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Yamaguchi A. Evaluation of fish pituitary spheroids to study annual endocrine reproductive control. Gen Comp Endocrinol 2024; 351:114481. [PMID: 38408711 DOI: 10.1016/j.ygcen.2024.114481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 02/06/2024] [Accepted: 02/23/2024] [Indexed: 02/28/2024]
Abstract
The pituitary gland is a small endocrine gland located below the hypothalamus. This gland releases several important hormones and controls the function of many other endocrine system glands to release hormones. Fish pituitary hormonal cells are controlled by neuroendocrine and sex steroid feedback. To study the complex pituitary function in vivo, we established an in vitro pituitary spheroid assay and evaluated its suitability for monitoring the annual reproductive physiological conditions in Takifugu rubripes, also known as torafugu, is one of the most economically important species distributed in the northwestern part of the Pacific Ocean, in the western part of the East China Sea, and in more northern areas near Hokkaido, Japan. Fish pituitary spheroids can be easily constructed in liquid or solid plates. The culture medium (L-15) made the aggregation faster than MEM (Hank's). A Rho-kinase inhibitor (Y-27632, 10 μM) and/or fish serum (2.5 %) also promoted spheroid formation. Laser confocal microscopy analysis of spheroids cultured with annual serum of both sexes revealed that luteinizing hormone (LH) synthesis has the highest peak in the final maturation stage (3 years old, May) in accordance with the highest serum sex steroid levels; in contrast, follicle stimulating hormone (FSH) synthesis has no correlation with the dose of serum or nutrients. Similarly, 3D cell propagation assays using female serum showed that total pituitary cells displayed the highest proliferation at puberty onset (2 years old, October) before half a year of the spawning season. These results indicate that pituitary spheroids are useful in vitro models for monitoring the reproductive physiological status of fish in vivo and may be applicable to the in vitro screening of environmental chemicals and bioactive compounds affecting reproductive efficiency in aquaculture.
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Affiliation(s)
- Akihiko Yamaguchi
- Laboratory of Marine Biology, Department of Bioresource Sciences, Faculty of Agriculture, Kyushu University, Fukuoka 819-0395, Japan.
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2
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Korbonits M, Blair JC, Boguslawska A, Ayuk J, Davies JH, Druce MR, Evanson J, Flanagan D, Glynn N, Higham CE, Jacques TS, Sinha S, Simmons I, Thorp N, Swords FM, Storr HL, Spoudeas HA. Consensus guideline for the diagnosis and management of pituitary adenomas in childhood and adolescence: Part 1, general recommendations. Nat Rev Endocrinol 2024; 20:278-289. [PMID: 38336897 DOI: 10.1038/s41574-023-00948-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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] [Accepted: 12/19/2023] [Indexed: 02/12/2024]
Abstract
Tumours of the anterior part of the pituitary gland represent just 1% of all childhood (aged <15 years) intracranial neoplasms, yet they can confer high morbidity and little evidence and guidance is in place for their management. Between 2014 and 2022, a multidisciplinary expert group systematically developed the first comprehensive clinical practice consensus guideline for children and young people under the age 19 years (hereafter referred to as CYP) presenting with a suspected pituitary adenoma to inform specialist care and improve health outcomes. Through robust literature searches and a Delphi consensus exercise with an international Delphi consensus panel of experts, the available scientific evidence and expert opinions were consolidated into 74 recommendations. Part 1 of this consensus guideline includes 17 pragmatic management recommendations related to clinical care, neuroimaging, visual assessment, histopathology, genetics, pituitary surgery and radiotherapy. While in many aspects the care for CYP is similar to that of adults, key differences exist, particularly in aetiology and presentation. CYP with suspected pituitary adenomas require careful clinical examination, appropriate hormonal work-up, dedicated pituitary imaging and visual assessment. Consideration should be given to the potential for syndromic disease and genetic assessment. Multidisciplinary discussion at both the local and national levels can be key for management. Surgery should be performed in specialist centres. The collection of outcome data on novel modalities of medical treatment, surgical intervention and radiotherapy is essential for optimal future treatment.
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Affiliation(s)
- Márta Korbonits
- Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
| | | | - Anna Boguslawska
- Department of Endocrinology, Jagiellonian University Medical College, Krakow, Poland
| | - John Ayuk
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Justin H Davies
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Maralyn R Druce
- Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Jane Evanson
- Neuroradiology, Barts Health NHS Trust, London, UK
| | | | - Nigel Glynn
- Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | | | - Thomas S Jacques
- Great Ormond Street Institute of Child Health, University College London, London, UK
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Saurabh Sinha
- Sheffield Children's and Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Ian Simmons
- The Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Nicky Thorp
- The Christie NHS Foundation Trust, Manchester, UK
| | | | - Helen L Storr
- Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Helen A Spoudeas
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
- University College London Hospitals NHS Foundation Trust, London, UK
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Stewart PM. Clinical Practice and Nomenclature of Pituitary Neoplasms: Common Sense Must Prevail. J Clin Endocrinol Metab 2024; 109:e1408-e1409. [PMID: 37758512 DOI: 10.1210/clinem/dgad567] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 09/20/2023] [Accepted: 09/22/2023] [Indexed: 10/03/2023]
Affiliation(s)
- Paul M Stewart
- Faculty of Medicine & Health, University of Leeds, Leeds LS2 3AA, UK
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Carreira A, Muna S, Grossman AB, Korbonits M. Beware of epistaxis: fatal pseudoaneurysm rupture 30 years after treatment of acromegaly. BMJ Case Rep 2024; 17:e258533. [PMID: 38642934 PMCID: PMC11033645 DOI: 10.1136/bcr-2023-258533] [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] [Indexed: 04/22/2024] Open
Abstract
We present a fatal complication of treatment in a patient with early-onset acromegaly, treated with two transsphenoidal operations, radiotherapy, radiosurgery and pegvisomant. He was diagnosed in his 30s, and controlled from his 40s, with stable residual tumour within the left cavernous sinus. In his 60s, 30 years after surgery/radiotherapy and 14 years after radiosurgery, he developed recurrent episodes of mild epistaxis. A week later, he presented at his local hospital's emergency department with severe epistaxis and altered consciousness. He was diagnosed with a ruptured internal carotid artery (ICA) pseudoaneurysm, but unfortunately died before treatment could be attempted.ICA pseudoaneurysms are rare complications of surgery or radiotherapy and can present with several years of delay, often with epistaxis. This case highlights the importance of life-long monitoring in patients with previous pituitary interventions and early recognition of epistaxis as a herald sign of a potentially catastrophic event, thus leading to timely treatment.
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Affiliation(s)
- Ana Carreira
- Department of Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- Department of Endocrinology, Diabetes and Metabolism, Hospitais da Universidade de Coimbra, Unidade Local de Saúde de Coimbra, Coimbra, Portugal
| | - Solomon Muna
- Department of Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Ashley B Grossman
- Department of Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Márta Korbonits
- Department of Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Alameri M, Alnuaimi A, Martin NM, Meeran K, Gontsarova A, Barwick TD, Ellis S, McAdoo S, Tomlinson J, Wernig F. Pituitary hypophysitis in granulomatosis with polyangiitis (GPA): a case series. Pituitary 2024; 27:230-237. [PMID: 38296897 PMCID: PMC11009729 DOI: 10.1007/s11102-023-01378-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/24/2023] [Indexed: 02/02/2024]
Abstract
Granulomatosis with polyangiitis (GPA) rarely involves the pituitary gland. Pituitary involvement has been reported in ~ 1% of all cases of GPA. Most commonly, pituitary swelling and inflammation results in symptoms due to pituitary mass effect and arginine vasopressin deficiency. To date, there are no pituitary-specific treatment guidelines for this rare condition. We present three patients with GPA-related hypophysitis highlighting the spectrum of pituitary involvement. All three patients were successfully treated with immunosuppressive regimens that included rituximab (RTX). Following remission induction with high-dose glucocorticoids, patients received 6 monthly RTX for remission maintenance. RTX was well tolerated without significant side effects.
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Affiliation(s)
- Majid Alameri
- Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
| | - Abdulla Alnuaimi
- Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
| | - Niamh M Martin
- Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
| | - Karim Meeran
- Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
| | | | - Tara D Barwick
- Department of Radiology, Imperial College Healthcare NHS Trust, London, UK
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Spencer Ellis
- Department of Rheumatology, East and North Hertfordshire NHS Trust, Stevenage, UK
| | - Stephen McAdoo
- Department of Renal Medicine, Imperial College Healthcare NHS Trust, London, UK
- Department of Immunology & Inflammation, Imperial College London, London, UK
| | - James Tomlinson
- Department of Renal Medicine, Imperial College Healthcare NHS Trust, London, UK
| | - Florian Wernig
- Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK.
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Cheung L, Davis SW, Perez-Millan MI. Editorial: New advances on hypothalamus-pituitary stem cell biology. Front Endocrinol (Lausanne) 2024; 15:1392076. [PMID: 38529397 PMCID: PMC10961418 DOI: 10.3389/fendo.2024.1392076] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 02/28/2024] [Indexed: 03/27/2024] Open
Affiliation(s)
- Leonard Cheung
- Department of Physiology & Biophysics, Stony Brook University, Stony Brook, NY, United States
| | - Shannon W. Davis
- Department of Biological Sciences, University of South Carolina, Columbia, SC, United States
| | - Maria Ines Perez-Millan
- Instituto de Biociencias, Biotecnología y Biología Traslacional (iB3), Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Buenos Aires, Argentina
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Miao DZ, Liu C, Deng ZY, Zhang C, Guo ZY, Li WQ, Wang Y, Yang HM, Wang ZY. Characterization of reproductive hormones and related gene expression in the hypothalamus and pituitary gland in the egg-laying interval in White King pigeon. Poult Sci 2024; 103:103422. [PMID: 38228063 PMCID: PMC10823133 DOI: 10.1016/j.psj.2024.103422] [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: 11/05/2023] [Revised: 12/22/2023] [Accepted: 01/01/2024] [Indexed: 01/18/2024] Open
Abstract
The egg-laying interval (LI) directly reflects the laying performance of breeding pigeons, influenced by reproductive hormones. This study aimed to assess reproductive hormone levels in serum and the expression of related genes and their receptors in the hypothalamus and pituitary gland in 4 stages: first (LI1), third (LI3), fifth (LI5), and seventh (LI7) days. The results showed that serum gonadotropin-releasing hormone (GnRH) level decreased from LI1 to LI7 (P < 0.01) and peaked in LI1. The serum follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels stayed at high levels from LI1 to LI5. The FSH level decreased slightly from LI5 to LI7 (P > 0.05), but the LH level decreased rapidly (P < 0.01). The prolactin (PRL) levels significantly increased in LI5 (P < 0.01) compared with LI1 and then stayed at a high level. The GnRH1 expression in the hypothalamus had no significant change in LI (P > 0.05). However, the GnRHR first decreased from LI1 to LI3 (P < 0.05) and then increased. The FSH mRNA level in the pituitary gland decreased from LI1 to LI3 and slightly increased in LI5 (P > 0.05). The change pattern of FSHR was similar to that of FSH and peaked in LI5 (P < 0.05). The LH expression level was the highest in LI5 and significantly higher than that in LI3 and LI7 (P < 0.05). However, the LHR mRNA level decreased in LI (P < 0.05). The expression patterns of PRL and PRLR were similar; they were upregulated in LI and peaked in LI7 (P < 0.01). The expression pattern of GnRHR was similar to that of FSH, LH, and FSHR, suggesting the critical role of GnRHR in LI. Furthermore, the expression levels of these genes peaked in LI5, closely correlating with the maturation of the first largest follicle in pigeons. PRL-PRLR signaling inhibited GnRH activity to promote ovulation. This study provided a basis for further investigating the molecular mechanisms underlying the regulation of reproduction in pigeons.
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Affiliation(s)
- D Z Miao
- College of Animal Science and Technology, Yangzhou University, Yangzhou, Jiangsu Province 225009, PR China
| | - C Liu
- College of Animal Science and Technology, Yangzhou University, Yangzhou, Jiangsu Province 225009, PR China
| | - Z Y Deng
- College of Animal Science and Technology, Yangzhou University, Yangzhou, Jiangsu Province 225009, PR China
| | - C Zhang
- College of Animal Science and Technology, Yangzhou University, Yangzhou, Jiangsu Province 225009, PR China
| | - Z Y Guo
- College of Animal Science and Technology, Yangzhou University, Yangzhou, Jiangsu Province 225009, PR China
| | - W Q Li
- College of Animal Science and Technology, Yangzhou University, Yangzhou, Jiangsu Province 225009, PR China
| | - Y Wang
- College of Animal Science and Technology, Yangzhou University, Yangzhou, Jiangsu Province 225009, PR China.
| | - H M Yang
- College of Animal Science and Technology, Yangzhou University, Yangzhou, Jiangsu Province 225009, PR China
| | - Z Y Wang
- College of Animal Science and Technology, Yangzhou University, Yangzhou, Jiangsu Province 225009, PR China
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8
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Ravichandran R, Saikia UK, Bhuyan AK, Baro A. Pituitary Stalk Interruption Syndrome: Analysis of Response to Growth Hormone Therapy. Indian Pediatr 2024; 61:154-157. [PMID: 38321728] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
OBJECTIVE To analyse the clinical and radiological characteristics of pituitary stalk interruption syndrome (PSIS). METHODS A retrospective analysis of confirmed cases of PSIS was performed. The development of new pituitary hormonal deficiencies and response to recombinant human growth hormone (rhGH) therapy were assessed during follow-up. RESULTS This study included 14 children (10 boys) of PSIS with median (range) age of 12.15 years (2 months - 18 years). Short stature was the most common presentation (n = 13), and micropenis (n = 4), cleft lip (n = 1) and single central incisor (n = 1) were other midline defects. Growth hormone (GH) deficiency was present in 14 children and 7 of them also had multiple pituitary hormone deficiencies at baseline. Central hypothyroidism (n = 5), secondary adrenal deficiency (n = 4) and gonadotropin deficiencies (n = 2) were also seen. All children received rhGH. The mean height gain on follow-up was 12.78 cm in first year (n = 14), 6.5 cm in second year (n = 8) and 4.07 cm in third year (n = 7) of rhGH therapy. Four children developed additional pituitary hormone deficiency on follow-up. CONCLUSION Short stature with isolated GH deficiency was the most common presentation of PSIS that showed good response to rhGH therapy.
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Affiliation(s)
| | - Uma K Saikia
- Department of Endocrinology, Gauhati Medical College, Guwahati, Assam, India
| | - Ashok K Bhuyan
- Department of Endocrinology, Gauhati Medical College, Guwahati, Assam, India
| | - Abhamoni Baro
- Department of Endocrinology, Gauhati Medical College, Guwahati, Assam, India. Correspondence to: Dr. Abhamoni Baro, Assistant Professor, Department of Endocrinology, Gauhati Medical College, Guwahati, Assam, India.
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Taieb A, Nassim BHS, Asma G, Jabeur M, Ghada S, Asma BA. The Growing Understanding of the Pituitary Implication in the Pathogenesis of Long COVID-19 Syndrome: A Narrative Review. Adv Respir Med 2024; 92:96-109. [PMID: 38392036 PMCID: PMC10886368 DOI: 10.3390/arm92010013] [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: 12/22/2023] [Revised: 02/01/2024] [Accepted: 02/06/2024] [Indexed: 02/24/2024]
Abstract
Long COVID-19, also known as post-acute sequelae of SARS-CoV-2 infection, is a condition where individuals who have recovered from the acute phase of COVID-19 continue to experience a range of symptoms for weeks or even months afterward. While it was initially thought to primarily affect the respiratory system, it has become clear that Long COVID-19 can involve various organs and systems, including the endocrine system, which includes the pituitary gland. In the context of Long COVID-19, there is a growing understanding of the potential implications for the pituitary gland. The virus can directly affect the pituitary gland, leading to abnormalities in hormone production and regulation. This can result in symptoms such as fatigue, changes in appetite, and mood disturbances. Long COVID-19, the persistent and often debilitating condition following acute COVID-19 infection, may be explained by deficiencies in ACTH and Growth hormone production from the pituitary gland. Corticotropin insufficiency can result in the dysregulation of the body's stress response and can lead to prolonged feelings of stress, fatigue, and mood disturbances in Long COVID-19 patients. Simultaneously, somatotropin insufficiency can affect growth, muscle function, and energy metabolism, potentially causing symptoms such as muscle weakness, exercise intolerance, and changes in body composition. Recently, some authors have suggested the involvement of the pituitary gland in Post COVID-19 Syndrome. The exact mechanisms of viral action on infected cells remain under discussion, but inflammatory and autoimmune mechanisms are primarily implicated. The aim of our study will be to review the main pituitary complications following COVID-19 infection. Moreover, we will explain the possible involvement of the pituitary gland in the persistence of Post COVID-19 Syndrome.
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Affiliation(s)
- Ach Taieb
- Department of Endocrinology, University Hospital of Farhat Hached Sousse, Sousse 4000, Tunisia; (B.H.S.N.); (G.A.); (S.G.); (B.A.A.)
- Faculty of Medicine of Sousse, University of Sousse, Sousse 4000, Tunisia;
- Laboratory of Exercise Physiology and Pathophysiology, L.R.19ES09, Sousse 4054, Tunisia
| | - Ben Haj Slama Nassim
- Department of Endocrinology, University Hospital of Farhat Hached Sousse, Sousse 4000, Tunisia; (B.H.S.N.); (G.A.); (S.G.); (B.A.A.)
- Faculty of Medicine of Sousse, University of Sousse, Sousse 4000, Tunisia;
| | - Gorchane Asma
- Department of Endocrinology, University Hospital of Farhat Hached Sousse, Sousse 4000, Tunisia; (B.H.S.N.); (G.A.); (S.G.); (B.A.A.)
- Faculty of Medicine of Sousse, University of Sousse, Sousse 4000, Tunisia;
| | - Methnani Jabeur
- Faculty of Medicine of Sousse, University of Sousse, Sousse 4000, Tunisia;
- Laboratory of Exercise Physiology and Pathophysiology, L.R.19ES09, Sousse 4054, Tunisia
| | - Saad Ghada
- Department of Endocrinology, University Hospital of Farhat Hached Sousse, Sousse 4000, Tunisia; (B.H.S.N.); (G.A.); (S.G.); (B.A.A.)
- Faculty of Medicine of Sousse, University of Sousse, Sousse 4000, Tunisia;
| | - Ben Abdelkrim Asma
- Department of Endocrinology, University Hospital of Farhat Hached Sousse, Sousse 4000, Tunisia; (B.H.S.N.); (G.A.); (S.G.); (B.A.A.)
- Faculty of Medicine of Sousse, University of Sousse, Sousse 4000, Tunisia;
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Zhang J, Zhu Y, Zhang R, Liu H, Sun B, Zhang W, Wang X, Nie M, Mao J, Wu X. Pulsatile Gonadotropin-Releasing Hormone Therapy Is Associated With Better Spermatogenic Outcomes than Gonadotropin Therapy in Patients With Pituitary Stalk Interruption Syndrome. Endocr Pract 2024; 30:146-154. [PMID: 38029930 DOI: 10.1016/j.eprac.2023.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 11/15/2023] [Accepted: 11/22/2023] [Indexed: 12/01/2023]
Abstract
OBJECTIVE To compare the effects of combined gonadotropin and pulsatile gonadotropin-releasing hormone (GnRH) therapy on spermatogenesis in patients with pituitary stalk interruption syndrome (PSIS). METHODS Male patients with PSIS (N = 119) were retrospectively studied. Patients received pulsatile GnRH therapy (N = 59) were divided into response and poor-response groups based on luteinizing hormone (LH) levels after 1-month treatment with a cutoff value of 1 or 2 IU/L. Participants with gonadotropin therapy were divided into human menopausal gonadotropin (hMG)/human chorionic gonadotropin (hCG) group (N = 60), and patients with pulsatile GnRH therapy were classified into GnRH group (N = 28) with treatment duration ≥6 months. RESULTS The overall success rates of spermatogenesis for hMG/hCG and GnRH therapy were 51.67% (31/60) vs 33.90% (20/59), respectively. GnRH group required a shorter period to induce spermatogenesis (8 vs 15 months, P = .019). hMG/hCG group had higher median total testosterone than GnRH group [2.16, interquartile range(IQR) 1.06-4.89 vs 1.31, IQR 0.21-2.26 ng/mL, P = .004]. GnRH therapy had a beneficial effect on spermatogenesis compared to hMG/hCG therapy (hazard ratio 1.97, 95% confidence interval 1.08-3.57, P = .026). In patients with pulsatile GnRH therapy, compared with the poor-response group, the response group had a higher successful spermatogenesis rate (5.00% vs 48.72%, P = .002) and higher median basal total testosterone (0.00, IQR 0.00-0.03 vs 0.04, IQR 0.00-0.16 ng/mL, P = .026) with LH = 1 IU/L as the cutoff value after 1-month pulsatile GnRH therapy. CONCLUSIONS Pulsatile GnRH therapy was superior to hMG/hCG therapy for spermatogenesis in patients with PSIS. Earlier spermatogenesis and higher concentrations of sperm could be obtained in the GnRH group if patients received therapy over 6 months.
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Affiliation(s)
- Junyi Zhang
- National Health Commission (NHC) Key Laboratory of Endocrinology, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yiyi Zhu
- National Health Commission (NHC) Key Laboratory of Endocrinology, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Rui Zhang
- National Health Commission (NHC) Key Laboratory of Endocrinology, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Hongying Liu
- National Health Commission (NHC) Key Laboratory of Endocrinology, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Bang Sun
- National Health Commission (NHC) Key Laboratory of Endocrinology, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Wei Zhang
- National Health Commission (NHC) Key Laboratory of Endocrinology, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Xi Wang
- National Health Commission (NHC) Key Laboratory of Endocrinology, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Min Nie
- National Health Commission (NHC) Key Laboratory of Endocrinology, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Jiangfeng Mao
- National Health Commission (NHC) Key Laboratory of Endocrinology, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Xueyan Wu
- National Health Commission (NHC) Key Laboratory of Endocrinology, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
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Affiliation(s)
- Andrea Giustina
- Institute of Endocrine and Metabolic Sciences, San Raffaele Vita Salute University and IRCCS San Raffaele Hospital, Milan, Italy.
- Division of Endocrinology, San Raffaele Hospital, via Olgettina 60, Milano, 20132, Italy.
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Wilk M, Zelger BG, Zelger B. Tumor des follikulären Infundibulums - Neubewertung in einer Serie von 28 Patienten mit kritischer Analyse der Literatur: Tumor of follicular infundibulum - reappraisal in a series of 28 patients with critical review of the literature. J Dtsch Dermatol Ges 2024; 22:223-235. [PMID: 38361187 DOI: 10.1111/ddg.15296_g] [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: 04/08/2023] [Accepted: 09/30/2023] [Indexed: 02/17/2024]
Abstract
ZusammenfassungHintergrund und ZieleDer Tumor des follikulären Infundibulums (TFI) wurde als Neoplasie – isoliert und multipel – und in Assoziation mit anderen epithelialen Läsionen beschrieben. Seine endgültige histopathologische Definition wird kontrovers diskutiert.Patienten und MethodikWir präsentieren eine retrospektive Serie von 28 Patienten mit TFI beziehungsweise TFI‐ähnlichen Veränderungen. Ergänzend wurde die in MEDLINE aufgeführte Literatur zum Thema TFI recherchiert und die darin publizierten Abbildungen interaktiv diskutiert und analysiert.ErgebnisseUnsere Patienten waren 16 Frauen und 12 Männer. TFI‐ähnliche Veränderungen fanden sich bei fünf Patienten mit Nävus sebaceus, zwei Trichofollikulomen, einer erweiterten Pore Winer, acht Virusakanthomen, einem Dermatofibrom, sechs seborrhoischen Keratosen, drei aktinischen Keratosen, einem invasiven Plattenepithelkarzinom und einem Basalzellkarzinom in Kombination mit Plattenepithelkarzinom/aktinischer Keratose. Nach Sichtung der Literatur, insbesondere von solitären Fällen von TFI, betrachten wir diese größtenteils als Variante von seborrhoischen Keratosen mit variablem Ausmaß von infundibulärer, isthmischer und/oder sebazärer Differenzierung mit oder ohne Regression.SchlussfolgerungenWir werten TFI insgesamt als ein epitheliales Wachstumsmuster, das bei hamartomatösen, entzündlichen inkludierend infektiösen, reaktiven oder neoplastischen Prozessen auftreten und in den meisten solitären Formen am ehesten innerhalb des histologischen Spektrums seborrhoischer Keratosen eingeordnet werden kann.
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Affiliation(s)
- Michael Wilk
- Dermatohistologisches Labor und Hautarztpraxis, Nürnberg, Deutschland
| | - Bettina G Zelger
- Institut für Pathologie, Medizinische Universität Innsbruck, Innsbruck, Österreich
| | - Bernhard Zelger
- Privatordination Dermatohistopathologie Zelger, Innsbruck, Österreich
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13
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Sofer Y, Osher E, Abu Ahmad W, Yacobi Bach M, Even Zohar N, Zaid D, Golani N, Moshe Y, Tordjman K, Stern N, Greenman Y. Gender-affirming hormone therapy effect on cortisol levels in trans males and trans females. Clin Endocrinol (Oxf) 2024; 100:164-169. [PMID: 37933843 DOI: 10.1111/cen.14985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 09/22/2023] [Accepted: 10/20/2023] [Indexed: 11/08/2023]
Abstract
PURPOSE Previous studies have shown differences in baseline and stimulated cortisol levels between men and women. Whether this difference is secondary to sex hormones or to other factors, such as genetic or epigenetic changes, is unknown. We investigated the effect of gender-affirming hormone treatment (GAHT) on the hypothalamo-pituitary-adrenal axis of transgender subjects in an effort to throw light on this question. METHODS Ten transgender males (TM) and eight transgender females (TF) underwent a low-dose (1 µg) adrenocorticotropic hormone (ACTH) stimulation test before and 6 months after GAHT initiation. Serum total, free and salivary cortisol (SC) levels were measured at baseline and at 20, 30 and 40 min. RESULTS For the TM, all three levels were significantly lower at several time points after ACTH injection compared to pretreatment levels following 6 months of treatment (p < .05). Likewise, the overall SC response as calculated by the area under the curve was significantly lower (p = .0053). For the TF, the basal total cortisol (TC) level increased after 6 months of treatment (p < .01) while ACTH-stimulated SC levels decreased significantly. The basal ACTH levels were significantly lower following hormonal therapy (p < .001). CONCLUSION Stimulated salivary cortisol levels decreased significantly after 6 months of GAHT in both male and female transgender subjects, possibly reflecting a decreased state of anxiety associated with treatment initiation. Additionally, basal and stimulated serum TC levels increased after hormonal treatment in the TF, probably secondary to the effect of oestrogen on cortisol-binding globulin.
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Affiliation(s)
- Yael Sofer
- Institute of Endocrinology, Diabetes, Metabolism and Hypertension, Tel Aviv-Sourasky Medical Center, Affiliated to The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Esther Osher
- Institute of Endocrinology, Diabetes, Metabolism and Hypertension, Tel Aviv-Sourasky Medical Center, Affiliated to The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Wiessam Abu Ahmad
- Braun School of Public Health and Community Medicine, Hebrew University-Hadassah, Jerusalem, Israel
| | - Michal Yacobi Bach
- Institute of Endocrinology, Diabetes, Metabolism and Hypertension, Tel Aviv-Sourasky Medical Center, Affiliated to The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Naomi Even Zohar
- Institute of Endocrinology, Diabetes, Metabolism and Hypertension, Tel Aviv-Sourasky Medical Center, Affiliated to The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dana Zaid
- Institute of Endocrinology, Diabetes, Metabolism and Hypertension, Tel Aviv-Sourasky Medical Center, Affiliated to The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nehama Golani
- Institute of Endocrinology, Diabetes, Metabolism and Hypertension, Tel Aviv-Sourasky Medical Center, Affiliated to The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yaffa Moshe
- Institute of Endocrinology, Diabetes, Metabolism and Hypertension, Tel Aviv-Sourasky Medical Center, Affiliated to The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Karen Tordjman
- Institute of Endocrinology, Diabetes, Metabolism and Hypertension, Tel Aviv-Sourasky Medical Center, Affiliated to The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Naftali Stern
- Institute of Endocrinology, Diabetes, Metabolism and Hypertension, Tel Aviv-Sourasky Medical Center, Affiliated to The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yona Greenman
- Institute of Endocrinology, Diabetes, Metabolism and Hypertension, Tel Aviv-Sourasky Medical Center, Affiliated to The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Kobayashi T, Iwama S, Arima H. Clinical characteristics and potential biomarkers of thyroid and pituitary immune-related adverse events. Endocr J 2024; 71:23-29. [PMID: 37940567 DOI: 10.1507/endocrj.ej23-0524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2023] Open
Abstract
Immune checkpoint inhibitors (ICIs) can cause immune-related adverse events (irAEs) in several organs including endocrine glands. Among endocrine irAEs, thyroid and pituitary irAEs are frequently observed, followed by primary adrenal insufficiency, insulin-dependent diabetes mellitus, and hypoparathyroidism. These conditions could lead to life-threatening consequences, such as adrenal crisis and diabetic ketoacidosis. On the other hand, several types of irAEs including thyroid and pituitary irAEs are reported to be associated with better overall survival. Therefore, it is important to understand and manage endocrine irAEs, which differ depending on the ICI regimen used. In this review, we describe the clinical features, potential biomarkers, management strategies, and possible mechanisms of thyroid and pituitary irAEs.
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Affiliation(s)
- Tomoko Kobayashi
- Department of Endocrinology and Diabetes, Nagoya University Hospital, Nagoya 466-8550, Japan
| | - Shintaro Iwama
- Department of Endocrinology and Diabetes, Nagoya University Hospital, Nagoya 466-8550, Japan
| | - Hiroshi Arima
- Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
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15
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Wu XY, Zhang JY. [Multidisciplinary efforts to improve the diagnosis and treatment of cirrhosis due to anterior pituitary hypopituitarism]. Zhonghua Yi Xue Za Zhi 2024; 104:241-246. [PMID: 38246768 DOI: 10.3760/cma.j.cn112137-20231012-00723] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
More and more clinical evidence confirms that hypopituitary dysfunction can lead to liver cirrhosis. The causes of hypopituitary dysfunction include sellarneoplastic diseases, hereditary diseases, perinatal adverse events, etc. Clinically, growth hormone deficiency (GHD) often the first cause in hypopituitary dysfunction.Hypopituitary dysfunction, especially GHD, can lead to liver cirrhosis, which in turn can result in damage to multiple organs such as the secondary lungs, spleen, and heart.Therefore, its clinical manifestations are complex, and the patients are first diagnosed in various departments.Reliable clinical observations have shown that GH replacement therapy at the early stage of the disease can effectively prevent and reverse the progression of cirrhosis, or even avoid inappropriate or unnecessary combined transplantation of liver or liver-related organs.Multidisciplinary collaboration and attention to the new findings that hypopituitary dysfunction can lead to liver cirrhosis will help to improve the accurate diagnosis and treatment of liver cirrhosis.
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Affiliation(s)
- X Y Wu
- National Health Commission, Key Laboratory of Endocrinology, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - J Y Zhang
- National Health Commission, Key Laboratory of Endocrinology, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China
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16
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Kőhalmi E, Bakó G. [Endocrine changes, endocrine diseases in the elderly]. Orv Hetil 2024; 165:51-58. [PMID: 38219229 DOI: 10.1556/650.2024.32950] [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: 10/11/2023] [Accepted: 11/09/2023] [Indexed: 01/16/2024]
Abstract
A világ népessége, a születéskor várható élettartam és ezzel együtt az idősek
aránya a népességen belül visszafordíthatatlanul növekszik. Ez a trend a
belátható időn belül megfordíthatatlannak látszik, aminek jelentős egészségügyi
kihatásai vannak. Az idősek körében aránytalanul magasabb az endokrin és
anyagcsere-betegségek prevalenciája. Az idősek patofiziológiai paraméterei
jelentősen eltérnek a fiatal felnőttekéitől, aminek következtében morbiditási
„mintázatuk” is más. A hypopituitarismus, a hypothyreosis, az osteoporosis, a
diabetes mellitus, a mellékvesekéreg-elégtelenség, a hypogonadismus különböző
formái, a malignus endokrin betegségek gyakoribbak idősekben. Nagy figyelmet
igényel, hogy időskorban a hormonok laboratóriumi értékei általában „normálisan”
alacsonyabbak a standardoknál. A kezelés során ennek a korcsoportnak az
adottságait fontos tényezőként kell figyelembe venni, hogy optimális eredményt
érhessünk el. A belgyógyászat és az endokrinológia oktatása során az időskorra
vonatkozó eltéréseknek fokozott hangsúlyt kellene kapniuk a graduális képzés
idején. Orv Hetil. 2024; 165(2): 51–58.
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Affiliation(s)
- Edit Kőhalmi
- 1 Debreceni Egyetem, Általános Orvostudományi Kar, Belgyógyászati Intézet, Geriátria Grémium Debrecen, Móricz Zs. út 22., 4032 Magyarország
| | - Gyula Bakó
- 1 Debreceni Egyetem, Általános Orvostudományi Kar, Belgyógyászati Intézet, Geriátria Grémium Debrecen, Móricz Zs. út 22., 4032 Magyarország
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Garcia C, Velez LM, Ujagar N, Del Mundo Z, Nguyen T, Fox C, Mark A, Fisch KM, Lawson MA, Duleba AJ, Seldin MM, Nicholas DA. Lipopolysaccharide-induced chronic inflammation increases female serum gonadotropins and shifts the pituitary transcriptomic landscape. Front Endocrinol (Lausanne) 2024; 14:1279878. [PMID: 38260148 PMCID: PMC10801245 DOI: 10.3389/fendo.2023.1279878] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 11/15/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction Female reproductive function depends on a choreographed sequence of hormonal secretion and action, where specific stresses such as inflammation exert profound disruptions. Specifically, acute LPS-induced inflammation inhibits gonadotropin production and secretion from the pituitary, thereby impacting the downstream production of sex hormones. These outcomes have only been observed in acute inflammatory stress and little is known about the mechanisms by which chronic inflammation affects reproduction. In this study we seek to understand the chronic effects of LPS on pituitary function and consequent luteinizing and follicle stimulating hormone secretion. Methods A chronic inflammatory state was induced in female mice by twice weekly injections with LPS over 6 weeks. Serum gonadotropins were measured and bulk RNAseq was performed on the pituitaries from these mice, along with basic measurements of reproductive biology. Results Surprisingly, serum luteinizing and follicle stimulating hormone was not inhibited and instead we found it was increased with repeated LPS treatments. Discussion Analysis of bulk RNA-sequencing of murine pituitary revealed paracrine activation of TGFβ pathways as a potential mechanism regulating FSH secretion in response to chronic LPS. These results provide a framework with which to begin dissecting the impacts of chronic inflammation on reproductive physiology.
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Affiliation(s)
- Christopher Garcia
- Department of Molecular Biology and Biochemistry, School of Biological Sciences, University of California Irvine, Irvine, CA, United States
| | - Leandro M. Velez
- Department of Biological Chemistry, University of California Irvine, Irvine, CA, United States
- Center for Epigenetics and Metabolism, University of California Irvine, Irvine, CA, United States
| | - Naveena Ujagar
- Department of Molecular Biology and Biochemistry, School of Biological Sciences, University of California Irvine, Irvine, CA, United States
| | - Zena Del Mundo
- Department of Molecular Biology and Biochemistry, School of Biological Sciences, University of California Irvine, Irvine, CA, United States
| | - Thu Nguyen
- Department of Molecular Biology and Biochemistry, School of Biological Sciences, University of California Irvine, Irvine, CA, United States
| | - Chelsea Fox
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Prisma Health Upstate/University of South Carolina School of Medicine Greenville, Greenville, SC, United States
| | - Adam Mark
- Center for Computational Biology & Bioinformatics, University of California San Diego, La Jolla, CA, United States
| | - Kathleen M. Fisch
- Center for Computational Biology & Bioinformatics, University of California San Diego, La Jolla, CA, United States
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, La Jolla, CA, United States
| | - Mark A. Lawson
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, La Jolla, CA, United States
| | - Antoni J. Duleba
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, La Jolla, CA, United States
| | - Marcus M. Seldin
- Department of Biological Chemistry, University of California Irvine, Irvine, CA, United States
- Center for Epigenetics and Metabolism, University of California Irvine, Irvine, CA, United States
| | - Dequina A. Nicholas
- Department of Molecular Biology and Biochemistry, School of Biological Sciences, University of California Irvine, Irvine, CA, United States
- Center for Epigenetics and Metabolism, University of California Irvine, Irvine, CA, United States
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Ay T, Akdag UB, Kilincli MF, Ogut E, Barut C. Anatomical variations of foramen of the diaphragma sellae and neighboring structures: a cadaveric study. Anat Sci Int 2024; 99:75-89. [PMID: 37500986 DOI: 10.1007/s12565-023-00736-4] [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: 03/14/2023] [Accepted: 07/13/2023] [Indexed: 07/29/2023]
Abstract
The aim of our study was to examine the variations and types of foramen of diaphragma sellae (FDS) and their relationship with nearby surgical landmarks on cadavers.Twenty adult (9 male, 11 female) formalin-fixed cadaveric heads were bilaterally used to analyze the anatomical relationships around the supradiaphragmatic region of sella turcica. Lengths and distances of nearby surgical landmarks were measured by a digital microcaliper. SPSS version 25 was used to analyze the comparison between genders and body sides. Dorsum sellae distances to tuberculum sellae and the optic chiasm(OC) were higher in males than females (p < 0.05). Type 8 infundibulum passage was the most common variation with 50%. There was no finding related to types 1-4 of infundibulum passage. Thus, the present study has indicated that the infundibulum passes mostly from the posterior half of the foramen. The shape of the foramen was irregular in 45%, circular in 20%, sagittally oval in 20%, and horizontally oval in 15% of the cases. The OC was noted normal in 60%, prefixed in 35%, and postfixed in 5% of the cases. Comprehensive anatomical knowledge about the types of the FDS and their neighboring structures is crucial for preoperative planning of sellar region diseases in terms of navigating the region when accessing the foramen. Discrimination of variations of FDS, OC, and pituitary stalk, their relationships, and differences between genders is useful to minimize potential surgical complications.
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Affiliation(s)
- Tufan Ay
- School of Medicine, Bahcesehir University, Istanbul, Turkey
| | | | | | - Eren Ogut
- Department of Anatomy, School of Medicine, Bahcesehir University, Istanbul, Turkey
| | - Cagatay Barut
- Department of Anatomy, School of Medicine, Istanbul Medeniyet University, 34715, Istanbul, Turkey.
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Gonzalez-Meljem JM, Martinez-Barbera JP. Implications of cellular senescence in paediatric pituitary tumours. EBioMedicine 2024; 99:104905. [PMID: 38043401 PMCID: PMC10730348 DOI: 10.1016/j.ebiom.2023.104905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 11/20/2023] [Accepted: 11/24/2023] [Indexed: 12/05/2023] Open
Abstract
The long-standing view of senescent cells as passive and dysfunctional biological remnants has recently shifted into a new paradigm where they are main players in the development of many diseases, including cancer. The senescence programme represents a first line of defence that prevents tumour cell growth but also leads to the secretion of multiple pro-inflammatory and pro-tumourigenic factors that fuel tumour initiation, growth, and progression. Here, we review the main molecular features and biological functions of senescent cells in cancer, including the outcomes of inducing or targeting senescence. We discuss evidence on the role of cellular senescence in pituitary tumours, with an emphasis on adamantinomatous craniopharyngioma (ACP) and pituitary adenomas. Although senescence has been proposed to be a tumour-preventing mechanism in pituitary adenomas, research in ACP has shown that senescent cells are tumour-promoting in both murine models and human tumours. Future studies characterizing the impact of targeting senescent cells may result in novel therapies against pituitary tumours.
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Affiliation(s)
| | - Juan Pedro Martinez-Barbera
- Developmental Biology and Cancer Programme, Birth Defects Research Centre, UCL Institute of Child Health, London, UK.
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20
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Bouzid N, Chamsi A, Barka I, Sghaier S, Tbessi S, Elleuch K, Tebra S. Hypothalamic pituitary dysfunction after nasopharyngeal carcinoma irradiation. Clin Neurol Neurosurg 2024; 236:108100. [PMID: 38218060 DOI: 10.1016/j.clineuro.2023.108100] [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: 11/22/2023] [Revised: 12/15/2023] [Accepted: 12/20/2023] [Indexed: 01/15/2024]
Abstract
PURPOSE Radiotherapy (RT) is the corner stone of nasopharyngeal carcinoma (NPC) treatment but it exposes to late effects especially hypothalamic pituitary deficiency (HPD). In this article,we aimed to assess the impact of RT on pituitary function in NPC survivors. METHODS We included 55 patients treated in the radiation oncology department, of Farhat Hached Hospital in Sousse, Tunisia. RESULTS All patients received facio-cervical RT with a mean dose of 73.3 Gy to the nasopharynx. After a mean follow up of 9.56 years, 34 patients (61.8%) presented HPD. Associated peripheral involvement was seen in 18.2%. The most prevalent deficiency was of the GH axis in 50.9% followed by secondary adrenal insufficiency in 20%. Panhypopituitarism was noted in 8.8%. The development of HPD wasn't related to RT dose (OR: 0.41(0.05-2.92), p = 0.36) but was significantly associated with male gender (OR: 1.67 (1.21-2.37), p = 0.01). CONCLUSION HPD post RT is a common phenomenon. Therefore, we recommend regular assessment of pituitary function amongst patients treated with RT for NPC because identification of deficits is crucial to allow early and appropriate hormone replacement therapy in order to improve patients quality of life.
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Affiliation(s)
- Nadia Bouzid
- Medical School Sousse, Radiation Oncology Department, University of Sousse, Farhat Hached Hospital, Sousse, Tunisia
| | - Amal Chamsi
- Medical School Sousse, Radiation Oncology Department, University of Sousse, Farhat Hached Hospital, Sousse, Tunisia.
| | - Ines Barka
- Medical School Sousse, Endocrinology Department, University of Sousse, Farhat Hached Hospital, Sousse, Tunisia
| | - Sarra Sghaier
- Medical School Sousse, Radiation Oncology Department, University of Sousse, Farhat Hached Hospital, Sousse, Tunisia
| | - Sabrine Tbessi
- Medical School Sousse, Radiation Oncology Department, University of Sousse, Farhat Hached Hospital, Sousse, Tunisia
| | - Koussay Elleuch
- Medical School Sousse, Endocrinology Department, University of Sousse, Farhat Hached Hospital, Sousse, Tunisia
| | - Sameh Tebra
- Medical School Sousse, Radiation Oncology Department, University of Sousse, Farhat Hached Hospital, Sousse, Tunisia
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Fazli M, Bertram R. Conversion of spikers to bursters in pituitary cell networks: Is it better to disperse for maximum exposure or circle the wagons? PLoS Comput Biol 2024; 20:e1011811. [PMID: 38289902 PMCID: PMC10826967 DOI: 10.1371/journal.pcbi.1011811] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 01/08/2024] [Indexed: 02/01/2024] Open
Abstract
The endocrine cells of the pituitary gland are electrically active, and in vivo they form small networks where the bidirectional cell-cell coupling is through gap junctions. Numerous studies of dispersed pituitary cells have shown that typical behaviors are tonic spiking and bursting, the latter being more effective at evoking secretion. In this article, we use mathematical modeling to examine the dynamics of small networks of spiking and bursting pituitary cells. We demonstrate that intrinsic bursting cells are capable of converting intrinsic spikers into bursters, and perform a fast/slow analysis to show why this occurs. We then demonstrate the sensitivity of network dynamics to the placement of bursting cells within the network, and demonstrate strategies that are most effective at maximizing secretion from the population of cells. This study provides insights into the in vivo behavior of cells such as the stress-hormone-secreting pituitary corticotrophs that are switched from spiking to bursting by hypothalamic neurohormones. While much is known about the electrical properties of these cells when isolated from the pituitary, how they behave when part of an electrically coupled network has been largely unstudied.
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Affiliation(s)
- Mehran Fazli
- Department of Mathematics, Florida State University, Tallahassee, Florida, United States of America
| | - Richard Bertram
- Department of Mathematics, Florida State University, Tallahassee, Florida, United States of America
- Programs in Neuroscience and Molecular Biophysics, Florida State University, Tallahassee, Florida, United States of America
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Ubah SA, Abalaka SE, Asibor VC, Ogundana EK, Iyojo IJ, Agbonu OA, Columbus PK, Abah KO, Obudu CE, Isaac OA, Ezinwo PA. Gonadotropic Activity of Pituitary Extract of African Catfish, Clarias gariepinus, in Mammals using Immature Wistar Rats as Models. Recent Pat Biotechnol 2024; 18:84-92. [PMID: 38205775 DOI: 10.2174/1872208317666230313153832] [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: 10/28/2022] [Revised: 01/22/2023] [Accepted: 02/02/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND The pituitary glands normally produce and stores gonadotropic hormones (GnH) that are responsible for ovulation and spermiation in animals. However, whether fish pituitary extracts can elicit same effects in treated animals need elucidation as a prelude to their practical usage in animals. OBJECTIVES The aim of this study was to investigate the oestrus-inducing potential of the pituitary gland extract of the Africa Catfish (Clarias gariepinus) in immature Wistar rats. METHODS The experiment involved the use of 18 immature female Wistar rats and 10 male catfish brood stocks with the use of six Wistar rats per groups as follows: Group A had human chorionic gonadotropin (hCG) treatment. Group B had only normal saline treatment as the control whereas Group C had the C. gariepinus pituitary extract administration to induce oestrus with treatments occurring twice six hours apart in each group. RESULTS There was an obvious expression of visible signs of heat and the presence of uterine horn oedema with significant (p < 0.05) increase in reproductive tract weight and uterine width and length. However, only progesterone levels increased significantly (p < 0.05) in the hCG and the C. gariepinus pituitary extract treated groups compared to other assayed hormones. CONCLUSION These results showed that C. gariepinus pituitary extract has the capacity to induce oestrus in Wistar rats because of its gonadotropic effects, which needs further investigations at higher doses and for longer exposure periods for possible oestrus induction and synchronization in higher mammals. Further favourable results could herald the possible patent of the catfish pituitary extract for either experimental or commercial use in mammals.
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Affiliation(s)
- Simon Azubuike Ubah
- Department of Theriogenology, Faculty of Veterinary Medicine, University of Abuja, Abuja, Nigeria
| | - Samson Eneojo Abalaka
- Department of Veterinary Pathology, Faculty of Veterinary Medicine, University of Abuja, Abuja, Nigeria
| | - Victory Clara Asibor
- Department of Theriogenology, Faculty of Veterinary Medicine, University of Abuja, Abuja, Nigeria
| | | | - Itodo Joy Iyojo
- Department of Animal Science, Faculty of Agriculture, Federal University of Lafia, Lafia, Nigeria
| | - Oluwa Adikpe Agbonu
- Department of Veterinary Physiology and Biochemistry, Faculty of Veterinary Medicine, University of Abuja, Abuja, Nigeria
| | | | - Kenneth Owoicho Abah
- Department of Theriogenology, Faculty of Veterinary Medicine, University of Abuja, Abuja, Nigeria
| | - Christopher Ese Obudu
- Department of Theriogenology, Faculty of Veterinary Medicine, University of Abuja, Abuja, Nigeria
| | - Oluwatobi Akefe Isaac
- Department of Veterinary Physiology, Biochemistry and Pharmacology, Faculty of Veterinary Medicine, University of Jos, Jos, Nigeria
| | - Prisca Adaoma Ezinwo
- Department of Theriogenology, Faculty of Veterinary Medicine, University of Abuja, Abuja, Nigeria
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23
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Kilci F, Jones JH, Çaklılı M, Ceylan S, Çizmecioğlu-Jones FM. Clinical and therapeutic outcomes of pediatric pituitary adenomas: a single pituitary center experience. Endocrine 2024; 83:160-170. [PMID: 37779166 DOI: 10.1007/s12020-023-03523-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 09/06/2023] [Indexed: 10/03/2023]
Abstract
PURPOSE Pediatric pituitary adenomas (PPA) are rare. Although PPAs are mostly benign, they can be challenging to manage. Most studies evaluating PPA are based on surgical series. We aimed to present the clinical features, hormonal status and treatment outcomes of children with PPA managed in a joint neuroendocrine setting. METHODS In this single-center study, demographic, clinical and endocrinological data of patients under 19 years old who were followed up with the diagnosis of PPA between 2002-2022 were retrospectively reviewed. A total of 21 studies published in the past 20 years were also systematically reviewed. RESULTS There were 79 patients (52 girls, 27 boys) with a median age of 15.8 years. Median follow-up time was 30 months. The most common adenoma subtype was non-functioning adenoma (NFA) (35.5%), followed by prolactinoma (29.1%), corticotropinoma (21.5%), and somatotropinoma (13.9%), respectively. The frequency of micro and macroadenomas was almost equal while 38% of all adenomas were invasive. Headache, visual impairment and menstrual irregularity were the most common complaints, while the most common hormonal deficiency at diagnosis was central hypothyroidism (31.6%), followed by hypogonadotropic hypogonadism (22.7%), growth hormone deficiency (15.2%) and central adrenal insufficiency (11.4%), respectively. Fifty patients (63.2%) underwent endoscopic endonasal transsphenoidal surgery (EETS). Following the surgery, impaired endocrine functions recovered at a rate of 62% while permanent central diabetes insipidus was observed in 6%, and new onset hypopituitarism developed in 4%. CONCLUSION NFA was more common in this cohort than in previous reports, which is one of the largest PPA series in the literature. Hormonal disorders, which were common at the time of diagnosis, were largely resolved with appropriate endocrinological and surgical approaches, while the rate of pituitary hormonal deficiencies after EETS was relatively low. Therefore, we recommend that children with PPA be managed in the setting of a high-volume pituitary center to provide long-term low morbidity.
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Affiliation(s)
- Fatih Kilci
- Department of Pediatric Endocrinology, School of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Jeremy Huw Jones
- Department of Academic Writing, Kocaeli University, Kocaeli, Turkey
| | - Melih Çaklılı
- Department of Neurosurgery and Pituitary Research Center, School of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Savaş Ceylan
- Department of Neurosurgery and Pituitary Research Center, School of Medicine, Kocaeli University, Kocaeli, Turkey
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24
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Chi H, Yang Y, Zhang J, Liu D. A case of hypophysis with HIV negative cryptococcal meningitis. Zhong Nan Da Xue Xue Bao Yi Xue Ban 2023; 48:1419-1424. [PMID: 38044654 PMCID: PMC10929872 DOI: 10.11817/j.issn.1672-7347.2023.220441] [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] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Indexed: 12/05/2023]
Abstract
The clinical mortality of cryptococcal meningitis (CM) is high. There is no report of hypopituitarism associated with HIV negative CM so far. The patients with hypopituitarism complicated with CM are easy to be misdiagnosed and mistreated. A patient with hypopituitarism and HIV negative CM was admitted to Weihai Municipal Hospital on August 27, 2021. The patient was treated for 18 years after craniopharyngioma with headache for more than 2 months, nausea and vomiting for 4 days. MRI showed abnormal enhancement of the right basal ganglia, edema of surrounding tissue, and multiple striated enhancement of the bilateral cerebellar hemisphere. The smear of cerebrospinal fluid showed a large number of fungi and Cryptococcus. Culture of cerebrospinal fluid showed positive in Cryptococcus. The patient's HIV and syphilis antibodies were negative. The condition of the patient was improved after active antifungal therapy. The clinician should make a definite diagnosis and give early treatment as soon as possible.
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Affiliation(s)
- Haiyan Chi
- PhD Candidate, Class of 2022, Shandong University of Traditional Chinese Medicine, Jinan 250012.
- Department of Endocrinology, Weihai Municipal Hospital, Affiliated Hospital of Shandong University, Weihai Shandong 264200.
| | - Yachao Yang
- Department of Endocrinology, Weihai Municipal Hospital, Affiliated Hospital of Shandong University, Weihai Shandong 264200.
| | - Jinbiao Zhang
- Department of Endocrinology, Weihai Municipal Hospital, Affiliated Hospital of Shandong University, Weihai Shandong 264200
| | - Deshan Liu
- Department of Traditional Chinese Medicine, Qilu Hospital, Shandong University, Jinan 250012, China.
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25
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Das L, Dutta P. Unusual and lesser-known rare causes of adult growth hormone deficiency. Best Pract Res Clin Endocrinol Metab 2023; 37:101820. [PMID: 37704550 DOI: 10.1016/j.beem.2023.101820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
Growth hormone is among the most common hormones to be deficient in pituitary insult. It can occur either in isolation or combined with other hormone deficiencies. Growth hormone deficiency in adults (AGHD) can be due to causes acquired in adulthood or have a childhood-onset etiology, but the former is about three times more common. Usual causes of AGHD include mass effects due to a pituitary tumour, and/or its treatment (surgery, medical therapy, or radiotherapy), or radiotherapy to the head and neck region for non-pituitary lesions. The unusual or lesser-known causes of AGHD, are usually due to non-tumoral etiology and range from vascular and infective to inflammatory and miscellaneous causes. These not only expand the spectrum of AGHD but may also contribute to increased morbidity, adverse metabolic consequences, and mortality due to the primary condition, if unrecognised. The review features these lesser-known and rare causes of AGHD and highlights their clinical and diagnostic implications.
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Affiliation(s)
- Liza Das
- Department of Telemedicine, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Pinaki Dutta
- Department of Endocrinology, PGIMER, Chandigarh, India.
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26
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Kato Y, Yoshida S, Kato T. Missing pieces of the pituitary puzzle: participation of extra-adenohypophyseal placode-lineage cells in the adult pituitary gland. Cell Tissue Res 2023; 394:487-496. [PMID: 37650920 DOI: 10.1007/s00441-023-03829-8] [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: 03/27/2023] [Accepted: 08/14/2023] [Indexed: 09/01/2023]
Abstract
The pituitary gland is a major endocrine tissue composing of two distinct entities, the adenohypophysis (anterior pituitary, cranial placode origin) and the neurohypophysis (posterior pituitary, neural ectoderm origin), and plays important roles in maintaining vital homeostasis. This tissue is maintained by a slow, consistent cell-renewal system of adult stem/progenitor cells. Recent accumulating evidence shows that neural crest-, head mesenchyme-, and endoderm lineage cells invade during pituitary development and contribute to the maintenance of the adult pituitary gland. Based on these novel observations, this article discusses whether these lineage cells are involved in pituitary organogenesis, maintenance, regeneration, dysplasia, or tumors.
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Affiliation(s)
- Yukio Kato
- Institute for Endocrinology, Meiji University, 1-1-1 Higashi-Mita, Tama-Ku, Kawasaki, Kanagawa, 214-8571, Japan.
| | - Saishu Yoshida
- Department of Biochemistry, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-Ku, Tokyo, 105-8461, Japan
| | - Takako Kato
- Institute for Endocrinology, Meiji University, 1-1-1 Higashi-Mita, Tama-Ku, Kawasaki, Kanagawa, 214-8571, Japan
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27
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Abstract
Traditional textbook physiology has ascribed unitary functions to hormones from the anterior and posterior pituitary gland, mainly in the regulation of effector hormone secretion from endocrine organs. However, the evolutionary biology of pituitary hormones and their receptors provides evidence for a broad range of functions in vertebrate physiology. Over the past decade, we and others have discovered that thyroid-stimulating hormone, follicle-stimulating hormone, adrenocorticotropic hormone, prolactin, oxytocin and arginine vasopressin act directly on somatic organs, including bone, adipose tissue and liver. New evidence also indicates that pituitary hormone receptors are expressed in brain regions, nuclei and subnuclei. These studies have prompted us to attribute the pathophysiology of certain human diseases, including osteoporosis, obesity and neurodegeneration, at least in part, to changes in pituitary hormone levels. This new information has identified actionable therapeutic targets for drug discovery.
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Affiliation(s)
- Mone Zaidi
- Center for Translational Medicine and Pharmacology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Departments of Medicine and Pharmacological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Tony Yuen
- Center for Translational Medicine and Pharmacology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Departments of Medicine and Pharmacological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Se-Min Kim
- Center for Translational Medicine and Pharmacology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Departments of Medicine and Pharmacological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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28
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La Marca A, Longo M, Sighinolfi G, Grisendi V, Imbrogno MG, Giulini S. New insights into the role of LH in early ovarian follicular growth: a possible tool to optimize follicular recruitment. Reprod Biomed Online 2023; 47:103369. [PMID: 37918055 DOI: 10.1016/j.rbmo.2023.103369] [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: 05/17/2023] [Revised: 08/19/2023] [Accepted: 08/22/2023] [Indexed: 11/04/2023]
Abstract
Evidence shows that LH participates in enhancing transition from the early stage to the antral stage of folliculogenesis. It has been demonstrated that functional LH receptors are expressed, albeit at a very low level and even in smaller follicles, during the phase that was traditionally considered to be gonadotrophin independent, suggesting a role for LH in accelerating the rate of progression of non-growing and primary follicles to the preantral/antral stage. Hypogonadotropic hypogonadism, together with other clinical conditions of pituitary suppression, has been associated with reduced functional ovarian reserve. The reduction in LH serum concentration is associated with a low concentration of anti-Müllerian hormone. This is the case in hypothalamic amenorrhoea, pregnancy, long-term GnRH-analogue therapy and hormonal contraception. The effect seems to be reversible, such that after pregnancy and after discontinuation of drugs, the functional ovarian reserve returns to the baseline level. Evidence suggests that women with similar primordial follicle reserves could present with different numbers of antral follicles, and that gonadotrophins may play a fundamental role in permitting a normal rate of progression of follicles through non-cyclic folliculogenesis. The precise role of gonadotrophins in early folliculogenesis, as well as their use to modify the functional ovarian reserve, must be investigated.
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Affiliation(s)
- Antonio La Marca
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Policlinico di Modena, via del Pozzo, 41124 Modena, Italy.
| | - Maria Longo
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Policlinico di Modena, via del Pozzo, 41124 Modena, Italy
| | - Giovanna Sighinolfi
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Policlinico di Modena, via del Pozzo, 41124 Modena, Italy
| | - Valentina Grisendi
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Policlinico di Modena, via del Pozzo, 41124 Modena, Italy
| | - Maria Giovanna Imbrogno
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Policlinico di Modena, via del Pozzo, 41124 Modena, Italy
| | - Simone Giulini
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Policlinico di Modena, via del Pozzo, 41124 Modena, Italy
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29
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Li Q. Pituitary-immune bidirectional crosstalk under systemic inflammation. PLoS Biol 2023; 21:e3002440. [PMID: 38113236 PMCID: PMC10729977 DOI: 10.1371/journal.pbio.3002440] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023] Open
Abstract
The pituitary gland responds to and modulates immune stress through the hypothalamus-pituitary-adrenal axis. A new study in PLOS Biology reveals unconventional bidirectional communication between hormone-producing cells and the immune system upon systemic inflammation.
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Affiliation(s)
- Qingyun Li
- Department of Neuroscience, Department of Genetics, Hope Center for Neurological Disorders, Center for Brain Immunology and Glia, Washington University in St. Louis School of Medicine, St. Louis, Missouri, United States of America
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30
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Wang YJ, Yeh CJ, Gao ZH, Hwang E, Chen HH, Wu SN. Inhibitory Perturbations of Fluvastatin on Afterhyperpolarization Current, Erg-mediated K + Current, and Hyperpolarization-activated Cation Current in Both Pituitary GH 3 Cells and Primary Embryonic Mouse Cortical Neurons. Neuroscience 2023; 531:12-23. [PMID: 37661016 DOI: 10.1016/j.neuroscience.2023.08.038] [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: 05/18/2023] [Revised: 08/27/2023] [Accepted: 08/29/2023] [Indexed: 09/05/2023]
Abstract
Fluvastatin (FLV), the first synthetically derived 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor, is a potent inhibitor of cholesterol biosynthesis. While its primary mechanism of action is to reduce cholesterol levels, there is some evidence suggesting that it may also have effects on K+ channels. However, the overall effects of fluvastatin on ionic currents are not yet well understood. The whole-cell clamp recordings were applied to evaluate the ionic currents and action potentials of cells. Here, we have demonstrated that FLV can effectively inhibit the amplitude of erg-mediated K+ current (IK(erg)) in pituitary tumor (GH3) cells, with an IC50 of approximately 3.2 µM. In the presence of FLV, the midpoint in the activation curve of IK(erg) was distinctly shifted to a less negative potential by 10 mV, with minimal modification of the gating charge. However, the magnitude of hyperpolarization-activated cation current (Ih) elicited by long-lasting membrane hyperpolarization was progressively decreased, with an IC50 value of 8.7 µM, upon exposure to FLV. More interestingly, we also found that FLV (5 µM) could regulate the action potential and afterhyperpolarization properties in primary embryonic mouse cortical neurons. Our study presents compelling evidence indicating that FLV has the potential to impact both the amplitude and gating of the ion channels IK(erg) and Ih. We also provide credible evidence suggesting that this drug has the potential to modify the properties of action potentials and the afterhyperpolarization current in electrically excitable cells. However, the assumption that these findings translate to similar in-vivo results remains unclear.
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Affiliation(s)
- Ya-Jean Wang
- Department of Senior Services Industry Management, Minghsin University of Science and Technology, Hsinchu, Taiwan.
| | - Che-Jui Yeh
- Institute of Molecular Medicine and Bioengineering, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Zi-Han Gao
- Department of Physiology, National Cheng Kung University Medical College, Tainan, Taiwan
| | - Eric Hwang
- Institute of Molecular Medicine and Bioengineering, National Yang Ming Chiao Tung University, Hsinchu, Taiwan; Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan; Institute of Bioinformatics and Systems Biology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Hwei-Hisen Chen
- Center for Neuropsychiatric Research, National Health Research Institutes, Miaoli, Taiwan; Institute of Neuroscience, National Chengchi University, Taipei, Taiwan.
| | - Sheng-Nan Wu
- Department of Physiology, National Cheng Kung University Medical College, Tainan, Taiwan; Institute of Basic Medical Sciences, National Cheng Kung University Medical College, Tainan, Taiwan; Department of Medical Research and Education, An Nan Hostpial, China Medical University Hospital, China Medical University, Tainan, Taiwan.
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31
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Harrylal CA, Lensink AV, Gupta SK, Aire TA. The ultrastructural features of the infundibulum of the green iguana, Iguana iguana. J Morphol 2023; 284:e21644. [PMID: 37856278 DOI: 10.1002/jmor.21644] [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: 05/09/2023] [Revised: 09/07/2023] [Accepted: 09/11/2023] [Indexed: 10/21/2023]
Abstract
The purpose of this study is to describe, in detail, the ultrastructure of the infundibulum of the sexually mature and active female green iguana, Iguana iguana. The infundibulum of five iguanas was remarkably distinct from the uterus, and was also clearly demarcated into cranial (expanded v-shaped) and caudal (tubular) divisions. Tissue samples obtained from five portions (three from the cranial division and two from the caudal division) of the infundibulum were processed conventionally for light and electron microscopy. The epithelial lining of the most anterior, middle, and posterior, parts of the cranial division displayed nonciliated cells predominantly, and occasionally ciliated cells. The numerous secretory granules in nonciliated type 1 cell found in the fimbrial aspect of the infundibulum were homogenous and deeply electron-dense, but those in the other two regions were variants of this cell type because they contained variably electron-dense secretory granules. Two main types of nonciliated cells (type 2 and its variant, type 3, as well as type 4) occurred in the epithelial lining of the caudal division of the infundibulum, but they, clearly, showed no dense secretory granules. Whereas the nonciliated type 2 cell and its variant (type 3 cell) contained large glycogen deposits, the type 4 cell lacked these deposits but its apical part contained large lipid-like droplets and, remarkably, blebbed into the duct lumen. The nonciliated cells lining the mucosal tubular glands contained highly electron-dense secretory granules, which were similar to those found in the nonciliated type 1 cell in the epithelial lining of the fimbrial part of the cranial division of the infundibulum.
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Affiliation(s)
- Crissy-Ann Harrylal
- Department of Anatomy, Physiology, and Pharmacology School of Veterinary Medicine, St. George's University, True Blue, Grenada
| | - Antoinette V Lensink
- Electron Microscope Unit, Department of Anatomy and Physiology, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa
| | - Sunil K Gupta
- Department of Anatomy, Physiology, and Pharmacology School of Veterinary Medicine, St. George's University, True Blue, Grenada
| | - Tom A Aire
- Department of Anatomy, Physiology, and Pharmacology School of Veterinary Medicine, St. George's University, True Blue, Grenada
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32
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Batista S, Almeida JA, Koester S, Gasparri LG, Santana LS, Gallo BHD, Palavani LB, Bertani R, Landeiro JA. Safety of withholding perioperative steroids for patients with pituitary resection with an intact hypothalamus-pituitary-adrenal axis: A meta-analysis of randomized clinical trials. Clin Neurol Neurosurg 2023; 234:107974. [PMID: 37797363 DOI: 10.1016/j.clineuro.2023.107974] [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: 07/25/2023] [Revised: 09/07/2023] [Accepted: 09/09/2023] [Indexed: 10/07/2023]
Abstract
INTRODUCTION Several observational studies have evaluated the effects of pre-operative steroids (STER) for transsphenoidal pituitary removal in patients with an intact hypothalamus-pituitary-adrenal axis. However, a consensus built upon randomized studies has not been previously performed. PURPOSE To comprehensively evaluate the clinical effects of patients receiving STER when compared to those not receiving steroids (NOSTER) in transsphenoidal pituitary resection, a meta-analysis of randomized clinical trials (RCT) was conducted. METHODS A systematic review of the literature of RCTs comparing STER and NOSTER was performed in accordance with the PRISMA guidelines. Databases, including PUBMED, Cochrane Library, Web of Science, and Embase were queried. The primary outcomes were adrenal insufficiency (AI) and diabetes insipidus (DI) post-operatively. RESULTS A total of 4 final studies were included, in which 530 total patients were analyzed. The meta-analysis suggested that there was no significant difference between STER and NOSTER groups post-operatively related to transient AI (RR= 0.83, 95% CI [0.51-1.35], p = 0.45; I² = 52%), permanent AI (RR= 0.97, 95% CI [0.41-2.31], p = 0.95; I² = 0%), and permanent DI (RR= 0.62, 95% CI [0.16-2.33], p = 0.48; I² = 0%). Nevertheless, STER group had significantly lower rates of transient DI (RR= 0.60, 95% CI [0.38-0.95], p = 0.03; I² = 5%), and post-op hyponatremia (RR = 0.49, 95% CI [0.28-0.87], p = 0.02; I² = 0%). CONCLUSION This study demonstrates evidence from RCTs that patients receiving pre-operative STER are both safe and effective pre-operatively for resection of pituitary adenomas with an intact hypothalamus-pituitary-adrenal axis.
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Affiliation(s)
- Sávio Batista
- Federal University of Rio de Janeiro, Faculty of Medicine, Brazil
| | - Jose Alberto Almeida
- Department of Neurosurgery, Hospital Municipal Miguel Couto, Rio de Janeiro, RJ, Brazil
| | - Stefan Koester
- Vanderbilt University, School of Medicine, Nashville, TN, USA
| | | | | | | | | | - Raphael Bertani
- Department of Neurosurgery, University of São Paulo, São Paulo, Brazil
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33
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Mark IT, Glastonbury CM. MR Imaging Appearance of Ruptured Rathke Cleft Cyst and Associated Bone Marrow Enhancement. AJNR Am J Neuroradiol 2023; 44:1314-1317. [PMID: 37798112 PMCID: PMC10631529 DOI: 10.3174/ajnr.a8009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 08/30/2023] [Indexed: 10/07/2023]
Abstract
Rathke cleft cysts are common cystic pituitary lesions seen on MR imaging. A subset of Rathke cleft cysts can rupture within the sella and are uncommon. The imaging appearance of a ruptured Rathke cleft cyst has been previously described with nonspecific imaging findings. We present 7 cases of ruptured Rathke cleft cysts and basisphenoid bone marrow enhancement below the sella that could be used to potentially distinguish a ruptured Rathke cleft cyst from other cystic lesions.
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Affiliation(s)
- Ian T Mark
- From the Department of Radiology (I.T.M.), Mayo Clinic, Rochester, Minnesota
- Department of Radiology and Biomedical Imaging (I.T.M., C.M.G.), University of California San Francisco, San Francisco, California
| | - Christine M Glastonbury
- Department of Radiology and Biomedical Imaging (I.T.M., C.M.G.), University of California San Francisco, San Francisco, California
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34
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Sugimoto R, Kenzaka T, Nishisaki H. Hyponatremia due to adrenal insufficiency after a Mamushi bite: a case report. BMC Endocr Disord 2023; 23:219. [PMID: 37821844 PMCID: PMC10566049 DOI: 10.1186/s12902-023-01466-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 09/20/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Mamushi bites are the most common venomous snake bites in Japan, with known complications including rhabdomyolysis and acute kidney injury; however, adrenal insufficiency as a result of snake bites has not been previously reported. We report a case of empty sella with transient adrenal insufficiency during hospitalization for a Mamushi bite. CASE PRESENTATION An 84-year-old man was admitted to our hospital with a Mamushi bite on the right fifth finger. Serum sodium (Na) level remained in the normal range. On the ninth day of admission, he developed hyponatremia, with a serum Na level of 114 mEq/L and serum cortisol level of 4.0 μg/dL (reference value 4.5-21.1 μg/dL). His serum Na level was restored within the normal range after administration of corticosteroids with 3% NaCl solution. Both rapid adrenocorticotrophin and corticotropin-releasing hormone loading tests showed low cortisol response. Based on the results of the hormone loading tests, a diagnosis of pituitary adrenal insufficiency was made. Contrast-enhanced pituitary magnetic resonance imaging (MRI) showed primary empty sella. After discontinuation of corticosteroids, the hyponatremia did not recur, and the patient was discharged on the 24th day of hospitalization. After discharge, the patient visited an outpatient clinic, but hyponatremia recurrence was not observed. CONCLUSIONS This is the first report of hyponatremia due to pituitary adrenal insufficiency during hospitalization for a Mamushi bite in a patient with empty sella. When hyponatremia occurs during hospitalization for a Mamushi bite, cortisol measurement, hormone loading test, and head MRI should be performed to search for pituitary lesions because of the possibility of adrenal insufficiency caused by snake venom.
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Affiliation(s)
- Ryu Sugimoto
- Department of Internal Medicine, Hyogo Prefectural Tamba Medical Center, 2002-7 Iso, Hikami-Cho, Tamba, 669-3495, Japan.
| | - Tsuneaki Kenzaka
- Department of Internal Medicine, Hyogo Prefectural Tamba Medical Center, 2002-7 Iso, Hikami-Cho, Tamba, 669-3495, Japan
- Division of Community Medicine and Career Development, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Hogara Nishisaki
- Department of Internal Medicine, Hyogo Prefectural Tamba Medical Center, 2002-7 Iso, Hikami-Cho, Tamba, 669-3495, Japan
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35
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Oliveira JM, Zenzeluk J, Bargi-Souza P, Szawka RE, Romano MA, Romano RM. The effects of glyphosate-based herbicide on the hypothalamic-pituitary thyroid axis are tissue-specific and dependent on age exposure. Environ Pollut 2023; 334:122216. [PMID: 37479171 DOI: 10.1016/j.envpol.2023.122216] [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: 06/23/2023] [Revised: 07/14/2023] [Accepted: 07/16/2023] [Indexed: 07/23/2023]
Abstract
The significant increase in glyphosate-based herbicide (GBH) use raises concerns about residues in the environment and food, potentially jeopardizing human health. The involvement of GBHs in the increased incidence of thyroid disorders is speculated, since glyphosate has been linked to an increased risk of thyroid disease in farmers. In this sense, this study aims to investigate the potential effects of low levels of GBH exposure (0, 0.5 or 5 mg/kg) from weaning (postnatal day PND23) to adult life (PND60 and PND90) in male Wistar rats on hypothalamic-pituitary-thyroid (HPT) axis function. The serum levels of T4 were increased. The hypothalamus showed reduced expression of Dio2, Thra1, and Thra2. The pituitary showed reduced expression of Mct8 and Dio2 and increased expression of Thra1. The thyroid showed increased expression of Tshr and Thra1. The heart showed increased expression of Mct8 and Myh6. The liver showed reduced expression of Mct8 and Thra2 and increased expression of Thra1. In thyroid morphometry, a decrease in both follicular diameter and area and decreased follicular and colloid diameters and areas were observed. These results suggested that GBH may affect several steps of HPT axis regulation at the transcriptional level in an age-dependent manner and alter the morphometric parameters of the thyroid gland and TH synthesis, with potential repercussions in the TH-target organs.
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Affiliation(s)
- Jeane Maria Oliveira
- Department of Medicine, State University of Central-West (UNICENTRO), Guarapuava, Parana, Brazil
| | - Jamilli Zenzeluk
- Department of Medicine, State University of Central-West (UNICENTRO), Guarapuava, Parana, Brazil
| | - Paula Bargi-Souza
- Department of Physiology and Biophysics, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Raphael Escorsim Szawka
- Department of Physiology and Biophysics, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Marco Aurelio Romano
- Department of Medicine, State University of Central-West (UNICENTRO), Guarapuava, Parana, Brazil
| | - Renata Marino Romano
- Department of Medicine, State University of Central-West (UNICENTRO), Guarapuava, Parana, Brazil.
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Contrera KJ, Phan J, Waguespack SG, Aldehaim M, Wang X, Lim TY, Roberts DB, Fuller CD, Spiotto MT, Raza SM, DeMonte F, Hanna EY, Su SY. Prevalence of pituitary hormone dysfunction following radiotherapy for sinonasal and nasopharyngeal malignancies. Head Neck 2023; 45:2525-2532. [PMID: 37534890 PMCID: PMC10766346 DOI: 10.1002/hed.27476] [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: 03/22/2023] [Revised: 06/17/2023] [Accepted: 07/23/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND There are limited studies and no surveillance protocols on pituitary dysfunction for adults who underwent anterior skull base radiation. METHODS Cross-sectional study of 50 consecutive patients with sinonasal or nasopharyngeal cancer who underwent definitive radiotherapy. The mean radiation doses, prevalence of pituitary dysfunction, and associated factors were calculated. RESULTS Pituitary hormone levels were abnormal in 23 (46%) patients, including 6 (12%) with symptomatic abnormalities requiring treatment. The most common hormonal abnormality was hyperprolactinemia (30%), central hypothyroidism (8%) and central hypogonadism (6%). Patients with abnormal pituitary hormone values received higher mean radiation doses to the pituitary gland (1143 cGy, P = 0.04), pituitary stalk (1129 cGy, P = 0.02), optic chiasm (1094 cGy, P = 0.01), and hypothalamus (900 cGy, P = 0.01). CONCLUSIONS Nearly half of the patients had abnormal pituitary function, including over a tenth requiring treatment. There may be a dose-dependent association between hormonal dysfunction and radiation.
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Affiliation(s)
- Kevin J. Contrera
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Jack Phan
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Steven G. Waguespack
- Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Mohammed Aldehaim
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
- Department of Radiation Oncology, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Xin Wang
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Tze Yee Lim
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Dianna B. Roberts
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - C. David Fuller
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Michael T. Spiotto
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Shaan M. Raza
- Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Franco DeMonte
- Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Ehab Y. Hanna
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Shirley Y. Su
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Giustina A, Uygur MM, Frara S, Barkan A, Biermasz NR, Chanson P, Freda P, Gadelha M, Kaiser UB, Lamberts S, Laws E, Nachtigall LB, Popovic V, Reincke M, Strasburger C, van der Lely AJ, Wass JAH, Melmed S, Casanueva FF. Pilot study to define criteria for Pituitary Tumors Centers of Excellence (PTCOE): results of an audit of leading international centers. Pituitary 2023; 26:583-596. [PMID: 37640885 PMCID: PMC10539196 DOI: 10.1007/s11102-023-01345-0] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/24/2023] [Indexed: 08/31/2023]
Abstract
PURPOSE The Pituitary Society established the concept and mostly qualitative parameters for defining uniform criteria for Pituitary Tumor Centers of Excellence (PTCOEs) based on expert consensus. Aim of the study was to validate those previously proposed criteria through collection and evaluation of self-reported activity of several internationally-recognized tertiary pituitary centers, thereby transforming the qualitative 2017 definition into a validated quantitative one, which could serve as the basis for future objective PTCOE accreditation. METHODS An ad hoc prepared database was distributed to nine Pituitary Centers chosen by the Project Scientific Committee and comprising Centers of worldwide repute, which agreed to provide activity information derived from registries related to the years 2018-2020 and completing the database within 60 days. The database, provided by each center and composed of Excel® spreadsheets with requested specific information on leading and supporting teams, was reviewed by two blinded referees and all 9 candidate centers satisfied the overall PTCOE definition, according to referees' evaluations. To obtain objective numerical criteria, median values for each activity/parameter were considered as the preferred PTCOE definition target, whereas the low limit of the range was selected as the acceptable target for each respective parameter. RESULTS Three dedicated pituitary neurosurgeons are preferred, whereas one dedicated surgeon is acceptable. Moreover, 100 surgical procedures per center per year are preferred, while the results indicated that 50 surgeries per year are acceptable. Acute post-surgery complications, including mortality and readmission rates, should preferably be negligible or nonexistent, but acceptable criterion is a rate lower than 10% of patients with complications requiring readmission within 30 days after surgery. Four endocrinologists devoted to pituitary diseases are requested in a PTCOE and the total population of patients followed in a PTCOE should not be less than 850. It appears acceptable that at least one dedicated/expert in pituitary diseases is present in neuroradiology, pathology, and ophthalmology groups, whereas at least two expert radiation oncologists are needed. CONCLUSION This is, to our knowledge, the first study to survey and evaluate the activity of a relevant number of high-volume centers in the pituitary field. This effort, internally validated by ad hoc reviewers, allowed for transformation of previously formulated theoretical criteria for the definition of a PTCOE to precise numerical definitions based on real-life evidence. The application of a derived synopsis of criteria could be used by independent bodies for accreditation of pituitary centers as PTCOEs.
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Affiliation(s)
- A Giustina
- Institute of Endocrine and Metabolic Sciences, San Raffaele Vita-Salute University and IRCCS Hospital, Via Olgettina 60, 20132, Milan, Italy.
| | - M M Uygur
- Institute of Endocrine and Metabolic Sciences, San Raffaele Vita-Salute University and IRCCS Hospital, Via Olgettina 60, 20132, Milan, Italy
- Department of Endocrinology and Metabolism Disease, School of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey
| | - S Frara
- Institute of Endocrine and Metabolic Sciences, San Raffaele Vita-Salute University and IRCCS Hospital, Via Olgettina 60, 20132, Milan, Italy
| | - A Barkan
- Division of Endocrinology, University of Michigan Health System, Ann Arbor, MI, USA
| | - N R Biermasz
- Leiden University Medical Center, Center for Endocrine Tumors Leiden, Leiden, The Netherlands
| | - P Chanson
- Université Paris-Saclay, Inserm, Physiologie et Physiopathologie Endocriniennes, APHP, Hôpital Bicêtre, Service d'Endocrinologie et des Maladies de la Reproduction et Centre de Référence des Maladies Rares de l'Hypophyse HYPO, Le Kremlin-Bicêtre, Paris, France
| | - P Freda
- Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - M Gadelha
- Instituto Estadual do Cérebro Paulo Niemeyer, Secretaria Estadual de Saúde do Rio de Janeiro, Rio de Janeiro, Brazil
| | - U B Kaiser
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - S Lamberts
- Erasmus Medical Center, Rotterdam, The Netherlands
| | - E Laws
- Pituitary/Neuroendocrine Center, Brigham & Women's Hospital, Boston, MA, USA
| | - L B Nachtigall
- Neuroendocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - V Popovic
- Medical Faculty, University of Belgrade, Belgrade, Serbia
| | - M Reincke
- Department of Medicine IV, LMU University Hospital, LMU Munich, Munich, Germany
| | - C Strasburger
- Department of Medicine for Endocrinology, Diabetes and Nutritional Medicine, Charité Universitätsmedizin, Berlin, Germany
| | - A J van der Lely
- Pituitary Center Rotterdam, Endocrinology Section, Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - J A H Wass
- Department of Endocrinology, Churchill Hospital, University of Oxford, Oxford, United Kingdom
| | - S Melmed
- Pituitary Center, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - F F Casanueva
- Division of Endocrinology, Santiago de Compostela University and Ciber OBN, Santiago, Spain
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Dai J, Chen J, Xu X, Gao N, Wang Y. A case report of dangerous pelvic infundibulum ligament in the second trimester of pregnancy with massive hemorrhage. Medicine (Baltimore) 2023; 102:e35230. [PMID: 37747006 PMCID: PMC10519526 DOI: 10.1097/md.0000000000035230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/15/2023] [Accepted: 08/24/2023] [Indexed: 09/26/2023] Open
Abstract
RATIONALE Abdominal pregnancy is a rare ectopic pregnancy and its diagnosis and treatment are more challenging than those of other ectopic pregnancies. Because of a variable pregnancy site, abdominal pregnancy is associated with an increased risk of fatal abdominal hemorrhage, and consequently, an increased risk of maternal death compared with intrauterine pregnancy. DIAGNOSES Pelvic infundibulum ligament pregnancy complicated with massive hemorrhage. PATIENT CONCERNS 42-year-old pregnant woman who did not undergo an obstetric examination during the first trimester presented with sudden abdominal pain during the second trimester. Abdominal pregnancy was confirmed after emergency treatment, causing difficulty in the comprehensive preoperative evaluation.Interventions: In order to save the patient life, we actively carried out surgical treatment. OUTCOMES The patient recovered well after the operation and was discharged on the 11th postoperative day. Blood β-human chorionic gonadotropin (β-hCG) levels and routine blood test results were normal 1 month after the surgery, and the patient had recovered. LESSONS Several challenges are encountered in the diagnosis of abdominal pregnancy with regard to insufficient economic, cultural, and medical resources. In case of ectopic pregnancies, surgery should be the first choice of treatment, and preparations of blood transfusion are essential to combat the risk of rapid hemorrhagic shock caused by placenta implantation in the infundibulum ligament of the pelvis. The operation must be performed by experienced obstetricians and gynecologists.
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Affiliation(s)
- Jiahui Dai
- Clinical Medical College, Jining Medical University, Jining, Shandong, China
| | - Jin Chen
- Program for Scientific Research Innovation Team in Precision Medicine of Gynecologic Oncology, Affiliated Hospital of Jining Medical University, Jining, Shandong China
| | - Xiaohan Xu
- Clinical Medical College, Jining Medical University, Jining, Shandong, China
| | - Ni Gao
- Clinical Medical College, Jining Medical University, Jining, Shandong, China
| | - Yunfei Wang
- Program for Scientific Research Innovation Team in Precision Medicine of Gynecologic Oncology, Affiliated Hospital of Jining Medical University, Jining, Shandong China
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Silver R, Yao Y, Roy RK, Stern JE. Parallel trajectories in the discovery of the SCN-OVLT and pituitary portal pathways: Legacies of Geoffrey Harris. J Neuroendocrinol 2023; 35:e13245. [PMID: 36880566 PMCID: PMC10423749 DOI: 10.1111/jne.13245] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/17/2023] [Accepted: 01/19/2023] [Indexed: 02/16/2023]
Abstract
A map of central nervous system organization based on vascular networks provides a layer of organization distinct from familiar neural networks or connectomes. As a well-established example, the capillary networks of the pituitary portal system enable a route for small amounts of neurochemical signals to reach local targets by traveling along specialized pathways, thereby avoiding dilution in the systemic circulation. The first evidence of such a pathway in the brain came from anatomical studies identifying a portal pathway linking the hypothalamus and the pituitary gland. Almost a century later, we demonstrated a vascular portal pathway that joined the capillary beds of the suprachiasmatic nucleus and a circumventricular organ, the organum vasculosum of the lamina terminalis, in a mouse brain. For each of these portal pathways, the anatomical findings opened many new lines of inquiry, including the determination of the direction of flow of information, the identity of the signal that flowed along this pathway, and the function of the signals that linked the two regions. Here, we review landmark steps to these discoveries and highlight the experiments that reveal the significance of portal pathways and more generally, the implications of morphologically distinct nuclei sharing capillary beds.
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Affiliation(s)
- Rae Silver
- Department of Neuroscience, Barnard College, 3009 Broadway, New York City, NY, 10027, USA
- Columbia University Department of Psychology, 1190 Amsterdam Avenue, New York City, NY, 10027, USA
- Department of Psychology, Barnard College, 3009 Broadway, New York City, NY, 10027, USA
| | - Yifan Yao
- Columbia University Department of Psychology, 1190 Amsterdam Avenue, New York City, NY, 10027, USA
| | - Ranjan K. Roy
- Center for Neuroinflammation and Cardiometabolic Diseases, Georgia State University, Atlanta, GA, 30303, USA
| | - Javier E. Stern
- Center for Neuroinflammation and Cardiometabolic Diseases, Georgia State University, Atlanta, GA, 30303, USA
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40
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Kurokawa R, Kurokawa M, Baba A, Nakaya M, Kato S, Bapuraj J, Nakata Y, Ota Y, Srinivasan A, Abe O, Moritani T. Neuroimaging of hypophysitis: etiologies and imaging mimics. Jpn J Radiol 2023; 41:911-927. [PMID: 37010787 PMCID: PMC10468747 DOI: 10.1007/s11604-023-01417-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 03/24/2023] [Indexed: 04/04/2023]
Abstract
Hypophysitis is an inflammatory disease affecting the pituitary gland. Hypophysitis can be classified into multiple types depending on the mechanisms (primary or secondary), histology (lymphocytic, granulomatous, xanthomatous, plasmacytic/IgG4 related, necrotizing, or mixed), and anatomy (adenohypophysitis, infundibulo-neurohypophysitis, or panhypophysitis). An appropriate diagnosis is vital for managing these potentially life-threatening conditions. However, physiological morphological alterations, remnants, and neoplastic and non-neoplastic lesions may masquerade as hypophysitis, both clinically and radiologically. Neuroimaging, as well as imaging findings of other sites of the body, plays a pivotal role in diagnosis. In this article, we will review the types of hypophysitis and summarize clinical and imaging features of both hypophysitis and its mimickers.
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Affiliation(s)
- Ryo Kurokawa
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI, 48109, USA.
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
| | - Mariko Kurokawa
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI, 48109, USA
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Akira Baba
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI, 48109, USA
| | - Moto Nakaya
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Shimpei Kato
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Jayapalli Bapuraj
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI, 48109, USA
| | - Yasuhiro Nakata
- Department Or Neuroradiology, Tokyo Metropolitan Neurological Hospital, 2-6-1 Musashidai, Fuchu, Tokyo, 183-0042, Japan
| | - Yoshiaki Ota
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI, 48109, USA
| | - Ashok Srinivasan
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI, 48109, USA
| | - Osamu Abe
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Toshio Moritani
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI, 48109, USA
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Gstrein NA, Zwicky S, Serra C, Hugelshofer M, Regli L, Soyka MB, Holzmann D, Meerwein CM. Rhinologic outcome of endoscopic transnasal-transsphenoidal pituitary surgery: an institutional series, systematic review, and meta-analysis. Eur Arch Otorhinolaryngol 2023; 280:4091-4099. [PMID: 36988686 PMCID: PMC10382340 DOI: 10.1007/s00405-023-07934-w] [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: 11/29/2022] [Accepted: 03/17/2023] [Indexed: 03/30/2023]
Abstract
PURPOSE We aimed to summarize the available data on the objective rhinologic outcome after endoscopic transnasal-transsphenoidal (ETT) surgery. METHODS Retrospective study on a consecutive cohort of treatment-naïve patients undergoing ETT pituitary gland surgery. Additionally, a systematic review and meta-analysis with focus on the rhinologic outcome, including postoperative smell function was performed. RESULTS The institutional series incorporated 168 patients. A concomitant endoscopic septoplasty was performed in 29/168 patients (17.3%). A nasoseptal flap was used for reconstruction of large skull-base defects or high-flow CSF leaks in 4/168 (2.4%) patients. Early postoperative rhinologic complications (< 4 weeks) included epistaxis (3%), acute rhinosinusitis (1.2%) and late postoperative complications (≥ 8 weeks) comprised prolonged crusting (15.6%), symptomatic synechiae (11.9%) and septal perforation (0.6%). Postoperative smell function was not impaired (Fisher's exact test, p = 1.0). The systematic review included 19 studies on 1533 patients with a median postoperative epistaxis rate of 1.4% (IQR 1.0-2.2), a postoperative acute rhinosinusitis rate of 2.3% (IQR 2.1-3.0), a postoperative synechiae rate of 7.5% (IQR 1.8-19.1) and a postoperative septal perforation rate of 2.2% (IQR 0.5-5.4). Seven studies including a total of 206 patients reported adequate outcome measures for smell function before and after ETT surgery. Only 2/7 studies reported an impairment of smell function postoperatively, especially in patients with nasoseptal flap harvesting. CONCLUSION Early and late postoperative rhinologic complication rates after ETT surgery for pituitary lesions seem to be low. A thorough evaluation of smell function, in particular in patients at risk for nasoseptal flap harvesting, may be an important factor in optimal postoperative care.
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Affiliation(s)
- Nathalie A Gstrein
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, University of Zurich, Frauenklinikstrasse 24, 8091, Zurich, Switzerland
| | - Sebastian Zwicky
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, University of Zurich, Frauenklinikstrasse 24, 8091, Zurich, Switzerland
| | - Carlo Serra
- Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Michael Hugelshofer
- Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Luca Regli
- Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Michael B Soyka
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, University of Zurich, Frauenklinikstrasse 24, 8091, Zurich, Switzerland
| | - David Holzmann
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, University of Zurich, Frauenklinikstrasse 24, 8091, Zurich, Switzerland
| | - Christian M Meerwein
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, University of Zurich, Frauenklinikstrasse 24, 8091, Zurich, Switzerland.
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Vigo V, Chang JE, Nunez MA, Prolo LM, Hwang PH, Fernandez-Miranda JC. Endoscopic Endonasal Transtuberculum Approach for Pediatric Tuberoinfundibular Craniopharyngioma: 2-Dimensional Operative Video. Oper Neurosurg (Hagerstown) 2023; 25:e147-e148. [PMID: 37350589 DOI: 10.1227/ons.0000000000000726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 02/24/2023] [Indexed: 06/24/2023] Open
Abstract
INDICATIONS CORRIDOR AND LIMITS OF EXPOSURE The endoscopic endonasal transtuberculum approach grants access to suprasellar and retrochiasmatic lesions with hypothalamic involvement. Here, we present a case of a 13-year-old boy with a history of stunted growth, decreased vision, headaches, and low energy with a tuberoinfundibular craniopharyngioma. The patient consented to the procedure. ANATOMIC ESSENTIALS NEED FOR PREOPERATIVE PLANNING AND ASSESSMENT Evaluation of the sphenoid sinus pneumatization, internal carotid artery disposition, presence of clinoidal rings, variations of the infrachiasmatic corridor (optic chiasm location, height of dorsum sella), and location of the pituitary stalk are crucial for surgical strategy. ESSENTIALS STEPS OF THE PROCEDURE Harvesting of nasoseptal flap and access to the sphenoid sinus; drilling the sella, tuberculum, and chiasmatic sulcus up to the limbus sphenoidalis and laterally exposing the clinoidal carotid artery segment; wide dural opening to the level of distal rings inferolaterally and falciform ligaments superolaterally; identification and coagulation of superior hypophyseal branches providing tumor supply; intracapsular dissection and debulking and subpial sharp dissection at the hypothalamic tumor interface to achieve complete removal; and reconstruction with inlay collagen, fascia lata, and nasoseptal flap. PITFALLS/AVOIDANCE OF COMPLICATIONS Preservation of the superior hypophyseal arteries and stalk is essential for preventing pituitary dysfunction. Preoperative reckoning of hypothalamic invasion and identification of adequate interface aids in avoiding complications. To reduce CSF leak risk, multilayer reconstruction was performed and lumbar drain placed postoperatively. VARIANTS AND INDICATIONS FOR THEIR USE For retroclival extension, intradural pituitary transposition should be considered to expand the corridor; in patients with preoperative hypopituitarism, pituitary sacrifice is most effective to increase retroclival access.
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Affiliation(s)
- Vera Vigo
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, California, USA
| | - Jose E Chang
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, California, USA
| | - Maximiliano A Nunez
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, California, USA
| | - Laura M Prolo
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, California, USA
| | - Peter H Hwang
- Department of Otolaryngology - Head and Neck Surgery, Stanford University School of Medicine, Stanford, California, USA
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43
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Kurosaki M. [Overview of the New World Health Organization Classification of Pituitary Neuroendocrine Tumors]. No Shinkei Geka 2023; 51:910-916. [PMID: 37743343 DOI: 10.11477/mf.1436204833] [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: 09/26/2023]
Abstract
The 5th edition of the World Health Organization(WHO)classification of endocrine and neuroendocrine tumors was revised in 2022. A major nomenclature change was from "adenoma" to "pituitary neuroendocrine tumor"(PitNET). Tumors are classified based on the cell lineage as determined by expression of transcription factors, such as, PIT1, TPIT, and SF1. Therapeutic modalities available for management of functioning PitNETs include surgery, medical treatment, and irradiation. Transsphenoidal surgery is the gold-standard surgical treatment. The aim of the present study was to summarize changes from the previous edition of the WHO classification and discuss topics regrading PIT1, TPIT, and SF1-lineage PitNETs with reference to clinicopathological findings.
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Affiliation(s)
- Masamichi Kurosaki
- Division of Neurosurgery, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University
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Gonigam RL, Weis KE, Ge X, Yao B, Zhang Q, Raetzman LT. Characterization of Somatotrope Cell Expansion in Response to GHRH in the Neonatal Mouse Pituitary. Endocrinology 2023; 164:bqad131. [PMID: 37616545 PMCID: PMC11009787 DOI: 10.1210/endocr/bqad131] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 07/25/2023] [Accepted: 08/22/2023] [Indexed: 08/26/2023]
Abstract
In humans and mice, loss-of-function mutations in growth hormone-releasing hormone receptor (GHRHR) cause isolated GH deficiency. The mutant GHRHR mouse model, GhrhrLit/Lit (LIT), exhibits loss of serum GH, but also fewer somatotropes. However, how loss of GHRH signaling affects expansion of stem and progenitor cells giving rise to GH-producing cells is unknown. LIT mice and wild-type littermates were examined for differences in proliferation and gene expression of pituitary lineage markers by quantitative reverse transcription polymerase chain reaction and immunohistochemistry at postnatal day 5 (p5) and 5 weeks. At p5, the LIT mouse shows a global decrease in pituitary proliferation measured by proliferation marker Ki67 and phospho-histone H3. This proliferative defect is seen in a pituitary cell expressing POU1F1 with or without GH. SOX9-positive progenitors show no changes in proliferation in p5 LIT mice. Additionally, the other POU1F1 lineage cells are not decreased in number; rather, we observe an increase in lactotrope cell population as well as messenger RNA for Tshb and Prl. In the 5-week LIT pituitary, the proliferative deficit in POU1F1-expressing cells observed neonatally persists, while the number and proliferative proportion of SOX9 cells do not appear changed. Treatment of cultured pituitary explants with GHRH promotes proliferation of POU1F1-expressing cells, but not GH-positive cells, in a mitogen-activated protein kinase-dependent manner. These findings indicate that hypothalamic GHRH targets proliferation of a POU1F1-positive cell, targeted to the somatotrope lineage, to fine tune their numbers.
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Affiliation(s)
- Richard L Gonigam
- Department of Molecular and Integrative Physiology, University of Illinois Urbana-Champaign, Urbana, IL 61801, USA
| | - Karen E Weis
- Department of Molecular and Integrative Physiology, University of Illinois Urbana-Champaign, Urbana, IL 61801, USA
| | - Xiyu Ge
- Department of Molecular and Integrative Physiology, University of Illinois Urbana-Champaign, Urbana, IL 61801, USA
| | - Boyuan Yao
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai 200031, China
- National Center for Neurological Disorders, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai 200031, China
| | - Qilin Zhang
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai 200031, China
- National Center for Neurological Disorders, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai 200031, China
| | - Lori T Raetzman
- Department of Molecular and Integrative Physiology, University of Illinois Urbana-Champaign, Urbana, IL 61801, USA
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Scagliotti V, Vignola ML, Willis T, Howard M, Marinelli E, Gaston-Massuet C, Andoniadou C, Charalambous M. Imprinted Dlk1 dosage as a size determinant of the mammalian pituitary gland. eLife 2023; 12:e84092. [PMID: 37589451 PMCID: PMC10468206 DOI: 10.7554/elife.84092] [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: 10/10/2022] [Accepted: 08/16/2023] [Indexed: 08/18/2023] Open
Abstract
Co-regulated genes of the Imprinted Gene Network are involved in the control of growth and body size, and imprinted gene dysfunction underlies human paediatric disorders involving the endocrine system. Imprinted genes are highly expressed in the pituitary gland, among them, Dlk1, a paternally expressed gene whose membrane-bound and secreted protein products can regulate proliferation and differentiation of multiple stem cell populations. Dosage of circulating DLK1 has been previously implicated in the control of growth through unknown molecular mechanisms. Here we generate a series of mouse genetic models to modify levels of Dlk1 expression in the pituitary gland and demonstrate that the dosage of DLK1 modulates the process of stem cell commitment with lifelong impact on pituitary gland size. We establish that stem cells are a critical source of DLK1, where embryonic disruption alters proliferation in the anterior pituitary, leading to long-lasting consequences on growth hormone secretion later in life.
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Affiliation(s)
- Valeria Scagliotti
- Department of Medical and Molecular Genetics, Faculty of Life Sciences and Medicine, King’s College LondonLondonUnited Kingdom
| | - Maria Lillina Vignola
- Department of Medical and Molecular Genetics, Faculty of Life Sciences and Medicine, King’s College LondonLondonUnited Kingdom
| | - Thea Willis
- Department of Medical and Molecular Genetics, Faculty of Life Sciences and Medicine, King’s College LondonLondonUnited Kingdom
- Centre for Craniofacial and Regenerative Biology, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College LondonLondonUnited Kingdom
| | - Mark Howard
- MRC Centre for Transplantation, Peter Gorer Department of Immunobiology, School of Immunology & Microbial Sciences, King’s College LondonLondonUnited Kingdom
| | - Eugenia Marinelli
- Department of Medical and Molecular Genetics, Faculty of Life Sciences and Medicine, King’s College LondonLondonUnited Kingdom
| | - Carles Gaston-Massuet
- Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of LondonLondonUnited Kingdom
| | - Cynthia Andoniadou
- Centre for Craniofacial and Regenerative Biology, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College LondonLondonUnited Kingdom
| | - Marika Charalambous
- Department of Medical and Molecular Genetics, Faculty of Life Sciences and Medicine, King’s College LondonLondonUnited Kingdom
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Laporte E, Vankelecom H. Organoid models of the pituitary gland in health and disease. Front Endocrinol (Lausanne) 2023; 14:1233714. [PMID: 37614709 PMCID: PMC10442803 DOI: 10.3389/fendo.2023.1233714] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 07/20/2023] [Indexed: 08/25/2023] Open
Abstract
The pituitary gland represents the hub of our endocrine system. Its cells produce specific hormones that direct multiple vital physiological processes such as body growth, fertility, and stress. The gland also contains a population of stem cells which are still enigmatic in phenotype and function. Appropriate research models are needed to advance our knowledge on pituitary (stem cell) biology. Over the last decade, 3D organoid models have been established, either derived from the pituitary stem cells or from pluripotent stem cells, covering both healthy and diseased conditions. Here, we summarize the state-of-the-art of pituitary-allied organoid models and discuss applications of these powerful in vitro research and translational tools to study pituitary development, biology, and disease.
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Affiliation(s)
- Emma Laporte
- Department of Development and Regeneration, Cluster of Stem Cell and Developmental Biology, Laboratory of Tissue Plasticity in Health and Disease, Katholieke Universiteit (KU) Leuven, Leuven, Belgium
| | - Hugo Vankelecom
- Department of Development and Regeneration, Cluster of Stem Cell and Developmental Biology, Laboratory of Tissue Plasticity in Health and Disease, Katholieke Universiteit (KU) Leuven, Leuven, Belgium
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Risbud A, Kuan EC, Wu AW, Mamelak AN, Tang DM. Postoperative Obstructive Sleep Apnea Management Following Endoscopic Pituitary Surgery: A Systematic Review. World Neurosurg 2023; 176:143-148. [PMID: 37149088 DOI: 10.1016/j.wneu.2023.04.116] [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: 04/17/2023] [Accepted: 04/26/2023] [Indexed: 05/08/2023]
Abstract
OBJECTIVE There is currently no consensus on the appropriate timing of noninvasive positive pressure ventilation (PPV) resumption in patients with obstructive sleep apnea (OSA) after endoscopic pituitary surgery. We performed a systematic review of the literature to better assess the safety of early PPV use in OSA patients following surgery. METHODS The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Databases in English were searched using the keywords: "sleep apnea," "CPAP," "endoscopic," "skull base," "transsphenoidal" and "pituitary surgery." Case reports, editorials, reviews, meta-analyses, unpublished and abstract-only articles were all excluded. RESULTS Five retrospective studies were identified, comprising 267 patients with OSA who underwent endoscopic endonasal pituitary surgery. The mean age of patients in four studies (n = 198) was 56.3 years (SD = 8.6) and the most common indication for surgery was pituitary adenoma resection. The timing of PPV resumption following surgery was reported in four studies (n = 130), with 29 patients receiving PPV therapy within two weeks. The pooled rate of postoperative cerebrospinal fluid leak associated with PPV resumption was 4.0% (95% CI: 1.3-6.7%) in three studies (n = 27) and there were no reports of pneumocephalus associated with PPV use in the early postoperative period (<2 weeks). CONCLUSIONS Early resumption of PPV in OSA patients after endoscopic endonasal pituitary surgery appears relatively safe. However, the current literature is limited. Additional studies with more rigorous outcome reporting are warranted to assess the true safety of re-initiating PPV postoperatively in this population.
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Affiliation(s)
- Adwight Risbud
- Division of Otolaryngology-Head & Neck Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Edward C Kuan
- Department of Otolaryngology-Head & Neck Surgery, University of California, Irvine, Orange, California, USA
| | - Arthur W Wu
- Division of Otolaryngology-Head & Neck Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Adam N Mamelak
- Department of Neurological Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Dennis M Tang
- Division of Otolaryngology-Head & Neck Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.
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Hong S, Atkinson JL, Erickson D, Kizilbash SH, Little JT, Routman DM, Van Gompel JJ. Treatment outcome of metastasis to the pituitary gland: a case series of 21 patients with pathological diagnosis. Neurosurg Focus 2023; 55:E13. [PMID: 37527679 DOI: 10.3171/2023.5.focus23185] [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: 03/26/2023] [Accepted: 05/16/2023] [Indexed: 08/03/2023]
Abstract
OBJECTIVE The aim of this study was to report the treatment course of histologically confirmed metastases to the pituitary gland (pituitary metastasis). METHODS The Mayo data explorer was used to find patients with pituitary metastasis. Twenty-one patients were identified between the years 2001 and 2021, and their data were retrospectively collected. RESULTS The most common primary cancer origin was lung in men (45%) and breast in women (33%). The median age was 66 years (IQR 56-68 years). Patients presented with headache (67% [14/21]), vision problems (86% [18/21]), anterior hypopituitarism (71% [15/21]), and arginine vasopressin deficiency (38% [8/21]). Pituitary metastases were found before the diagnosis of the primary cancer in 5 patients (24%). The mean ± SD tumor size was 2.0 ± 0.7 cm, and 90% (19/21) presented as a solitary pituitary mass with no other intracranial metastatic lesions. Common radiological features were pituitary stalk thickening (90% [19/21]), cavernous sinus involvement (71% [15/21]), and constriction at the diaphragma sellae (52% [11/21]). Transsphenoidal surgery was performed in 20 patients, and subtotal resection was most frequently attained (76% [16/21]). Fourteen patients (67%) had adjuvant radiation therapy, and 15 patients (71%) were treated with systemic therapy. The median time from surgery to the initiation of radiation therapy was 16 days (IQR 11-21 days), and that from surgery to the initiation of systemic therapy was 5.0 months (IQR 1.5-14 months). During management, headaches improved in 57% (8/14) and vision problems improved in 61% (11/18) of cases; new hypopituitarism occurred in 5 patients. Six patients developed recurrence, and the median progression-free survival was 24 months (95% CI 5.4-43 months). After recurrence, 1 patient with adenoid cystic carcinoma was treated with rescue radiotherapy twice, and 4 patients responded well to systemic therapy. The median overall survival (OS) was 25 months (95% CI 7.1-43 months). The mean OS was better in patients with neuroendocrine lung tumor (261 months) and papillary thyroid carcinoma (80 months) and worse in patients with small cell lung cancer (4 months) and unknown origin (5 months). CONCLUSIONS Surgery with or without adjuvant radiotherapy is effective for mass reduction, rapid symptomatic improvement of vision and headaches, and definitive diagnosis. Even after local tumor control failure, some patients still benefit from radiation and/or systemic therapy.
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Affiliation(s)
| | | | - Dana Erickson
- 3Division of Endocrinology, Metabolism and Nutrition
| | | | | | - David M Routman
- 6Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota
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Götz V, Qiao S, Das D, Wartenberg P, Wyatt A, Wahl V, Gamayun I, Alasmi S, Fecher-Trost C, Meyer MR, Rad R, Kaltenbacher T, Kattler K, Lipp P, Becherer U, Mollard P, Candlish M, Boehm U. Ovulation is triggered by a cyclical modulation of gonadotropes into a hyperexcitable state. Cell Rep 2023; 42:112543. [PMID: 37224016 DOI: 10.1016/j.celrep.2023.112543] [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: 09/17/2018] [Revised: 04/17/2023] [Accepted: 05/04/2023] [Indexed: 05/26/2023] Open
Abstract
Gonadotropes in the anterior pituitary gland are essential for fertility and provide a functional link between the brain and the gonads. To trigger ovulation, gonadotrope cells release massive amounts of luteinizing hormone (LH). The mechanism underlying this remains unclear. Here, we utilize a mouse model expressing a genetically encoded Ca2+ indicator exclusively in gonadotropes to dissect this mechanism in intact pituitaries. We demonstrate that female gonadotropes exclusively exhibit a state of hyperexcitability during the LH surge, resulting in spontaneous [Ca2+]i transients in these cells, which persist in the absence of any in vivo hormonal signals. L-type Ca2+ channels and transient receptor potential channel A1 (TRPA1) together with intracellular reactive oxygen species (ROS) levels ensure this state of hyperexcitability. Consistent with this, virus-assisted triple knockout of Trpa1 and L-type Ca2+ subunits in gonadotropes leads to vaginal closure in cycling females. Our data provide insight into molecular mechanisms required for ovulation and reproductive success in mammals.
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Affiliation(s)
- Viktoria Götz
- Institute of Experimental and Clinical Pharmacology and Toxicology, Center for Molecular Signaling (PZMS), Saarland University School of Medicine, Homburg 66421, Germany
| | - Sen Qiao
- Institute of Experimental and Clinical Pharmacology and Toxicology, Center for Molecular Signaling (PZMS), Saarland University School of Medicine, Homburg 66421, Germany
| | - Debajyoti Das
- Institute of Experimental and Clinical Pharmacology and Toxicology, Center for Molecular Signaling (PZMS), Saarland University School of Medicine, Homburg 66421, Germany
| | - Philipp Wartenberg
- Institute of Experimental and Clinical Pharmacology and Toxicology, Center for Molecular Signaling (PZMS), Saarland University School of Medicine, Homburg 66421, Germany
| | - Amanda Wyatt
- Institute of Experimental and Clinical Pharmacology and Toxicology, Center for Molecular Signaling (PZMS), Saarland University School of Medicine, Homburg 66421, Germany
| | - Vanessa Wahl
- Institute of Experimental and Clinical Pharmacology and Toxicology, Center for Molecular Signaling (PZMS), Saarland University School of Medicine, Homburg 66421, Germany
| | - Igor Gamayun
- Institute of Experimental and Clinical Pharmacology and Toxicology, Center for Molecular Signaling (PZMS), Saarland University School of Medicine, Homburg 66421, Germany
| | - Samer Alasmi
- Institute of Experimental and Clinical Pharmacology and Toxicology, Center for Molecular Signaling (PZMS), Saarland University School of Medicine, Homburg 66421, Germany
| | - Claudia Fecher-Trost
- Institute of Experimental and Clinical Pharmacology and Toxicology, Center for Molecular Signaling (PZMS), Saarland University School of Medicine, Homburg 66421, Germany
| | - Markus R Meyer
- Institute of Experimental and Clinical Pharmacology and Toxicology, Center for Molecular Signaling (PZMS), Saarland University School of Medicine, Homburg 66421, Germany
| | - Roland Rad
- Institute of Molecular Oncology and Functional Genomics, School of Medicine, Technical University of Munich, Munich 80333, Germany
| | - Thorsten Kaltenbacher
- Institute of Molecular Oncology and Functional Genomics, School of Medicine, Technical University of Munich, Munich 80333, Germany
| | - Kathrin Kattler
- Department of Genetics and Epigenetics, Saarland University, Saarbrücken 66123, Germany
| | - Peter Lipp
- Molecular Cell Biology, Center for Molecular Signaling (PZMS), Saarland University School of Medicine, Homburg 66421, Germany
| | - Ute Becherer
- Cellular Neurophysiology, Center for Integrative Physiology and Molecular Medicine (CIPMM), Saarland University School of Medicine, Homburg 66421, Germany
| | - Patrice Mollard
- IGF, CNRS, INSERM, University of Montpellier, Montpellier 34090, France
| | - Michael Candlish
- Institute of Experimental and Clinical Pharmacology and Toxicology, Center for Molecular Signaling (PZMS), Saarland University School of Medicine, Homburg 66421, Germany
| | - Ulrich Boehm
- Institute of Experimental and Clinical Pharmacology and Toxicology, Center for Molecular Signaling (PZMS), Saarland University School of Medicine, Homburg 66421, Germany.
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50
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Trivellin G, Daly AF, Hernández-Ramírez LC, Araldi E, Tatsi C, Dale RK, Fridell G, Mittal A, Faucz FR, Iben JR, Li T, Vitali E, Stojilkovic SS, Kamenicky P, Villa C, Baussart B, Chittiboina P, Toro C, Gahl WA, Eugster EA, Naves LA, Jaffrain-Rea ML, de Herder WW, Neggers SJCMM, Petrossians P, Beckers A, Lania AG, Mains RE, Eipper BA, Stratakis CA. Germline loss-of-function PAM variants are enriched in subjects with pituitary hypersecretion. Front Endocrinol (Lausanne) 2023; 14:1166076. [PMID: 37388215 PMCID: PMC10303134 DOI: 10.3389/fendo.2023.1166076] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 04/10/2023] [Indexed: 07/01/2023] Open
Abstract
Introduction Pituitary adenomas (PAs) are common, usually benign tumors of the anterior pituitary gland which, for the most part, have no known genetic cause. PAs are associated with major clinical effects due to hormonal dysregulation and tumoral impingement on vital brain structures. PAM encodes a multifunctional protein responsible for the essential C-terminal amidation of secreted peptides. Methods Following the identification of a loss-of-function variant (p.Arg703Gln) in the peptidylglycine a-amidating monooxygenase (PAM) gene in a family with pituitary gigantism, we investigated 299 individuals with sporadic PAs and 17 familial isolated PA kindreds for PAM variants. Genetic screening was performed by germline and tumor sequencing and germline copy number variation (CNV) analysis. Results In germline DNA, we detected seven heterozygous, likely pathogenic missense, truncating, and regulatory SNVs. These SNVs were found in sporadic subjects with growth hormone excess (p.Gly552Arg and p.Phe759Ser), pediatric Cushing disease (c.-133T>C and p.His778fs), or different types of PAs (c.-361G>A, p.Ser539Trp, and p.Asp563Gly). The SNVs were functionally tested in vitro for protein expression and trafficking by Western blotting, splicing by minigene assays, and amidation activity in cell lysates and serum samples. These analyses confirmed a deleterious effect on protein expression and/or function. By interrogating 200,000 exomes from the UK Biobank, we confirmed a significant association of the PAM gene and rare PAM SNVs with diagnoses linked to pituitary gland hyperfunction. Conclusion The identification of PAM as a candidate gene associated with pituitary hypersecretion opens the possibility of developing novel therapeutics based on altering PAM function.
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Affiliation(s)
- Giampaolo Trivellin
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- IRCCS Humanitas Research Hospital, Milan, Italy
| | - Adrian F. Daly
- Department of Endocrinology, Centre Hospitalier Universitaire de Liège, University of Liège, Domaine Universitaire du Sart-Tilman, Liège, Belgium
| | - Laura C. Hernández-Ramírez
- Red de Apoyo a la Investigación, Coordinación de la Investigación Científica, Universidad Nacional Autónoma de México e Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- Section on Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, United States
| | - Elisa Araldi
- Energy Metabolism Laboratory, Department of Health Sciences and Technology, Institute of Translational Medicine, Swiss Federal Institute of Technology (ETH) Zurich, Schwerzenbach, Switzerland
| | - Christina Tatsi
- Section on Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, United States
| | - Ryan K. Dale
- Bioinformatics and Scientific Programming Core, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, United States
| | - Gus Fridell
- Bioinformatics and Scientific Programming Core, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, United States
| | - Arjun Mittal
- Bioinformatics and Scientific Programming Core, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, United States
| | - Fabio R. Faucz
- Section on Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, United States
- Molecular Genomics Core, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, United States
| | - James R. Iben
- Molecular Genomics Core, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, United States
| | - Tianwei Li
- Molecular Genomics Core, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, United States
| | | | - Stanko S. Stojilkovic
- Section on Cellular Signaling, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, United States
| | - Peter Kamenicky
- Université Paris-Saclay, Institut national de la santé et de la recherche médicale (INSERM), Physiologie et Physiopathologie Endocriniennes, Le Kremlin-Bicêtre, France
| | - Chiara Villa
- Département de Neuropathologie de la Pitié Salpêtrière, Hôpital de la Pitié-Salpêtrière - Assistance Publique–Hôpitaux de Paris (APHP) Sorbonne Université, Paris, France
- Institut national de la santé et de la recherche médicale (INSERM) U1016, Centre national de la recherche scientifique Unité Mixte de Recherche (CNRS UMR) 8104, Institut Cochin, Paris, France
| | - Bertrand Baussart
- Institut national de la santé et de la recherche médicale (INSERM) U1016, Centre national de la recherche scientifique Unité Mixte de Recherche (CNRS UMR) 8104, Institut Cochin, Paris, France
- Service de Neurochirurgie, Hôpital Pitié-Salpêtrière, AP-HP Sorbonne, Paris, France
| | - Prashant Chittiboina
- Neurosurgery Unit for Pituitary and Inheritable Diseases and Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH), Bethesda, MD, United States
| | - Camilo Toro
- National Institutes of Health (NIH) Undiagnosed Diseases Program, Office of the Clinical Director, National Human Genome Research Institute (NHGRI), National Institutes of Health (NIH), Bethesda, MD, United States
| | - William A. Gahl
- National Institutes of Health (NIH) Undiagnosed Diseases Program, Office of the Clinical Director, National Human Genome Research Institute (NHGRI), National Institutes of Health (NIH), Bethesda, MD, United States
| | - Erica A. Eugster
- Division of Endocrinology and Diabetes, Department of Pediatrics, Riley Hospital for Children at Indiana University (IU) Health, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Luciana A. Naves
- Service of Endocrinology, University Hospital, Faculty of Medicine, University of Brasilia, Brasilia, Brazil
| | - Marie-Lise Jaffrain-Rea
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
- Neuromed Institute, Istituto di Ricovero e Cura a Carattere Scientifico, Pozzilli, Italy
| | - Wouter W. de Herder
- Department of Medicine, Section Endocrinology, Pituitary Center Rotterdam, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Sebastian JCMM Neggers
- Department of Medicine, Section Endocrinology, Pituitary Center Rotterdam, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Patrick Petrossians
- Department of Endocrinology, Centre Hospitalier Universitaire de Liège, University of Liège, Domaine Universitaire du Sart-Tilman, Liège, Belgium
| | - Albert Beckers
- Department of Endocrinology, Centre Hospitalier Universitaire de Liège, University of Liège, Domaine Universitaire du Sart-Tilman, Liège, Belgium
| | - Andrea G. Lania
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- IRCCS Humanitas Research Hospital, Milan, Italy
| | - Richard E. Mains
- Department of Neuroscience, University of Connecticut (UConn) Health, Farmington, CT, United States
| | - Betty A. Eipper
- Department of Molecular Biology and Biophysics, UConn Health, Farmington, CT, United States
| | - Constantine A. Stratakis
- Section on Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, United States
- Human Genetics and Precision Medicine, Institute of Molecular Biology and Biotechnology (IMBB), Foundation for Research and Technology Hellas, Heraklion, Greece
- Research Institute, ELPEN, Athens, Greece
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