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Irelli A, Sirufo MM, Scipioni T, Aielli F, Martella F, Ginaldi L, Pancotti A, Martinis MD. The VES-13 and G-8 tools as predictors of toxicity associated with aromatase inhibitors in the adjuvant treatment of breast cancer in elderly patients: A single-center study. Indian J Cancer 2022; 59:485-492. [PMID: 36861519 DOI: 10.4103/ijc.ijc_954_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
Background Adjuvant hormone treatment of postmenopausal breast cancer is mainly based on aromatase inhibitors. Adverse events associated with such class of drugs are particularly severe in elderly patients. Therefore, we investigated the possibility of ab initio predict which elderly patients could encounter toxicity. Methods In light of national and international oncological guidelines recommending the use of screening tests for multidimensional geriatric assessment in elderly patients aged ≥70 years and eligible for active cancer treatment, we assessed whether the Vulnerable Elder Survey (VES)-13 and the Geriatric (G)-8 could be predictors of toxicity associated with aromatase inhibitors. Seventy-seven consecutive patients aged ≥70 diagnosed with non-metastatic hormone-responsive breast cancer and therefore eligible for adjuvant hormone therapy with aromatase inhibitors, were screened with the VES-13 and the G-8, and underwent a six-monthly clinical and instrumental follow-up in our medical oncology unit, from September 2016 to March 2019 (30 months). Said patients were identified as vulnerable (VES-13 score ≥3 or G-8 score ≤14) and fit (VES-13 score <3 or G-8 score >14). The likelihood of experiencing toxicity is greater among vulnerable patients. Results The correlation between the VES-13 or the G-8 tools and the presence of adverse events is equal to 85.7% (p = 0.03). The VES-13 demonstrated 76.9% sensitivity, 90.2% specificity, 80.0% positive predictive value, 88.5% negative predictive value. The G-8 demonstrated 79.2% sensitivity, 88.7% specificity, 76% positive predictive value, 90.4% negative predictive value. Conclusion The VES-13 and the G-8 tools could be valuable predictors of the onset of toxicity associated with aromatase inhibitors in the adjuvant treatment of breast cancer in elderly patients aged ≥70.
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Affiliation(s)
- Azzurra Irelli
- Medical Oncology Unit, Department of Oncology, AUSL 04 Teramo, Italy
| | - Maria Maddalena Sirufo
- Department of Life, Health and Environmental Sciences, University of L'Aquila; Allergy and Clinical Immunology Unit, Center for the Diagnosis and Treatment of Osteoporosis, AUSL 04 Teramo, Italy
| | - Teresa Scipioni
- Medical Oncology Unit, Department of Oncology, AUSL 04 Teramo, Italy
| | - Federica Aielli
- Medical Oncology Unit, Department of Oncology, AUSL 04 Teramo, Italy
| | | | - Lia Ginaldi
- Department of Life, Health and Environmental Sciences, University of L'Aquila; Allergy and Clinical Immunology Unit, Center for the Diagnosis and Treatment of Osteoporosis, AUSL 04 Teramo, Italy
| | - Amedeo Pancotti
- Medical Oncology Unit, Department of Oncology, AUSL 04 Teramo, Italy
| | - Massimo De Martinis
- Department of Life, Health and Environmental Sciences, University of L'Aquila; Allergy and Clinical Immunology Unit, Center for the Diagnosis and Treatment of Osteoporosis, AUSL 04 Teramo, Italy
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Irelli A, Sirufo MM, Scipioni T, Aielli F, Martella F, Ginaldi L, Pancotti A, De Martinis M. The VES-13 and G-8 tools as predictors of toxicity associated with aromatase inhibitors in the adjuvant treatment of breast cancer in elderly patients: A single-center study. Indian J Cancer 2021; 0:319470. [PMID: 34380841 DOI: 10.4103/0019-509x.319470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Adjuvant hormone treatment of postmenopausal breast cancer is mainly based on aromatase inhibitors. Adverse events associated with such class of drugs are particularly severe in elderly patients. Therefore, we investigated the possibility of ab initio predict which elderly patients could encounter toxicity. Methods In light of national and international oncological guidelines recommending the use of screening tests for multidimensional geriatric assessment in elderly patients aged ≥70 years and eligible for active cancer treatment, we assessed whether the Vulnerable Elder Survey (VES)-13 and the Geriatric (G)-8 could be predictors of toxicity associated with aromatase inhibitors. Seventy-seven consecutive patients aged ≥70 diagnosed with non-metastatic hormone-responsive breast cancer and therefore eligible for adjuvant hormone therapy with aromatase inhibitors, were screened with the VES-13 and the G-8, and underwent a six-monthly clinical and instrumental follow-up in our medical oncology unit, from September 2016 to March 2019 (30 months). Said patients were identified as vulnerable (VES-13 score ≥3 or G-8 score ≤14) and fit (VES-13 score <3 or G-8 score >14). The likelihood of experiencing toxicity is greater among vulnerable patients. Results The correlation between the VES-13 or the G-8 tools and the presence of adverse events is equal to 85.7% (p = 0.03). The VES-13 demonstrated 76.9% sensitivity, 90.2% specificity, 80.0% positive predictive value, 88.5% negative predictive value. The G-8 demonstrated 79.2% sensitivity, 88.7% specificity, 76% positive predictive value, 90.4% negative predictive value. Conclusion The VES-13 and the G-8 tools could be valuable predictors of the onset of toxicity associated with aromatase inhibitors in the adjuvant treatment of breast cancer in elderly patients aged ≥70.
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Affiliation(s)
- Azzurra Irelli
- Medical Oncology Unit, Department of Oncology, AUSL 04 Teramo, Italy
| | - Maria Maddalena Sirufo
- Department of Life, Health and Environmental Sciences, University of L'Aquila, Italy; Allergy and Clinical Immunology Unit, Center for the Diagnosis and Treatment of Osteoporosis, AUSL 04 Teramo, Italy
| | - Teresa Scipioni
- Medical Oncology Unit, Department of Oncology, AUSL 04 Teramo, Italy
| | - Federica Aielli
- Medical Oncology Unit, Department of Oncology, AUSL 04 Teramo, Italy
| | | | - Lia Ginaldi
- Department of Life, Health and Environmental Sciences, University of L'Aquila, Italy; Allergy and Clinical Immunology Unit, Center for the Diagnosis and Treatment of Osteoporosis, AUSL 04 Teramo, Italy
| | - Amedeo Pancotti
- Medical Oncology Unit, Department of Oncology, AUSL 04 Teramo, Italy
| | - Massimo De Martinis
- Department of Life, Health and Environmental Sciences, University of L'Aquila, Italy; Allergy and Clinical Immunology Unit, Center for the Diagnosis and Treatment of Osteoporosis, AUSL 04 Teramo, Italy
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Irelli A, Sirufo MM, Scipioni T, De Pietro F, Pancotti A, Ginaldi L, De Martinis M. Breast cancer patients receiving denosumab during adjuvant aromatase inhibitors treatment: who are the "inadequate responders" patients to denosumab? J BUON 2020; 25:648-654. [PMID: 32521848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE Adjuvant hormone therapy with aromatase inhibitors (AIs) through the induction of tissue hypo-estrogenism induces an increase in osteoclast activity and inhibition of osteoblast activity through the production of RANKL. This is a relevant cause of comorbility in women affected by breast cancer with negative impact on quality of life. We conducted an observational study on patients treated with AIs and denosumab to compare responders and inadequate responders. METHODS The study design was a historical cohort survey that represented a 42-month follow-up period for patients on hormone treatment with AI for breast cancer and concomitant denosumab (Prolia®) at 60 mg subcutaneously every 6 months. Sixty-eight patients treated consecutively at our Medical Oncology Unit were studied. The comparison was carried out by stratifying on the basis of age, body mass index (BMI), weight, carboxy-terminal collagen crosslink (CTX), lumbar spine and femoral T-scores, FRAX 10-year probability of a fracture, FRAX 10-year probability of a major osteoporotic fracture at baseline and at the end of follow-up. RESULTS Calculating and comparing the FRAX 10-year probability of hip fragility fracture at baseline in the subgroup of responders and in the inadequate responders subgroup, we found a statistically significant difference (p=0.039). Similarly, a statistically significant difference was found between the two subgroups of patients in terms of FRAX 10-year probability of hip fragility at the end of follow-up (p=0.014) and FRAX 10-year probability of a mayor osteoporotic fracture at the end of follow-up (p=0.043). CONCLUSION This study suggests the need to control weight in breast cancer survivors and adjuvant AIs treatment in order not only to reduce the incidence of disease relapse but also to safeguard bone health undergoing treatment with denosumab. Indeed, patients tend to respond inadequately to denosumab if they are not careful to control their body weight.
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Affiliation(s)
- Azzurra Irelli
- Medical Oncology Unit, Department of Oncology, AUSL 04 Teramo, Italy
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Mercadante S, Caraceni A, Masedu F, Scipioni T, Aielli F. Breakthrough Cancer Pain in Patients Receiving Low Doses of Opioids for Background Pain. Oncologist 2020; 25:156-160. [PMID: 31862860 PMCID: PMC7011660 DOI: 10.1634/theoncologist.2019-0542] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 09/09/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND This study aimed to assess the characteristics of breakthrough cancer pain (BTcP) in patients receiving low doses of opioids for background pain in comparison with patients receiving at least 60 mg of oral morphine equivalents (OME). MATERIALS AND METHODS Patients with advanced cancer receiving less than 60 mg/day of OME with episodes of BTcP were included in the analysis (group L). Data were compared with patients receiving doses of opioids ≥60 mg of OME (group H). Pain intensity, current analgesic therapy, number of BTcP episodes, intensity of BTcP, its predictability and triggers, onset duration, interference with daily activities, BTcP medications, and time to meaningful pain relief were collected. Adverse effects imputable to a BTcP medication were recorded. RESULTS A total of 1,418 and 2,474 patients were included in groups L and H, respectively. A lower number of BTcP episodes (p = .005), a lower BTcP intensity (p = .0001), a faster BTcP onset (p = .024), and a longer time to meaningful pain relief after taking a BTcP medication (p = .009) were found in group L as compared with group H. In group L, BTcP interference on daily activity was less than in group H (p = .009). Patients in group L were less likely to be prescribed an opioid as BTcP medication in comparison with patients in group H (p = .0001). Opioid doses used for BTcP were significantly higher in group H. Patients in group L were more likely to be less satisfied (p = .003) than patients in group H. No adverse effects of severe intensity were reported in both groups. CONCLUSION Patients receiving lower doses of opioids exhibit some differences in BTcP presentation: fewer episodes with lower intensity and a faster onset, a longer time to meaningful pain relief, and less satisfaction with BTcP medication. A relevant percentage of patients was receiving fentanyl preparations normally reserved for patients receiving higher doses of opioids. IMPLICATIONS FOR PRACTICE Breakthrough pain is present in patients receiving low doses of opioids. It has its own peculiarities: less frequent, lower intensity, faster onset, longer time to meaningful pain relief, and less satisfaction with medication. Many patients were prescribed fentanyl preparations, which are normally reserved for patients receiving higher doses of opioids.
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Affiliation(s)
- Sebastiano Mercadante
- Main Regional Center for Pain Relief and Supportive/Palliative Care, La Maddalena Cancer CenterPalermoItaly
- Supportive/Palliative Care, MD Anderson Cancer CenterHoustonTexasUSA
| | | | - Francesco Masedu
- Department of Biotechnological and Applied Clinical Sciences, Section of Clinical Epidemiology and Environmental Medicine, University of L'AquilaL'AquilaItaly
| | - Teresa Scipioni
- Medical Oncology Department, Hospital “Giuseppe Mazzini”TeramoItaly
| | - Federica Aielli
- Medical Oncology Department, Hospital “Giuseppe Mazzini”TeramoItaly
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Irelli A, Sirufo MM, Scipioni T, Pietro FD, Pancotti A, Ginaldi L, De Martinis M. Denosumab in breast cancer patients receiving aromatase inhibitors: A single-center observational study of effectiveness in adjuvant setting. Indian J Cancer 2020; 58:136-139. [PMID: 33402577 DOI: 10.4103/ijc.ijc_16_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Azzurra Irelli
- Medical Oncology Unit, Department of Oncology, AUSL 04 Teramo, Italy
| | - Maria Maddalena Sirufo
- Allergy and Clinical Immunology Unit, Center for the Diagnosis and Treatment of Osteoporosis, AUSL 04 Teramo; Department of Life, Health and Environmental Sciences, University of L'Aquila, Italy
| | - Teresa Scipioni
- Medical Oncology Unit, Department of Oncology, AUSL 04 Teramo, Italy
| | - Francesca De Pietro
- Allergy and Clinical Immunology Unit, Center for the Diagnosis and Treatment of Osteoporosis, AUSL 04 Teramo; Department of Life, Health and Environmental Sciences, University of L'Aquila, Italy
| | - Amedeo Pancotti
- Allergy and Clinical Immunology Unit, Center for the Diagnosis and Treatment of Osteoporosis, AUSL 04 Teramo; Department of Life, Health and Environmental Sciences, University of L'Aquila, Italy
| | - Lia Ginaldi
- Allergy and Clinical Immunology Unit, Center for the Diagnosis and Treatment of Osteoporosis, AUSL 04 Teramo; Department of Life, Health and Environmental Sciences, University of L'Aquila, Italy
| | - Massimo De Martinis
- Allergy and Clinical Immunology Unit, Center for the Diagnosis and Treatment of Osteoporosis, AUSL 04 Teramo; Department of Life, Health and Environmental Sciences, University of L'Aquila, Italy
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Irelli A, Sirufo MM, Scipioni T, De Pietro F, Pancotti A, Ginaldi L, De Martinis M. mTOR Links Tumor Immunity and Bone Metabolism: What are the Clinical Implications? Int J Mol Sci 2019; 20:ijms20235841. [PMID: 31766386 PMCID: PMC6928935 DOI: 10.3390/ijms20235841] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 11/19/2019] [Accepted: 11/19/2019] [Indexed: 12/20/2022] Open
Abstract
Phosphoinositide 3-kinase (PI3K)/protein kinase B (AKT)/mammalian target of rapamycin (mTOR) plays a crucial role in the control of cellular growth, proliferation, survival, metabolism, angiogenesis, transcription, and translation. In most human cancers, alterations to this pathway are common and cause activation of other downstream signaling pathways linked with oncogenesis. The mTOR pathway modulates the interactions between the stroma and the tumor, thereby affecting both tumor immunity and angiogenesis. Inflammation is a hallmark of cancer, playing a central role in the tumor dynamics, and immune cells can exert antitumor functions or promote the growth of cancer cells. In this context, mTOR may regulate the activity of macrophages and T cells by regulating the expression of cytokines/chemokines, such as interleukin (IL)-10 and transforming growth factor (TGF-β), and/or membrane receptors, such as cytotoxic T-Lymphocyte protein 4 (CTLA-4) and Programmed Death 1 (PD-1). Furthermore, inhibitors of mammalian target of rapamycin are demonstrated to actively modulate osteoclastogenesis, exert antiapoptotic and pro-differentiative activities in osteoclasts, and reduce the number of lytic bone metastases, increasing bone mass in tumor-bearing mice. With regard to the many actions in which mTOR is involved, the aim of this review is to describe its role in the immune system and bone metabolism in an attempt to identify the best strategy for therapeutic opportunities in the metastatic phase of solid tumors.
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Affiliation(s)
- Azzurra Irelli
- Medical Oncology Unit, Department of Oncology, AUSL 04 Teramo, 64100 Teramo, Italy; (A.I.); (T.S.); (A.P.)
| | - Maria Maddalena Sirufo
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.M.S.); (F.D.P.); (L.G.)
- Allergy and Clinical Immunology Unit, Center for the diagnosis and treatment of Osteoporosis, AUSL 04 Teramo, 64100 Teramo, Italy
| | - Teresa Scipioni
- Medical Oncology Unit, Department of Oncology, AUSL 04 Teramo, 64100 Teramo, Italy; (A.I.); (T.S.); (A.P.)
| | - Francesca De Pietro
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.M.S.); (F.D.P.); (L.G.)
- Allergy and Clinical Immunology Unit, Center for the diagnosis and treatment of Osteoporosis, AUSL 04 Teramo, 64100 Teramo, Italy
| | - Amedeo Pancotti
- Medical Oncology Unit, Department of Oncology, AUSL 04 Teramo, 64100 Teramo, Italy; (A.I.); (T.S.); (A.P.)
| | - Lia Ginaldi
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.M.S.); (F.D.P.); (L.G.)
- Allergy and Clinical Immunology Unit, Center for the diagnosis and treatment of Osteoporosis, AUSL 04 Teramo, 64100 Teramo, Italy
| | - Massimo De Martinis
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.M.S.); (F.D.P.); (L.G.)
- Allergy and Clinical Immunology Unit, Center for the diagnosis and treatment of Osteoporosis, AUSL 04 Teramo, 64100 Teramo, Italy
- Correspondence: ; Tel.: +39-08-6142-9548; Fax: +39-08-6121-1395
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Pancotti A, Santomaggio A, Cianci G, Scipioni T, Martella F, Foglia R, Marchetti P. The DOC combination in advanced gastric cancer: Preliminary data of a phase II study. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.4_suppl.104] [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
104 Background: We describe activity of first line chemotherapy in advanced gastric carcinoma with docetaxel (DTX), oxaliplatin (OHP) and capecitabine (CAP). Methods: Patients (pts) were enrolled in the phase II study, if they had the main subsequent criteria: histologically confirmed diagnosis of advanced gastric cancer (AGC) (local advanced or metastatic disease); normal renal and hepatic function; no myocardial infarction or angina pectoris; no uncontrolled severe diseases or active infections. Treatment schedule: DTX at fixed dose of 65 mg/m2 on day 1, OHP at fixed dose of 110 mg/m2 on day 1, CAP at fixed dose of 1,600 mg/ m2 with crhonomodulation in trhee daily administration from day 1 to day 14, every 3 weeks. Dose-limiting toxicity (DLT): G3 non-haematological or G4 haematological. Study design: Simon two-stage phase II optimal design with power (1- b) 80%, error a 5%, error b 20%, P0 40%, P1 60%. Planned sample size: I stage 7/16, II stage 23/46. Primary endpoint was response rate (RR). Secondary endpoints were time to progression (TTP), overall survival (OS), toxicity and quality of life. Results: 38 pts were enrolled: 24 men and 14 women, median age of 58 years (range 50-67). Median number of cycles per pts was 4,5 (range 3-6). Total cycles administered: 41. Cumulative G3-4 toxicities were: neutropenia 21%, anemia 14%, asthenia 9%. G1-2 toxicities were: diarrhea 22%, neurotoxicity 18%. Median received-DI of DTX: 20 mg/mq/week (93% of recommended-DI), OHP 35 mg/mq/week (95%), CAP 7,000 mg/mq/week (94%) per patient, respectively. Overall pts were assessable (according to intent-to-treat analysis) with 58% (a0.05, CI + 29) of objective responses (OR): 7 partial responses, 4 stable disease and 1 progression. The disease control rate (DCR) was 91%. TTP and OS not done because median follow-up was of 8 months (2-15) only. Conclusions: The combination DOC is tolerable without G3-4 toxicity and preliminary data show very high activity. No significant financial relationships to disclose.
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Affiliation(s)
- A. Pancotti
- Medical Oncology, G. Mazzini Hospital, Teramo, Italy; S. Andrea Hospital, La Sapienza University, Rome, Italy
| | - A. Santomaggio
- Medical Oncology, G. Mazzini Hospital, Teramo, Italy; S. Andrea Hospital, La Sapienza University, Rome, Italy
| | - G. Cianci
- Medical Oncology, G. Mazzini Hospital, Teramo, Italy; S. Andrea Hospital, La Sapienza University, Rome, Italy
| | - T. Scipioni
- Medical Oncology, G. Mazzini Hospital, Teramo, Italy; S. Andrea Hospital, La Sapienza University, Rome, Italy
| | - F. Martella
- Medical Oncology, G. Mazzini Hospital, Teramo, Italy; S. Andrea Hospital, La Sapienza University, Rome, Italy
| | - R. Foglia
- Medical Oncology, G. Mazzini Hospital, Teramo, Italy; S. Andrea Hospital, La Sapienza University, Rome, Italy
| | - P. Marchetti
- Medical Oncology, G. Mazzini Hospital, Teramo, Italy; S. Andrea Hospital, La Sapienza University, Rome, Italy
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Martegani P, Silvestri M, Mascarello F, Scipioni T, Ghezzi C, Rota C, Cattaneo V. Morphometric Study of the Interproximal Unit in the Esthetic Region to Correlate Anatomic Variables Affecting the Aspect of Soft Tissue Embrasure Space. J Periodontol 2007; 78:2260-5. [PMID: 18052697 DOI: 10.1902/jop.2007.060517] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Limone P, Scipioni T, Calvelli P, Scaglione E, Barberis AM, Dentelli P, Isaia GC, Molinatti GM. Alpha-melanocyte-stimulating hormone antagonizes the inhibitory effect of corticotropin-releasing hormone on luteinizing hormone secretion during the luteal phase in normal women. J Clin Endocrinol Metab 1994; 79:571-5. [PMID: 8045978 DOI: 10.1210/jcem.79.2.8045978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
CRH inhibits the secretion of gonadotropins by activating endogenous opioids, whereas alpha MSH, which displays various behavioral and neuroendocrine effects contrary to those of the opioids, stimulates their release. To evaluate the possible interaction of CRH and alpha MSH, eight women in the luteal phase underwent the following tests: 1) ovine CRH infused at 100 micrograms/h for 3 h, 2) alpha MSH (2.5 mg as an iv bolus 60 min after the start of saline infusion), 3) CRH plus alpha MSH (injected 60 min after the start of CRH infusion), and 4) placebo. LH, FSH, PRL, ACTH, and cortisol were determined every 15 min for 180 min. CRH significantly (P < 0.001) reduced serum LH. alpha MSH alone significantly (P < 0.001) increased LH to a peak within 15-30 min (baseline, 3.3 +/- 0.7 mIU/mL; maximum increase, 3.5 +/- 0.9 mIU/mL) and induced an even greater rise when injected during the CRH infusion (baseline, 2.8 +/- 03 mIU/mL; maximum increase 7.5 +/- 1.6 mIU/mL; P < 0.05 vs. alpha MSH alone). FSH was always unaffected. ACTH and cortisol increased (P < 0.001) during the CRH infusion and fell significantly (P < 0.001) during the placebo infusion. alpha MSH had no effect on these changes. PRL fell during the placebo infusion (P < 0.001). No changes were induced by CRH or alpha MSH. In conclusion, alpha MSH antagonizes CRH inhibition of LH secretion. This finding lends support to the view that differential posttranslational processing of POMC contributes to the regulation of LH secretion. Further investigation is needed to clarify the mechanism of the antagonism between alpha MSH and CRH.
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Affiliation(s)
- P Limone
- Institute of Internal Medicine, University of Turin, Torino, Italy
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10
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Limone P, Scipioni T, Calvelli P, Scaglione E, Ambrogio C, Boeri E, Barberis AM, Molinatti GM. Preliminary results of an investigation on the possible interaction of alpha-MSH and CRH in the regulation of gonadotropin secretion. Ann N Y Acad Sci 1993; 680:561-3. [PMID: 8390193 DOI: 10.1111/j.1749-6632.1993.tb19739.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- P Limone
- Institute of Internal Medicine, University of Turin, Italy
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