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Koniari E, Skouma A, Sariklaki M, Vasilogiannakis G, Maniadaki I, Papadopoulou E, Chrousos G. Chylomicron retention disease: A case report in Greece. Atherosclerosis 2022. [DOI: 10.1016/j.atherosclerosis.2022.06.215] [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: 11/26/2022]
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Koniari E, Skouma A, Chrousos G. Genetic analysis of a rare form of dyslipidemia: De novo ABCG5/APOB mutations in Greece. Atherosclerosis 2022. [DOI: 10.1016/j.atherosclerosis.2022.06.645] [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: 11/02/2022]
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3
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Cokkinos D, Chrousos G, Geronikolou S. Cyclic myocardial infarctions follow solar variations: A pilot study in Mediterranean populations. Archives of Cardiovascular Diseases Supplements 2022. [DOI: 10.1016/j.acvdsp.2021.09.062] [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: 10/19/2022]
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Alexopoulos A, Chouliaras G, Kakourou T, Dakoutrou M, Nasi L, Petrocheilou A, Siahanidou S, Kanaka-Gantenbein C, Chrousos G, Loukou I, Michos A. Aquagenic wrinkling of the palms after brief immersion to water test as a screening tool for cystic fibrosis diagnosis. J Eur Acad Dermatol Venereol 2021; 35:1717-1724. [PMID: 33914973 DOI: 10.1111/jdv.17312] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 03/16/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Aquagenic wrinkling of the palms (AWP) is an excessive and early palmar wrinkling occurring after Brief Immersion to Water (BIW), and has been reported as a frequent finding among cystic fibrosis (CF) patients. OBJECTIVES To evaluate and assess the diagnostic performance of BIW test as an initial screening tool for CF diagnosis. METHODS We measured AWP in CF patients, CF-heterozygotes (CF-het) and normal controls. The AWP parameters of palmar wrinkling, oedema, papules, pruritus and pain were assessed at 3, 7 and 11 min after a BIW test was performed for all the participants. Statistical analyses explored the progression of AWP in time for the three groups and assessed the diagnostic performance of BIW test as a diagnostic screening tool for CF. RESULTS A total of 250 individuals (100 CF patients, their 50 CF-het parents, 100 healthy controls) were included in the analysis. The average age in years (mean ± SD) was 10.4 ± 4.0 for CF, 35.9 ± 6.1 for CF-het and 10.5 ± 4.0 for controls. The rate of positives for AWP at 3 min among CF patients, CF-het and controls was 68%, 8% and 0%, respectively (P < 0.01). Kaplan-Meier analysis showed a clear trend towards earlier appearance of all five parameters in the direction controls < hetCF < CF (P values <0.01). The best diagnostic performance in detecting between CF patients and non-CF was achieved by the presence of papules and wrinkling at 7 min (sensitivity/specificity: 94.0%/98.3% and 100.0%/92.0%, respectively). CONCLUSIONS A strong association between AWP and CF was detected. AWP after BIW could be elicited easily and possibly can be used as an initial screening tool to assess if an individual with symptoms and signs that raise the likelihood of CF is a CF patient.
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Affiliation(s)
- A Alexopoulos
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sofia' Children's Hospital, Athens, Greece
| | - G Chouliaras
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sofia' Children's Hospital, Athens, Greece
| | - T Kakourou
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sofia' Children's Hospital, Athens, Greece
| | - M Dakoutrou
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sofia' Children's Hospital, Athens, Greece
| | - L Nasi
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sofia' Children's Hospital, Athens, Greece
| | - A Petrocheilou
- Department of Cystic Fibrosis, 'Aghia Sofia', Children's Hospital, Athens, Greece
| | - S Siahanidou
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sofia' Children's Hospital, Athens, Greece
| | - C Kanaka-Gantenbein
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sofia' Children's Hospital, Athens, Greece
| | - G Chrousos
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sofia' Children's Hospital, Athens, Greece
| | - I Loukou
- Department of Cystic Fibrosis, 'Aghia Sofia', Children's Hospital, Athens, Greece
| | - A Michos
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sofia' Children's Hospital, Athens, Greece
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Cokkinos D, Poulidakis E, Chrousos G, Geronikolou S. Heart rate variability response to a mobile phone call in a Greek adult population. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2020.10.227] [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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Koniari E, Skouma A, Dragoti A, Garoufi A, Maroulis V, Papadakis M, Chrousos G. Spectrum of LDLR gene mutations, causing familial hypercholesterolemia (FH) in Greece: Un update. Atherosclerosis 2020. [DOI: 10.1016/j.atherosclerosis.2020.10.213] [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: 10/22/2022]
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7
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Pervanidou P, Makris G, Bouzios I, Chrousos G, Roma E, Chouliaras G. Bullying victimization: Associated contextual factors in a Greek sample of children and adolescents. Psychiatriki 2020; 30:216-225. [PMID: 31685453 DOI: 10.22365/jpsych.2019.303.216] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
School bullying is increasingly recognized as an important factor affecting both individual's wellbeing and social functioning. Several studies provide evidence for the potential role of contextual factors that relate to bullying victimization such as the socioeconomic status of the parents/ family, the quality of family and home environment, the school climate, structure and ethos, and also various community characteristics. The objectives of this school-based, cross-sectional study were to report the prevalence of the perception of being bullied in a sample of Greek children and adolescents from 6 to 17 years of age and to investigate the relations among the subjective impression of bullying victimization and several sociodemographic and socioeconomic factors. We hypothesized that influences external to individual children and adolescents play a decisive role to their perception of being victimized. Bullying victimization was measured through a simple "yes/no" question, which confirmed or rejected respectively the fact that the child or adolescent has been at some time victimized in the school environment. Also, demographic and socioeconomic data about the families of children and adolescents were collected. A total of 1,588 children (51.8% females, mean age ± SD: 12.9±2.8 years) were assessed. The overall prevalence of victimization was 10.4%. Multiple logistic regression analysis on the probability of being victimized identified that living at a main urban center (Odds Ratio[OR]: 2.63, CI: 1.78-3.87, p<0.001), presence of a person with a chronic illness at home (OR: 1.90, CI: 1.12-3.20, p=0.016), poor family economic status (OR: 1.83, CI: 1.05-3.20, p=0.032),and increased number of adults at home (OR: 2.00, CI: 1.00-3.77, p=0,041) had a positive correlation with the prevalence of reported bullying victimization. Moreover, higher parental educational level related to lower probability of victimization (OR: 0.88, CI: 0.78-0.99, p=0.05). These findings demonstrate that several demographic and socioeconomic factors play a potential role in bullying victimization among schoolchildren. Our results also highlight the need to consider the influence of contextual factors in the design of targeting efforts countering and/or preventing bullying victimization.
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Affiliation(s)
- P Pervanidou
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - G Makris
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - I Bouzios
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - G Chrousos
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - E Roma
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - G Chouliaras
- First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Athens, Greece
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Kosteria I, Aloumanis K, Kanaka-Gantenbein C, Vlachopapadopoulou E, Michalacos S, Stamoyannou L, Drossinos E, Chrousos G. Pediatric growth hormone therapy in Greece: analysis of the Hellenic cohort of the GeNeSIS study. Hormones (Athens) 2019; 18:423-434. [PMID: 31696446 DOI: 10.1007/s42000-019-00148-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 05/20/2019] [Accepted: 10/21/2019] [Indexed: 12/31/2022]
Abstract
PURPOSE To describe the data from the Greek cohort of the Genetics and Neuroendocrinology of Short Stature International Study (GeNeSIS). METHODS GeNeSIS was a prospective, open-label, multinational, observational study collecting information on clinical outcomes and treatment safety of children with growth disorders treated with growth hormone (GH), according to national indications. After informed consent, 305 patients (143 females), including 255 patients with growth hormone deficiency (GHD) and 30 with Turner syndrome (TS), from eight investigational sites, were enrolled in Greece. Demographic data, treatment efficacy, and adverse events were reported at the discretion of attending physicians. RESULTS Treatment with GH was undertaken for 247/255 patients with GHD and 29/30 with TS. The majority of patients treated with GHD (73.7%) and TS (84%) with recorded Tanner stage were prepubertal at enrolment. Among patients treated with GHD and TS, 70.45% and 55% were GH-naïve at study entry, respectively. Height standard deviation score (SDS), height velocity SDS, and height SDS-target height SDS numerically improved during the 4-year observation period. The effect of GH treatment was more prominent in the first year of treatment, especially in the GHD group. CONCLUSIONS In the Greek cohort of GeNeSIS, GHD is the most frequent indication for GH treatment, followed by TS. While the latter is diagnosed somewhat earlier, GH treatment is not as efficacious as for patients with GHD. No major safety issues were reported during follow-up. The results, which are in accordance with the international literature, should be interpreted in the context of observational studies.
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Affiliation(s)
- I Kosteria
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, "Agia Sophia" Children's Hospital, Athens, Greece
| | - K Aloumanis
- Department of Medical Research, Pharmaserve-Lilly SACI, 15th Nat. Road Athens-Lamia, 14564, Kifissia, Greece.
| | - C Kanaka-Gantenbein
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, "Agia Sophia" Children's Hospital, Athens, Greece
| | | | - S Michalacos
- Department of Growth, P. & A. Kyriakou Children's Hospital, Athens, Greece
| | - L Stamoyannou
- First Pediatric Clinic, P. & A. Kyriakou Children's Hospital, Athens, Greece
| | - E Drossinos
- Department of Medical Research, Pharmaserve-Lilly SACI, 15th Nat. Road Athens-Lamia, 14564, Kifissia, Greece
| | - G Chrousos
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, "Agia Sophia" Children's Hospital, Athens, Greece
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Koutagiar I, Vlachopoulos C, Terentes-Printzios D, Kosteria I, Sakka S, Gkourogianni A, Skoumas I, Miliou A, Papassotioriou I, Gardikioti V, Solomou E, Rigatou A, Chrousos G, Kanaka-Gantenbein C, Tousoulis D. P4467PCSK9 and Lp(a) levels of children born after assisted reproduction technologies: results from a pilot study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0864] [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: 11/14/2022] Open
Abstract
Abstract
Background
Since the introduction of Assisted Reproduction Technologies (ART) in clinical practice several studies have addressed concerns regarding the long-term health of the offspring and have revealed indications of an adverse cardiovascular/cardiometabolic outcome. Proprotein convertase subtilisin/kexin type 9 (PCSK9) and lipoprotein (a) (Lp[a]) levels have been associated with cardiovascular risk.
Purpose
To investigate PCSK9 and Lp(a) levels of children born after ART compared with naturally conceived (NC) controls.
Methods
In this case-control study, 73 sex- and age-matched children (mean age 98±35 months) of ART (intracytoplasmic sperm injection [ICSI]: n=33, classic in vitro fertilization [IVF]: n=40) and 73 NC children were assessed. Blood lipid profile, including PCSK9 and Lp(a) levels, was measured. Children were grouped according to age (<8 years, 8–10 years, ≥10 years).
Results
In the univariate model of the overall population, circulating PCSK9 levels were related to total cholesterol (r=0.186, P=0.025), LDL-C (r=0.180, P=0.029) and SBP (r=0.199, P=0.021). Similarly, circulating Lp(a) levels were related to age (r=0.269, P=0.001), apoB (r=0.214, P=0.01), birth weight (r=−0.183, P=0.037), height (r=0.263, P=0.001), waist-to-hip ratio (r=−0.350, P<0.001), HOMA-IR (r=0.319, P<0.001), insulin (r=0.316, P<0.001), and hsCRP (ρ=0.241, P=0.018). No significant differences were observed regarding lipid biomarkers between ART and NC children. (p=0.515 for PCSK9 and p=0.277 for Lp(a) values). It is noteworthy that a significant interaction was found between age groups and conception method (P<0.001) showing that PCSK9 levels increase with age in ART children, while they decline with age in NC offspring (Figure 1). IVF children showed higher levels of adjusted mean Lp(a) than ICSI (13.5 vs. 6.8 mg/dl, P=0.010) and NC children (12.3 vs. 8.3 mg/dl, P=0.048).
Mean LogPCSK9 concentrations with the st
Conclusions
PCSK9 and Lp(a) levels did not differ between ART and NC children. Nonetheless, PCSK9 levels increase with age in ART children indicating a gradual deterioration of lipidemic profile that could lead to increased cardiovascular risk. Moreover, our results imply that ART method may be of importance given that classic IVF is associated with higher levels of Lp(a). The impact of the method of conception on PCSK9 and Lp(a) values should be validated in larger patient series.
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Affiliation(s)
- I Koutagiar
- Hippokration General Hospital, First Department of Cardiology, Athens, Greece
| | - C Vlachopoulos
- Hippokration General Hospital, First Department of Cardiology, Athens, Greece
| | | | - I Kosteria
- Aghia Sophia Children's Hospital, First Department of Paediatrics, Athens, Greece
| | - S Sakka
- Aghia Sophia Children's Hospital, First Department of Paediatrics, Athens, Greece
| | - A Gkourogianni
- Aghia Sophia Children's Hospital, First Department of Paediatrics, Athens, Greece
| | - I Skoumas
- Hippokration General Hospital, First Department of Cardiology, Athens, Greece
| | - A Miliou
- Hippokration General Hospital, First Department of Cardiology, Athens, Greece
| | - I Papassotioriou
- Aghia Sophia Children's Hospital, First Department of Paediatrics, Athens, Greece
| | - V Gardikioti
- Hippokration General Hospital, First Department of Cardiology, Athens, Greece
| | - E Solomou
- Hippokration General Hospital, First Department of Cardiology, Athens, Greece
| | - A Rigatou
- Hippokration General Hospital, First Department of Cardiology, Athens, Greece
| | - G Chrousos
- Aghia Sophia Children's Hospital, First Department of Paediatrics, Athens, Greece
| | - C Kanaka-Gantenbein
- Aghia Sophia Children's Hospital, First Department of Paediatrics, Athens, Greece
| | - D Tousoulis
- Hippokration General Hospital, First Department of Cardiology, Athens, Greece
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Manios Y, Karatzi K, Moschonis G, Ioannou G, Androutsos O, Lionis C, Chrousos G. Lifestyle, anthropometric, socio-demographic and perinatal correlates of early adolescence hypertension: The Healthy Growth Study. Nutr Metab Cardiovasc Dis 2019; 29:159-169. [PMID: 30660688 DOI: 10.1016/j.numecd.2018.10.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 04/04/2018] [Revised: 10/12/2018] [Accepted: 10/15/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND AIMS Various lifestyle, anthropometric, socio-demographic and perinatal characteristics have been separately associated with elevated blood pressure in children and adolescents. The aim of this study was to simultaneously evaluate all potential risk factors and to identify the most dominant correlates of early adolescence hypertension in a large group of school children 9-13 years old. METHODS AND RESULTS A cross-sectional study with 1444 schoolchildren 9-13 years old, having full data on lifestyle, anthropometric, socio-demographic and perinatal indices, as well as blood pressure measurements. Early adolescents born large for their gestational age (LGA) (OR, 95% C.I. 0.49 (0.25-0.97)), those with higher levels of moderate to vigorous physical activity (MVPA) (OR, 95% C.I. 0.71 (0.53-0.96)) and those of a higher socioeconomic status (SES) (OR, 95% C.I. 0.51 (0.33-0.79)), had lower risk of hypertension, compared with their counterparts with appropriate birth weight, low levels of PA and with low SES respectively, independently of the variables used in the multivariate model. On the other hand, overweight and obese early adolescents (OR, 95% C.I. 2.61 (1.88-3.62)), those with central obesity (OR, 95% C.I. 1.75 (1.12-2.73)) and those having a hypertensive father (OR, 95% C.I. 1.93 (1.20-3.12)) had higher risk of hypertension compared with normal weight early adolescents and those without a family history of hypertension. CONCLUSIONS Among the parameters examined, early adolescence abnormal body weight and central obesity, low PA, non LGA, low SES family and family history of hypertension were found to be independently associated with higher risk of hypertension. The identified correlates of early adolescence hypertension can be used by public health initiatives for early detection and management of this major public health problem, prioritizing early adolescents and families at the highest possible risk for hypertension.
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Affiliation(s)
- Y Manios
- Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University of Athens, Greece.
| | - K Karatzi
- Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University of Athens, Greece
| | - G Moschonis
- Department of Rehabilitation, Nutrition and Sport, College of Science, Health and Engineering, La Trobe University, Bundoora, VIC 3086, Melbourne, Australia
| | - G Ioannou
- Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University of Athens, Greece
| | - O Androutsos
- Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University of Athens, Greece
| | - C Lionis
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - G Chrousos
- First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece
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11
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Affiliation(s)
| | | | - G Chrousos
- National & Kapodistrian University of Athens, Athens, Greece
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12
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Vgontzas AN, Fernandez-Mendoza J, Bixler EO, Basta M, Chrousos G. 0341 Impaired Negative Feedback of the Hypothalamic-Pituitary-Adrenal Axis in Chronic Insomnia: A Corticotrophin Releasing Hormone (CRH) Challenge Test. Sleep 2018. [DOI: 10.1093/sleep/zsy061.340] [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] [Indexed: 11/14/2022] Open
Affiliation(s)
- A N Vgontzas
- Sleep Research & Treatment Center, Penn State University College of Medicine, Hershey, PA
| | - J Fernandez-Mendoza
- Sleep Research & Treatment Center, Penn State University College of Medicine, Hershey, PA
| | - E O Bixler
- Sleep Research & Treatment Center, Penn State University College of Medicine, Hershey, PA
| | - M Basta
- University of Crete Medical School, Heraklion, GREECE
| | - G Chrousos
- Athens University Medical School, Athens, GREECE
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13
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Ng YS, Lax NZ, Maddison P, Alston CL, Blakely EL, Hepplewhite PD, Riordan G, Meldau S, Chinnery PF, Pierre G, Chronopoulou E, Du A, Hughes I, Morris AA, Kamakari S, Chrousos G, Rodenburg RJ, Saris CGJ, Feeney C, Hardy SA, Sakakibara T, Sudo A, Okazaki Y, Murayama K, Mundy H, Hanna MG, Ohtake A, Schaefer AM, Champion MP, Turnbull DM, Taylor RW, Pitceathly RDS, McFarland R, Gorman GS. MT-ND5 Mutation Exhibits Highly Variable Neurological Manifestations at Low Mutant Load. EBioMedicine 2018; 30:86-93. [PMID: 29506874 PMCID: PMC5952215 DOI: 10.1016/j.ebiom.2018.02.010] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 02/03/2018] [Accepted: 02/12/2018] [Indexed: 01/06/2023] Open
Abstract
Mutations in the m.13094T>C MT-ND5 gene have been previously described in three cases of Leigh Syndrome (LS). In this retrospective, international cohort study we identified 20 clinically affected individuals (13 families) and four asymptomatic carriers. Ten patients were deceased at the time of analysis (median age of death was 10years (range: 5·4months-37years, IQR=17·9years). Nine patients manifested with LS, one with mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS), and one with Leber hereditary optic neuropathy. The remaining nine patients presented with either overlapping syndromes or isolated neurological symptoms. Mitochondrial respiratory chain activity analysis was normal in five out of ten muscle biopsies. We confirmed maternal inheritance in six families, and demonstrated marked variability in tissue segregation, and phenotypic expression at relatively low blood mutant loads. Neuropathological studies of two patients manifesting with LS/MELAS showed prominent capillary proliferation, microvacuolation and severe neuronal cell loss in the brainstem and cerebellum, with conspicuous absence of basal ganglia involvement. These findings suggest that whole mtDNA genome sequencing should be considered in patients with suspected mitochondrial disease presenting with complex neurological manifestations, which would identify over 300 known pathogenic variants including the m.13094T>C.
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Affiliation(s)
- Yi Shiau Ng
- Wellcome Centre for Mitochondrial Research, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Nichola Z Lax
- Wellcome Centre for Mitochondrial Research, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Paul Maddison
- Department of Neurology, Queen's Medical Centre, Nottingham, UK
| | - Charlotte L Alston
- Wellcome Centre for Mitochondrial Research, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Emma L Blakely
- Wellcome Centre for Mitochondrial Research, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Philippa D Hepplewhite
- Wellcome Centre for Mitochondrial Research, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Gillian Riordan
- Paediatric Neurology Department, Red Cross War Memorial Children's Hospital, Cape Town, South Africa
| | - Surita Meldau
- Division of Chemical Pathology, Faculty of Health Sciences, University of Cape Town, South Africa; National Health Laboratory Service, Cape Town, South Africa
| | - Patrick F Chinnery
- Wellcome Centre for Mitochondrial Research, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK; Medical Research Council Mitochondrial Biology Unit, Cambridge Biomedical Campus, Cambridge, UK
| | - Germaine Pierre
- Department of Inherited Metabolic Disease, Division of Women's and Children's Services, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Efstathia Chronopoulou
- Department of Inherited Metabolic Disease, Division of Women's and Children's Services, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Ailian Du
- Tongren Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Imelda Hughes
- Royal Manchester Children's Hospital, Central Manchester University Hospitals NHS Foundation Trust, UK
| | - Andrew A Morris
- Institute of Human Development, University of Manchester, Manchester M13 9WL, UK; Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester M13 9WL, UK
| | - Smaragda Kamakari
- Ophthalmic Genetics Unit, OMMA, Institute of Ophthalmology, Athens, Greece
| | - Georgia Chrousos
- Pediatric Ophthalmology Department, MITERA Children's Hospital, Athens, Greece
| | - Richard J Rodenburg
- Radboud Center for Mitochondrial Medicine, Department of Pediatrics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Christiaan G J Saris
- Department of Neurology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Catherine Feeney
- Wellcome Centre for Mitochondrial Research, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Steven A Hardy
- Wellcome Centre for Mitochondrial Research, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Takafumi Sakakibara
- Department of Pediatrics, Nara Medical University Hospital, Nara 634-8522, Japan
| | - Akira Sudo
- Department of Pediatrics, Sapporo City General Hospital, Sapporo 060-8604, Japan
| | - Yasushi Okazaki
- Diagnostics and Therapeutics of Intractable Diseases, Intractable Disease Research Center, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan
| | - Kei Murayama
- Department of Metabolism, Chiba Children's Hospital, Chiba 266-0007, Japan
| | - Helen Mundy
- Evelina London Children's Hospital, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - Michael G Hanna
- MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK
| | - Akira Ohtake
- Department of Pediatrics, Faculty of Medicine, Saitama Medical University, Saitama 350-0495, Japan
| | - Andrew M Schaefer
- Wellcome Centre for Mitochondrial Research, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Mike P Champion
- Evelina London Children's Hospital, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - Doug M Turnbull
- Wellcome Centre for Mitochondrial Research, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Robert W Taylor
- Wellcome Centre for Mitochondrial Research, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Robert D S Pitceathly
- MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK
| | - Robert McFarland
- Wellcome Centre for Mitochondrial Research, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Gráinne S Gorman
- Wellcome Centre for Mitochondrial Research, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.
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Nikolakopoulou P, Poser SW, Masjkur J, Fernandez Rubin de Celis M, Toutouna L, Andoniadou CL, McKay RD, Chrousos G, Ehrhart-Bornstein M, Bornstein SR, Androutsellis-Theotokis A. STAT3-Ser/Hes3 Signaling: A New Molecular Component of the Neuroendocrine System? Horm Metab Res 2016; 48:77-82. [PMID: 26783739 DOI: 10.1055/s-0041-111699] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The endocrine system involves communication among different tissues in distinct organs, including the pancreas and components of the Hypothalamic-Pituitary-Adrenal Axis. The molecular mechanisms underlying these complex interactions are a subject of intense study as they may hold clues for the progression and treatment of a variety of metabolic and degenerative diseases. A plethora of signaling pathways, activated by hormones and other endocrine factors have been implicated in this communication. Recent advances in the stem cell field introduce a new level of complexity: adult progenitor cells appear to utilize distinct signaling pathways than the more mature cells in the tissue they co-reside. It is therefore important to elucidate the signal transduction requirements of adult progenitor cells in addition to those of mature cells. Recent evidence suggests that a common non-canonical signaling pathway regulates adult progenitors in several different tissues, rendering it as a potentially valuable starting point to explore their biology. The STAT3-Ser/Hes3 Signaling Axis was first identified as a major regulator of neural stem cells and, subsequently, cancer stem cells. In the endocrine/neuroendocrine system, this pathway operates on several levels, regulating other types of plastic cells: (a) it regulates pancreatic islet cell function and insulin release; (b) insulin in turn activates the pathway in broadly distributed neural progenitors and possibly also hypothalamic tanycytes, cells with important roles in the control of the adrenal gland; (c) adrenal progenitors themselves operate this pathway. The STAT3-Ser/Hes3 Signaling Axis therefore deserves additional research in the context of endocrinology.
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Affiliation(s)
- P Nikolakopoulou
- Department of Internal Medicine III, Technische Universität Dresden, Dresden, Germany
| | - S W Poser
- Department of Internal Medicine III, Technische Universität Dresden, Dresden, Germany
| | - J Masjkur
- Department of Internal Medicine III, Technische Universität Dresden, Dresden, Germany
| | | | - L Toutouna
- Department of Internal Medicine III, Technische Universität Dresden, Dresden, Germany
| | - C L Andoniadou
- Department of Craniofacial Development and Stem Cell Biology, King's College London, UK
| | - R D McKay
- Lieber Institute for Brain Development, Baltimore, USA
| | - G Chrousos
- 1st Department of Pediatrics, University of Athens Medical School, Athens, Aghia Sophia Children's Hospital, Athens, Greece
| | - M Ehrhart-Bornstein
- Department of Internal Medicine III, Technische Universität Dresden, Dresden, Germany
| | - S R Bornstein
- Department of Internal Medicine III, Technische Universität Dresden, Dresden, Germany
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15
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Hassiakos D, Eleftheriades M, Papastefanou I, Lambrinoudaki I, Kappou D, Lavranos D, Akalestos A, Aravantinos L, Pervanidou P, Chrousos G. Increased Maternal Serum Interleukin-6 Concentrations at 11 to 14 Weeks of Gestation in Low Risk Pregnancies Complicated with Gestational Diabetes Mellitus: Development of a Prediction Model. Horm Metab Res 2016; 48:35-41. [PMID: 25565094 DOI: 10.1055/s-0034-1395659] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [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] [Indexed: 10/24/2022]
Abstract
The aim of the study was to examine interleukin-6 (IL-6) maternal serum concentration at 11 to 14 gestational weeks in normal pregnancies and pregnancies complicated by gestational diabetes mellitus (GDM) and to create first trimester prediction models for GDM. Case-control study conducted in a Fetal Medicine Unit. Study population included 40 GDM cases and 94 controls. Maternal characteristics, first trimester ultrasound markers, biochemical indices, and IL-6 levels were used for our analysis. IL-6 was related to maternal weight among the maternal characteristics, (R(2)=0.0679, p=0.01). IL-6 was increased (p=0.001) in the GDM group (median=2 pg/ml) compared to the control group (median=1.5 pg/ml) even after adjustment for maternal weight. IL-6 was inversely related to birth weight adjusted for gestational age at delivery (r=-0.3382, p<0.001) and glucose levels at oral glucose test. Maternal weight and age were the only predictors of GDM among the maternal characteristics [Detection Rate (DR)=59.4%; for 25% False Positive Rate (FPR); Area Under the Curve (AUC)=0.7291; Model R(2)=0.1096, p<0.001]. IL-6 alone was a significant predictor of GDM (DR=51.3%; for 25% FPR; AUC=0.6731; Model R(2)=0.0616, p<0.001). Combination of maternal characteristics with IL-6 yielded an improved prediction (DR=67.5%; for 25% FPR; AUC=0.7586; Model R(2)=0.1521, p<0.001). IL-6 concentrations are increased at 11-14 weeks in pregnancies with GDM. Combination of maternal characteristics and maternal serum IL-6 levels may provide effective first trimester screening for GDM.
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Affiliation(s)
- D Hassiakos
- 2nd Department of Obstetrics and Gynecology, University of Athens Medical School, Aretaieio Hospital, Athens, Greece
| | | | - I Papastefanou
- Fetal Medicine Unit, 3rd Department of Obstetrics and Gynaecology, University of Athens Medical School, Attikon University Hospital, Athens, Greece
| | - I Lambrinoudaki
- 2nd Department of Obstetrics and Gynecology, University of Athens Medical School, Aretaieio Hospital, Athens, Greece
| | - D Kappou
- 1st Department of Obstetrics and Gynecology, University of Athens Medical School, Alexandra Hospital, Athens, Greece
| | - D Lavranos
- Bioiatriki SA, Hormone Laboratory, Athens, Greece
| | - A Akalestos
- Roche Diagnostics (Hellas) S.A., Marousi, Greece
| | - L Aravantinos
- 2nd Department of Obstetrics and Gynecology, University of Athens Medical School, Aretaieio Hospital, Athens, Greece
| | - P Pervanidou
- Childhood Obesity Clinic, 1st Department of Pediatrics, University of Athens Medical School, Athens, Aghia Sophia Children's Hospital, Athens, Greece
| | - G Chrousos
- 1st Department of Pediatrics, University of Athens Medical School, Athens, Aghia Sophia Children's Hospital, Athens, Greece
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16
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Panagiotopoulos G, Galanakis M, Varvogli L, Chrousos G, Darviri C. Validation of the Greek version of Mini Tinnitus Questionnaire as a Brief Screening Test for Assessment of Tinnitus-related Distress: our experience in 301 adult patients. Clin Otolaryngol 2015; 40:363-9. [DOI: 10.1111/coa.12383] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2015] [Indexed: 10/24/2022]
Affiliation(s)
- G. Panagiotopoulos
- Postgraduate Course Stress Management and Health Promotion; School of Medicine; University of Athens; Athens Greece
- Department of Audiology - Neurootology; 401 General Military Hospital of Athens; Athens Greece
| | - M. Galanakis
- Panteion University of Social and Political Sciences; Athens Greece
| | - L. Varvogli
- Postgraduate Course Stress Management and Health Promotion; School of Medicine; University of Athens; Athens Greece
| | - G. Chrousos
- Postgraduate Course Stress Management and Health Promotion; School of Medicine; University of Athens; Athens Greece
- Aghia Sophia Children's Hospital; University of Athens; Athens Greece
| | - C. Darviri
- Postgraduate Course Stress Management and Health Promotion; School of Medicine; University of Athens; Athens Greece
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17
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Hassiakos D, Eleftheriades M, Papastefanou I, Lambrinoudaki I, Kappou D, Lavranos D, Akalestos A, Aravantinos L, Pervanidou P, Chrousos G. Increased Maternal Serum Interleukin-6 Concentrations at 11 to 14 Weeks of Gestation in Low Risk Pregnancies Complicated with Gestational Diabetes Mellitus: Development of a Prediction Model. Horm Metab Res 2015. [PMID: 25565094 DOI: 10.1055/s-0034–1395659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The aim of the study was to examine interleukin-6 (IL-6) maternal serum concentration at 11 to 14 gestational weeks in normal pregnancies and pregnancies complicated by gestational diabetes mellitus (GDM) and to create first trimester prediction models for GDM. Case-control study conducted in a Fetal Medicine Unit. Study population included 40 GDM cases and 94 controls. Maternal characteristics, first trimester ultrasound markers, biochemical indices, and IL-6 levels were used for our analysis. IL-6 was related to maternal weight among the maternal characteristics, (R(2)=0.0679, p=0.01). IL-6 was increased (p=0.001) in the GDM group (median=2 pg/ml) compared to the control group (median=1.5 pg/ml) even after adjustment for maternal weight. IL-6 was inversely related to birth weight adjusted for gestational age at delivery (r=-0.3382, p<0.001) and glucose levels at oral glucose test. Maternal weight and age were the only predictors of GDM among the maternal characteristics [Detection Rate (DR)=59.4%; for 25% False Positive Rate (FPR); Area Under the Curve (AUC)=0.7291; Model R(2)=0.1096, p<0.001]. IL-6 alone was a significant predictor of GDM (DR=51.3%; for 25% FPR; AUC=0.6731; Model R(2)=0.0616, p<0.001). Combination of maternal characteristics with IL-6 yielded an improved prediction (DR=67.5%; for 25% FPR; AUC=0.7586; Model R(2)=0.1521, p<0.001). IL-6 concentrations are increased at 11-14 weeks in pregnancies with GDM. Combination of maternal characteristics and maternal serum IL-6 levels may provide effective first trimester screening for GDM.
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Affiliation(s)
- D Hassiakos
- 2nd Department of Obstetrics and Gynecology, University of Athens Medical School, Aretaieio Hospital, Athens, Greece
| | | | - I Papastefanou
- Fetal Medicine Unit, 3rd Department of Obstetrics and Gynaecology, University of Athens Medical School, Attikon University Hospital, Athens, Greece
| | - I Lambrinoudaki
- 2nd Department of Obstetrics and Gynecology, University of Athens Medical School, Aretaieio Hospital, Athens, Greece
| | - D Kappou
- 1st Department of Obstetrics and Gynecology, University of Athens Medical School, Alexandra Hospital, Athens, Greece
| | - D Lavranos
- Bioiatriki SA, Hormone Laboratory, Athens, Greece
| | - A Akalestos
- Roche Diagnostics (Hellas) S.A., Marousi, Greece
| | - L Aravantinos
- 2nd Department of Obstetrics and Gynecology, University of Athens Medical School, Aretaieio Hospital, Athens, Greece
| | - P Pervanidou
- Childhood Obesity Clinic, 1st Department of Pediatrics, University of Athens Medical School, Athens, Aghia Sophia Children's Hospital, Athens, Greece
| | - G Chrousos
- 1st Department of Pediatrics, University of Athens Medical School, Athens, Aghia Sophia Children's Hospital, Athens, Greece
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18
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Linardatou C, Parios A, Varvogli L, Chrousos G, Darviri C. An 8-week stress management program in pathological gamblers: a pilot randomized controlled trial. J Psychiatr Res 2014; 56:137-43. [PMID: 24912736 DOI: 10.1016/j.jpsychires.2014.05.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [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: 11/11/2013] [Revised: 04/15/2014] [Accepted: 05/16/2014] [Indexed: 10/25/2022]
Abstract
Stress plays a major role at the onset and relapse of pathological gambling (PG), but at the same time it can also be the aftermath of gambling behavior, thus revealing a reciprocal relationship. Although the role of stress has been well-documented, there is a paucity of studies investigating the effect of an adjunctive stress management program on PG. In this 8-week parallel randomized waitlist controlled trial pathological gamblers, already in the gamblers anonymous (GA) group, were assigned randomly in two groups, with the intervention group (n = 22) receiving an additional stress management program (consisting of education on diet and exercise, stress coping methods, relaxation breathing -RB- and progressive muscle relaxation -PMR). Self-reported measures were used in order to evaluate stress, depression, anxiety, sleep quality/disturbances, life-satisfaction and daily routine. The statistical analyses for the between group differences concerning the main psychosocial study outcomes revealed a statistically significant amelioration of stress, depression, anxiety symptoms and an increase of life-satisfaction and a better daily routine in participants of the intervention group. We hope that these will encourage researchers and clinicians to adopt stress management in their future work.
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Affiliation(s)
- C Linardatou
- Postgraduate Course Stress Management and Health Promotion, School of Medicine, University of Athens, Soranou Ephessiou Str., 4, GR-115-27 Athens, Greece.
| | - A Parios
- Therapeutic Program for Alcohol and Gambling Addiction of KETHEA-ALFA, Charvouri Str., 1, GR-11636, Athens, Greece
| | - L Varvogli
- Postgraduate Course Stress Management and Health Promotion, School of Medicine, University of Athens, Soranou Ephessiou Str., 4, GR-115-27 Athens, Greece
| | - G Chrousos
- Postgraduate Course Stress Management and Health Promotion, School of Medicine, University of Athens, Soranou Ephessiou Str., 4, GR-115-27 Athens, Greece; First Department of Pediatrics, Children's Hospital Aghia Sofia, School of Medicine, University of Athens, Thivon & Papadiamantopoulou Str., GR-115-27 Athens, Greece
| | - C Darviri
- Postgraduate Course Stress Management and Health Promotion, School of Medicine, University of Athens, Soranou Ephessiou Str., 4, GR-115-27 Athens, Greece
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Apostolakou F, Papassotiriou I, Chouliaras G, Bastaki D, Chrousos G, Pervanidou P. Increased placental growth factor concentrations in children and adolescents with obesity and the metabolic syndrome. Clin Biochem 2014. [DOI: 10.1016/j.clinbiochem.2014.04.033] [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: 11/15/2022]
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20
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Papastamataki M, Papassotiriou I, Bartzeliotou A, Vazeou A, Roma E, Chrousos G, Kanaka-Gantenbein C. Incretins, amylin and other gut–brain axis hormones in children with celiac disease. Clin Biochem 2014. [DOI: 10.1016/j.clinbiochem.2014.04.064] [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: 11/26/2022]
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21
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Kamakari S, Koutsodontis G, Tsilimbaris M, Fitsios A, Chrousos G. First report of OPA1 screening in Greek patients with autosomal dominant optic atrophy and identification of a previously undescribed OPA1 mutation. Mol Vis 2014; 20:691-703. [PMID: 24883014 PMCID: PMC4037535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Accepted: 05/24/2014] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To describe the genotype-phenotype correlation in four Greek pedigrees with autosomal dominant optic atrophy (ADOA) and OPA1 mutations. METHODS Seven patients from four unrelated families (F1, F2, F3, F4) were clinically assessed for visual acuity, color vision, ptosis, afferent pupillary defects, and visual fields and underwent orthoptic assessment, slit-lamp biomicroscopy, and fundus examination to establish their clinical status. Genomic DNA was extracted from peripheral blood samples from all participants. The coding region (exons 1-28), including the intron-exon boundaries of the OPA1 gene, was screened in the probands of the four families, as well as in seven additional family members (four affected and three unaffected) with PCR and direct DNA sequencing. RESULTS All patients presented bilateral decrease in best-corrected visual acuity and temporal pallor of the optic disc. The visual fields of the adult patients showed characteristic scotomata. Other signs were present in some patients such as decreased color discrimination and a gray crescent within the neuroretinal rim. After the OPA1 gene was sequenced, a previously undescribed heterozygous splice-site mutation c.784-1G>T in intron 7 was detected in family F2. In families F1, F3, and F4, a previously reported in-frame deletion c.876_878delTGT/p.(Val294del), the frameshift c.2366delA/p.(Asn789Metfs*11), and splice-site c.1140+5G>C mutations were detected, respectively. CONCLUSIONS This is the first report of molecular characterization of Greek patients with ADOA. Our findings provide additional information regarding the genotype-phenotype correlation and establish the role of the OPA1 gene in Greek patients with ADOA.
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Affiliation(s)
- Smaragda Kamakari
- Ophthalmic Genetics Unit, OMMA Ophthalmological Institute of Athens, Greece
| | | | - Miltiadis Tsilimbaris
- Department of Ophthalmology, School of Medicine, University of Crete, Iraklion, Greece
| | - Athanasios Fitsios
- Pediatric Ophthalmology Department, MITERA Childrens’ Hospital, Athens, Greece
| | - Georgia Chrousos
- Pediatric Ophthalmology Department, MITERA Childrens’ Hospital, Athens, Greece
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Kalaitzidou I, Venetikou MS, Konstadinidis K, Artemiadis AK, Chrousos G, Darviri C. Stress management and erectile dysfunction: a pilot comparative study. Andrologia 2013; 46:698-702. [DOI: 10.1111/and.12129] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2013] [Indexed: 11/28/2022] Open
Affiliation(s)
- I. Kalaitzidou
- Postgraduate Course Stress Management and Health Promotion; School of Medicine; University of Athens at Biomedical Research Foundation; Academy of Athens; Athens Greece
| | - M. S. Venetikou
- Department of Essential Medical Sciences School of Health and Caring Professions; Highest Technological Educational Institution of Athens (TEI); Athens Greece
| | | | - A. K. Artemiadis
- Postgraduate Course Stress Management and Health Promotion; School of Medicine; University of Athens at Biomedical Research Foundation; Academy of Athens; Athens Greece
| | - G. Chrousos
- Postgraduate Course Stress Management and Health Promotion; School of Medicine; University of Athens at Biomedical Research Foundation; Academy of Athens; Athens Greece
- First Department of Pediatrics; Children's Hospital Aghia Sofia; School of Medicine; University of Athens; Athens Greece
| | - C. Darviri
- Postgraduate Course Stress Management and Health Promotion; School of Medicine; University of Athens at Biomedical Research Foundation; Academy of Athens; Athens Greece
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Settas N, Dracopoulou-Vabouli M, Dastamani A, Katsikis I, Chrousos G, Panidis D, Dacou-Voutetakis C. CYP21A2 mutations in women with polycystic ovary syndrome (PCOS). Horm Metab Res 2013; 45:383-6. [PMID: 23386413 DOI: 10.1055/s-0033-1333727] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [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] [Indexed: 10/27/2022]
Abstract
The question of the contribution of CYP21A2 heterozygosity to the development of polycystic ovary syndrome (PCOS) has repeatedly been raised in the literature. The available data, however, do not offer a satisfactory answer. The discrepancy must be attributed, primarily, to the small number of subjects in the various studies, the type of selected phenotype, and the number of searched mutations. The aim of the study was to define the contribution of CYP21A2 heterozygous mutations to the pathogenesis of PCOS. We searched for 14 molecular defects of the CYP21A2 gene in 197 PCOS women, employing allele specific PCR. Androgen levels were determined at baseline by appropriate methodology in the follicular phase. PCOS women with 17-hydroxyprogesterone (17OHP) basal values >2 ng/ml and/or post-ACTH >10 ng/ml were excluded. Appropriate controls were included. The frequency of the CYP21A2 heterozygous mutations in PCOS women and in controls was 7.6% and 5.9%, respectively [p-value (PCOS vs. controls): 0.663]. Homozygosity for CYP21A2 gene defects was not detected. In conclusion, the contribution of CYP21A2 heterozygous mutations to the pathogenesis of PCOS is not substantiated by our data. Moreover, 17-hydroxyprogesterone values of < 10 ng/ml post-ACTH exclude homozygosity of CYP21A2 mutations.
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Affiliation(s)
- N Settas
- First Department of Pediatrics, Unit of Molecular Endocrinology Choremis Research Laboratory, University of Athens, School of Medicine, Aghia Sophia Children's Hospital, Athens, Greece
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24
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Kouni S, Karakitsos P, Chranioti A, Theodoridou M, Chrousos G, Michos A. Evaluation of viral co-infections in hospitalized and non-hospitalized children with respiratory infections using microarrays. Clin Microbiol Infect 2012; 19:772-7. [PMID: 23020634 PMCID: PMC7129253 DOI: 10.1111/1469-0691.12015] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The impact of viral co‐infections and recently discovered viruses on the epidemiology of respiratory infections in children is still unclear. To simultaneously detect viruses that are involved in the aetiology of respiratory infections, we used a DNA/RNA microarray assay that identifies 17 different viruses or viral subtypes. Rhinopharyngeal washes were taken from 611 children (aged 1 month to 14 years) who presented in the emergency department with respiratory infections from June 2010 to June 2011 and were treated as outpatients (299, 48.9%) or hospitalized (312, 51.1%). Lower respiratory tract infection was diagnosed more often in hospitalized children (68% versus 36%, p 0.001). Of 397 children in which microarrays detected viral infection (70.1%), a single virus was found in 228 (57.4%) and two or more viruses in 169 (42.5%). The most prevalent viruses among children with positive samples were respiratory syncytial virus (RSV) in 225 (56.6%), parainfluenza virus (PIV) in 118 (29.7%), rhinovirus (RV) in 73 (18.4%), followed by influenza in 56 (14.1%), adenoviruses in 31 (7.8%), bocavirus in 25 (6.3%), human metapneumovirus in 15 (3.7%) and enteroviruses in 12 (3%). Most common viral co‐infections were RSVA–RSVB in 46 children (27.2%), RSV–Influenza in 20 (11.8%), RSV–RV in 18 (10.6%) and PIV–RV in 13 (7.7%). Multiple logistic regression analysis revealed that viral co‐infections were associated with increased probability for hospitalization (OR 1.52, 95% CI 1.01–2.29, p 0.04), and previous pneumococcal vaccination was associated with decreased probability for hospitalization (OR 0.52, 95% CI 0.33–0.81, p 0.004). We conclude that viral co‐infections are involved in a significant proportion of children with an acute respiratory infection and may increase the severity of clinical presentation and the risk for hospitalization.
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Affiliation(s)
- S Kouni
- First Department of Paediatrics, University of Athens, Aghia Sophia, Children's Hospital, Athens, Greece
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25
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Sakka S, Kaminioti C, Pervanidou P, Lazopoulou N, Kanaka-Gantenbein C, Chrousos G, Papassotiriou I. Lipoprotein-associated phospholipase A2 levels are elevated in obese children. Clin Biochem 2011. [DOI: 10.1016/j.clinbiochem.2011.03.096] [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: 11/26/2022]
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26
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Margeli A, Gkourogianni A, Konsta M, Kosteria I, Loutradis D, Mastorakos G, Papassotiriou I, Chrousos G, Kanaka-Gantenbein C. Serum YKL-40 levels in naturally conceived children and children born after intracytoplasmic sperm injection: Correlation with metabolic syndrome parameters. Clin Biochem 2011. [DOI: 10.1016/j.clinbiochem.2011.03.085] [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: 11/24/2022]
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27
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Tsara V, Amfilochiou A, Papagrigorakis JM, Georgopoulos D, Liolios E, Kadiths A, Koudoumnakis E, Aulonitou E, Emporiadou M, Tsakanikos M, Chatzis A, Choulakis M, Chrousos G. Guidelines for diagnosing and treating sleep related breathing disorders in adults and children (Part 3: obstructive sleep apnea in children, diagnosis and treatment). Hippokratia 2010; 14:57-62. [PMID: 20411064 PMCID: PMC2843575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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28
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Papaevangelou V, Papassotiriou I, Vounatsou M, Chrousos G, Theodoridou M. Changes in leptin serum levels in HIV‐infected children receiving highly active antiretroviral therapy. Scandinavian Journal of Clinical and Laboratory Investigation 2009; 67:291-6. [PMID: 17454843 DOI: 10.1080/00365510601045062] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Highly active antiretroviral therapy (HAART) has significantly improved the prognosis of HIV(+) in children. Human immunodeficiency-associated lipodystrophy syndrome (HALS) is a side effect of HAART seen predominantly in adults and less often in children. Leptin is a protein thought to play an important role in body composition and has been shown to have immunomodulatory effects. We retrospectively studied serum levels of leptin in a cohort of eight HIV-infected children followed prospectively before and during HAART and investigated whether there is a correlation of these levels with the clinical, immunological, viral or nutritional changes observed during treatment in these children. None of our children developed HALS. In this small cohort of children, we found that serum leptin levels were appropriate to the nutritional status of the patient and that leptin/BMI increased in patients who responded to HAART. In conclusion, in HIV(+) children during HAART, leptin levels are related to the nutritional status of the child.
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Affiliation(s)
- V Papaevangelou
- 2nd Department of Pediatrics, University of Athens, Medical School, Athens, Greece.
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Koniari E, Laios E, andrikopoulos G, Richter D, Gialafos E, Manolis A, Chrousos G, Drogari E. IDENTIFICATION 0F SIX PCSK9 SNPS IN THE GREEK GENERAL POPULATION AND GREEK FAMILIAL HYPERCHOLESTEROLEMIC PATIENTS. ATHEROSCLEROSIS SUPP 2008. [DOI: 10.1016/s1567-5688(08)70132-6] [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: 10/22/2022]
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Mansky P, Hoffman K, Gerber L, Chrousos G, Steinberg S, Mackall C. 54 INVITED Long-term cancer survivorship issues: Is there a role for CAM? EJC Suppl 2007. [DOI: 10.1016/s1359-6349(07)70168-4] [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: 10/22/2022] Open
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Kakourou T, Karachristou K, Chrousos G. A case series of alopecia areata in children: impact of personal and family history of stress and autoimmunity. J Eur Acad Dermatol Venereol 2007; 21:356-9. [PMID: 17309458 DOI: 10.1111/j.1468-3083.2006.01931.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND The epidemiology of alopecia areata (AA) is well documented in adults but has not been studied adequately in children. OBJECTIVE To evaluate the clinical and epidemiological profile of AA in children and assess the significance of thyroid screening. METHODS One hundred and fifty-seven children (83 boys, 74 girls, aged 1-16 years) who visited our clinic with a first episode of AA from 1996 to 2000 were retrospectively studied. One hundred children served as clinical controls. RESULTS The age of peak incidence of AA was 0-5 years. The youngest child was 1 year old. In the majority of the cases (131/157, 83.4%) the disease was mild or moderate (less than 50% hair loss). In 15 patients (9.5%), AA was preceded by a stressful event. Five patients had a personal history of autoimmune disease (3.2 vs. 5% of the controls, (P = not significant [NS]) while 18 patients had a personal history of atopy (11.4 vs. 18% of the controls, P = NS). Twenty-one patients had a family history of autoimmune disease other than thyroiditis (13.4 vs. 5% of the controls, P = 0.04), while 23 patients had a family history of thyroid disorder (14.6 vs. 3% of the controls, P = 0.006). In eight patients (5%) subclinical hypothyroidism of autoimmune aetiology (Hashimoto's thyroiditis) was revealed at the time of investigation. Six out of the eight patients with Hashimoto's thyroiditis had a family history of thyroid disorder, which was statistically significant when compared to AA patients without thyroiditis (P < 0.001). The severity of AA was associated with early age of onset of the disease (P = 0.02). CONCLUSION The age of peak incidence of AA in children is 0-5 years. Children with AA have an increased family history of autoimmunity, and, among children with a first episode and short duration of AA (< 6 months), thyroid screening might be restricted in those with a positive family history of thyroid disorder. Thyroid screening should be routinely performed in all children with long-standing AA.
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Affiliation(s)
- T Kakourou
- First Department of Pediatrics, Athens University Medical School, Aghia Sophia Children's Hospital, 11527 Athens, Greece.
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Bartzeliotou A, Margeli A, Tsironi M, Skenderi K, Bacoula C, Chrousos G, Papassotiriou I. CIRCULATING LEVELS OF ADHESION MOLECULES AND MARKERS OF ENDOTHELIAL DYSFUNCTION IN ACUTE INFLAMMATION INDUCED BY PROLONGED BRISK EXERCISE: RAPID ENDOTHELIAL RECOVERY AND POTENTIAL BENEFICIAL EFFECTS. J Thromb Haemost 2007. [DOI: 10.1111/j.1538-7836.2007.tb00602.x] [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: 11/29/2022]
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Nicolaidou P, Tsitsika A, Papadimitriou A, Karantana A, Papadopoulou A, Psychou F, Liakopoulou D, Georgouli H, Kakourou T, Chrousos G. Hereditary vitamin D-resistant rickets in Greek children: genotype, phenotype, and long-term response to treatment. J Pediatr Endocrinol Metab 2007; 20:425-30. [PMID: 17451081 DOI: 10.1515/jpem.2007.20.3.425] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [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] [Indexed: 11/15/2022]
Abstract
We describe four patients (two pairs of children from two unrelated kindreds) from a Greek island, suffering from hereditary vitamin D-resistant rickets (HVDRR) with alopecia. There were two different homozygous mutations in the vitamin D receptor (VDR) gene of the affected members of the two kindreds that resulted in a truncated or missing receptor. The disorder began in early infancy with similar clinical, biochemical and radiological findings in all four patients, namely, alopecia (which provided the initial diagnostic evidence for HVDRR), rachitic deformities, hypocalcemia, hypophosphatemia, secondary hyperparathyroidism, and elevated serum levels of 1,25-dihydroxyvitamin D; however, the patients of kindred B had a more severe clinical expression. Treatment options include oral or intravenous calcium and active vitamin D metabolites. The response varies widely in different cases. Our patients were initially treated with high doses of 1alpha(OH)D3 and oral calcium supplementation. Kindred A patients had a satisfactory response to this regimen, while kindred B patients presented clinical and biochemical improvement when 1alpha(OH)D3 was changed to 1,25(OH)2D3. In the older patients of each kindred, treatment requirements gradually decreased during puberty, and therapy was finally discontinued before adulthood.
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Affiliation(s)
- P Nicolaidou
- Third Department of Pediatrics, Athens University Medical School, University General Hospital "Attikon", Haidari, Greece.
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Hoffman KE, Derdak J, Bernstein D, Reynolds JC, Steinberg SM, Chrousos G, Gerber L, Mackall CL, Mansky PJ. Metabolic syndrome traits in long-term survivors of pediatric sarcoma at a single institution. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.9041] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
9041 Multi-modality therapy (MMT) for pediatric sarcoma (SARC) may result in late endocrine abnormalities and increased cardiovascular morbidity. Metabolic syndrome (MS; NCEP ATPIII definition), a cluster of obesity, dyslipidemia, hyperglycemia and hypertension, conveys an increased risk of type 2 diabetes and cardiovascular disease. This cross-sectional study investigated the prevalence of the MS traits (MST) in long-term survivors of MMT for SARC. 32 survivors of SARC (predominantly Ewing’s; median age 36.5 years, range 17–54; f:m = 15:17; median age at MMT of 15 years, range 7–34; median time since completion of MMT 18 years, range 3–33) completed CT evaluation of abdominal obesity, DEXA scan for body mass composition, fasting serum lipid profile (FLP), the Human Activity Profile (HAP) and PAI and beta 2 microglobulin (B2M) analysis. Results, compared to appropriate controls were considered statistically significant if the p-value < 0.01. SARC survivors were more likely to have one or more MST (common OR 4.04, CI:[1.52, 13.55], p=0.0045). Subjects aged 20–39 had a higher pooled prevalence of the MS (common OR 4.29 [1.50, 11.21], p=0.0077), defined as 3 or more traits, compared to controls stratified by gender. Analysis of individual MST demonstrated higher prevalence of hypertension (common OR 2.61,[1.20, 5.59], p=0.015), hypertriglyceridemia (common OR 3.63, [1.75, 7.60], p=0.0006), and male abdominal obesity (common OR 4.52, [1.57, 13.39], p=0.0046). SARC survivors had a higher prevalence of hypercholesterolemia than healthy adults (p=0.012). PAI antigen (p=0.043), PAI activity (p=0.018) and B2M levels (p=0.043) increased with an increasing number of MST. In male subjects, total testosterone declined (p=0.008) as the number of MST increased. Average (p=0.028) and maximum (p=0.041) activity levels decreased as the number of MST increased. After a median follow up of 18 years, adult SARC survivors of MMT have an increased prevalence of MST, especially between ages 20–39 years. The development of MST may be associated with decreased testosterone and decreased activity level. Younger male adult SARC survivors may be at particular risk for type 2 diabetes and cardiovascular disease and should be monitored. No significant financial relationships to disclose.
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Affiliation(s)
- K. E. Hoffman
- National Cancer Institute, Bethesda, MD; National Institutes of Health Clinical Center, Bethesda, MD; National Institute of Child Health and Human Development, Bethesda, MD; National Center for Complementary and Alternative Medicine, Bethesda, MD
| | - J. Derdak
- National Cancer Institute, Bethesda, MD; National Institutes of Health Clinical Center, Bethesda, MD; National Institute of Child Health and Human Development, Bethesda, MD; National Center for Complementary and Alternative Medicine, Bethesda, MD
| | - D. Bernstein
- National Cancer Institute, Bethesda, MD; National Institutes of Health Clinical Center, Bethesda, MD; National Institute of Child Health and Human Development, Bethesda, MD; National Center for Complementary and Alternative Medicine, Bethesda, MD
| | - J. C. Reynolds
- National Cancer Institute, Bethesda, MD; National Institutes of Health Clinical Center, Bethesda, MD; National Institute of Child Health and Human Development, Bethesda, MD; National Center for Complementary and Alternative Medicine, Bethesda, MD
| | - S. M. Steinberg
- National Cancer Institute, Bethesda, MD; National Institutes of Health Clinical Center, Bethesda, MD; National Institute of Child Health and Human Development, Bethesda, MD; National Center for Complementary and Alternative Medicine, Bethesda, MD
| | - G. Chrousos
- National Cancer Institute, Bethesda, MD; National Institutes of Health Clinical Center, Bethesda, MD; National Institute of Child Health and Human Development, Bethesda, MD; National Center for Complementary and Alternative Medicine, Bethesda, MD
| | - L. Gerber
- National Cancer Institute, Bethesda, MD; National Institutes of Health Clinical Center, Bethesda, MD; National Institute of Child Health and Human Development, Bethesda, MD; National Center for Complementary and Alternative Medicine, Bethesda, MD
| | - C. L. Mackall
- National Cancer Institute, Bethesda, MD; National Institutes of Health Clinical Center, Bethesda, MD; National Institute of Child Health and Human Development, Bethesda, MD; National Center for Complementary and Alternative Medicine, Bethesda, MD
| | - P. J. Mansky
- National Cancer Institute, Bethesda, MD; National Institutes of Health Clinical Center, Bethesda, MD; National Institute of Child Health and Human Development, Bethesda, MD; National Center for Complementary and Alternative Medicine, Bethesda, MD
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Chrousos G, Kaltsas G. How accurate are currently used methods of determining glycemia in critically ill patients, and do they affect their clinical course?*. Crit Care Med 2005; 33:2849-51. [PMID: 16352973 DOI: 10.1097/01.ccm.0000191121.87316.e1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Makrigiannakis A, Zoumakis E, Kalantaridou S, Chrousos G. Endometrial and placental CRH as regulators of human embryo implantation. J Reprod Immunol 2004; 62:53-9. [PMID: 15288181 DOI: 10.1016/j.jri.2003.11.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 11/28/2003] [Accepted: 11/28/2003] [Indexed: 11/29/2022]
Abstract
Epithelial cells of the human endometrium and differentiated endometrial stromal cells express the corticotropin-releasing hormone (CRH) gene. CRH is also produced by human placental cytotrophoblast. Endometrial and placental CRH are under the endocrine control of gonadal steroids as well as under autocrine/paracrine regulation by prostanoids and interleukins. Human endometrium, myometrium and placenta express the relevant receptors. Human trophoblast and decidualized endometrial cells also express Fas ligand (FasL), a pro-apoptotic molecule. These findings suggest that intra-uterine CRH may participate in local inflammatory phenomena associated with blastocyst implantation, while FasL may assist with maternal immune tolerance to the semi-allograft embryo. A nonpeptidic CRH receptor type 1 (CRH-R1)-specific antagonist decreased the expression of FasL by human trophoblasts, suggesting that CRH regulates the pro-apoptotic potential of these cells in an auto-paracrine fashion. Invasive trophoblasts promoted apoptosis of activated Fas-expressing human T lymphocytes, an effect potentiated by CRH and inhibited by the CRH antagonist. Female rats treated with the CRH antagonist in the first 6 days of gestation had a dose-dependent decrease of endometrial implantation sites and live embryos as well as markedly diminished endometrial FasL expression. However, embryos of mothers lacking T cells (nude rats) and embryos of syngeneic matings were not rejected when mothers were treated with antalarmin, suggesting that the effect of antalarmin on embryonic implantation is not due to a nonspecific toxicity of this compound but a specific effect on T cells. Our data suggest important physiological roles of endometrial and placental CRH in the regulation of blastocyst implantation and early maternal tolerance.
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Affiliation(s)
- A Makrigiannakis
- Department of Obstetrics & Gynocology, Medical School, University of Crete, Heraklion 71110, Greece.
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Makrigiannakis A, Zoumakis E, Kalantaridou S, Chrousos G, Gravanis A. Participation of Maternal and Fetal CRH in Early Phases of Human Implantation: The Role of Antalarmin. ACTA ACUST UNITED AC 2004; 4:75-8. [PMID: 15032629 DOI: 10.2174/1568008043339992] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [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: 11/22/2022]
Abstract
The hypothalamic neuropeptide corticotropin-releasing hormone (CRH) is produced by several tissues of the female reproductive system. It is also secreted at inflammatory sites and possesses potent pro-inflammatory properties influencing both innate and acquired immune processes. Uterine CRH participates in local immune early pregnancy phenomena, such as decidualization of endometrial strom a and protection of the fetus from maternal immune system. This is maintained through induction of the expression of apoptotic FasL on invasive extravillous trophoblast and maternal decidual cells at the fetal-maternal interface. Furthermore, CRH increases apoptosis of activated T lymphocytes through FasL induction participating in the process of implantation and early pregnancy. Female rats treated with the non-peptidic CRH receptor 1 (CRHR1) specific antagonist antalarmin, in the first 6 days of gestation, have undergone a decrease of endometrial implantation sites and live embryos and markedly diminished endometrial FasL expression.
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Affiliation(s)
- A Makrigiannakis
- Department of Ob/Gyn Medical School, University of Crete, Heraklion 71110, Greece.
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Skalkidou A, Petridou E, Papathom E, Salvanos H, Chrousos G, Trichopoulos D. Birth size and neonatal levels of major components of the IGF system: implications for later risk of cancer. J Pediatr Endocrinol Metab 2002; 15:1479-86. [PMID: 12503854 DOI: 10.1515/jpem.2002.15.9.1479] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [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] [Indexed: 11/15/2022]
Abstract
Pre- and perinatal conditions and processes may affect the risk for some forms of cancer in later life, while the insulin-like growth factor (IGF) system may play a role in both early somatic growth and later carcinogenesis. Birth weight and length, and the variation of major components of the IGF system immediately after birth, were analyzed in relation to selected physiological and pathological variables. The study comprised 331 healthy full-term newborns from whom blood samples were taken during routine phlebotomy no later than the fifth day of life. Measurements of IGF-I, IGF-II and IGF-binding protein-3 concentrations were performed. Birth length and weight were measured and information on socio-economic and medical variables was recorded. The concentrations of all three proteins were lower when blood bilirubin levels were high, possibly as a result of compromised liver function and/or as a component of an activated acute phase reaction. Birth weight was significantly higher by about 46 g among children whose IGF-I was higher by one SD, while the associations of birth weight and length with other components of the IGF system were in the predicted directions, albeit only in trend. We conclude that in early life, growth is related to the IGF system, mostly IGF-I. The latter is lower in children with jaundice, possibly because of hepatic dysfunction and/or as part of an acute phase reaction. We speculate that elevations of IGF-I in early life might explain the increased risk of cancer in individuals born with a higher birth weight.
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Affiliation(s)
- A Skalkidou
- Department of Hygiene and Epidemiology, Athens University Medical School, Athens, Greece
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Erickson K, Thorsen P, Chrousos G, Grigoriadis DE, Khongsaly O, McGregor J, Schulkin J. Preterm birth: associated neuroendocrine, medical, and behavioral risk factors. J Clin Endocrinol Metab 2001; 86:2544-52. [PMID: 11397853 DOI: 10.1210/jcem.86.6.7607] [Citation(s) in RCA: 35] [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] [Indexed: 11/19/2022]
Abstract
Increased CRH secretion by the placenta of pregnant women has been associated with preterm birth. Certain indices of risk, both medical and psychosocial in nature, have been linked to preterm delivery. Levels of total, bound, and free CRH, CRH-binding protein (CRH-BP), and cortisol were measured prospectively in a large sample of pregnant Danish women who delivered preterm and term infants. Measures of maternal serum hormones were taken at 7--23 and 27--37 weeks gestation and, for those who delivered at term, at 37--43 weeks gestation. At 7--23 weeks gestation, maternal levels of total CRH (P = 0.01), bound CRH (P = 0.03), and CRH-BP (P = 0.01) were higher in the preterm than in the term group. At 27--37 weeks gestation, levels of total CRH (P < 0.0001), bound CRH (P < 0.0001), free CRH (P < 0.0001), and cortisol (P < 0.0001) were all higher in the preterm than the term group, whereas levels of CRH-BP (P < 0.0001) were lower in the preterm than in the term group. The best medical and behavioral factors associated with preterm delivery were, respectively, previous preterm delivery (P < 0.0001) and engagement in certain risk-taking behaviors (P = 0.008). The positive relations between preterm delivery and various adverse medical and socioeconomic variables with increases in placental secretion of CRH suggest that the latter may participate in the pathophysiology of preterm delivery.
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Affiliation(s)
- K Erickson
- Department of Psychology, American University, Washington, D.C. 20016, USA
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Abstract
Pro-inflammatory cytokines, such as interleukin-1 beta (IL-1 beta), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF alpha), released from inflammatory foci, can activate the hypothalamus to produce corticotrophin-releasing hormone (CRH) and arginine vasopressin (AVP). These hypothalamic peptides in synergy increase ACTH production by the pituitary gland and hence corticosteroid (CS) secretion by the adrenal cortices. CS dampens inflammation. The pituitary also produces prolactin (PRL), which is pro-inflammatory, and macrophage inhibitory factor (MIF), which by counteracting the anti-inflammatory and immunosuppressive effects of CS, is pro-inflammatory. Lewis rats develop a variety of induced-autoimmune inflammatory conditions, such as streptococcal cell wall arthritis, whereas the histocompatible F344 Fisher rats are resistant to this condition. Lewis rats have a defective hypothalamic-pituitary adrenal (HPA) response to a variety of hypothalamic stimuli, but have augmented systemic secretion of AVP. Patients with rheumatoid arthritis (RA) have deficient CS with exaggerated PRL responses to inflammatory stimuli. Within inflammatory foci, CRH is pro-inflammatory. AVP, which augments autologous mixed lymphocyte reactions, can replace the IL-2 requirement for gamma IFN production by T cells via V1a receptors, and potentiates primary antibody responses, is also pro-inflammatory. Lewis rats have significantly high plasma levels, hypothalamic content, and in vitro release of AVP in comparison to the inflammatory disease-resistant Fischer rats. Immunoneutralization of AVP attenuates inflammatory responses. In Sprague-Dawley rats, AVP potentiates PRL secretion. Preliminary studies in patients with RA have shown that the circulating levels of AVP are significantly increased, which might be a compensatory response to low CS levels or a result of elevated levels of IL-6 in these patients but could nevertheless contribute to rheumatoid inflammation. A similar observation has been made in patients with ankylosing spondylitis.
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Affiliation(s)
- I C Chikanza
- Bone & Joint Research Unit, St. Bartholomews & Royal London School of Medicine and Dentistry, New Science Building, Charterhouse Square, London EC1 6BQ, UK.
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Abstract
Transgenic animals and knockout mice have been generated with defined defects in various components of the hypothalamic-pituitary-adrenal axis and the autonomic nervous system. These models provide valuable and novel insights into the development, crosstalk, organization, and functioning of the stress system.
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Affiliation(s)
- S Bornstein
- Developmental Endocrinology Branch, National Institute of Child Health and Human Development, Bethesda, MD 20892, USA.
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Franchimont D, Louis E, Dupont P, Vrindts-Gevaert Y, Dewe W, Chrousos G, Geenen V, Belaiche J. Decreased corticosensitivity in quiescent Crohn's disease: an ex vivo study using whole blood cell cultures. Dig Dis Sci 1999; 44:1208-15. [PMID: 10389698 DOI: 10.1023/a:1026644711530] [Citation(s) in RCA: 28] [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: 12/09/2022]
Abstract
Corticosensitivity influences the degree and the duration of an inflammatory reaction by altering target cell responses to endogenous and/or exogenous glucocorticoids. Indeed, different clinical responses to glucocorticoids have been observed among patients with Crohn's disease, suggesting different degrees of corticosensitivity in these subjects. The purpose of this study was to compare the corticosensitivity of patients with quiescent Crohn's disease to that of healthy subjects (HS). Nineteen patients with quiescent Crohn's disease and 14 HS were studied; all patients were steroid-free for at least six months; 7 of the 19 were corticosteroid-dependent (CSD) and treated with nonglucocorticoid immunosuppressants at the time of the study. Corticosensitivity was measured by the inhibition of LPS-induced cytokine secretion in whole blood cell cultures treated with increasing concentrations (10(-9) to 10(-6) M) of dexamethasone. Tumor-necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), and interleukin-1 beta (IL-1 beta) were measured using specific immunoassays. Crohn's disease patients had a markedly decreased dexamethasone-mediated inhibition of TNF-alpha (P < 0.01), IL-6 (P < 0.001), and IL-1 beta (P < 0.01) compared to healthy subjects, with a shift of the dexamethasone dose-response curve to the right. No significant differences in the basal and LPS-stimulated secretion of the three cytokines were observed between CSD and non-CSD patients, and both subgroups of patients had similar degrees of dexamethasone-mediated cytokine inhibition. We conclude that patients with Crohn's disease have a significant decrease in the corticosensitivity of their leukocytes. This may be related to a specific genetic/constitutional background and/or could be acquired, due to inflammation-related endocrine and/or immune factors.
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Affiliation(s)
- D Franchimont
- Department of Medicine, University Hospital of Liège, Belgium
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Doppman JL, Chang R, Oldfield EH, Chrousos G, Stratakis CA, Nieman LK. The hypoplastic inferior petrosal sinus: a potential source of false-negative results in petrosal sampling for Cushing's disease. J Clin Endocrinol Metab 1999; 84:533-40. [PMID: 10022412 DOI: 10.1210/jcem.84.2.5475] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [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
Our purpose was to describe the hypoplastic or plexiform inferior petrosal sinus as a potential cause of false-negative sampling results in patients with Cushing's disease. Five hundred and one patients with surgically proven Cushing's disease and negative or equivocal magnetic resonance imaging scans of the pituitary gland underwent petrosal sinus sampling. Four patients (0.8%) with surgically proven Cushing's disease had false-negative results of petrosal sinus sampling. Retrograde inferior petrosal sinograms in these patients were reviewed to evaluate the anatomy of the inferior petrosal sinuses for abnormalities that could have contributed to this misdiagnosis. In addition, the retrograde inferior petrosal sinograms of 100 consecutive patients were reviewed to establish the frequency of asymmetric and/or hypoplastic inferior petrosal sinuses. All four patients with false-negative results of petrosal sampling demonstrated a hypoplastic or plexiform inferior petrosal sinus ipsilateral to an ACTH-secreting microadenoma. When the sampling catheter was in the hypoplastic petrosal sinus, retrograde sinograms from the contralateral side demonstrated anomalous drainage patterns on the side of the hypoplastic sinus. Because the negative results of petrosal sinus sampling false-suggested the presence of the ectopic ACTH syndrome, curative transsphenoidal surgery in these four patients was delayed up to 31 months. We conclude that the presence of a unilateral hypoplastic or plexiform inferior petrosal sinus can result in anomalous drainage from the pituitary gland that may lead to false-negative sampling results in patients with Cushing's disease.
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Affiliation(s)
- J L Doppman
- Diagnostic Radiology Department, Warren Grant Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland 20892-1182, USA.
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Theoharides TC, Singh LK, Boucher W, Pang X, Letourneau R, Webster E, Chrousos G. Corticotropin-releasing hormone induces skin mast cell degranulation and increased vascular permeability, a possible explanation for its proinflammatory effects. Endocrinology 1998; 139:403-13. [PMID: 9421440 DOI: 10.1210/endo.139.1.5660] [Citation(s) in RCA: 222] [Impact Index Per Article: 8.5] [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] [Indexed: 02/05/2023]
Abstract
Mast cells are involved in atopic disorders, often exacerbated by stress, and are located perivascularly close to sympathetic and sensory nerve endings. Mast cells are activated by electrical nerve stimulation and millimolar concentrations of neuropeptides, such as substance P (SP). Moreover, acute psychological stress induces CRH-dependent mast cell degranulation. Intradermal administration of rat/human CRH (0.1-10 microM) in the rat induced mast cell degranulation and increased capillary permeability in a dose-dependent fashion. The effect of CRH on Evans blue extravasation was stronger than equimolar concentrations of the mast cell secretagogue compound 48/80 or SP. The free acid analog of CRH, which does not interact with its receptors (CRHR), had no biological activity. Moreover, systemic administration of antalarmin, a nonpeptide CRHR1 antagonist, prevented vascular permeability only by CRH and not by compound 48/80 or SP. CRHR1 was also identified in cultured leukemic human mast cells using RT-PCR. The stimulatory effect of CRH, like that of compound 48/80 on skin vasodilation, could not be elicited in the mast cell deficient W/Wv mice but was present in their +/+ controls, as well as in C57BL/6J mice; histamine could still induce vasodilation in the W/Wv mice. Treatment of rats neonatally with capsaicin had no effect on either Evans blue extravasation or mast cell degranulation, indicating that the effect of exogenous CRH in the skin was not secondary to or dependent on the release of neuropeptides from sensory nerve endings. The effect of CRH on Evans blue extravasation and mast cell degranulation was inhibited by the mast cell stabilizer disodium cromoglycate (cromolyn), but not by the antisecretory molecule somatostatin. To investigate which vasodilatory molecules might be involved in the increase in vascular permeability, the CRH injection site was pretreated with the H1-receptor antagonist diphenhydramine, which largely inhibited the CRH effect, suggesting that histamine was involved in the CRH-induced vasodilation. The possibility that nitric oxide might also be involved was tested using pretreatment with a nitric oxide synthase inhibitor that, however, increased the effect of CRH. These findings indicate that CRH activates skin mast cells at least via a CRHR1-dependent mechanism leading to vasodilation and increased vascular permeability. The present results have implications for the pathophysiology and possible therapy of skin disorders, such as atopic dermatitis, eczema, psoriasis, and urticaria, which are exacerbated or precipitated by stress.
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Affiliation(s)
- T C Theoharides
- Department of Pharmacology and Experimental Therapeutics, Tufts University School of Medicine, Boston, Massachusetts 02111, USA.
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Michelson D, Galliven E, Hill L, Demitrack M, Chrousos G, Gold P. Chronic imipramine is associated with diminished hypothalamic-pituitary-adrenal axis responsivity in healthy humans. J Clin Endocrinol Metab 1997; 82:2601-6. [PMID: 9253341 DOI: 10.1210/jcem.82.8.4172] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.7] [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: 02/05/2023]
Abstract
The hypercortisolism of melancholic depression is thought to reflect hypothalamic hypersecretion of CRH and may be related to the hyperarousal associated with this syndrome. Although chronic administration of imipramine to experimental animals significantly decreases CRH messenger RNA levels in the paraventricular nucleus, it is generally thought that resolution of hypercortisolism following recovery from depression is related to the improvement in mood and decrease in anxiety that accompanies recovery rather than an intrinsic effect of imipramine. The present study was designed to explore whether chronic imipramine administration to healthy, nondepressed volunteers is associated with effects on hypothalamic-pituitary-adrenal (HPA) axis function. We studied basal and provocative measures of HPA axis function in 14 healthy volunteers before and after 6 weeks of imipramine treatment at therapeutic doses. Imipramine was associated with decreased responses in peak ACTH and cortisol to ovine CRH and in peak ACTH to arginine vasopressin (P = 0.02, P = 0.003, and P = 0.02, respectively) without changes in indices of basal HPA axis function. These data are consistent with preclinical findings and support the hypothesis that imipramine has an intrinsic effect on central components of HPA axis function, potentially related to its therapeutic effects.
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Affiliation(s)
- D Michelson
- Clinical Neuroendocrinology Branch, National Institute of Mental Health, Bethesda, Maryland, USA.
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Oberfield SE, Nirenberg A, Allen JC, Cohen H, Donahue B, Prasad V, Schiff R, Pang S, Ghavimi F, David R, Chrousos G, Sklar C. Hypothalamic-pituitary-adrenal function following cranial irradiation. Horm Res 1997; 47:9-16. [PMID: 9010712 DOI: 10.1159/000185357] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
We assessed the effect of cranial irradiation on hypothalamic-pituitary (HP)-adrenal function in 17 patients (12 females, 5 males) treated with cranial/ craniospinal irradiation for acute leukemia (2 patients) or tumors distant from the hypothalamus and pituitary (8 medulloblastoma, 3 astrocytoma, 3 rhabdomyosarcoma, 1 ependymoma). Estimated doses of radiation (RT) to the HP region ranged from 18 to 72 Gy. Thirteen of seventeen patients were also treated with chemotherapy. Patients were a median of 3.75 years of age (1.5-19 years) at diagnosis and were studied at a median of 5 years (0.1-20 years) after RT. Patients received corticotropin-releasing factor (oCRF, 1 microgram/kg i.v.), and sampling for cortisol and ACTH levels was performed at -15, 0, 15, 30, 60, 90 and 120 min. The-5- and 0-min levels were combined for a standardized baseline value (Base). Cortisol levels at 0, Base, 30 and 120 min, as well as the peak cortisol response, were significantly lower in the patients. Twelve of seventeen patients' peak cortisol levels fell below the normal range. The patients' mean integrated values for cortisol (area under the curve) were not, however, different from controls. The ACTH responses to oCRF did not differ between patients and controls. No relationship was observed between ACTH or cortisol responses and the time elapsed from treatment or dose of HP RT. Further, in 10 of 12 patients, 0-min dehydroepiandrosterone sulfate levels were lower than the expected normal mean levels for age, sex and pubertal status, and in 4 of these 10 patients the values were below the normal range. These data suggest that some patients treated with HP RT may be at risk for adrenal insufficiency.
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Affiliation(s)
- S E Oberfield
- Department of Pediatrics, New York University Medical Center, NY 10016, USA
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Abstract
BACKGROUND Depression is associated with alterations in behavior and neuroendocrine systems that are risk factors for decreased bone mineral density. This study was undertaken to determine whether women with past or current major depression have demonstrable decreases in bone density. METHODS We measured bone mineral density at the hip, spine, and radius in 24 women with past or current major depression and 24 normal women matched for age, body-mass index, menopausal status, and race, using dual-energy x-ray absorptiometry. We also evaluated cortisol and growth hormone secretion, bone metabolism, and vitamin D-receptor alleles. RESULTS As compared with the normal women, the mean (+/-SD) bone density in the women with past or current depression was 6.5 percent lower at the spine (1.00+/-0.15 vs. 1.07+/-0.09 g per square centimeter, P=0.02), 13.6 percent lower at the femoral neck (0.76+/-0.11 vs. 0.88+/-0.11 g per square centimeter, P<0.001), 13.6 percent lower at Ward's triangle (0.70+/-0.14 vs. 0.81+/-0.13 g per square centimeter, P<0.001), and 10.8 percent lower at the trochanter (0.66+/-0.11 vs. 0.74+/-0.08 g per square centimeter, P<0.001). In addition, women with past or current depression had higher urinary cortisol excretion (71+/-29 vs. 51+/-19 micrograms per day [196+/-80 vs. 141+/-52 nmol per day], P=0.006), lower serum osteocalcin concentration (P=0.04), and lower urinary excretion of deoxypyridinoline (P=0.02). CONCLUSIONS Past or current depression in women is associated with decreased bone mineral density.
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Affiliation(s)
- D Michelson
- Clinical Neuroendocrinology Branch, National Institute of Mental Health, Bethesda, MD 20892-1284, USA
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Abstract
Cognitive theory ascribes nonendogenous depression to latent dysfunctional beliefs activated by stressors impinging upon core values (e.g., rejection for a sociotropic person). To address ambiguities in past tests of the theory, this study measured personality (Sociotropy-Autonomy Scale) and recent stressors (Life Experience Survey and Hassles Scale) among 14 Cushing syndrome patients and 12 controls. Patients scored nonsignificantly higher in sociotropy, and sociotropy correlated positively with depression among patients. Because depression in Cushing syndrome presumably results from biological dysfunction rather than from the interaction of personality and relevant stressors, these results imply that sociotropy may be a consequence of depression as opposed to a contributory cause. There was no congruence between personality and types of stressors reported, which suggest that mood-dependent recall does not account for past evidence of congruence.
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Affiliation(s)
- E Burgess
- Department of Psychology, Asbury Building, The American University, Washington, D.C. 20016-8062, USA
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Amikura K, Alexander HR, Norton JA, Doppman JL, Jensen RT, Nieman L, Cutler G, Chrousos G, Fraker DL. Role of surgery in management of adrenocorticotropic hormone-producing islet cell tumors of the pancreas. Surgery 1995; 118:1125-30. [PMID: 7491532 DOI: 10.1016/s0039-6060(05)80123-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.3] [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: 01/25/2023]
Abstract
BACKGROUND Ectopic adrenocorticotropic hormone-producing islet cell tumors of the pancreas (ACTH-ICT) are a rare cause of Cushing's syndrome with a severe and rapidly progressive clinical course. METHODS Charts were reviewed on all patients evaluated and treated for proven Cushing's syndrome caused by ACTH-ICT (n = 12), specifically for the role of surgery in the management of this disease. RESULTS Ten (83%) of twelve patients with ACTH-ICT had liver metastases at the time of diagnosis (eight of eight with Zollinger-Ellison syndrome, two of four without Zollinger-Ellison syndrome). Surgical management of the primary tumor included three patients who underwent distal pancreatectomy combined with hepatic resection and one patient who underwent laparoscopic enucleation of a tumor from the pancreatic tail. Eight of twelve patients underwent bilateral adrenalectomy to control symptoms of Cushing's syndrome, including three patients who underwent concurrent distal pancreatectomy and hepatic resection. Six of twelve patients died of the disease within 2 1/2 years of diagnosis, four are alive with progressive hepatic metastases, and one has biochemical evidence of disease. CONCLUSIONS ACTH-ICT of the pancreas is an aggressive tumor, particularly when there is coproduction of gastrin. The benefit of aggressive surgical resection of primary or metastatic ACTH-ICT has not been established. However, palliative bilateral adrenalectomy is justified, because no patients had biochemical cures after aggressive surgical resection in this series.
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Affiliation(s)
- K Amikura
- Surgical Metabolism Section, National Cancer Institute, Bethesda, MD 20892-1502, USA
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Chikanza IC, Petrou P, Chrousos G, Kingsley G, Panayi GS. Excessive and dysregulated secretion of prolactin in rheumatoid arthritis: immunopathogenetic and therapeutic implications. Br J Rheumatol 1993; 32:445-8. [PMID: 8508278 DOI: 10.1093/rheumatology/32.6.445] [Citation(s) in RCA: 53] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Prolactin (PL) is essential for the normal function of the immune system. It is required for the induction of a number of autoimmune conditions in experimental animals. The role of prolactin in the immunopathogenesis of autoimmune human disease has not been established. RA is characterized by a variety of immune and inflammatory processes which determine disease activity. It has a pronounced diurnal periodicity with a peak at 03.15 hours. Since PL has a diurnal rhythm of secretion in man with a peak at about 02.00 hours, it may contribute to the nocturnal worsening of RA. We show that patients with RA secrete an excess of prolactin as evidenced by an upregulated diurnal periodicity and an abnormal increase in plasma prolactin concentration following surgery. By contrast, patients with chronic osteomyelitis, who had chronic inflammation of similar severity to patients with RA, had a normal prolactin diurnal rhythm and response to surgery. Hence, the abnormal changes in prolactin physiology seen in RA appear to be a feature of the disease per se rather than related to chronic inflammation. The elevated levels of prolactin may contribute to disease activity by augmenting immune processes and may be an additional genetic factor, independent of HLA-DR4, in the immunopathogenesis of RA. Furthermore, the effective inhibition of prolactin secretion and/or action may have potential as therapy for RA.
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Affiliation(s)
- I C Chikanza
- Rheumatology Unit, United Medical School, Guy's Hospital, London
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