNET-cells, paving the way to explore these compounds as a possible tool to treat PitNETs.
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Affiliation(s)
- Mari C Vázquez-Borrego
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, Cordoba, Spain
- Reina Sofia University Hospital (HURS), Cordoba, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Cordoba, Spain
| | - Antonio C Fuentes-Fayos
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, Cordoba, Spain
- Reina Sofia University Hospital (HURS), Cordoba, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Cordoba, Spain
| | - Aura D Herrera-Martínez
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain
- Reina Sofia University Hospital (HURS), Cordoba, Spain
- Service of Endocrinology and Nutrition, IMIBIC, HURS, Cordoba, Spain
| | - Eva Venegas-Moreno
- Metabolism and Nutrition Unit, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla, Sevilla, Spain
| | - Fernando L-López
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, Cordoba, Spain
- Reina Sofia University Hospital (HURS), Cordoba, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Cordoba, Spain
| | - Alessandro Fanciulli
- Division of Endocrinology, Diabetes and Metabolism, Department of Medical Sciences, University of Turin and Città Della Salute e Della Scienza Hopital, Turin, Italy
| | - Paloma Moreno-Moreno
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain
- Reina Sofia University Hospital (HURS), Cordoba, Spain
- Service of Endocrinology and Nutrition, IMIBIC, HURS, Cordoba, Spain
| | - María R Alhambra-Expósito
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain
- Reina Sofia University Hospital (HURS), Cordoba, Spain
- Service of Endocrinology and Nutrition, IMIBIC, HURS, Cordoba, Spain
| | - Ana Barrera-Martín
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain
- Reina Sofia University Hospital (HURS), Cordoba, Spain
- Service of Endocrinology and Nutrition, IMIBIC, HURS, Cordoba, Spain
| | - Elena Dios
- Metabolism and Nutrition Unit, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla, Sevilla, Spain
| | - Cristóbal Blanco-Acevedo
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain
- Reina Sofia University Hospital (HURS), Cordoba, Spain
- Service of Neurosurgery, HURS, Cordoba, Spain
| | - Juan Solivera
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain
- Reina Sofia University Hospital (HURS), Cordoba, Spain
- Service of Neurosurgery, HURS, Cordoba, Spain
| | - Riccarda Granata
- Division of Endocrinology, Diabetes and Metabolism, Department of Medical Sciences, University of Turin and Città Della Salute e Della Scienza Hopital, Turin, Italy
| | - Rhonda D Kineman
- Division of Research and Developments, Department of Medicine, Jesse Brown Veterans Affairs Medical Center, Section of Endocrinology, Diabetes, and Metabolism, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Manuel D Gahete
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, Cordoba, Spain
- Reina Sofia University Hospital (HURS), Cordoba, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Cordoba, Spain
| | - Alfonso Soto-Moreno
- Metabolism and Nutrition Unit, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla, Sevilla, Spain
| | - María A Gálvez-Moreno
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain
- Reina Sofia University Hospital (HURS), Cordoba, Spain
- Service of Endocrinology and Nutrition, IMIBIC, HURS, Cordoba, Spain
| | - Justo P Castaño
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, Cordoba, Spain
- Reina Sofia University Hospital (HURS), Cordoba, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Cordoba, Spain
| | - Raúl M Luque
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain,
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, Cordoba, Spain,
- Reina Sofia University Hospital (HURS), Cordoba, Spain,
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Cordoba, Spain,
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Vázquez-Borrego MC, Fuentes-Fayos AC, Venegas-Moreno E, Rivero-Cortés E, Dios E, Moreno-Moreno P, Madrazo-Atutxa A, Remón P, Solivera J, Wildemberg LE, Kasuki L, López-Fernández JM, Gadelha MR, Gálvez-Moreno MA, Soto-Moreno A, Gahete MD, Castaño JP, Luque RM. Splicing Machinery is Dysregulated in Pituitary Neuroendocrine Tumors and is Associated with Aggressiveness Features. Cancers (Basel) 2019; 11:cancers11101439. [PMID: 31561558 PMCID: PMC6826715 DOI: 10.3390/cancers11101439] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 09/09/2019] [Accepted: 09/23/2019] [Indexed: 12/17/2022] Open
Abstract
Pituitary neuroendocrine tumors (PitNETs) constitute approximately 15% of all brain tumors, and most have a sporadic origin. Recent studies suggest that altered alternative splicing and, consequently, appearance of aberrant splicing variants, is a common feature of most tumor pathologies. Moreover, spliceosome is considered an attractive therapeutic target in tumor pathologies, and the inhibition of SF3B1 (e.g., using pladienolide-B) has been shown to exert antitumor effects. Therefore, we aimed to analyze the expression levels of selected splicing-machinery components in 261 PitNETs (somatotropinomas/non-functioning PitNETS/corticotropinomas/prolactinomas) and evaluated the direct effects of pladienolide-B in cell proliferation/viability/hormone secretion in human PitNETs cell cultures and pituitary cell lines (AtT-20/GH3). Results revealed a severe dysregulation of splicing-machinery components in all the PitNET subtypes compared to normal pituitaries and a unique fingerprint of splicing-machinery components that accurately discriminate between normal and tumor tissue in each PitNET subtype. Moreover, expression of specific components was associated with key clinical parameters. Interestingly, certain components were commonly dysregulated throughout all PitNET subtypes. Finally, pladienolide-B reduced cell proliferation/viability/hormone secretion in PitNET cell cultures and cell lines. Altogether, our data demonstrate a drastic dysregulation of the splicing-machinery in PitNETs that might be associated to their tumorigenesis, paving the way to explore the use of specific splicing-machinery components as novel diagnostic/prognostic and therapeutic targets in PitNETs.
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Affiliation(s)
- Mari C Vázquez-Borrego
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), 14004 Cordoba, Spain.
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, 14004 Cordoba, Spain.
- Reina Sofia University Hospital (HURS), 14004 Cordoba, Spain.
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), 14004 Cordoba, Spain.
| | - Antonio C Fuentes-Fayos
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), 14004 Cordoba, Spain.
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, 14004 Cordoba, Spain.
- Reina Sofia University Hospital (HURS), 14004 Cordoba, Spain.
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), 14004 Cordoba, Spain.
| | - Eva Venegas-Moreno
- Metabolism and Nutrition Unit, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS), 41013 Sevilla, Spain.
| | - Esther Rivero-Cortés
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), 14004 Cordoba, Spain.
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, 14004 Cordoba, Spain.
- Reina Sofia University Hospital (HURS), 14004 Cordoba, Spain.
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), 14004 Cordoba, Spain.
| | - Elena Dios
- Metabolism and Nutrition Unit, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS), 41013 Sevilla, Spain.
| | - Paloma Moreno-Moreno
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), 14004 Cordoba, Spain.
- Reina Sofia University Hospital (HURS), 14004 Cordoba, Spain.
- Service of Endocrinology and Nutrition, Reina Sofia University Hospital (HURS), 14004 Cordoba, Spain.
| | - Ainara Madrazo-Atutxa
- Metabolism and Nutrition Unit, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS), 41013 Sevilla, Spain.
| | - Pablo Remón
- Metabolism and Nutrition Unit, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS), 41013 Sevilla, Spain.
| | - Juan Solivera
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), 14004 Cordoba, Spain.
- Reina Sofia University Hospital (HURS), 14004 Cordoba, Spain.
- Service of Neurosurgery, Reina Sofia University Hospital (HURS), 14004 Cordoba, Spain.
| | - Luiz E Wildemberg
- Neuroendocrinology Research Center/Endocrinology Division, Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-590, Brazil.
- Neuroendocrinology Division, Instituto Estadual do Cérebro Paulo Niemeyer, Rio de Janeiro 20231-092, Brazil.
| | - Leandro Kasuki
- Neuroendocrinology Research Center/Endocrinology Division, Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-590, Brazil.
- Neuroendocrinology Division, Instituto Estadual do Cérebro Paulo Niemeyer, Rio de Janeiro 20231-092, Brazil.
| | - Judith M López-Fernández
- Service of Endocrinology and Nutrition, Hospital Universitario de Canarias, 38320 La Laguna, Santa Cruz de Tenerife, Spain.
| | - Mônica R Gadelha
- Neuroendocrinology Research Center/Endocrinology Division, Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-590, Brazil.
- Neuroendocrinology Division, Instituto Estadual do Cérebro Paulo Niemeyer, Rio de Janeiro 20231-092, Brazil.
| | - María A Gálvez-Moreno
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), 14004 Cordoba, Spain.
- Reina Sofia University Hospital (HURS), 14004 Cordoba, Spain.
- Service of Endocrinology and Nutrition, Reina Sofia University Hospital (HURS), 14004 Cordoba, Spain.
| | - Alfonso Soto-Moreno
- Metabolism and Nutrition Unit, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS), 41013 Sevilla, Spain.
| | - Manuel D Gahete
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), 14004 Cordoba, Spain.
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, 14004 Cordoba, Spain.
- Reina Sofia University Hospital (HURS), 14004 Cordoba, Spain.
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), 14004 Cordoba, Spain.
| | - Justo P Castaño
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), 14004 Cordoba, Spain.
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, 14004 Cordoba, Spain.
- Reina Sofia University Hospital (HURS), 14004 Cordoba, Spain.
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), 14004 Cordoba, Spain.
| | - Raúl M Luque
- Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), 14004 Cordoba, Spain.
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, 14004 Cordoba, Spain.
- Reina Sofia University Hospital (HURS), 14004 Cordoba, Spain.
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), 14004 Cordoba, Spain.
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García-Martínez A, Cano DA, Flores-Martínez A, Gil J, Puig-Domingo M, Webb SM, Soto-Moreno A, Picó A. Why don't corticotroph tumors always produce Cushing's disease? Eur J Endocrinol 2019; 181:351-361. [PMID: 31319379 DOI: 10.1530/eje-19-0338] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 07/18/2019] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Silent corticotroph tumors are a pituitary neuroendocrine tumor subtype of corticotroph lineage that do not clinically express Cushing's disease. The silencing of this type of tumor is not fully understood. The aim of the present study was to delve into the lack of secretory activity, studying the post-transcriptional and post-translational regulation of POMC/ACTH in a series of molecularly identified functioning and silent corticotroph tumors. DESIGN We analyzed 24 silent corticotroph, 23 functioning corticotroph and 25 silent gonadotroph tumors. METHODS We used Sanger sequencing, quantitative real-time PCR and Western blot to analyze genetic alterations in POMC, gene expression of TBX19, NEUROD1, POMC, PCSK1, PCSK2, CPE and PAM and protein expression of POMC, PC1/3, PC2, CPE and PAM. RESULTS We found different polymorphisms in the POMC gene of corticotroph tumors, some of them related to deficiency of proopiomelanocortin. Silent corticotroph tumors showed lower PC1/3 gene and protein expression than functioning ones, especially compared to micro-functioning corticotroph tumors (all P < 0.05). Moreover, we found a positive correlation between PC2 and CPE gene and protein expression (rho ≥ 0.670, P < 0.009) in silent corticotroph tumors compared with functioning ones. CONCLUSIONS By studying the post-transcriptional and post-translational processing of POMC and ACTH, respectively, in a large series of silent and functioning corticotroph tumors, we found that the lack of secretory activity of these tumors is related to an impaired processing of POMC and a high degradation of ACTH, with the macro-functioning corticotroph tumor behaving as an intermediate state between micro-functioning and silent corticotroph tumors.
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Affiliation(s)
- A García-Martínez
- Research Laboratory, Alicante General University Hospital-Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - D A Cano
- Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - A Flores-Martínez
- Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - J Gil
- Department of Endocrinology and Nutrition, University Hospital and Health Science Research Institute Germans Trias i Pujol, Badalona, Spain
| | - M Puig-Domingo
- Department of Endocrinology and Nutrition, University Hospital and Health Science Research Institute Germans Trias i Pujol, Badalona, Spain
| | - S M Webb
- Endocrinology/Medicine Department, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, Unidad 747), ISCIII, Research Center for Pituitary Diseases, Hospital Sant Pau, IIB-Sant Pau, and Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - A Soto-Moreno
- Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - A Picó
- Endocrinology Department, Alicante General University Hospital-ISABIAL, Miguel Hernández University, CIBERER, Alicante, Spain
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Vázquez-Borrego MC, Fuentes-Fayos AC, Herrera-Martínez AD, L-López F, Ibáñez-Costa A, Moreno-Moreno P, Alhambra-Expósito MR, Barrera-Martín A, Blanco-Acevedo C, Dios E, Venegas-Moreno E, Solivera J, Gahete MD, Soto-Moreno A, Gálvez-Moreno MA, Castaño JP, Luque RM. Biguanides Exert Antitumoral Actions in Pituitary Tumor Cells Through AMPK-Dependent and -Independent Mechanisms. J Clin Endocrinol Metab 2019; 104:3501-3513. [PMID: 30860580 DOI: 10.1210/jc.2019-00056] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 03/06/2019] [Indexed: 12/17/2022]
Abstract
CONTEXT Pituitary neuroendocrine tumors (PitNETs) are a commonly underestimated pathology in terms of incidence and associated morbimortality. Currently, an appreciable subset of patients are resistant or poorly responsive to the main current medical treatments [i.e., synthetic somatostatin analogs (SSAs) and dopamine agonists]. Thus, development and optimization of novel and available medical therapies is necessary. Biguanides (metformin, buformin, and phenformin) are antidiabetic drugs that exert antitumoral actions in several tumor types, but their pharmacological effects on PitNETs are poorly known. OBJECTIVE We aimed to explore the direct effects of biguanides on key functions (cell viability, hormone release, apoptosis, and signaling pathways) in primary cell cultures from human PitNETs and cell lines. Additionally, we evaluated the effect of combined metformin with SSAs on cell viability and hormone secretion. DESIGN A total of 13 corticotropinomas, 13 somatotropinomas, 13 nonfunctioning PitNETs, 3 prolactinomas, and 2 tumoral pituitary cell lines (AtT-20 and GH3) were used to evaluate the direct effects of biguanides on cell viability, hormone release, apoptosis, and signaling pathways. RESULTS Biguanides reduced cell viability in all PitNETs and cell lines (with phenformin being the most effective biguanide) and increased apoptosis in somatotropinomas. Moreover, buformin and phenformin, but not metformin, reduced hormone secretion in a cell type-specific manner. Combination metformin/SSA therapy did not increase SSA monotherapy effectiveness. Effects of biguanides on PitNETs could involve the modulation of AMP-activated protein kinase-dependent ([Ca2+]i, PI3K/Akt) and independent (MAPK) mechanisms. CONCLUSION Altogether, our data unveil clear antitumoral effects of biguanides on PitNET cells, opening avenues to explore their potential as drugs to treat these pathologies.
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Affiliation(s)
- Mari C Vázquez-Borrego
- Maimonides Institute of Biomedical Research of Cordoba, Cordoba, Spain
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, Cordoba, Spain
- Reina Sofia University Hospital, Cordoba, Spain
- CIBER Physiopathology of Obesity and Nutrition, Cordoba, Spain
| | - Antonio C Fuentes-Fayos
- Maimonides Institute of Biomedical Research of Cordoba, Cordoba, Spain
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, Cordoba, Spain
- Reina Sofia University Hospital, Cordoba, Spain
- CIBER Physiopathology of Obesity and Nutrition, Cordoba, Spain
| | - Aura D Herrera-Martínez
- Maimonides Institute of Biomedical Research of Cordoba, Cordoba, Spain
- Reina Sofia University Hospital, Cordoba, Spain
- Service of Endocrinology and Nutrition, IMIBIC, Reina Sofia University Hospital, Cordoba, Spain
| | - Fernando L-López
- Maimonides Institute of Biomedical Research of Cordoba, Cordoba, Spain
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, Cordoba, Spain
- Reina Sofia University Hospital, Cordoba, Spain
- CIBER Physiopathology of Obesity and Nutrition, Cordoba, Spain
| | - Alejandro Ibáñez-Costa
- Maimonides Institute of Biomedical Research of Cordoba, Cordoba, Spain
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, Cordoba, Spain
- Reina Sofia University Hospital, Cordoba, Spain
- CIBER Physiopathology of Obesity and Nutrition, Cordoba, Spain
| | - Paloma Moreno-Moreno
- Maimonides Institute of Biomedical Research of Cordoba, Cordoba, Spain
- Reina Sofia University Hospital, Cordoba, Spain
- Service of Endocrinology and Nutrition, IMIBIC, Reina Sofia University Hospital, Cordoba, Spain
| | - María R Alhambra-Expósito
- Maimonides Institute of Biomedical Research of Cordoba, Cordoba, Spain
- Reina Sofia University Hospital, Cordoba, Spain
- Service of Endocrinology and Nutrition, IMIBIC, Reina Sofia University Hospital, Cordoba, Spain
| | - Ana Barrera-Martín
- Maimonides Institute of Biomedical Research of Cordoba, Cordoba, Spain
- Reina Sofia University Hospital, Cordoba, Spain
- Service of Endocrinology and Nutrition, IMIBIC, Reina Sofia University Hospital, Cordoba, Spain
| | - Cristóbal Blanco-Acevedo
- Maimonides Institute of Biomedical Research of Cordoba, Cordoba, Spain
- Reina Sofia University Hospital, Cordoba, Spain
- Service of Neurosurgery, Reina Sofia University Hospital, Cordoba, Spain
| | - Elena Dios
- Metabolism and Nutrition Unit, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla, Sevilla, Spain
| | - Eva Venegas-Moreno
- Metabolism and Nutrition Unit, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla, Sevilla, Spain
| | - Juan Solivera
- Maimonides Institute of Biomedical Research of Cordoba, Cordoba, Spain
- Reina Sofia University Hospital, Cordoba, Spain
- Service of Neurosurgery, Reina Sofia University Hospital, Cordoba, Spain
| | - Manuel D Gahete
- Maimonides Institute of Biomedical Research of Cordoba, Cordoba, Spain
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, Cordoba, Spain
- Reina Sofia University Hospital, Cordoba, Spain
- CIBER Physiopathology of Obesity and Nutrition, Cordoba, Spain
| | - Alfonso Soto-Moreno
- Metabolism and Nutrition Unit, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla, Sevilla, Spain
| | - María A Gálvez-Moreno
- Maimonides Institute of Biomedical Research of Cordoba, Cordoba, Spain
- Reina Sofia University Hospital, Cordoba, Spain
- Service of Endocrinology and Nutrition, IMIBIC, Reina Sofia University Hospital, Cordoba, Spain
| | - Justo P Castaño
- Maimonides Institute of Biomedical Research of Cordoba, Cordoba, Spain
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, Cordoba, Spain
- Reina Sofia University Hospital, Cordoba, Spain
- CIBER Physiopathology of Obesity and Nutrition, Cordoba, Spain
| | - Raúl M Luque
- Maimonides Institute of Biomedical Research of Cordoba, Cordoba, Spain
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, Cordoba, Spain
- Reina Sofia University Hospital, Cordoba, Spain
- CIBER Physiopathology of Obesity and Nutrition, Cordoba, Spain
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Herguido NG, Fuentes ED, Venegas-Moreno E, Maorad LB, Flores-Martinez A, Ruiz PR, Dueñas MC, Roldán F, Fajardo E, Ruiz-Valdepeñas EC, Kaen A, Martín Schrader I, Cano DA, Soto-Moreno A. Surgical Outcome and Treatment of Thyrotropin-Secreting Pituitary Tumors in a Tertiary Referral Center. World Neurosurg 2019; 130:e634-e639. [PMID: 31276853 DOI: 10.1016/j.wneu.2019.06.180] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Revised: 06/23/2019] [Accepted: 06/24/2019] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Thyrotropin (TSH)-secreting pituitary tumors are rare and typically present with hyperthyroidism. Here we report the diagnosis, treatment, and surgical outcomes in a series of patients with TSH-secreting pituitary tumors in a tertiary referral center. METHODS Descriptive retrospective study that included all patients with TSH-secreting pituitary tumors who underwent transsphenoidal surgery in the endocrinology and nutrition unit of the Virgen del Rocío University Hospital (Seville, Spain) between 2004 and 2016. RESULTS The mean age at diagnosis was 42.8 ± 17 years. The mean time from onset of symptoms to diagnosis was 13 ± 10 months. Four patients displayed symptoms indicating hyperthyroidism (1 suffered from tachycardia); 3 patients showed symptoms because of mass effect (visual impairment and headache) and 3 patients were diagnosed based on incidental findings after routine blood tests (high free thyroxine levels). Eight patients had macroadenomas, and 2 patients had microadenomas. Five patients underwent conventional pituitary surgery, and 5 patients underwent expanded endoscopic transsphenoidal surgery. Six patients achieved cure after surgery. The other patients received radiotherapy and/or treatment with somatostatin analogs. Analysis of somatostatin receptor (SSTR) expression by immunohistochemistry could be performed in 6 tumors. CONCLUSIONS Our results confirm the clinical and hormonal heterogeneity caused by TSH-secreting pituitary adenomas. Surgery is considered the first choice of treatment for these tumors. We observed surgical cure rates similar to those reported in recent published series. SSTR2 and SSTR3 are highly expressed in TSH-secreting pituitary adenomas. Our results suggest that somatostatin analog treatment may be also helpful in the treatment of TSH-secreting pituitary adenomas.
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Affiliation(s)
- Noelia Gros Herguido
- Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - Elena Dios Fuentes
- Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - Eva Venegas-Moreno
- Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - Laura Borau Maorad
- Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - Alvaro Flores-Martinez
- Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - Pablo Remón Ruiz
- Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - Miriam Cózar Dueñas
- Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - Florinda Roldán
- Servicios de Radiología, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Elena Fajardo
- Servicios de Radiología, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | | | - Ariel Kaen
- Servicios de Neurocirugía, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | | | - David A Cano
- Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - Alfonso Soto-Moreno
- Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain.
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Martínez Ortega AJ, Venegas-Moreno E, Dios E, Remón Ruíz PJ, Márquez Rivas FJ, Valdepeñas EC, Kaen AM, Cano DA, Soto-Moreno A. Surgical Outcomes and Comorbidities in Cushing Disease: 30 Years of Experience in a Referral Center. World Neurosurg 2019; 122:e436-e442. [PMID: 31108069 DOI: 10.1016/j.wneu.2018.10.067] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 10/08/2018] [Accepted: 10/09/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Cushing disease (CD) is a rare, poorly understood entity. Our aim was to add our clinical experience of >30 years in a multidisciplinary specialized unit to the global knowledge of CD. METHODS This descriptive retrospective study included all patients admitted to the Endocrinology and Nutrition Department of the Virgen del Rocío University Hospital, Seville, Spain, from January 1980 to May 2016. All patients had a definitive diagnosis of CD. RESULTS Total sample included 119 patients; 100 (84%) were female. Median age at diagnosis was 37.97 years (interquartile range [IQR]: 25.89-45.07 years). Median follow-up was 88 months (IQR: 45.50-157.00 months). Most tumors were microadenomas (62/95) (5.1 mm [IQR: 4.0-7.0 mm]) without sinus invasion. Surgical procedures were conventional transsphenoidal surgery (CTSS) (101/108; cured 70 after first attempt) and expanded endoscopic transsphenoidal surgery (EETSS) (7/108; cured 5 after first attempt); 11 patients did not receive surgical treatment. Fourteen patients received radiotherapy after a first surgery and 5 patients after a second surgical removal attempt. In 13 patients (12.04%), CD relapse was demonstrated after initial CTSS (median disease-free period 65 months [IQR: 45-120 months]). Ten patients developed panhypopituitarism owing to the surgical procedure (CTSS); 8 patients developed panhypopituitarism after adjuvant radiotherapy. CONCLUSIONS We observed slightly inferior cure rate after first surgery compared with moderately better relapse rates and time to relapse. Radiotherapy after surgery failure seemed to be more effective than CTSS; however, EETSS may be a valid alternative. Postoperative panhypopituitarism rate after first surgery was lower than expected; after radiotherapy, our results were comparable to other series.
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Affiliation(s)
- Antonio Jesús Martínez Ortega
- Endocrinology and Clinical Nutrition Department, Virgen del Rocío University Hospital, Institute of Biomedicine of Seville (IBIS), Seville, Spain
| | - Eva Venegas-Moreno
- Endocrinology and Clinical Nutrition Department, Virgen del Rocío University Hospital, Institute of Biomedicine of Seville (IBIS), Seville, Spain
| | - Elena Dios
- Endocrinology and Clinical Nutrition Department, Virgen del Rocío University Hospital, Institute of Biomedicine of Seville (IBIS), Seville, Spain
| | - Pablo Jesús Remón Ruíz
- Endocrinology and Clinical Nutrition Department, Virgen del Rocío University Hospital, Institute of Biomedicine of Seville (IBIS), Seville, Spain
| | - Francisco Javier Márquez Rivas
- Neurosurgery Department, Virgen del Rocío University Hospital, CSIC (Superior Council of Scientific Investigations), Seville University, Seville, Spain
| | - Eugenio Cárdenas Valdepeñas
- Neurosurgery Department, Virgen del Rocío University Hospital, CSIC (Superior Council of Scientific Investigations), Seville University, Seville, Spain
| | - Ariel Matías Kaen
- Neurosurgery Department, Virgen del Rocío University Hospital, CSIC (Superior Council of Scientific Investigations), Seville University, Seville, Spain
| | - David A Cano
- Endocrinology and Clinical Nutrition Department, Virgen del Rocío University Hospital, Institute of Biomedicine of Seville (IBIS), Seville, Spain
| | - Alfonso Soto-Moreno
- Endocrinology and Clinical Nutrition Department, Virgen del Rocío University Hospital, Institute of Biomedicine of Seville (IBIS), Seville, Spain.
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Gahete M, Jiménez-Vacas J, Lopez-Canovas J, Vazquez-Borrego M, Pedraza-Arevalo S, del Río-Moreno M, Herrero-Aguayo V, Saez-Martinez P, Montero-Hidalgo A, Blazquez-Encinas R, Lara-Lopez A, Pérez-Gómez J, Gomez-Gomez E, Herrera-Martínez A, Soto-Moreno A, Castano J, Luque R. SUN-LB056 The Pharmacological Blockade of the Splicing Factor SF3B1 Exerts Antitumor Actions in Different Endocrine-Related Cancers. J Endocr Soc 2019. [PMCID: PMC6552932 DOI: 10.1210/js.2019-sun-lb056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The intrinsic heterogeneity of endocrine-related cancers (ERCs) hampers the identification and development of global and effective therapeutic treatments for these pathologies. However, the dysregulation of the splicing process has been postulated as a new common hallmark shared by most cancer types, since it is associated with the appearance of splicing variants with oncogenic potential (e.g. CD44v6, BCL-xs, AR-v7, SST5TMD4, In1-ghrelin). Yet, the putative alteration, pathophysiological role and potential therapeutic utility of the elements involved in the control of the splicing process [i.e. spliceosome components (SCs) and splicing factors (SFs)] remain still unknown. For this reason, we have analysed the expression levels of a representative set of SCs (n=18) and SFs (n=27) in different cohorts of ERCs [i.e. growth hormone secreting pituitary tumors (n=96); non-functioning pituitary tumors (n=23); pancreatic neuroendocrine tumors (n=20); prostate cancer (n=126); and in four in silico cohorts of liver cancer (HCC; n=445, n=115, n=75, n=45)]. Our results showed that the SF3b subunit 1 (SF3B1) gene, which encodes a protein necessary for spliceosome assembly, was consistently overexpressed in all the ERCs evaluated in this study. Interestingly, SF3B1 expression was positively correlated and associated with clinical and molecular aggressiveness features (e.g. histopathological grade, presence of metastasis, expression of oncogenic splicing variants, etc.) in these ERCs. In vitro analyses revealed that the specific blockade of SF3B1 activity, using the pladienolide-B compound, exhibited potent and relevant antitumor effects (reducing cell proliferation, migration, tumorospheres and colonies formation, hormone release and inducing apoptosis) in the vast majority of representative models of ERC cells tested herein (primary ERCs cell cultures and cell lines such as BON-1, QGP-1, LNCaP, 22Rv1, PC-3, HepG2, Hep3b or SNU-387). Remarkably, the antitumor effects of pladienolide-B treatment were further validated in vivo in that we found a significant reduction of tumor volume after 9-days of local treatment of pladienolide-B in a xenograft model of ERC. Moreover, we found that pladienolide-B treatment modulated an ample repertoire of molecular events, such as inhibition of major oncogenic signalling pathways (e.g. PI3K/AKT and JNK), modulation of the expression of key tumour markers (e.g. MKI67/CDK6/CDKN2A) and oncogenic splicing variants (e.g. AR-v7/In1-ghrelin), and regulation of the expression pattern of key components of mRNA homeostasis-associated machineries (spliceosome and SURF/EJC). In conclusion, these results indicate that SF3B1 is consistently overexpressed in different ERCs and associated to malignant features and that its pharmacological blockade with pladienolide-B could represent a novel, global and effective therapeutic approach for ERCs Unless otherwise noted, all abstracts presented at ENDO are embargoed until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. Abstracts presented at a news conference are embargoed until the date and time of the news conference. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.
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Affiliation(s)
| | - Juan Jiménez-Vacas
- Hormones and Cancer, Maimnides Biomedical Research Institute of Crdoba (IMIBIC) / University of Crdoba, Crdoba, , Spain
| | | | | | | | - Mercedes del Río-Moreno
- Hormones and Cancer Group (GC-08), Maimonides Institute of Biomedical Research of Cordoba (IMIBIC); University of Cordoba; Reina Sofia, Crdoba, , Spain
| | | | | | | | | | | | | | | | | | | | | | - Raul Luque
- Cell Biol Immunology and Physiol, Univ of Cordoba, Cordoba, , Spain
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Daly AF, Cano DA, Venegas-Moreno E, Petrossians P, Dios E, Castermans E, Flores-Martínez A, Bours V, Beckers A, Soto-Moreno A. AIP and MEN1 mutations and AIP immunohistochemistry in pituitary adenomas in a tertiary referral center. Endocr Connect 2019; 8:338-348. [PMID: 30822274 PMCID: PMC6432872 DOI: 10.1530/ec-19-0027] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 03/01/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Pituitary adenomas have a high disease burden due to tumor growth/invasion and disordered hormonal secretion. Germline mutations in genes such as MEN1 and AIP are associated with early onset of aggressive pituitary adenomas that can be resistant to medical therapy. AIMS We performed a retrospective screening study using published risk criteria to assess the frequency of AIP and MEN1 mutations in pituitary adenoma patients in a tertiary referral center. METHODS Pituitary adenoma patients with pediatric/adolescent onset, macroadenomas occurring ≤30 years of age, familial isolated pituitary adenoma (FIPA) kindreds and acromegaly or prolactinoma cases that were uncontrolled by medical therapy were studied genetically. We also assessed whether immunohistochemical staining for AIP (AIP-IHC) in somatotropinomas was associated with somatostatin analogs (SSA) response. RESULTS Fifty-five patients met the study criteria and underwent genetic screening for AIP/MEN1 mutations. No mutations were identified and large deletions/duplications were ruled out using MLPA. In a cohort of sporadic somatotropinomas, low AIP-IHC tumors were significantly larger (P = 0.002) and were more frequently sparsely granulated (P = 0.046) than high AIP-IHC tumors. No significant relationship between AIP-IHC and SSA responses was seen. CONCLUSIONS Germline mutations in AIP/MEN1 in pituitary adenoma patients are rare and the use of general risk criteria did not identify cases in a large tertiary-referral setting. In acromegaly, low AIP-IHC was related to larger tumor size and more frequent sparsely granulated subtype but no relationship with SSA responsiveness was seen. The genetics of pituitary adenomas remains largely unexplained and AIP screening criteria could be significantly refined to focus on large, aggressive tumors in young patients.
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Affiliation(s)
- Adrian F Daly
- Department of Endocrinology, Centre Hospitalier Universitaire de Liège, Liège Université, Liège, Belgium
| | - David A Cano
- Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - Eva Venegas-Moreno
- Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - Patrick Petrossians
- Department of Endocrinology, Centre Hospitalier Universitaire de Liège, Liège Université, Liège, Belgium
| | - Elena Dios
- Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - Emilie Castermans
- Department of Human Genetics, Centre Hospitalier Universitaire de Liège, Liège Université, Liège, Belgium
| | - Alvaro Flores-Martínez
- Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - Vincent Bours
- Department of Human Genetics, Centre Hospitalier Universitaire de Liège, Liège Université, Liège, Belgium
| | - Albert Beckers
- Department of Endocrinology, Centre Hospitalier Universitaire de Liège, Liège Université, Liège, Belgium
- Correspondence should be addressed to A Beckers or A Soto-Moreno: or
| | - Alfonso Soto-Moreno
- Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
- Correspondence should be addressed to A Beckers or A Soto-Moreno: or
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Venegas-Moreno E, Flores-Martinez A, Dios E, Vazquez-Borrego MC, Ibañez-Costa A, Madrazo-Atutxa A, Japón MA, Castaño JP, Luque RM, Cano DA, Soto-Moreno A. E-cadherin expression is associated with somatostatin analogue response in acromegaly. J Cell Mol Med 2019; 23:3088-3096. [PMID: 30843342 PMCID: PMC6484433 DOI: 10.1111/jcmm.13851] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 06/11/2018] [Accepted: 07/20/2018] [Indexed: 12/11/2022] Open
Abstract
Acromegaly is a rare disease resulting from hypersecretion of growth hormone (GH) and insulin‐like growth factor 1 (IGF1) typically caused by pituitary adenomas, which is associated with increased mortality and morbidity. Somatostatin analogues (SSAs) represent the primary medical therapy for acromegaly and are currently used as first‐line treatment or as second‐line therapy after unsuccessful pituitary surgery. However, a considerable proportion of patients do not adequately respond to SSAs treatment, and therefore, there is an urgent need to identify biomarkers predictors of response to SSAs. The aim of this study was to examine E‐cadherin expression by immunohistochemistry in fifty‐five GH‐producing pituitary tumours and determine the potential association with response to SSAs as well as other clinical and histopathological features. Acromegaly patients with tumours expressing low E‐cadherin levels exhibit a worse response to SSAs. E‐cadherin levels are associated with GH‐producing tumour histological subtypes. Our results indicate that the immunohistochemical detection of E‐cadherin might be useful in categorizing acromegaly patients based on the response to SSAs.
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Affiliation(s)
- Eva Venegas-Moreno
- Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - Alvaro Flores-Martinez
- Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - Elena Dios
- Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - Mari C Vazquez-Borrego
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain.,Department of Cell Biology, Physiology and Immunology, Universidad de Córdoba, Córdoba, Spain.,Hospital Universitario Reina Sofía, Córdoba, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Córdoba, Spain
| | - Alejandro Ibañez-Costa
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain.,Department of Cell Biology, Physiology and Immunology, Universidad de Córdoba, Córdoba, Spain.,Hospital Universitario Reina Sofía, Córdoba, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Córdoba, Spain
| | - Ainara Madrazo-Atutxa
- Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - Miguel A Japón
- Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain.,Department of Pathology, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Justo P Castaño
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain.,Department of Cell Biology, Physiology and Immunology, Universidad de Córdoba, Córdoba, Spain.,Hospital Universitario Reina Sofía, Córdoba, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Córdoba, Spain
| | - Raúl M Luque
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain.,Department of Cell Biology, Physiology and Immunology, Universidad de Córdoba, Córdoba, Spain.,Hospital Universitario Reina Sofía, Córdoba, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Córdoba, Spain
| | - David A Cano
- Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - Alfonso Soto-Moreno
- Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
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36
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Venegas-Moreno E, Vazquez-Borrego MC, Dios E, Gros-Herguido N, Flores-Martinez A, Rivero-Cortés E, Madrazo-Atutxa A, Japón MA, Luque RM, Castaño JP, Cano DA, Soto-Moreno A. Association between dopamine and somatostatin receptor expression and pharmacological response to somatostatin analogues in acromegaly. J Cell Mol Med 2017; 22:1640-1649. [PMID: 29266696 PMCID: PMC5824369 DOI: 10.1111/jcmm.13440] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 09/27/2017] [Indexed: 12/14/2022] Open
Abstract
Acromegaly is a hormonal disorder resulting from excessive growth hormone (GH) secretion frequently produced by pituitary adenomas and consequent increase in insulin‐like growth factor 1 (IGF‐I). Elevated GH and IGF‐I levels result in a wide range of somatic, cardiovascular, endocrine, metabolic and gastrointestinal morbidities. Somatostatin analogues (SSAs) form the basis of medical therapy for acromegaly and are currently used as first‐line treatment or as second‐line therapy in patients undergoing unsuccessful surgery. However, a considerable percentage of patients do not respond to SSAs treatment. Somatostatin receptors (SSTR1‐5) and dopamine receptors (DRD1‐5) subtypes play critical roles in the regulation of hormone secretion. These receptors are considered important pharmacological targets to inhibit hormone oversecretion. It has been proposed that decreased expression of SSTRs may be associated with poor response to SSAs. Here, we systematically examine SSTRs and DRDs expression in human somatotroph adenomas by quantitative PCR. We observed an association between the response to SSAs treatment and DRD4, DRD5, SSTR1 and SSTR2 expression. We also examined SSTR expression by immunohistochemistry and found that the immunohistochemical detection of SSTR2 in particular might be a good predictor of response to SSAs.
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Affiliation(s)
- Eva Venegas-Moreno
- Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - Mari C Vazquez-Borrego
- Department of Cell Biology, Physiology and Immunology, Maimonides Institute For Biomedical Research of Cordoba (IMIBIC), Reina Sofia University Hospital (HURS), CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Agrifood Campus of International Excellence (ceiA3), University of Cordoba, Cordoba, Spain
| | - Elena Dios
- Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - Noelia Gros-Herguido
- Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - Alvaro Flores-Martinez
- Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - Esther Rivero-Cortés
- Department of Cell Biology, Physiology and Immunology, Maimonides Institute For Biomedical Research of Cordoba (IMIBIC), Reina Sofia University Hospital (HURS), CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Agrifood Campus of International Excellence (ceiA3), University of Cordoba, Cordoba, Spain
| | - Ainara Madrazo-Atutxa
- Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - Miguel A Japón
- Department of Pathology, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - Raúl M Luque
- Department of Cell Biology, Physiology and Immunology, Maimonides Institute For Biomedical Research of Cordoba (IMIBIC), Reina Sofia University Hospital (HURS), CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Agrifood Campus of International Excellence (ceiA3), University of Cordoba, Cordoba, Spain
| | - Justo P Castaño
- Department of Cell Biology, Physiology and Immunology, Maimonides Institute For Biomedical Research of Cordoba (IMIBIC), Reina Sofia University Hospital (HURS), CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Agrifood Campus of International Excellence (ceiA3), University of Cordoba, Cordoba, Spain
| | - David A Cano
- Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - Alfonso Soto-Moreno
- Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
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Ibáñez-Costa A, Rivero-Cortés E, Vázquez-Borrego MC, Gahete MD, Jiménez-Reina L, Venegas-Moreno E, de la Riva A, Arráez MÁ, González-Molero I, Schmid HA, Maraver-Selfa S, Gavilán-Villarejo I, García-Arnés JA, Japón MA, Soto-Moreno A, Gálvez MA, Luque RM, Castaño JP. Octreotide and pasireotide (dis)similarly inhibit pituitary tumor cells in vitro. J Endocrinol 2016; 231:135-145. [PMID: 27587848 DOI: 10.1530/joe-16-0332] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 09/01/2016] [Indexed: 02/01/2023]
Abstract
Somatostatin analogs (SSA) are the mainstay of pharmacological treatment for pituitary adenomas. However, some patients escape from therapy with octreotide, a somatostatin receptor 2 (sst2)-preferring SSA, and pasireotide, a novel multi-sst-preferring SSA, may help to overcome this problem. It has been proposed that correspondence between sst1-sst5 expression pattern and SSA-binding profile could predict patient's response. To explore the cellular/molecular features associated with octreotide/pasireotide response, we performed a parallel comparison of their in vitro effects, evaluating sst1-sst5 expression, intracellular Ca2+ signaling ([Ca2+]i), hormone secretion and cell viability, in a series of 85 pituitary samples. Somatotropinomas expressed sst5>sst2, yet octreotide reduced [Ca2+]i more efficiently than pasireotide, while both SSA similarly decreased growth hormone release/expression and viability. Corticotropinomas predominantly expressed sst5, but displayed limited response to pasireotide, while octreotide reduced functional endpoints. Non-functioning adenomas preferentially expressed sst3 but, surprisingly, both SSA increased cell viability. Prolactinomas mainly expressed sst1 but were virtually unresponsive to SSA. Finally, both SSA decreased [Ca2+]i in normal pituitaries. In conclusion, both SSA act in vitro on pituitary adenomas exerting both similar and distinct effects; however, no evident correspondence was found with the sst1-sst5 profile. Thus, it seems plausible that additional factors, besides the simple abundance of a given sst, critically influence the SSA response.
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Affiliation(s)
- Alejandro Ibáñez-Costa
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)Córdoba, Spain
- Department of Cell BiologyPhysiology and Immunology, Universidad de Córdoba, Córdoba, Spain
- Hospital Universitario Reina SofíaCórdoba, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn)Córdoba, Spain
| | - Esther Rivero-Cortés
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)Córdoba, Spain
- Department of Cell BiologyPhysiology and Immunology, Universidad de Córdoba, Córdoba, Spain
- Hospital Universitario Reina SofíaCórdoba, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn)Córdoba, Spain
| | - Mari C Vázquez-Borrego
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)Córdoba, Spain
- Department of Cell BiologyPhysiology and Immunology, Universidad de Córdoba, Córdoba, Spain
- Hospital Universitario Reina SofíaCórdoba, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn)Córdoba, Spain
| | - Manuel D Gahete
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)Córdoba, Spain
- Department of Cell BiologyPhysiology and Immunology, Universidad de Córdoba, Córdoba, Spain
- Hospital Universitario Reina SofíaCórdoba, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn)Córdoba, Spain
| | - Luis Jiménez-Reina
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)Córdoba, Spain
- Department of Morphological SciencesUniversidad de Córdoba, Córdoba, Spain
| | - Eva Venegas-Moreno
- Metabolism and Nutrition UnitHospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS), Seville, Spain
| | - Andrés de la Riva
- Service of NeurosurgeryHospital Universitario Reina Sofía, Córdoba, Spain
| | | | | | - Herbert A Schmid
- Novartis Pharma AGNovartis Institutes for Biomedical Research, Oncology, CH-4057 Basel, Switzerland
| | - Silvia Maraver-Selfa
- Service of Endocrinology and NutritionHospital Clínico Universitario Virgen de la Victoria, Málaga, Spain
| | | | | | - Miguel A Japón
- Department of PathologyHospital Universitario Virgen del Rocío, Seville, Spain
| | - Alfonso Soto-Moreno
- Metabolism and Nutrition UnitHospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS), Seville, Spain
| | - María A Gálvez
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)Córdoba, Spain
- Service of Endocrinology and NutritionHospital Universitario Reina Sofía, Córdoba, Spain
| | - Raúl M Luque
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)Córdoba, Spain
- Department of Cell BiologyPhysiology and Immunology, Universidad de Córdoba, Córdoba, Spain
- Hospital Universitario Reina SofíaCórdoba, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn)Córdoba, Spain
| | - Justo P Castaño
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)Córdoba, Spain
- Department of Cell BiologyPhysiology and Immunology, Universidad de Córdoba, Córdoba, Spain
- Hospital Universitario Reina SofíaCórdoba, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn)Córdoba, Spain
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Luque RM, Ibáñez-Costa A, Sánchez-Tejada L, Rivero-Cortés E, Robledo M, Madrazo-Atutxa A, Mora M, Álvarez CV, Lucas-Morante T, Álvarez-Escolá C, Fajardo C, Castaño L, Gaztambide S, Venegas-Moreno E, Soto-Moreno A, Gálvez MÁ, Salvador J, Valassi E, Webb SM, Picó A, Puig-Domingo M, Gilabert M, Bernabéu I, Marazuela M, Leal-Cerro A, Castaño JP. The Molecular Registry of Pituitary Adenomas (REMAH): A bet of Spanish Endocrinology for the future of individualized medicine and translational research. Endocrinol Nutr 2016; 63:274-84. [PMID: 27091627 DOI: 10.1016/j.endonu.2016.03.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 02/17/2016] [Accepted: 03/07/2016] [Indexed: 12/13/2022]
Abstract
Pituitary adenomas are uncommon, difficult to diagnose tumors whose heterogeneity and low incidence complicate large-scale studies. The Molecular Registry of Pituitary Adenomas (REMAH) was promoted by the Andalusian Society of Endocrinology and Nutrition (SAEN) in 2008 as a cooperative clinical-basic multicenter strategy aimed at improving diagnosis and treatment of pituitary adenomas by combining clinical, pathological, and molecular information. In 2010, the Spanish Society of Endocrinology and Nutrition (SEEN) extended this project to national level and established 6 nodes with common protocols and methods for sample and clinical data collection, molecular analysis, and data recording in a common registry (www.remahnacional.com). The registry combines clinical data with molecular phenotyping of the resected pituitary adenoma using quantitative real-time PCR of expression of 26 genes: Pituitary hormones (GH-PRL-LH-FSH-PRL-ACTH-CGA), receptors (somatostatin, dopamine, GHRH, GnRH, CRH, arginine-vasopressin, ghrelin), other markers (Ki67, PTTG1), and control genes. Until 2015, molecular information has been collected from 704 adenomas, out of 1179 patients registered. This strategy allows for comparative and relational analysis between the molecular profile of the different types of adenoma and the clinical phenotype of patients, which may provide a better understanding of the condition and potentially help in treatment selection. The REMAH is therefore a unique multicenter, interdisciplinary network founded on a shared database that provides a far-reaching translational approach for management of pituitary adenomas, and paves the way for the conduct of combined clinical-basic innovative studies on large patient samples.
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Affiliation(s)
- Raúl M Luque
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC); Departamento de Biología Celular, Fisiología e Inmunología, Universidad de Córdoba; Hospital Universitario Reina Sofía; Campus de Excelencia Internacional Agroalimentario (ceiA3); CIBER Fisiopatología de la Obesidad y Nutrición, Córdoba, España
| | - Alejandro Ibáñez-Costa
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC); Departamento de Biología Celular, Fisiología e Inmunología, Universidad de Córdoba; Hospital Universitario Reina Sofía; Campus de Excelencia Internacional Agroalimentario (ceiA3); CIBER Fisiopatología de la Obesidad y Nutrición, Córdoba, España
| | - Laura Sánchez-Tejada
- Departamento de Endocrinología, Hospital General Universitario de Alicante, Alicante, España
| | - Esther Rivero-Cortés
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC); Departamento de Biología Celular, Fisiología e Inmunología, Universidad de Córdoba; Hospital Universitario Reina Sofía; Campus de Excelencia Internacional Agroalimentario (ceiA3); CIBER Fisiopatología de la Obesidad y Nutrición, Córdoba, España
| | - Mercedes Robledo
- Grupo de Cáncer Endocrino Hereditario, Centro Nacional de Investigaciones Oncológicas (CNIO), Madrid, España
| | - Ainara Madrazo-Atutxa
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío, Consejo Superior de Investigaciones Científicas, Universidad de Sevilla, Sevilla, España
| | - Mireia Mora
- Unidad de Endocrinología, Hospital Clinic i Universitari de Barcelona, Barcelona, España
| | - Clara V Álvarez
- Grupo de Neoplasia y Diferenciación Endocrina, Centro Singular de Investigación en Medicina Molecular y Enfermedades Crónicas (CIMUS), Instituto de Investigaciones Sanitarias; Facultad de Medicina, Universidad de Santiago de Compostela, Santiago de Compostela, España
| | - Tomás Lucas-Morante
- Servicio de Endocrinología y Nutrición, Hospital Universitario Puerta de Hierro, Madrid, España
| | - Cristina Álvarez-Escolá
- Servicio de Endocrinología y Nutrición, Hospital Universitario La Paz, Universidad Autónoma de Madrid, Madrid, España
| | - Carmen Fajardo
- Servicio de Endocrinología, Hospital Universitario de La Ribera, Alzira, España
| | - Luis Castaño
- Grupo de Investigación de Endocrinología y Diabetes, Hospital Universitario de Cruces, Barakaldo, España
| | - Sonia Gaztambide
- Departamento de Endocrinología y Nutrición, Hospital Universitario de Cruces, Barakaldo, España
| | - Eva Venegas-Moreno
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío, Consejo Superior de Investigaciones Científicas, Universidad de Sevilla, Sevilla, España
| | - Alfonso Soto-Moreno
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío, Consejo Superior de Investigaciones Científicas, Universidad de Sevilla, Sevilla, España
| | - María Ángeles Gálvez
- Servicio de Endocrinología y Nutrición, Hospital Universitario Reina Sofía; Instituto Maimónides de Investigación Biomédica de Córdoba, Córdoba, España
| | - Javier Salvador
- Departamento de Endocrinología y Nutrición, Clínica Universidad de Navarra, Universidad de Navarra; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, España
| | - Elena Valassi
- Institut d'Investigació Biomèdica Sant Pau, Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBER-ER, Unidad 747), Instituto de Salud Carlos III, Barcelona, España
| | - Susan M Webb
- Institut d'Investigació Biomèdica Sant Pau, Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBER-ER, Unidad 747), Instituto de Salud Carlos III, Barcelona, España; Servicio de Endocrinología, Departamento de Medicina, Institut d'Investigació Biomèdica Sant Pau, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, España
| | - Antonio Picó
- Departamento de Endocrinología, Hospital General Universitario de Alicante, Alicante, España
| | - Manel Puig-Domingo
- Departamento de Endocrinología y Nutrición, Hospital Universitari Germans Trias i Pujol; Centro de Investigación Biomédica en Enfermedades Raras (CIBER-ER), Badalona, España
| | | | - Ignacio Bernabéu
- Servicio de Endocrinología y Nutrición, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, España
| | - Mónica Marazuela
- Servicio de Endocrinología y Nutrición, Hospital Universitario de La Princesa, Madrid, España
| | - Alfonso Leal-Cerro
- Laboratorio de Endocrinología, IBiS, Hospital Universitario Virgen del Rocío, Consejo Superior de Investigaciones Científicas, Universidad de Sevilla, Sevilla, España.
| | - Justo P Castaño
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC); Departamento de Biología Celular, Fisiología e Inmunología, Universidad de Córdoba; Hospital Universitario Reina Sofía; Campus de Excelencia Internacional Agroalimentario (ceiA3); CIBER Fisiopatología de la Obesidad y Nutrición, Córdoba, España.
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Luque RM, Ibáñez-Costa A, Neto LV, Taboada GF, Hormaechea-Agulla D, Kasuki L, Venegas-Moreno E, Moreno-Carazo A, Gálvez MÁ, Soto-Moreno A, Kineman RD, Culler MD, Gahete MD, Gadelha MR, Castaño JP. Truncated somatostatin receptor variant sst5TMD4 confers aggressive features (proliferation, invasion and reduced octreotide response) to somatotropinomas. Cancer Lett 2015; 359:299-306. [PMID: 25637790 DOI: 10.1016/j.canlet.2015.01.037] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 01/23/2015] [Accepted: 01/23/2015] [Indexed: 11/30/2022]
Abstract
The GH/IGF1 response of somatotropinomas to somatostatin analogues (SSA) is associated with their pattern of somatostatin receptor (sst1-sst5) expression. Recently, we demonstrated that expression of a truncated sst5-variant (sst5TMD4) can influence the secretory response of somatotropinomas to SSA-therapy; however, its potential relationship with aggressive features (e.g. invasion/proliferation) is still unknown. Here, we show that sst5TMD4 is present in 50% of non-functioning pituitary-adenomas (NFPA) (n = 30) and 89% of somatotropinomas (n = 36), its expression levels being highest in somatotropinomas > > NFPAs > > > normal pituitaries (negligible expression; n = 8). In somatotropinomas, sst5TMD4 mRNA and protein levels correlated positively, and its expression was directly associated with tumor invasiveness (cavernous/sphenoid sinus), and inversely correlated with age and GH/IGF1 reduction after 3-6 months with octreotide-LAR therapy. GNAS+ somatotropinomas expressed lower sst5TMD4 levels. ROC analysis revealed sst5TMD4 expression as the only marker, within all sst-subtypes, capable to predict tumor invasiveness in somatotropinomas. sst5TMD4 overexpression increased cell viability in cultured somatotropinoma (n = 5). Hence, presence of sst5TMD4 associates with increased aggressive features and worse prognosis in somatotropinomas, thereby providing a potentially useful tool to refine somatotropinoma diagnosis, predict outcome of clinical response to SSA-therapy and develop new therapeutic targets.
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Affiliation(s)
- Raúl M Luque
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), and Hospital Universitario Reina Sofia.; CIBER Fisiopatología de la Obesidad y Nutrición; Campus de Excelencia Internacional Agroalimentario (ceiA3), 14014, Córdoba, Spain.
| | - Alejandro Ibáñez-Costa
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), and Hospital Universitario Reina Sofia.; CIBER Fisiopatología de la Obesidad y Nutrición; Campus de Excelencia Internacional Agroalimentario (ceiA3), 14014, Córdoba, Spain
| | - Leonardo Vieira Neto
- Endocrinology Unit, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Endocrinology Section, Federal Hospital of Lagoa, Rio de Janeiro, Brazil
| | - Giselle F Taboada
- Endocrinology Section, Hospital Universitario Antônio Pedro, Universidade Federal Fluminense, Rio de Janeiro, Brazil
| | - Daniel Hormaechea-Agulla
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), and Hospital Universitario Reina Sofia.; CIBER Fisiopatología de la Obesidad y Nutrición; Campus de Excelencia Internacional Agroalimentario (ceiA3), 14014, Córdoba, Spain
| | - Leandro Kasuki
- Endocrinology Unit, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Eva Venegas-Moreno
- Metabolism and Nutrition Unit, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío, Seville 41013, Spain
| | | | - María Ángeles Gálvez
- Service of Endocrinology and Nutrition, Instituto Maimónides de Investigación Biomédica de Córdoba, Hospital Universitario Reina Sofia, Córdoba 14004, Spain
| | - Alfonso Soto-Moreno
- Metabolism and Nutrition Unit, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío, Seville 41013, Spain
| | - Rhonda D Kineman
- Department of Medicine, Jesse Brown Veterans Affairs Medical Center, Research and Development Division, University of Illinois at Chicago, Chicago, IL, USA
| | | | - Manuel D Gahete
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), and Hospital Universitario Reina Sofia.; CIBER Fisiopatología de la Obesidad y Nutrición; Campus de Excelencia Internacional Agroalimentario (ceiA3), 14014, Córdoba, Spain
| | - Mônica R Gadelha
- Endocrinology Unit, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Justo P Castaño
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), and Hospital Universitario Reina Sofia.; CIBER Fisiopatología de la Obesidad y Nutrición; Campus de Excelencia Internacional Agroalimentario (ceiA3), 14014, Córdoba, Spain.
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Ibáñez-Costa A, Gahete MD, Rivero-Cortés E, Rincón-Fernández D, Nelson R, Beltrán M, de la Riva A, Japón MA, Venegas-Moreno E, Gálvez MÁ, García-Arnés JA, Soto-Moreno A, Morgan J, Tsomaia N, Culler MD, Dieguez C, Castaño JP, Luque RM. In1-ghrelin splicing variant is overexpressed in pituitary adenomas and increases their aggressive features. Sci Rep 2015; 5:8714. [PMID: 25737012 PMCID: PMC4649711 DOI: 10.1038/srep08714] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 02/02/2015] [Indexed: 01/26/2023] Open
Abstract
Pituitary adenomas comprise a heterogeneous subset of pathologies causing serious comorbidities, which would benefit from identification of novel, common molecular/cellular biomarkers and therapeutic targets. The ghrelin system has been linked to development of certain endocrine-related cancers. Systematic analysis of the presence and functional implications of some components of the ghrelin system, including native ghrelin, receptors and the recently discovered splicing variant In1-ghrelin, in human normal pituitaries (n = 11) and pituitary adenomas (n = 169) revealed that expression pattern of ghrelin system suffers a clear alteration in pituitary adenomasas comparedwith normal pituitary, where In1-ghrelin is markedly overexpressed. Interestingly, in cultured pituitary adenoma cells In1-ghrelin treatment (acylated peptides at 100 nM; 24–72 h) increased GH and ACTH secretion, Ca2+ and ERK1/2 signaling and cell viability, whereas In1-ghrelin silencing (using a specific siRNA; 100 nM) reduced cell viability. These results indicate that an alteration of the ghrelin system, specially its In1-ghrelin variant, could contribute to pathogenesis of different pituitary adenomas types, and suggest that this variant and its related ghrelin system could provide new tools to identify novel, more general diagnostic, prognostic and potential therapeutic targets in pituitary tumors.
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Affiliation(s)
- Alejandro Ibáñez-Costa
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofia; CIBER Fisiopatología de la Obesidad y Nutrición; and Campus de Excelencia Internacional Agroalimentario (ceiA3), 14014 Córdoba, Spain
| | - Manuel D Gahete
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofia; CIBER Fisiopatología de la Obesidad y Nutrición; and Campus de Excelencia Internacional Agroalimentario (ceiA3), 14014 Córdoba, Spain
| | - Esther Rivero-Cortés
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofia; CIBER Fisiopatología de la Obesidad y Nutrición; and Campus de Excelencia Internacional Agroalimentario (ceiA3), 14014 Córdoba, Spain
| | - David Rincón-Fernández
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofia; CIBER Fisiopatología de la Obesidad y Nutrición; and Campus de Excelencia Internacional Agroalimentario (ceiA3), 14014 Córdoba, Spain
| | | | - Manuel Beltrán
- Department of Pathology, Puerta del Mar University Hospital, Cádiz
| | - Andrés de la Riva
- Service of Neurosurgery, Hospital Universitario Reina Sofia, 14004 Córdoba, Spain
| | - Miguel A Japón
- Department of Pathology, Hospital Universitario Virgen del Rocío, 41013 Seville, Spain
| | - Eva Venegas-Moreno
- Metabolism and Nutrition Unit, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS), 41013 Seville, Spain
| | - Ma Ángeles Gálvez
- Service of Endocrinology and Nutrition, Hospital Universitario Reina Sofia, and Instituto Maimónides de Investigación Biomédica de Córdoba, 14004 Córdoba, Spain
| | - Juan A García-Arnés
- Department of Endocrinology and Nutrition, Carlos Haya Hospital, 29010 Málaga, Spain
| | - Alfonso Soto-Moreno
- Metabolism and Nutrition Unit, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS), 41013 Seville, Spain
| | | | - Natia Tsomaia
- IPSEN Bioscience, Cambridge, 02142 Massachusetts, USA
| | | | - Carlos Dieguez
- Department of Physiology, University of Santiago de Compostela, and CIBER Fisiopatología de la Obesidad y Nutrición, 15782 Santiago de Compostela, Spain
| | - Justo P Castaño
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofia; CIBER Fisiopatología de la Obesidad y Nutrición; and Campus de Excelencia Internacional Agroalimentario (ceiA3), 14014 Córdoba, Spain
| | - Raúl M Luque
- Department of Cell Biology, Physiology and Immunology, University of Cordoba, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofia; CIBER Fisiopatología de la Obesidad y Nutrición; and Campus de Excelencia Internacional Agroalimentario (ceiA3), 14014 Córdoba, Spain
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Abstract
Animal models constitute valuable tools for investigating the pathogenesis of cancer as well as for preclinical testing of novel therapeutics approaches. However, the pathogenic mechanisms of pituitary-tumor formation remain poorly understood, particularly in sporadic adenomas, thus, making it a challenge to model pituitary tumors in mice. Nevertheless, genetically engineered mouse models (GEMMs) of pituitary tumors have provided important insight into pituitary tumor biology. In this paper, we review various GEMMs of pituitary tumors, highlighting their contributions and limitations, and discuss opportunities for research in the field.
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Affiliation(s)
- David A Cano
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío , Seville , Spain ; Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Consejo Superior de Investigaciones Científicas/Universidad de Sevilla , Seville , Spain
| | - Alfonso Soto-Moreno
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío , Seville , Spain ; Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Consejo Superior de Investigaciones Científicas/Universidad de Sevilla , Seville , Spain
| | - Alfonso Leal-Cerro
- Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Consejo Superior de Investigaciones Científicas/Universidad de Sevilla , Seville , Spain
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Leal-Cerro A, Martín-Rodríguez JF, Ibáñez-Costa A, Madrazo-Atutxa A, Venegas-Moreno E, León-Justel A, García-Hernández N, Luque RM, Castaño JP, Cano DA, Soto-Moreno A. Desmopressin test in the diagnosis and follow-up of cyclical Cushing's disease. Endocrinol Nutr 2013; 61:69-76. [PMID: 24183946 DOI: 10.1016/j.endonu.2013.04.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Revised: 04/01/2013] [Accepted: 04/30/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess the utility of the desmopressin (DDAVP) test in the diagnosis and follow-up of a cyclical Cushing's disease (CCS) case. MATERIAL AND METHODS Laboratory tests included morning and midnight serum cortisol levels, 24h urine free cortisol excretion, midnight salivary cortisol levels, serum cortisol levels after low (1 mg) and high (8 mg) dexamethasone, plasma ACTH and serum cortisol levels after DDAVP. Magnetic resonance imaging (MRI) was used to assess the presence of a pituitary adenoma. The resected tumor specimen was studied by histological, immunohistochemical and cell biology techniques. RESULTS A patient was referred to our unit with a diagnosis of Cushing's syndrome (CS) for further evaluation and treatment. However, no biochemical evidence of hypercortisolism was observed in the follow-up evaluations. Furthermore, the typical features of CS fluctuated throughout this period. A consistent positive response to the DDAVP stimulation test was observed during the diagnostic work-up, even when overt clinical features of CS were not apparent, raising suspicion for CCS. After two years of follow-up a definitive diagnosis of hypercortisolism was established. An MRI scan revealed a pituitary adenoma, as the source of ACTH production. After transphenoidal surgery, clinical signs of CS resolved and the response to DDAVP became negative. DDAVP induced a significant increase in ACTH levels in cultured pituitary adenoma cells, consistent with the in vivo DDAVP test results. CONCLUSIONS Our case illustrates the utility of the DDAVP test in the evaluation of patients with suspected CCS. The DDAVP test could facilitate the management of CCS by shortening the time of diagnosis.
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Affiliation(s)
- Alfonso Leal-Cerro
- Instituto de Biomedicina de Sevilla (IBiS), University Hospital Virgen del Rocío/Consejo Superior de Investigaciones Científicas/University of Sevilla and Division of Endocrinology, Virgen del Rocío University Hospital, Sevilla, Spain; Departamento de Biología Celular, Fisiología e Inmunología, Universidad de Córdoba, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC); CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn); Departamento de Bioquímica Clínica, Hospital Universitario Virgen del Rocío, Sevilla, Spain.
| | - Juan Francisco Martín-Rodríguez
- Instituto de Biomedicina de Sevilla (IBiS), University Hospital Virgen del Rocío/Consejo Superior de Investigaciones Científicas/University of Sevilla and Division of Endocrinology, Virgen del Rocío University Hospital, Sevilla, Spain
| | - Alejandro Ibáñez-Costa
- Departamento de Biología Celular, Fisiología e Inmunología, Universidad de Córdoba, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC); CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn)
| | - Ainara Madrazo-Atutxa
- Instituto de Biomedicina de Sevilla (IBiS), University Hospital Virgen del Rocío/Consejo Superior de Investigaciones Científicas/University of Sevilla and Division of Endocrinology, Virgen del Rocío University Hospital, Sevilla, Spain
| | - Eva Venegas-Moreno
- Instituto de Biomedicina de Sevilla (IBiS), University Hospital Virgen del Rocío/Consejo Superior de Investigaciones Científicas/University of Sevilla and Division of Endocrinology, Virgen del Rocío University Hospital, Sevilla, Spain
| | - Antonio León-Justel
- Departamento de Bioquímica Clínica, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Natividad García-Hernández
- Instituto de Biomedicina de Sevilla (IBiS), University Hospital Virgen del Rocío/Consejo Superior de Investigaciones Científicas/University of Sevilla and Division of Endocrinology, Virgen del Rocío University Hospital, Sevilla, Spain
| | - Raúl M Luque
- Departamento de Biología Celular, Fisiología e Inmunología, Universidad de Córdoba, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC); CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn)
| | - Justo P Castaño
- Departamento de Biología Celular, Fisiología e Inmunología, Universidad de Córdoba, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC); CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn)
| | - David A Cano
- Instituto de Biomedicina de Sevilla (IBiS), University Hospital Virgen del Rocío/Consejo Superior de Investigaciones Científicas/University of Sevilla and Division of Endocrinology, Virgen del Rocío University Hospital, Sevilla, Spain
| | - Alfonso Soto-Moreno
- Instituto de Biomedicina de Sevilla (IBiS), University Hospital Virgen del Rocío/Consejo Superior de Investigaciones Científicas/University of Sevilla and Division of Endocrinology, Virgen del Rocío University Hospital, Sevilla, Spain
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Luque RM, Ibáñez-Costa A, López-Sánchez LM, Jiménez-Reina L, Venegas-Moreno E, Gálvez MA, Villa-Osaba A, Madrazo-Atutxa AM, Japón MA, de la Riva A, Cano DA, Benito-López P, Soto-Moreno A, Gahete MD, Leal-Cerro A, Castaño JP. A cellular and molecular basis for the selective desmopressin-induced ACTH release in Cushing disease patients: key role of AVPR1b receptor and potential therapeutic implications. J Clin Endocrinol Metab 2013; 98:4160-9. [PMID: 23884782 DOI: 10.1210/jc.2013-1992] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Desmopressin is a synthetic agonist of vasopressin receptors (AVPRs). The desmopressin stimulation test is used in the diagnosis and postsurgery prognosis of Cushing disease (CD). However, the cellular and molecular mechanisms underlying the desmopressin-induced ACTH increase in patients with CD are poorly understood. OBJECTIVE The objectives of this study were to determine, for the first time, whether desmopressin acts directly and exclusively on pituitary corticotropinoma cells to stimulate ACTH expression/release and to elucidate the cellular and molecular mechanisms involved in desmopressin-induced ACTH increase in CD. DESIGN A total of 8 normal pituitaries (NPs), 23 corticotropinomas, 14 nonfunctioning pituitary adenomas, 17 somatotropinomas, and 3 prolactinomas were analyzed for AVPR expression by quantitative real-time RT-PCR. Primary cultures derived from corticotropinomas, nonfunctioning pituitary adenomas, somatotropinomas, prolactinomas, and NPs were treated with desmopressin, and ACTH secretion/expression, [Ca(2+)]i kinetics, and AVPR expression and/or proliferative response were evaluated. The relationship between AVPR expression and plasma adrenocorticotropin/cortisol levels obtained from desmopressin tests was assessed. RESULTS Desmopressin affects all functional parameters evaluated in corticotropinoma cells but not in NPs or other pituitary adenomas cells. These effects might be due to the dramatic elevation of AVPR1b expression levels found in corticotropinomas. In line with this notion, the use of an AVPR1b antagonist completely blocked desmopressin stimulatory effects. Remarkably, only AVPR1b expression was positively correlated with elevated plasma adrenocorticotropin levels in corticotropinomas. CONCLUSIONS The present results provide a cellular and molecular basis to support the desmopressin stimulation test as a reliable, specific test for the diagnosis and postsurgery prognosis of CD. Furthermore, our data indicate that AVPR1b is responsible for the direct/exclusive desmopressin stimulatory pituitary effects observed in CD, thus opening the possibility of exploring AVPR1b antagonists as potential therapeutic tools for CD treatment.
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Affiliation(s)
- R M Luque
- Department of Cell Biology, Physiology and Immunology, Campus Universitario de Rabanales, Edificio Severo Ochoa (C6), Planta 3, University of Córdoba, E-14014 Córdoba, Spain.
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Martín-Rodríguez JF, Madrazo-Atutxa A, Venegas-Moreno E, Benito-López P, Gálvez MÁ, Cano DA, Tinahones FJ, Torres-Vela E, Soto-Moreno A, Leal-Cerro A. Neurocognitive function in acromegaly after surgical resection of GH-secreting adenoma versus naïve acromegaly. PLoS One 2013; 8:e60041. [PMID: 23593161 PMCID: PMC3617159 DOI: 10.1371/journal.pone.0060041] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2012] [Accepted: 02/20/2013] [Indexed: 11/18/2022] Open
Abstract
Patients with active untreated acromegaly show mild to moderate neurocognitive disorders that are associated to chronic exposure to growth hormone (GH) and insulin-like growth factor (IGF-I) hypersecretion. However, it is unknown whether these disorders improve after controlling GH/IGF-I hypersecretion. The aim of this study was to compare neurocognitive functions of patients who successfully underwent GH-secreting adenoma transsphenoidal surgery (cured patients) with patients with naive acromegaly. In addition, we wanted to determine the impact of different clinical and biochemical variables on neurocognitive status in patients with active disease and after long-term cure. A battery of six standardized neuropsychological tests assessed attention, memory and executive functioning. In addition, a quantitative electroencephalography with Low-Resolution Electromagnetic Tomography (LORETA) solution was performed to obtain information about the neurophysiological state of the patients. Neurocognitive data was compared to that of a healthy control group. Multiple linear regression analysis was also conducted using clinical and hormonal parameters to obtain a set of independent predictors of neurocognitive state before and after cure. Both groups of patients scored significantly poorer than the healthy controls on memory tests, especially those assessing visual and verbal recall. Patients with cured acromegaly did not obtain better cognitive measures than naïve patients. Furthermore memory deficits were associated with decreased beta activity in left medial temporal cortex in both groups of patients. Regression analysis showed longer duration of untreated acromegaly was associated with more severe neurocognitive complications, regardless of the diagnostic group, whereas GH levels at the time of assessment was related to neurocognitive outcome only in naïve patients. Longer duration of post-operative biochemical remission of acromegaly was associated with better neurocognitive state. Overall, this data suggests that the effects of chronic exposure to GH/IGF-I hypersecretion could have long-term effects on brain functions.
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Affiliation(s)
- Juan Francisco Martín-Rodríguez
- Instituto de Biomedicina de Sevilla (IBiS), University Hospital Virgen del Rocío/Consejo Superior de Investigaciones Científicas/University of Seville and Division of Endocrinology, Virgen del Rocío University Hospital, Seville, Spain
| | - Ainara Madrazo-Atutxa
- Instituto de Biomedicina de Sevilla (IBiS), University Hospital Virgen del Rocío/Consejo Superior de Investigaciones Científicas/University of Seville and Division of Endocrinology, Virgen del Rocío University Hospital, Seville, Spain
| | - Eva Venegas-Moreno
- Instituto de Biomedicina de Sevilla (IBiS), University Hospital Virgen del Rocío/Consejo Superior de Investigaciones Científicas/University of Seville and Division of Endocrinology, Virgen del Rocío University Hospital, Seville, Spain
| | - Pedro Benito-López
- Division of Endocrinology, Hospital Universitario Reina Sofía, University of Córdoba, Córdoba, Spain
| | - María Ángeles Gálvez
- Division of Endocrinology, Hospital Universitario Reina Sofía, University of Córdoba, Córdoba, Spain
| | - David A. Cano
- Instituto de Biomedicina de Sevilla (IBiS), University Hospital Virgen del Rocío/Consejo Superior de Investigaciones Científicas/University of Seville and Division of Endocrinology, Virgen del Rocío University Hospital, Seville, Spain
| | | | | | - Alfonso Soto-Moreno
- Instituto de Biomedicina de Sevilla (IBiS), University Hospital Virgen del Rocío/Consejo Superior de Investigaciones Científicas/University of Seville and Division of Endocrinology, Virgen del Rocío University Hospital, Seville, Spain
| | - Alfonso Leal-Cerro
- Instituto de Biomedicina de Sevilla (IBiS), University Hospital Virgen del Rocío/Consejo Superior de Investigaciones Científicas/University of Seville and Division of Endocrinology, Virgen del Rocío University Hospital, Seville, Spain
- * E-mail:
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González-Duarte D, Madrazo-Atutxa A, Soto-Moreno A, Leal-Cerro A. Measurement of oxidative stress and endothelial dysfunction in patients with hypopituitarism and severe deficiency adult growth hormone deficiency. Pituitary 2012; 15:589-97. [PMID: 22228310 DOI: 10.1007/s11102-011-0374-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Patients with adult GH deficiency (AGHD) have a high cardiovascular risk and probably an alteration of the oxidative balance, although evidence is lacking. To evaluate the presence of endothelial dysfunction and oxidative stress in patients with AGHD. Biochemical parameters of oxidative stress and endothelial dysfunction were compared in 25 patients with previously untreated AGHD and 25 healthy controls matched by age and sex. Multivariate analysis was performed to identify independent predictors of oxidative stress. Vascular function of subcutaneous resistance arteries was also analyzed by means of wire myography in 7 patients with untreated AGHD and in 7 healthy controls with similar characteristics. The values of C-reactive protein, interleukin-6 (IL-6) and tumour necrosis factor alpha (TNF-α), were higher in the AGHD group (4.6 vs. 0.2 μg/L, P = 0.02; 5.6 vs. 1.2 pg/mL, P = 0.001; 6.7 vs. 2.1 pg/mL, P = 0.04; respectively). The levels of type-1 vascular cell adhesion molecule, total anti-oxidant state, oxidized LDL (LDL-ox) were also greater in AGHD patients (678 vs. 423 ng/mL, P = 0.004; 1235.6 vs. 1002.3 μmol/L, P = 0.01; 172.2.5 vs. 42.3 ng/mL, P = 0.02; respectively). Nitric oxide (NO), reduced glutathione (GSH) and reduced/oxidized glutathione ratio (GSH/GSSG) values were lower than controls (18.7 vs. 31.6 mmol/mg protein, P = 0.01; 372.2 vs. 756.2 μmol/L, P = 0.03; 17.2 vs. 38.4, P = 0.04; respectively). Multiple regression analysis showed that AGHD was an independent predictor of increased LDL-ox (P = 0.002) and decreased GSH (P = 0.000). Furthermore, the degree of vascular relaxation to repeated exposure of acetylcholine was lower in AGHD (P = 0.025). Patients with AGHD have an increased degree of oxidative stress and endothelial dysfunction that could already be present in early stages of the disease. Studies with a greater number of patients are needed in order to confirm our findings.
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Affiliation(s)
- Daniel González-Duarte
- Endocrinology Unit, Hospital Punta Europa de Algeciras, Carretera Getares, 11204 Algeciras, Cádiz, Spain.
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León-Justel A, Mangas MA, Fontán RI, Luque JC, Moreno EV, Atutxa AM, del Rey TH, Martin-Rodriguez JF, Soto-Moreno A, Leal-Cerro A. Budget impact of using midnight salivary cortisol in the diagnosis of hypercortisolism. Clin Chim Acta 2011; 412:2248-53. [DOI: 10.1016/j.cca.2011.08.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2011] [Revised: 08/10/2011] [Accepted: 08/10/2011] [Indexed: 10/17/2022]
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Leon-Carrion J, Martin-Rodriguez JF, Madrazo-Atutxa A, Soto-Moreno A, Venegas-Moreno E, Torres-Vela E, Benito-López P, Gálvez MA, Tinahones FJ, Leal-Cerro A. Evidence of cognitive and neurophysiological impairment in patients with untreated naive acromegaly. J Clin Endocrinol Metab 2010; 95:4367-79. [PMID: 20554710 DOI: 10.1210/jc.2010-0394] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
CONTEXT Recent studies have suggested that long-term exposure to high levels of GH and IGF-I affect brain and cognitive functions. However, very few human studies have challenged this hypothesis. OBJECTIVE The aim of this study is to explore whether GH/IGF-I excess in naive patients with acromegaly alters cognitive functions, particularly memory, and whether these alterations are accompanied by neurophysiological correlates. DESIGN We conducted a comprehensive neuropsychological and neurophysiological exam on 16 naive acromegaly patients and 16 strictly matched healthy controls. Comparative analyses were carried out on major neurocognitive domains (executive functions, visual/verbal memory, attention, visuoconstructive abilities, and verbal fluency) and on quantitative electroencephalogram and low-resolution brain electromagnetic tomography sources. Results were correlated with GH and IGF-I hormone concentrations. RESULTS Short- and long-term memory were the most severely impaired cognitive functions. Moreover, memory performance correlated negatively with GH and IGF-I concentrations. No association was detected between depression and memory impairment, and only a marginal association was found with quality of life. Finally, acromegaly patients showed power attenuation in fast frequency electroencephalogram bands, as well as decreased activity in prefrontal and middle temporal cortices, that was associated to cognitive performance. CONCLUSIONS Results provide evidence of cognitive and neurophysiological impairment, characterized by moderate-to-severe memory impairment and decreased neural activity in specific brain areas. High levels of GH and IGF-I in acromegaly patients could be the basis for these findings.
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Affiliation(s)
- José Leon-Carrion
- Human Neuropsychology Laboratory, Experimental Psychology Department, Universityof Seville, 41018 Seville, Spain.
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León-Carrión J, Atutxa AM, Mangas MA, Soto-Moreno A, Pumar A, Leon-Justel A, Martín-Rodriguez JF, Venegas E, Domínguez-Morales MR, Leal-Cerro A. A clinical profile of memory impairment in humans due to endogenous glucocorticoid excess. Clin Endocrinol (Oxf) 2009; 70:192-200. [PMID: 18702680 DOI: 10.1111/j.1365-2265.2008.03355.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Glucocorticoid excess is commonly related to neuropsychiatric and neurological disorders, with memory impairment typically found among these disorders. The objective of this study is to offer a clinical profile of memory deficits resulting from exposure to chronic stress-level elevations of endogenous glucocorticoids in patients with Cushing's Syndrome (CS). STUDY SUBJECTS Thirty female participants of matching age and education level were studied: 15 had untreated CS (mean age 38 +/- 14) and 15 were healthy. In all patients, CS was confirmed by histology of the lesion after surgery. DESIGN Different learning and memory processes were assessed using an adapted version of Luria's Memory Words-Revised task (LMW-R). Participants' performances were measured in an immediate condition and, 30 min later, in a delayed condition. Attentional and executive functions were also evaluated. RESULTS Our data show that chronic exposure to elevated levels of cortisol is clinically associated with significant working memory deficits, which included less shot-term memory volume, slow learning rate, memory contamination and no accurate perception of own performance. Patients also show impairment in the delayed recall task. No relation was detected between learning and delayed conditions. CS group did not differ significantly from control group in basic attentional and executive functioning. CONCLUSIONS Our clinical profile of memory deficits related to CS relates chronic exposure to hypercortisolemia to impaired attentional-dependent working memory and delayed recall process, suggesting that cortisol levels play a critical role in the modulation of learning and memory. Possible damage to hippocampus and extrahippocampal areas is discussed.
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Affiliation(s)
- José León-Carrión
- Human Neuropsychology Laboratory, University of Seville, Seville, Spain.
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Acosta-Feria M, Amaya-García MJ, Martos JM, Razak A, Lozano M, Salvador-Almeida D, Soto-Moreno A, del Valle A. [Surgical treatment of primary hyperparathyroidism in pregnancy]. Cir Esp 2006; 77:287-9. [PMID: 16420935 DOI: 10.1016/s0009-739x(05)70855-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Primary hyperparathyroidism during pregnancy is a pathological entity with an unknown incidence that presents certain physiological, therapeutic and prognostic characteristics leading to greater difficulty in diagnosis and a high risk of complications. We present the case of a 16-week pregnant woman who presented with asymptomatic hypercalcemia secondary to a solitary parathyroid adenoma. Since conservative measures produced no improvement, surgery was performed in the second trimester of pregnancy, with satisfactory pre- and postnatal results. Surgery in the second trimester constitutes a safe alternative to conservative treatment.
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Affiliation(s)
- M Acosta-Feria
- Unidad de Cirugía Endocrina, Servicio de Cirugía General, Hospital Universitario Virgen del Rocío, Sevilla, Spain.
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