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Gol M, Costa AM, Biagini G, Lucchi C. Seizure progression is slowed by enhancing neurosteroid availability in the brain of epileptic rats. Epilepsia 2024; 65:e41-e46. [PMID: 38243753 DOI: 10.1111/epi.17887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 01/04/2024] [Accepted: 01/05/2024] [Indexed: 01/21/2024]
Abstract
Trilostane is a 3β-hydroxysteroid dehydrogenase/Δ5-4 isomerase inhibitor able to produce a manyfold increase in brain levels of various neurosteroids, including allopregnanolone. We previously found that treatment with trilostane can slow down epileptogenesis in the kainic acid (KA) model of temporal lobe epilepsy. It is unknown whether trilostane may have a similar effect on the progression of epilepsy severity, as observed in KA-treated rats. Consequently, we investigated the effects of trilostane (50 mg/kg/day, 1 week) in epileptic rats, given 64 days after KA administration. Seizures were monitored by video-electrocorticographic recordings before and during the treatment with trilostane or vehicle (sesame oil), and neurosteroid levels were measured in serum and cerebral tissue using liquid chromatography-electrospray tandem mass spectrometry after treatment. Pregnenolone sulfate, pregnenolone, progesterone, 5α-dihydroprogesterone, and allopregnanolone peripheral levels were massively increased by trilostane. With the only exception of hippocampal pregnenolone sulfate, the other neurosteroids augmented in both the neocortex and hippocampus. Only pregnanolone levels were not upregulated by trilostane. As expected, a significant increase in the seizure occurrence was observed in rats receiving the vehicle, but not in the trilostane group. This suggests that the increased availability of neurosteroids produced a disease-modifying effect in the brain of epileptic rats.
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Affiliation(s)
- Mohammad Gol
- Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Anna Maria Costa
- Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Giuseppe Biagini
- Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy
| | - Chiara Lucchi
- Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
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García San José P, Pérez-Alenza MD, Alonso-Miguel D, González Sanz S, Arenas Bermejo C. Prevalence of Systemic Hypertension and Control of Systolic Blood Pressure in a Cohort of 14 Dogs with Adrenal-Dependent Hypercortisolism during the First Year of Trilostane Treatment or after Adrenalectomy. Animals (Basel) 2024; 14:511. [PMID: 38338154 PMCID: PMC10854962 DOI: 10.3390/ani14030511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 01/29/2024] [Accepted: 01/31/2024] [Indexed: 02/12/2024] Open
Abstract
Hypercortisolism in dogs is frequently associated with systemic hypertension (SH). However, there are no studies evaluating the changes in systolic blood pressure (SBP) in dogs with adrenal-dependent hypercortisolism (ADH) during trilostane treatment or after adrenalectomy and their response to antihypertensive treatments. For this reason, the objectives of this study were to evaluate the changes in SBP in dogs with ADH during the first year of trilostane treatment or after adrenalectomy, the relation with clinical control of hypercortisolism and certain laboratory parameters, and the response to antihypertensive drugs. Fourteen dogs newly diagnosed with ADH were prospectively included and evaluated at diagnosis (T0) and 1, 3, 6, and 12 months after (T1, T3, T6, and T12, respectively). Dogs were classified as hypertensive (HT; SBP ≥ 160 mmHg) and non-hypertensive. In HT dogs, benazepril was considered as the first-line drug, and, if necessary, amlodipine was prescribed. The prevalence of SH at T0 was 79%, and it was reduced to 25% at T12. Blood pressure (BP) was not associated with disease control or selected laboratory parameters at any endpoint. Only 22% of dogs with SH needed more than one drug to normalize their SBP. In all dogs surgically treated that were HT at T0, BP normalized at T3.
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Affiliation(s)
- Paula García San José
- Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, 28040 Madrid, Spain; (M.D.P.-A.); (D.A.-M.)
| | - María Dolores Pérez-Alenza
- Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, 28040 Madrid, Spain; (M.D.P.-A.); (D.A.-M.)
| | - Daniel Alonso-Miguel
- Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, 28040 Madrid, Spain; (M.D.P.-A.); (D.A.-M.)
| | | | - Carolina Arenas Bermejo
- AniCura Hospital Veterinario Valencia Sur, 46460 Valencia, Spain;
- VetCT Teleconsulting, Cambridge CB3 0FA, UK
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Wyatt S, Singer L, King J. Adrenocortical hemorrhage following intravenous tetracosactide in a dog with hypercortisolism. J Am Vet Med Assoc 2024; 262:1-4. [PMID: 37922711 DOI: 10.2460/javma.23.07.0391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 10/12/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVE To summarize findings from a case of adrenocortical hemorrhage following tetracosactide injection during ACTH stimulation testing for monitoring of trilostane therapy in a dog. ANIMAL A 12-year old neutered male dog with adrenal-dependent hypercortisolism. CLINICAL PRESENTATION, PROGRESSION, AND PROCEDURES 4 hours after ACTH stimulation testing, the patient developed vomiting, lethargy, and abdominal pain. Abdominal ultrasound was performed before and after an ACTH stimulation test. Following ACTH stimulation testing, there was progressive bilateral adrenal enlargement and free abdominal fluid had developed. This was considered to be caused by adrenocortical inflammation and hemorrhage secondary to the synthetic ACTH analog, tetracosactide, used during stimulation testing. A resting cortisol performed 5 hours after tetracosactide injection was not consistent with iatrogenic hypoadrenocorticism. TREATMENT AND OUTCOME The patient was managed with analgesia, IV fluids, and corticosteroids and made a full recovery. CLINICAL RELEVANCE To the authors' knowledge, this was the first reported case of adrenocortical hemorrhage following administration of a synthetic ACTH analog in a dog. This should be considered as a rare potential complication of ACTH stimulation testing.
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Affiliation(s)
- Sophia Wyatt
- 1Veterinary Specialist Services, Jindalee, QLD, Australia
| | - Lisa Singer
- 2Veterinary Specialist Services, Carrara, QLD, Australia
| | - Joshua King
- 1Veterinary Specialist Services, Jindalee, QLD, Australia
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Park SW, Kim K, Kim OK, Ro WB, Lee CM. Case report: Successful medical management of adrenocortical carcinoma with metastasis in a Maltese dog. Front Vet Sci 2023; 10:1142418. [PMID: 37519993 PMCID: PMC10378588 DOI: 10.3389/fvets.2023.1142418] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 06/29/2023] [Indexed: 08/01/2023] Open
Abstract
Introduction Adrenocortical carcinoma (ACC) with metastasis has a grave prognosis, and adrenalectomy is associated with a high perioperative mortality rate in dogs. A favorable outcome following trilostane treatment in patients with metastatic ACC confirmed by a decreased size of the adrenal tumor and metastatic lesions has not been reported in dogs. Case description A 12-year-old neutered male Maltese dog was diagnosed with a right adrenal tumor and a hepatic mass. Adrenal-dependent hyperadrenocorticism (ADH) was diagnosed based on clinical signs and an adrenocorticotropic hormone stimulation test (ACTHST). In addition, tests for plasma metanephrine and normetanephrine ruled out a pheochromocytoma. Based on cytology and computed tomography, unresectable metastatic ACC was confirmed. The dog was managed with trilostane due to the presence of distant metastasis. Medical management improved the clinical signs and post-ACTHST cortisol concentrations. One year after the first presentation, the clinical signs and ACTHST test showed a favorable outcome. In addition, computed tomography revealed a decreased size of the right adrenal tumor and resolution of the hepatic mass. Conclusions Trilostane could be considered as a treatment option for unresectable metastatic ACC. A decrease in tumor size following treatment with trilostane has not been reported in dogs. This case report is the first to demonstrate a favorable outcome of metastatic ACC following trilostane mono therapy for >1 year.
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Affiliation(s)
- Sin-Wook Park
- Department of Veterinary Internal Medicine, College of Veterinary Medicine and BK21 FOUR Program for Creative Veterinary Science Research Center, Chonnam National University, Gwangju, South Korea
| | - Keon Kim
- Department of Veterinary Internal Medicine, College of Veterinary Medicine and BK21 FOUR Program for Creative Veterinary Science Research Center, Chonnam National University, Gwangju, South Korea
| | - Ock-Kyu Kim
- Department of Veterinary Internal Medicine, College of Veterinary Medicine and BK21 FOUR Program for Creative Veterinary Science Research Center, Chonnam National University, Gwangju, South Korea
| | - Woong-Bin Ro
- Cat Vet Animal Hospital, Seongnam-si, Gyeonggi-do, South Korea
| | - Chang-Min Lee
- Department of Veterinary Internal Medicine, College of Veterinary Medicine and BK21 FOUR Program for Creative Veterinary Science Research Center, Chonnam National University, Gwangju, South Korea
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Costa AM, Gol M, Lucchi C, Biagini G. Antiepileptogenic effects of trilostane in the kainic acid model of temporal lobe epilepsy. Epilepsia 2023; 64:1376-1389. [PMID: 36861666 DOI: 10.1111/epi.17561] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 02/20/2023] [Accepted: 02/27/2023] [Indexed: 03/03/2023]
Abstract
OBJECTIVE Epileptogenesis after status epilepticus (SE) has a faster onset in rats treated to reduce brain levels of the anticonvulsant neurosteroid allopregnanolone with the 5α-reductase inhibitor finasteride; however, it still has to be evaluated whether treatments aimed at increasing allopregnanolone levels could result in the opposite effect of delaying epileptogenesis. This possibility could be tested using the peripherally active inhibitor of 3β-hydroxysteroid dehydrogenase/Δ5-4 isomerase trilostane, which has been shown repeatedly to increase allopregnanolone levels in the brain. METHODS Trilostane (50 mg/kg) was administered subcutaneously once daily for up to six consecutive days, starting 10 min after intraperitoneal administration of kainic acid (15 mg/kg). Seizures were evaluated by video-electrocorticographic recordings for 70 days maximum, and endogenous neurosteroid levels were assessed by liquid chromatography-electrospray tandem mass spectrometry. Immunohistochemical staining was performed to evaluate the presence of brain lesions. RESULTS Trilostane did not alter the latency of kainic acid-induced SE onset or its overall duration. When compared to the vehicle-treated group, rats receiving six daily trilostane injections presented a remarkable delay of the first spontaneous electrocorticographic seizure and subsequent tonic-clonic spontaneous recurrent seizures (SRSs). Conversely, rats treated with only the first trilostane injection during SE did not differ from vehicle-treated rats in developing the SRSs. Notably, trilostane did not modify neuronal cell densities or the overall damage in the hippocampus. In comparison to the vehicle group, repeated administration of trilostane significantly decreased the activated microglia morphology in the subiculum. As expected, allopregnanolone and other neurosteroid levels were remarkably increased in the hippocampus and neocortex of rats treated for 6 days with trilostane, but pregnanolone was barely detectable. Neurosteroids returned to basal levels after a week of trilostane washout. SIGNIFICANCE Overall, these results suggest that trilostane led to a remarkable increase in allopregnanolone brain levels, which was associated with protracted effects on epileptogenesis.
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Affiliation(s)
- Anna Maria Costa
- Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Mohammad Gol
- Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,PhD School of Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Chiara Lucchi
- Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Giuseppe Biagini
- Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy
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Abstract
PRACTICAL RELEVANCE Diabetes mellitus (DM) is a common feline endocrinopathy, and is often driven by underlying insulin resistance with associated pancreatic beta (β)-cell dysfunction. Although spontaneous hyperadrenocorticism (HAC) with hypercortisolemia (hypercortisolism) is relatively uncommon in cats, it is a well-established cause of insulin resistance and is routinely associated with DM in this species. CLINICAL CHALLENGES Many of the clinical signs associated with feline HAC are subtle and may be attributed to concurrent DM or the aging process. Failure to recognize HAC in the diabetic cat can impact patient wellbeing and predispose the patient to progressive compromise. Unfortunately, it can be difficult to establish a diagnosis of HAC, as test results may be influenced by poor diabetic regulation, and protocols are different to those used in canine patients. Treatment options depend on the underlying cause, and often require careful, ongoing assessment and modulation of both adrenal function and insulin requirements. However, various approaches have been shown to either improve glycemic control in cats with sustained insulin dependence, or facilitate diabetic remission. EVIDENCE BASE This review summarizes the current literature on feline HAC, with a particular focus on cats with concurrent DM. The clinical findings that suggest HAC are discussed, along with an outline of diagnostic options and their limitations. Published outcomes for various medical options, surgical procedures and radiation therapy are provided. The authors also share their thoughts on the safe and effective management of cats with HAC and DM, with an emphasis on the anticipation and recognition of changing insulin requirements.
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Affiliation(s)
- Audrey K Cook
- BVM&S, MSc Vet Ed, MRCVS, Dip ACVIM-SAIM, Dip ECVIM-CA, Dip ABVP (Feline)
| | - Jeremy B Evans
- DVM, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
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Schofield I, O'Neill DG, Brodbelt DC, Church DB, Geddes RF, Niessen SJM. Development and evaluation of a health-related quality-of-life tool for dogs with Cushing's syndrome. J Vet Intern Med 2019; 33:2595-2604. [PMID: 31660657 PMCID: PMC6872869 DOI: 10.1111/jvim.15639] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 09/26/2019] [Indexed: 12/17/2022] Open
Abstract
Background Clinical signs and consequences of Cushing's syndrome are likely to impact upon a dog's life. Quantification of this impact on a dog's health‐related quality‐of‐life (HRQoL) could contribute to optimized disease management. Hypothesis/objectives To develop a novel HRQoL tool to aid assessment of dogs with Cushing's syndrome and to evaluate factors that impact upon dogs living with this disease. Animals Two hundred and ten dogs with Cushing's syndrome and 617 dogs without Cushing's syndrome. Methods Cross‐sectional study design. Dog owners answered questions relating to the HRQoL of their dogs which were refined to develop the final tool. The tool was analyzed for reliability, validity, and interpretability, including Cronbach's alpha and principal components analysis. Factors impacting upon the HRQoL of dogs with Cushing's syndrome were assessed using appropriate nonparametric tests. Results The tool was refined from 32 questions to 19 and showed good internal consistency (α = .83). Owners rated questions related to “owner impact” as more important and those related to demeanor as less important. There was a positive correlation between the tool score of dogs with Cushing's syndrome and owner's assessment of their dog's quality‐of‐life (r = .41, P < .001). Dogs currently on treatment with trilostane had a statistically better HRQoL (.33, interquartile range [IQR] .23–.44) than those not receiving trilostane (.36, IQR .33–.54, P = .04). Conclusions and Clinical Importance The developed tool quantifies the HRQoL of dogs with Cushing's syndrome and could assist clinicians in the clinical assessment of dogs with Cushing's syndrome.
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Affiliation(s)
- Imogen Schofield
- Pathobiology and Population Science, The Royal Veterinary College, Hatfield, United Kingdom
| | - Dan G O'Neill
- Pathobiology and Population Science, The Royal Veterinary College, Hatfield, United Kingdom
| | - Dave C Brodbelt
- Pathobiology and Population Science, The Royal Veterinary College, Hatfield, United Kingdom
| | - David B Church
- Clinical Sciences and Services, The Royal Veterinary College, Hatfield, United Kingdom
| | - Rebecca F Geddes
- Clinical Sciences and Services, The Royal Veterinary College, Hatfield, United Kingdom
| | - Stijn J M Niessen
- Clinical Sciences and Services, The Royal Veterinary College, Hatfield, United Kingdom.,The VetCT Telemedicine Hospital, St John's Innovation Centre, Cambridge, United Kingdom
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Chistyakov DV, Azbukina NV, Astakhova AA, Goriainov SV, Chistyakov VV, Sergeeva MG. Sex-Mediated Differences in LPS Induced Alterations of TNFα, IL-10 Expression, and Prostaglandin Synthesis in Primary Astrocytes. Int J Mol Sci 2018; 19:ijms19092793. [PMID: 30227622 PMCID: PMC6164227 DOI: 10.3390/ijms19092793] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [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: 08/27/2018] [Revised: 09/12/2018] [Accepted: 09/14/2018] [Indexed: 01/14/2023] Open
Abstract
Although many neurological and psychiatric disorders reveal clear sex-dependent variations, the molecular mechanism of this process is not clear enough. Astrocytes are involved in the response of neural tissue to injury and inflammation, produce steroid hormones, and sense steroid presence. To explore the hypothesis that astrocytes may participate in sex-mediated differences of inflammatory responses, we have examined whether male and female primary rat astrocytes show different responses to lipopolysaccharide (LPS) as a toll-like receptor 4 (TLR4) agonist. Levels of mRNA and proteins of tumor necrosis factor alpha (TNFα), interleukin-10 (IL-10), and cyclooxygenase (COX)-2 were assessed using qPCR, immunoblotting, and ELISA. UPLC-MS/MS was used to detect prostaglandins (PGs). LPS stimulation resulted in different levels of cytokine production; more TNFα and less IL-10 were produced in female cells compared with male astrocytes. Although the levels of the COX-2 expression were not altered, LPS significantly induced the synthesis of PGs with notable sex-related differences. PGE2 and PGD2 were less and 6-keto-PGF1α was more upregulated in female astrocytes, and TXB2 had similar levels in cells obtained from males and females. Trilostane, an inhibitor of 3β-Hydroxysteroid dehydrogenase (3β-HSD), inhibited the LPS-induced TNFα production and the release of PGE2, PGD2, and 6-keto-PGF1α in female astrocytes. Thus, male and female astrocytes differentially respond to inflammatory challenges on the level of production of cytokines and steroid hormones. Sex-mediated differences in pro- and anti-inflammatory responses should be taken into consideration for the effective treatment of disorders with neuroinflammation.
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Affiliation(s)
- Dmitry V Chistyakov
- Belozersky Institute of Physico-Chemical Biology, Moscow State University, Moscow 119992, Russia.
- Laboratory of electrophysiology, Pirogov Russian National Research Medical University, Moscow 117997, Russia.
| | - Nadezda V Azbukina
- Faculty of Bioengineering and Bioinformatics, Moscow Lomonosov State University, Moscow 119234, Russia.
| | - Alina A Astakhova
- Belozersky Institute of Physico-Chemical Biology, Moscow State University, Moscow 119992, Russia.
| | - Sergei V Goriainov
- SREC PFUR, Peoples' Friendship University of Russia (RUDN University), Moscow 117198, Russia.
| | - Viktor V Chistyakov
- SREC PFUR, Peoples' Friendship University of Russia (RUDN University), Moscow 117198, Russia.
| | - Marina G Sergeeva
- Belozersky Institute of Physico-Chemical Biology, Moscow State University, Moscow 119992, Russia.
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Hoffrogge S, Fels L, Schmicke M, Mischke R. [Atypical Cushing's syndrome in a dog. A case report]. Tierarztl Prax Ausg K Kleintiere Heimtiere 2017; 45:186-192. [PMID: 28447709 DOI: 10.15654/tpk-160255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2016] [Accepted: 09/27/2016] [Indexed: 06/07/2023]
Abstract
In a 12-year-old male Labrador Retriever, presented due to other disease symptoms, clinical signs of hyperadrenocorticism (polyuria, polydipsia, abdominal distention, muscle atrophy) were an incidental finding. Abnormal laboratory results and sonographic findings of the adrenal glands, but negative low-dose dexamethasone suppression tests with low basal cortisol concentrations, a negative andrenocorticotropic hormone (ACTH)-stimulation test and exclusion of iatrogenic hyperadrenocorticism, suggested an atypical hyperadrenocorticism (AHAC). Results of further examinations, particularly stimulation of progesterone production by ACTH (0 h value: 0.21 ng/ml; 1 h value: 4.9 ng/ml) and good response to therapy with trilostane, supported this diagnosis. However, it has to be critically considered, whether and to what extent additionally present diseases (arthroses, testicular tumour) played a role regarding the symptoms and laboratory results in this dog. This case illustrates the difficulties with the diagnosis of AHAC.
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Affiliation(s)
| | | | | | - Reinhard Mischke
- Prof. Dr. Reinhard Mischke, Klinik für Kleintiere, Stiftung Tierärztliche Hochschule Hannover, Bünteweg 9, 30559 Hannover, E-Mail:
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Tung D, Ciallella J, Hain H, Cheung PH, Saha S. Possible therapeutic effect of trilostane in rodent models of inflammation and nociception. Curr Ther Res Clin Exp 2014; 75:71-6. [PMID: 24465047 PMCID: PMC3898193 DOI: 10.1016/j.curtheres.2013.09.004] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/26/2013] [Indexed: 11/25/2022]
Abstract
Background Trilostane was identified in an in vivo screen of compounds in a lipopolysaccharide model of inflammation to support a repurposing effort. There is no previous documentation of any anti-inflammatory effects of trilostane. Objective The aim of this study was to elucidate the novel pharmacologic activity of trilostane in a series of inflammation and nociception signal-finding models. Methods Anti-inflammatory effects of trilostane were evaluated in lipopolysaccharide-induced systemic and lung inflammation models and in a 2,4-dinitrofluorobenzene–induced delayed-type hypersensitivity (DTH) model in the mouse ear. The analgesic activities of trilostane were evaluated in a hot plate nociception model as a function of paw-withdrawal latency and in the formalin-induced nociception model with a behavioral end point. In all studies, trilostane was administered 15 minutes before challenge. In the DTH model, the animals were given a second dose 24 hours after the first dose. Results Trilostane inhibited tumor necrosis factor-α and monocyte chemoattractant protein-1 production in the lipopolysaccharide-induced systemic and pulmonary inflammation models. It also significantly reduced ear swelling in the 2,4-dinitrofluorobenzene–induced DTH model. In the hot plate nociception model, trilostane increased the latency of paw-licking behavior. Trilostane also significantly reduced the duration of pain behaviors in the late phase of the formalin-induced inflammatory pain model. Conclusions These signal-finding studies suggest that trilostane has novel anti-inflammatory and analgesic properties.
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Affiliation(s)
- David Tung
- BioMed Valley Discoveries, Kansas City, Missouri
| | | | | | | | - Saurabh Saha
- BioMed Valley Discoveries, Kansas City, Missouri
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Braun C, Boretti FS, Reusch CE, Sieber-Ruckstuhl NS. Comparison of two treatment regimens with trilostane in dogs with pituitary-dependent hyperadrenocorticism. SCHWEIZ ARCH TIERH 2013; 155:551-8. [PMID: 24091230 DOI: 10.1024/0036-7281/a000511] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 11/19/2022]
Abstract
Trilostane is used to treat dogs with pituitary-dependent hyperadrenocorticism (PDH). In our institution, it was initially dosed based on bodyweight (BW) categories, since April 06 it is dosed per kg BW. Our objectives were to compare effectiveness, number of dose adjustments and side effects of the two dose regimens in dogs with PDH. Dogs of group 1 (28 dogs) received trilostane based on BW categories (< 5 kg, 30 mg; 5 - 20 kg, 60 mg and > 20 kg, 120 mg; SID); dogs of group 2 (20 dogs) received 2 - 5 mg/kg SID. Treatment goal was a post-ACTH cortisol of 1 - 2.5 and 1.5 - 5.4 µg/dl in group 1 and 2, respectively. Starting doses were significantly higher in group 1 and stayed higher until re-check at 4 - 7 months. Baseline and post-ACTH cortisol were significantly decreased compared to pre-treatment at all time points in both groups. Significantly more dogs of group 2 (5/20) needed a dose increase at the first re-check and significantly more dogs of group 1 (10/23) a dose reduction at the last re-check. Intermittent discontinuation was necessary in 25 and 10 % of dogs of group 1 and 2, respectively. We conclude that dosing per kg BW results in comparable clinical improvement, decrease in cortisol, but lower risk of side effects.
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Affiliation(s)
- C Braun
- Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Switzerland
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