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Vesterinen T, Peltola E, Leijon H, Hannula P, Huhtala H, Mäkinen MJ, Nieminen L, Pirinen E, Rönty M, Söderström M, Jaatinen P, Arola J. Immunohistochemical Glucagon-like Peptide-1 Receptor Expression in Human Insulinomas. Int J Mol Sci 2023; 24:15164. [PMID: 37894845 PMCID: PMC10606800 DOI: 10.3390/ijms242015164] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/04/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023] Open
Abstract
Insulinomas are rare functional pancreatic neuroendocrine tumours, which metastasize in 10% of cases. As predicting the prognosis can be challenging, there is a need for the determination of clinicopathological factors associated with metastatic potential. The aim of this study is to evaluate the glucagon-like peptide-1 receptor (GLP-1R) expression in insulinomas and to analyse its association with clinicopathological features and patient outcome. This retrospective study involves pancreatic tumour tissue samples from fifty-two insulinoma patients. After histological re-evaluation, formalin-fixed paraffin-embedded tissue samples were processed into tissue microarrays and stained immunohistochemically with a monoclonal GLP-1R antibody. Forty-eight of the forty-nine (98%) non-metastatic tumours expressed GLP-1R, while one non-metastatic, multiple endocrine neoplasia type 1 (MEN1)-related tumour and all three of the metastatic tumours lacked GLP-1R expression. The lack of GLP-1R expression was associated with impaired overall survival, larger tumour diameter, higher Ki-67 PI and weaker insulin staining. Somatostatin receptor 1-5 expression did not differ between GLP-1R-positive and GLP-1R-negative insulinomas. In conclusion, the lack of GLP-1R expression is associated with metastatic disease and impaired survival in insulinoma patients. Thus, GLP-1R expression could be a useful biomarker in estimating the metastatic potential of the tumour and the prognosis of surgically treated patients.
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Affiliation(s)
- Tiina Vesterinen
- Department of Pathology, HUSLAB, HUS Diagnostic Center, Helsinki University Hospital, University of Helsinki, 00290 Helsinki, Finland; (T.V.); (H.L.); (M.R.); (J.A.)
- Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science (HiLIFE), University of Helsinki, 00290 Helsinki, Finland
| | - Elina Peltola
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland; (E.P.); (P.H.)
- Department of Internal Medicine, Tampere University Hospital, 33520 Tampere, Finland
| | - Helena Leijon
- Department of Pathology, HUSLAB, HUS Diagnostic Center, Helsinki University Hospital, University of Helsinki, 00290 Helsinki, Finland; (T.V.); (H.L.); (M.R.); (J.A.)
| | - Päivi Hannula
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland; (E.P.); (P.H.)
- Endocrinology, Department of Internal Medicine, Tampere University Hospital, 33520 Tampere, Finland
| | - Heini Huhtala
- Faculty of Social Sciences, Tampere University, 33014 Tampere, Finland;
| | - Markus J. Mäkinen
- Department of Pathology, Research Unit of Translational Medicine, Oulu University Hospital, University of Oulu, 90220 Oulu, Finland;
| | - Lasse Nieminen
- Fimlab Laboratories, Pathology Department, Tampere University Hospital, 33520 Tampere, Finland;
| | - Elina Pirinen
- Department of Clinical Pathology, Kuopio University Hospital, 70029 Kuopio, Finland;
| | - Mikko Rönty
- Department of Pathology, HUSLAB, HUS Diagnostic Center, Helsinki University Hospital, University of Helsinki, 00290 Helsinki, Finland; (T.V.); (H.L.); (M.R.); (J.A.)
| | - Mirva Söderström
- Department of Pathology, Turku University Hospital, 20521 Turku, Finland;
| | - Pia Jaatinen
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland; (E.P.); (P.H.)
- Department of Internal Medicine, Tampere University Hospital, 33520 Tampere, Finland
- Division of Internal Medicine, Seinäjoki Central Hospital, 60220 Seinäjoki, Finland
| | - Johanna Arola
- Department of Pathology, HUSLAB, HUS Diagnostic Center, Helsinki University Hospital, University of Helsinki, 00290 Helsinki, Finland; (T.V.); (H.L.); (M.R.); (J.A.)
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Peltola E, Vesterinen T, Leijon H, Hannula P, Huhtala H, Mäkinen M, Nieminen L, Pirinen E, Rönty M, Söderström M, Arola J, Jaatinen P. Immunohistochemical somatostatin receptor expression in insulinomas. APMIS 2023; 131:152-160. [PMID: 36680557 DOI: 10.1111/apm.13297] [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] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 01/19/2023] [Indexed: 01/22/2023]
Abstract
Insulinomas are rare pancreatic neuroendocrine tumours. Most patients can be cured with surgery, but patients with a metastatic disease show impaired survival. The aim of this study was to evaluate somatostatin receptor (SSTR) 1-5 expression in insulinomas and to correlate the expression profile with clinicopathological variables and with patient outcome. This retrospective study involved 52 insulinoma patients. After histological re-evaluation, formalin-fixed paraffin-embedded tissue samples were processed into tissue microarrays and stained immunohistochemically with monoclonal SSTR1-5 antibodies. All the 52 tumours (49 non-metastatic, 3 metastatic) expressed at least one SSTR subtype. SSTR2 was expressed most frequently (71%), followed by SSTR3 (33%), SSTR1 (27%), SSTR5 (6%) and SSTR4 (0%). SSTR3 expression was associated with a larger tumour size (median diameter 19 mm vs. 13 mm, p = 0.043), and SSTR3 and SSTR5 expression were associated with impaired overall survival [HR 3.532 (95% CI 1.106-11,277), p = 0.033, and HR 6.805 (95% CI 1.364-33.955), p = 0.019 respectively]. Most insulinomas express SSTR2, which may be utilized in diagnostic imaging, and in planning individualized treatment strategies for insulinoma patients. Further studies are needed to clarify the association between SSTR profile and overall survival.
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Affiliation(s)
- Elina Peltola
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
| | - Tiina Vesterinen
- HUS Diagnostic Center, HUSLAB, Department of Pathology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
| | - Helena Leijon
- HUS Diagnostic Center, HUSLAB, Department of Pathology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Päivi Hannula
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Endocrinology, Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
| | - Heini Huhtala
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Markus Mäkinen
- Research Unit of Cancer and Translational Medicine, Department of Pathology, University of Oulu and Department of Pathology, Oulu University Hospital, Oulu, Finland
| | - Lasse Nieminen
- Fimlab Laboratories, Pathology Department, Tampere University Hospital, Tampere, Finland
| | - Elina Pirinen
- Department of Clinical Pathology, Kuopio University Hospital, Kuopio, Finland
| | - Mikko Rönty
- HUS Diagnostic Center, HUSLAB, Department of Pathology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Mirva Söderström
- Department of Pathology, Turku University Hospital, Turku, Finland
| | - Johanna Arola
- HUS Diagnostic Center, HUSLAB, Department of Pathology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Pia Jaatinen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Department of Internal Medicine, Tampere University Hospital, Tampere, Finland.,Division of Internal Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland
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Hulmi JJ, Penna F, Pöllänen N, Nissinen TA, Hentilä J, Euro L, Lautaoja JH, Ballarò R, Soliymani R, Baumann M, Ritvos O, Pirinen E, Lalowski M. Muscle NAD + depletion and Serpina3n as molecular determinants of murine cancer cachexia-the effects of blocking myostatin and activins. Mol Metab 2020; 41:101046. [PMID: 32599075 PMCID: PMC7364159 DOI: 10.1016/j.molmet.2020.101046] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 06/16/2020] [Accepted: 06/23/2020] [Indexed: 12/26/2022] Open
Abstract
Objective Cancer cachexia and muscle loss are associated with increased morbidity and mortality. In preclinical animal models, blocking activin receptor (ACVR) ligands has improved survival and prevented muscle wasting in cancer cachexia without an effect on tumour growth. However, the underlying mechanisms are poorly understood. This study aimed to identify cancer cachexia and soluble ACVR (sACVR) administration-evoked changes in muscle proteome. Methods Healthy and C26 tumour-bearing (TB) mice were treated with recombinant sACVR. The sACVR or PBS control were administered either prior to the tumour formation or by continued administration before and after tumour formation. Muscles were analysed by quantitative proteomics with further examination of mitochondria and nicotinamide adenine dinucleotide (NAD+) metabolism. To complement the first prophylactic experiment, sACVR (or PBS) was injected as a treatment after tumour cell inoculation. Results Muscle proteomics in TB cachectic mice revealed downregulated signatures for mitochondrial oxidative phosphorylation (OXPHOS) and increased acute phase response (APR). These were accompanied by muscle NAD+ deficiency, alterations in NAD+ biosynthesis including downregulation of nicotinamide riboside kinase 2 (Nrk2), and decreased muscle protein synthesis. The disturbances in NAD+ metabolism and protein synthesis were rescued by treatment with sACVR. Across the whole proteome and APR, in particular, Serpina3n represented the most upregulated protein and the strongest predictor of cachexia. However, the increase in Serpina3n expression was associated with increased inflammation rather than decreased muscle mass and/or protein synthesis. Conclusions We present evidence implicating disturbed muscle mitochondrial OXPHOS proteome and NAD+ homeostasis in experimental cancer cachexia. Treatment of TB mice with a blocker of activin receptor ligands restores depleted muscle NAD+ and Nrk2, as well as decreased muscle protein synthesis. These results indicate putative new treatment therapies for cachexia and that although acute phase protein Serpina3n may serve as a predictor of cachexia, it more likely reflects a condition of elevated inflammation. Cachectic muscle proteome shows decreased OXPHOS and increased acute phase response. Cancer cachexia is characterized by lowered muscle Nrk2 expression and NAD+ levels. Blocking activin receptor 2B ligands rescues muscle NAD+ homeostasis in cachexia. Blocking activin receptor 2B ligands prevents affected protein synthesis in cachexia. Serpina3n predicts cachexia and cancer-induced APR independently from muscle atrophy.
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Affiliation(s)
- J J Hulmi
- Faculty of Sport and Health Sciences, NeuroMuscular Research Center, University of Jyväskylä, Jyväskylä, Finland; Department of Physiology, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
| | - F Penna
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - N Pöllänen
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - T A Nissinen
- Faculty of Sport and Health Sciences, NeuroMuscular Research Center, University of Jyväskylä, Jyväskylä, Finland
| | - J Hentilä
- Faculty of Sport and Health Sciences, NeuroMuscular Research Center, University of Jyväskylä, Jyväskylä, Finland
| | - L Euro
- Stem Cells and Metabolism Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - J H Lautaoja
- Faculty of Sport and Health Sciences, NeuroMuscular Research Center, University of Jyväskylä, Jyväskylä, Finland
| | - R Ballarò
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - R Soliymani
- Meilahti Clinical Proteomics Core Facility, HiLIFE, Faculty of Medicine, Biochemistry and Developmental biology, University of Helsinki, Helsinki, Finland
| | - M Baumann
- Meilahti Clinical Proteomics Core Facility, HiLIFE, Faculty of Medicine, Biochemistry and Developmental biology, University of Helsinki, Helsinki, Finland
| | - O Ritvos
- Department of Physiology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - E Pirinen
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - M Lalowski
- Meilahti Clinical Proteomics Core Facility, HiLIFE, Faculty of Medicine, Biochemistry and Developmental biology, University of Helsinki, Helsinki, Finland
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Peltola E, Hannula P, Huhtala H, Metso S, Kiviniemi U, Vornanen M, Sand J, Laukkarinen J, Tiikkainen M, Schalin-Jäntti C, Arola J, Sirén J, Piiroinen A, Soinio M, Nuutila P, Söderström M, Hämäläinen H, Moilanen L, Laaksonen D, Pirinen E, Sundelin F, Ebeling T, Salmela P, Mäkinen MJ, Jaatinen P. Characteristics and Outcomes of 79 Patients with an Insulinoma: A Nationwide Retrospective Study in Finland. Int J Endocrinol 2018; 2018:2059481. [PMID: 30425741 PMCID: PMC6218736 DOI: 10.1155/2018/2059481] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Accepted: 09/09/2018] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE Insulinomas are rare pancreatic tumours. Population-based data on their incidence, clinical picture, diagnosis, and treatment are almost nonexistent. The aim of this study was to clarify these aspects in a nationwide cohort of insulinoma patients diagnosed during three decades. DESIGN AND METHODS Retrospective analysis on all adult patients diagnosed with insulinoma in Finland during 1980-2010. RESULTS Seventy-nine patients were diagnosed with insulinoma over the research period. The median follow-up from diagnosis to last control visit was one (min 0, max 31) year. The incidence increased from 0.5/million/year in the 1980s to 0.9/million/year in the 2000s (p = 0.002). The median diagnostic delay was 13 months and did not change over the study period. The mean age at diagnosis was 52 (SD 16) years. The overall imaging sensitivity improved from 39% in the 1980s to 98% in the 2000s (p < 0.001). Seventy-one (90%) of the patients underwent surgery with a curative aim, two (3%) had palliative surgery, and 6 (8%) were inoperable. There were no significant differences in the types of surgical procedures between the 1980s, 1990s, and 2000s; tumour enucleations comprised 43% of the operations, distal pancreatic resections 45%, and pancreaticoduodenectomies 12%, over the whole study period. Of the patients who underwent surgery with a curative aim, 89% had a full recovery. Postoperative complications occurred in half of the patients, but postoperative mortality was rare. CONCLUSIONS The incidence of insulinomas has increased during the past three decades. Despite the improved diagnostic options, diagnostic delay has remained unchanged. To shorten the delay, clinicians should be informed and alert to consider the possibility of hypoglycemia and insulinoma, when symptomatic attacks are investigated in different sectors of the healthcare system. Developing the surgical treatment is another major target, in order to lower the overall complication rate, without compromising the high cure rate of insulinomas.
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Affiliation(s)
- Elina Peltola
- Faculty of Medicine and Life Sciences, University of Tampere, Finland
- Division of Internal Medicine, Seinäjoki Central Hospital, Finland
| | - Päivi Hannula
- Endocrinology, Department of Internal Medicine, Tampere University Hospital, Finland
| | - Heini Huhtala
- Faculty of Social Sciences, University of Tampere, Finland
| | - Saara Metso
- Endocrinology, Department of Internal Medicine, Tampere University Hospital, Finland
| | - Ulla Kiviniemi
- Endocrinology, Department of Internal Medicine, Tampere University Hospital, Finland
| | - Martine Vornanen
- Fimlab Laboratories, Pathology Department, Tampere University Hospital, Finland
| | - Juhani Sand
- Päijät-Häme Joint Authority for Health and Wellbeing, Finland
| | - Johanna Laukkarinen
- Faculty of Medicine and Life Sciences, University of Tampere, Finland
- Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Finland
| | - Mirja Tiikkainen
- Endocrinology, Abdominal Center, Helsinki University Hospital, Finland
| | - Camilla Schalin-Jäntti
- Endocrinology, Abdominal Center, Helsinki University Hospital, Finland
- Endocrinology, Abdominal Center, University of Helsinki, Finland
| | - Johanna Arola
- Pathology, HUSLAB Helsinki University Hospital, Finland
- Pathology, University of Helsinki, Finland
| | - Jukka Sirén
- Abdominal Center, Helsinki University Hospital, Finland
| | | | - Minna Soinio
- Endocrinology, Department of Internal Medicine, Turku University Hospital, Finland
| | - Pirjo Nuutila
- Faculty of Medicine, University of Turku, Finland
- Endocrinology, Department of Internal Medicine, Turku University Hospital, Finland
| | | | - Hanna Hämäläinen
- Faculty of Health Sciences, School of Medicine, University of Eastern Finland, Finland
| | - Leena Moilanen
- Department of Medicine, Kuopio University Hospital, Finland
| | | | - Elina Pirinen
- Department of Clinical Pathology, Kuopio University Hospital, Finland
| | - Fia Sundelin
- Faculty of Medicine, University of Oulu, Finland
| | - Tapani Ebeling
- Faculty of Medicine, University of Oulu, Finland
- Endocrinology, Oulu University Hospital, Finland
| | - Pasi Salmela
- Endocrinology, Oulu University Hospital, Finland
| | - Markus J. Mäkinen
- Research Unit of Cancer and Translational Medicine, Department of Pathology, University of Oulu, Finland
- Department of Pathology, Oulu University Hospital, Finland
| | - Pia Jaatinen
- Faculty of Medicine and Life Sciences, University of Tampere, Finland
- Division of Internal Medicine, Seinäjoki Central Hospital, Finland
- Endocrinology, Department of Internal Medicine, Tampere University Hospital, Finland
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Pirinen E, Soini Y. Expression of thioredoxin, 8Hydroxy-deguanosine and peroxiredoxins in placental tissues. Int J Clin Exp Pathol 2017; 10:8353-8360. [PMID: 31966686 PMCID: PMC6965487] [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] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 01/13/2017] [Indexed: 06/10/2023]
Abstract
In this study we analyzed the expression of 8-hydroxy-deguanosine (8OHdG), thioredoxin (Trx) and peroxiredoxins (Prx) 2, 3, 4, 5 and 6 in 80 cases of placental samples representing both normal and diseased placentas. The staining was evaluated separately in the stromal, trophoblastic and vascular components of the tissues. The results indicate that during the first trimester the level of reactive oxygen species (ROS) as indicated by 8OHdG was highest in the stromal component, which was also the case for Trx, Prx3, Prx4 and Prx6. In diseased placentas stromal 8OHdG was lower in cases with chromosomal aberrations but higher in molar disease in both trophoblastic and stromal cells. In chorioamnionitis stromal prx 5 and prx6 were high. Stromal prx4 and trophoblastic prx6 and stromal and endothelial Trx were also higher in molar disease. The results show that the oxidative stress is high in placentas during the first trimester. This probably reflects the oxidation burst of the placental tissues due to development of vascularity. In diseased placentas elevated levels of Prxs were seen in chorioamnionitis reflecting the ROS stress induced by inflammatory cells. The higher values of antioxidative enzymes in molar disease are possibly due to defective placentation. All in all, the results underline the importance on ROS associated mechanisms in placental development and the function of placenta to protect the developing fetus from harmful effects of reactive oxygen species as evidenced by their abundant expression in different cellular compartments of the placenta.
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Affiliation(s)
- Elina Pirinen
- Imaging Center, Clinical Pathology, Kuopio University HospitalP.O. Box 1777, FI-70211 Kuopio, Finland
| | - Ylermi Soini
- Imaging Center, Clinical Pathology, Kuopio University HospitalP.O. Box 1777, FI-70211 Kuopio, Finland
- Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern FinlandP.O. Box 1627, FI-70211 Kuopio, Finland
- Department of Pathology, University of OuluFinland
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Kraus D, Yang Q, Kong D, Banks AS, Zhang L, Rodgers JT, Pirinen E, Pulinilkunnil TC, Gong F, Wang YC, Cen Y, Sauve AA, Asara JM, Peroni OD, Monia BP, Bhanot S, Alhonen L, Puigserver P, Kahn BB. Nicotinamide N-methyltransferase is a novel regulator of energy metabolism in adipose tissue. DIABETOL STOFFWECHS 2014. [DOI: 10.1055/s-0034-1374908] [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] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Pirinen E, Soini Y. A survey of zeb1, twist and claudin 1 and 4 expression during placental development and disease. APMIS 2013; 122:530-8. [DOI: 10.1111/apm.12187] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Accepted: 08/14/2013] [Indexed: 02/06/2023]
Affiliation(s)
- Elina Pirinen
- Imaging Center; Clinical Pathology; Kuopio University Hospital; Kuopio Finland
| | - Ylermi Soini
- Imaging Center; Clinical Pathology; Kuopio University Hospital; Kuopio Finland
- Institute of Clinical Medicine, Pathology and Forensic Medicine; University of Eastern Finland; Kuopio Finland
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Tauriainen MM, Pirinen E, Ristimäki A. [Cronkhite-Canada syndrome - a rare intestinal polypotic syndrome]. Duodecim 2013; 129:2157-2162. [PMID: 24340716] [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] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Cronkhite-Canada syndrome is a rare polypotic disease of the gastrointestinal tract. There are no specific diagnostic criteria for this syndrome. Suspicion may arise if both an endoscopic and a histopathologic finding together with the patient's symptom picture are indicative of the disease. Other polypotic conditions should be excluded. No established treatment is available for the syndrome. The principles of treatment have remained almost unchanged at least over the past decade. With a large proportion of the patients eventually developing a gastrointestinal malignancy, the prognosis of the disease is mostly poor.
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Affiliation(s)
| | | | - Ari Ristimäki
- Meilahden patologian laboratoriot, patologian ja genetiikan vastuualue, HUSLAB
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9
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Popova SN, Tarvainen I, Capellari S, Parchi P, Hannikainen P, Pirinen E, Haapasalo H, Alafuzoff I. Divergent clinical and neuropathological phenotype in a Gerstmann-Sträussler-Scheinker P102L family. Acta Neurol Scand 2012; 126:315-23. [PMID: 22211828 DOI: 10.1111/j.1600-0404.2011.01628.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2011] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Gerstmann-Sträussler-Scheinker syndrome belongs to the genetic prion diseases being associated with mutations in the prion protein gene (PRNP). The most common is the point mutation at codon 102, leading to the substitution of proline to leucine (P102L). Previous reports have indicated a phenotypic heterogeneity among individuals with this mutation. Here, we describe the clinical and pathological phenotype in members of the first Finnish kindred with the P102L mutation in the PNRP gene. MATERIALS AND METHODS Genetic and clinical information was available in five members of a family, while a systematic histologic and immunohistochemical assessment of the post-mortem brain was carried out in three. RESULTS Clinical presentation, disease duration and the clinical phenotype (ataxia vs dementia) varied between patients. There was a significant correlation between clinical symptoms and the neuroanatomical distribution of prion protein-immunoreactive aggregates, i.e. subtentorial predominance in ataxia vs cortical predominance in dementia. A significant concomitant Alzheimer is disease-related pathology was observed in the brain of one patient with dementia as onset symptom. CONCLUSIONS This is the first Scandinavian family carrying the P102L mutation in the PRNP gene. Gerstmann-Sträussler-Scheinker syndrome should be considered in the differential diagnosis when handling with patients with ataxia and/or dementia of unclear aetiology.
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Affiliation(s)
- S. N. Popova
- Department of Genetics and Pathology; Rudbeck's Laboratory; Uppsala University; Uppsala; Sweden
| | | | - S. Capellari
- Dipartimento di Scienze Neurologiche; Università di Bologna; Bologna; Italy
| | - P. Parchi
- Dipartimento di Scienze Neurologiche; Università di Bologna; Bologna; Italy
| | - P. Hannikainen
- Department of Forenzic Medicine; University of Eastern Finland; Kuopio; Finland
| | - E. Pirinen
- Kuopio University Hospital; Kuopio; Finland
| | - H. Haapasalo
- Department of Pathology; Centre for Laboratory Medicine; Tampere University Hospital; Tampere; Finland
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Cerrada-Gimenez M, Tusa M, Casellas A, Pirinen E, Moya M, Bosch F, Alhonen L. Altered glucose-stimulated insulin secretion in a mouse line with activated polyamine catabolism. Transgenic Res 2011; 21:843-53. [PMID: 22180015 DOI: 10.1007/s11248-011-9579-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2011] [Accepted: 11/30/2011] [Indexed: 11/28/2022]
Abstract
Ubiquitous activation of polyamine catabolism has been demonstrated to have protective effects in mice on fat accumulation and insulin sensitivity/glucose tolerance in, both, normal conditions and after a high fat diet. We have analyzed the endocrine pancreas functionality in four months-old male mice overexpressing the rate limiting enzyme in the polyamine catabolism, spermidine/spermine N¹-acetyltransferase (SSAT). The pancreatic SSAT activity was 37-fold elevated in the transgenic mice, which reduced the total pancreatic and islet pools of spermidine (71%) and spermine (69%), and increased putrescine and N¹-acetyl spermidine. Reduction in the islet ATP levels (65%) was accompanied with increased transcription of 5'-AMP-activated protein kinase (AMPK) (1.5-fold) and Foxa2 (2.7-fold), and reduced HNF4α (67%) and HNF1α (92%), insulin 1 (47%), insulin 2 (50%), and Glut2 (57%). Moreover, the SSAT transgenic mice also presented increased beta cell area, decreased insulin production, and altered glucose-stimulated insulin secretion. It has been hypothesized that the acute activation of the polyamine catabolism produces a futile cycle that greatly decreases the energy reserves of the cell. The lower energy status would activate the energy expenditure regulator, AMPK, which would consequently repress the PI3K/Akt pathway, and activate the transcription factor Foxa2.
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Affiliation(s)
- M Cerrada-Gimenez
- Biotechnology and Molecular Medicine, A.I. Virtanen Institute, Biocenter Kuopio, University of Eastern Finland, Kuopio Campus, P.O.Box 1627, 70211 Kuopio, Finland.
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Pihlajamäki J, Grönlund S, Simonen M, Käkelä P, Moilanen L, Pääkkönen M, Pirinen E, Kolehmainen M, Kärjä V, Kainulainen S, Uusitupa M, Alhava E, Miettinen TA, Gylling H. Cholesterol absorption decreases after Roux-en-Y gastric bypass but not after gastric banding. Metabolism 2010; 59:866-72. [PMID: 20015521 DOI: 10.1016/j.metabol.2009.10.004] [Citation(s) in RCA: 66] [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] [Received: 08/29/2009] [Revised: 10/02/2009] [Accepted: 10/05/2009] [Indexed: 12/15/2022]
Abstract
The differences in cholesterol metabolism after the 2 most common forms of obesity surgery, Roux-en-Y gastric bypass (RYGB) and gastric banding (GB), have not been well characterized. In this study, effects of RYGB and GB on cholesterol absorption and synthesis were investigated. To this aim, 1-year follow-up of cholesterol metabolism in 2 nonrandomized cohorts undergoing either RYGB (n = 29; age, 45.2 +/- 7.7 years; body mass index [BMI], 46.0 +/- 6.1 kg/m(2)) or GB (n = 26; age, 45.9 +/- 8.6 years; BMI, 50.1 +/- 7.7 kg/m(2)) was performed in a university hospital center specializing in the treatment of morbid obesity. Serum markers of cholesterol synthesis (cholestenol, desmosterol, and lathosterol) and cholesterol absorption (campesterol, sitosterol, avenasterol, and cholestanol) were measured preoperatively and at follow-up and expressed as ratios to cholesterol. As expected based on observed weight loss (25% after RYGB and 17% after GB, P < .001 between groups), both operations decreased serum levels of cholesterol synthesis markers by 12% to 28% (all Ps < .001). A decrease in cholesterol absorption markers was only observed after RYGB (-26% for sitosterol) and not after GB (+16%, P = 2 x 10(-6) for difference between the groups). The difference in sitosterol ratio between the groups remained significant after adjustment for age, BMI, fasting insulin levels, and nutritional status (P = 2 x 10(-4)), indicating a specific effect related to RYGB. We conclude that decrease in cholesterol absorption is a novel beneficial effect of RYGB. Together with an improved control of blood glucose, this may contribute to a better cardiovascular risk profile after RYGB.
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Affiliation(s)
- Jussi Pihlajamäki
- Department of Medicine, University of Kuopio and Kuopio University Hospital, 70210 Kuopio, Finland.
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Karamanakos PN, Jaaskelainen JE, Alafuzoff I, Pirinen E, Vanninen R, Silvennoinen S, Sankilampi U, Immonen A. Malignant giant cell tumor in the posterior fossa of a neonate. J Neurosurg Pediatr 2010; 5:277-82. [PMID: 20192645 DOI: 10.3171/2009.10.peds09453] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [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: 11/06/2022]
Abstract
Giant cell tumors (GCTs) of the bone are rare, usually benign but locally aggressive neoplasms that primarily occur in the epiphyses of long bones. They seldom develop in the cranium; when they do, they involve principally the sphenoid and temporal bones. These tumors usually affect young adults, and few reports in children have been published. Primary malignant GCTs of the skull are even more uncommon. The 3 published cases all involved adults over 40 years of age. Herein, the authors present a case of a highly aggressive primary malignant GCT of the posterior fossa in a 5-week old preterm infant. One month after the gross-total resection of the tumor found in the bone, the infant's condition rapidly deteriorated and she died. Magnetic resonance imaging and postmortem examination revealed a tumor larger than it had been before the operation, with expansion toward the brain. To the best of the authors' knowledge, this is the youngest patient reported with a primary malignant GCT of the skull, and actually the first case in a pediatric patient. In addition, the extremely high growth rate of the tumor in the postoperative period renders this case the most aggressive primary malignant GCT of the cranium described so far.
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Eskola L, Pirinen E, Teitti S, Könönen M, Määttä S, Karhu J. P39.4 The effect of muscle activation on duration of the silent period. Clin Neurophysiol 2006. [DOI: 10.1016/j.clinph.2006.06.704] [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] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Pirinen E, Westeren-Punnonen S, Määttä S, Soininen H, Karhu J. P08.6 Navigated brain stimulation (NBS) in MCI and Alzheimer. Clin Neurophysiol 2006. [DOI: 10.1016/j.clinph.2006.06.298] [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] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Heinonen MV, Purhonen AK, Miettinen P, Pääkkönen M, Pirinen E, Alhava E, Akerman K, Herzig KH. Apelin, orexin-A and leptin plasma levels in morbid obesity and effect of gastric banding. ACTA ACUST UNITED AC 2005; 130:7-13. [PMID: 15970339 DOI: 10.1016/j.regpep.2005.05.003] [Citation(s) in RCA: 169] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2005] [Revised: 05/10/2005] [Accepted: 05/11/2005] [Indexed: 11/16/2022]
Abstract
UNLABELLED Maintenance of human energy homeostasis is regulated by a complex network. Peptides secreted from the gastrointestinal tract (GI) are signaling to the brain and other organs initiating or terminating food intake and energy expenditure. In the present study we investigated basal plasma levels of apelin, orexin-A, and leptin in morbid obese patients. In addition, we measured in a subgroup of these patients in the same individual orexin-A and leptin plasma levels one year after gastric banding surgery. METHODS Basal plasma values were determined in obese patients (BMI=48+/-1 kg/m2n=32) after an overnight fast and compared to healthy, normal weighted (BMI=22+/-2 kg/m2n=12) controls. In addition, blood samples were collected in a subgroup of patients (BMI=48+/-1 kg/m2n=8) the day before surgery and 1 year after the operation. Apelin, orexin-A, and leptin levels were analysed using ELISAs. RESULTS One year after the operation obese patients significantly lost weight (from 48+/-2 kg/m2 to 39+/-2 kg/m2; p<0,001). Apelin, orexin-A and leptin levels in obese patients were significantly higher compared to control individuals (736+/-50 pg/ml vs. 174+/-14 pg/ml, p<0.0001; 75.3+/-24.1 pg/ml vs. 0.8+/-0.4 pg/ml, p<0.0001; 79.0+/-2.4 ng/ml vs. 5.8+/-0.8 ng/ml, p<0.0001, respectively). Apelin and leptin plasma concentrations also correlated significantly with BMI (r=0.769, p<0.0001; r=0.778; p<0.0001, respectively), while orexin-A correlation was rather weak (r=0.335, p<0.03). No difference between pre- and post-operative orexin-A levels was observed, while leptin plasma levels significantly decreased from 45.1+/-5.4 ng/ml to 27.3+/-6.0 ng/ml (p=0.015). CONCLUSIONS Apelin, orexin-A, and leptin plasma levels correlated positively with the BMI. One year after gastric banding with significant loss in BMI basal plasma levels of leptin decreased, while orexin-A remained unchanged.
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Affiliation(s)
- M V Heinonen
- Department of Biotechnology/Molecular Medicine, A. I. Virtanen Institute for Molecular Sciences, University of Kuopio, 70211 Kuopio, Finland
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Martikainen T, Pirinen E, Alhava E, Poikolainen E, Pääkkönen M, Uusitupa M, Gylling H. Long-term Results, Late Complications and Quality of Life in a Series of Adjustable Gastric Banding. Obes Surg 2004; 14:648-54. [PMID: 15186633 DOI: 10.1381/096089204323093435] [Citation(s) in RCA: 90] [Impact Index Per Article: 4.5] [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: 11/08/2022]
Abstract
BACKGROUND Adjustable gastric banding is currently the most common bariatric operation. This study is a retrospective analysis of the Finnish experience with this procedure over the last 10 years. METHODS Between March 1993 and June 1999, 123 patients underwent either open (36) or laparoscopic (87) surgery for morbid obesity by the application of an adjustable gastric band. Data on preoperative clinical characteristics and postoperative outcome and weight-loss patterns up to 9 years (mean 55 months) are presented and also evaluated by the Bariatric Analysis and Reporting Outcome System (BAROS). Sex ratio was 31% males / 69% females, mean age 44 years and mean +/- SD preoperative BMI 49 +/- 8 kg/m(2) (range 33.6-85.1). RESULTS During the evaluation period (March 1993 December 2002), 54% of patients experienced postoperative complications requiring hospital treatment >or= 7 days, and 52% underwent a reoperation. 33% of bands were removed. The most important late complications were esophagitis (30%), obstruction due to slippage / pouch dilatation (21%), incisional hernia (9%) and band erosion (9%). Mean excess weight loss at 1 and 2 year follow-up was 36% and 38%, which later stabilized to 30%. During the evaluation period, there were 10 deaths, 2 of which were 30-day deaths, and the remainder were not associated with the band. According to BAROS, the outcome was regarded as "very good" in 3%, "good" in 7%, "fair" in 40% and "failure" in 50%. CONCLUSION Our long-term data found that weight reduction is acceptable,but the incidence of late complications and reoperations was high.
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Affiliation(s)
- Tarja Martikainen
- Division of Clinical Nutrition, Kuopio University Hospital, University of Kuopio, Finland.
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Kolehmainen M, Vidal H, Ohisalo JJ, Pirinen E, Alhava E, Uusitupa MIJ. Hormone sensitive lipase expression and adipose tissue metabolism show gender difference in obese subjects after weight loss. Int J Obes (Lond) 2002; 26:6-16. [PMID: 11791141 DOI: 10.1038/sj.ijo.0801858] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.5] [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: 01/30/2001] [Revised: 06/12/2001] [Accepted: 07/13/2001] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The effect of weight reduction on hormone sensitive lipase (HSL) and lipoprotein lipase (LPL) gene expression and their relationship with adipose tissue metabolism were studied in massively obese men and women. SUBJECTS Seventeen obese subjects (eight men, nine women) participated in the study (age 44+/-2 y, weight 145+/-8 kg, fat 40+/-2% of body mass, mean+/-s.e.m.), who were going through a gastric-banding operation for weight reduction. MEASUREMENTS HSL and LPL mRNA expressions were analyzed using the reverse transcription competitive polymerase chain reaction. Subcutaneous fat lipolysis was measured in vivo by microdialysis and in vitro in isolated subcutaneous abdominal adipocytes. Measurements were done before and after 1 y of weight reduction. RESULTS Significant reductions in weight (for men -20.3+/-2.5%, for women -18.3+/-2.1% (mean+/-s.e.m.) and fat mass (for men -27.6+/-7.9%, for women -21.8+/-3.9%) were observed in both genders. In women HSL mRNA expression decreased by 31% (P=0.008) and LPL expression increased slightly, but nonsignificantly (42%, P=0.110). These changes were not observed in men. In men, inhibition of lipolysis with alpha(2)-adrenergic and adenosine agonist was improved (P=0.001) in isolated adipocytes. CONCLUSIONS This study uncovers new differences between genders in adipocyte metabolism along with weight reduction. In women, the observed changes in HSL and LPL gene expression suggest that deposition of lipids into adipose tissue might be favored after weight reduction. In men, the results indicate improved responsiveness to inhibition in adipose tissue metabolism along with weight reduction.
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Affiliation(s)
- M Kolehmainen
- Department of Clinical Nutrition, University of Kuopio and Kuopio University Hospital, Kuopio, Finland.
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Pirinen E, Uusitupa M, Tuononen V, Poikolainen E, Pääkkönen M, Alhava E. [Gastric banding - a new operative way to treat morbid obesity]. Duodecim 2001; 113:1471-5. [PMID: 10643121] [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] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
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Heikkinen S, Pietilä M, Halmekytö M, Suppola S, Pirinen E, Deeb SS, Jänne J, Laakso M. Hexokinase II-deficient mice. Prenatal death of homozygotes without disturbances in glucose tolerance in heterozygotes. J Biol Chem 1999; 274:22517-23. [PMID: 10428828 DOI: 10.1074/jbc.274.32.22517] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Type 2 diabetes is characterized by decreased rates of insulin-stimulated glucose uptake and utilization, reduced hexokinase II mRNA and enzyme production, and low basal levels of glucose 6-phosphate in insulin-sensitive skeletal muscle and adipose tissues. Hexokinase II is primarily expressed in muscle and adipose tissues where it catalyzes the phosphorylation of glucose to glucose 6-phosphate, a possible rate-limiting step for glucose disposal. To investigate the role of hexokinase II in insulin action and in glucose homeostasis as well as in mouse development, we generated a hexokinase II knock-out mouse. Mice homozygous for hexokinase II deficiency (HKII(-/-)) died at approximately 7.5 days post-fertilization, indicating that hexokinase II is vital for mouse embryogenesis after implantation and before organogenesis. HKII(+/-) mice were viable, fertile, and grew normally. Surprisingly, even though HKII(+/-) mice had significantly reduced (by 50%) hexokinase II mRNA and activity levels in skeletal muscle, heart, and adipose tissue, they did not exhibit impaired insulin action or glucose tolerance even when challenged with a high-fat diet.
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Affiliation(s)
- S Heikkinen
- Department of Medicine, University of Kuopio, FIN-70211 Kuopio, Finland
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