Decreased insulin requirements after LAR-octreotide but not after lanreotide in an acromegalic patient.

A diabetic acromegalic man, not cured after surgery and radiosurgery, received lanreotide i.m. with great clinical and biochemical improvement. He required NPH insulin (76 to 84 units/day) to control his diabetes mellitus. Thirty-six hours after changing to LAR-octreotide (20 mg i.m/month) he presented symptomatic hypoglycemia, repeated at 48 and 72 h (50 mg/dL), despite reducing insulin to 26 Units/day. Thereafter, he reduced insulin by 30 to 50% for the first week after each LAR-octreotide injection, and gradually increased it again over the next 3 weeks. This situation persists after every injection 3 years later; this consistent behavior supports a specific effect of LAR-octreotide, and not a by chance phenomenon. No marked changes in circulating GH, IGF-1, immunoreative insulin, C-peptide, testosterone and glucose were observed prior to, and 3, 7, 14, 21, and 28 days after LAR-octreotide; however, there was 28% fall in plasma glucagon after 7 days, which rose thereafter. C-peptide (< 1.8 ng/mL) was indicative of decreased beta-cell function. To our knowledge, this is the first report of such a distinct differential behaviour of blood glucose and insulin requirements with different somatostatin analogs, and is worth recalling when starting an insulin-treated diabetic patient on this treatment. It may be related to a preferential binding of LAR-octreotide to subtype 2 somatostatin receptors in the pancreas, while lanreotide preferentially binds to subtype 5, not expressed in this tissue; this would explain the fall in glucagon, in parallel to the decrease in insulin requirements after LAR-octreotide; however, a contribution of differences in the effect of both somatostatin analogues on postreceptor signalling systems and/or intestinal carbohydrate absorption cannot be entirely ruled out.

Antiproliferative effect and cell cycle modulation by melatonin on GH(3) cells.

We have investigated the effect of melatonin on cell proliferation and modulation, in the GH(3) experimental rat pituitary cell line; the expression of oncogenes c-myc, c-jun and the tumor suppressor gene p53 were also analyzed basally and after exposure to melatonin (10(-6), 10(-8) and 10(-10) M). Melatonin exhibited an antiproliferative effect at all the doses tested, decreasing the proliferating index by 50%. After exposure to melatonin, a decrease in Ki67 and Proliferation cell nuclear antigen occurred acute- and transiently (at 2 h) after a single dose which recovered at 4 h, as well as chronically after repeated 12-hour doses which persisted at 48 h; a similar behavior was observed both acute- and chronically for c-myc and c-jun, while it was opposite for p53, rising acute- and transiently as well as after repeated exposure. These results demonstrate that melatonin modulates the proliferation mechanisms of the GH(3) cells.

Introduction of p53 induces cell-cycle arrest in p53-deficient human medullary-thyroid-carcinoma cells.

The structural integrity of the p53 gene in a human thyroid-medullary-carcinoma-derived cell line has been studied. Analysis of high-molecular-weight DNA showed that the p53 locus is severely rearranged. PCR and single-strand conformation polymorphism analysis revealed that a large portion of the 5' end of the p53 gene is lost, while a region encompassing exons 8 and 9 is rearranged. As a consequence, no virtual expression of a p53-specific transcript is detected in mRNA from the medullary-carcinoma cell line. The absence of a p53 protein prompted us to analyze the biological effect of exogenous expression of this tumor-suppressor gene on cell growth and viability, introducing retroviral constructs carrying full-length human wild-type p53 cDNA. Contrary to what has been described for other cell types, including most thyroid-carcinoma cell lines of follicular origin, these experiments allowed us to establish clonal-cell populations which constitutively express p53. Cytometric analysis revealed G1-specific cell-cycle arrest, responsible for growth retardation in the transfected clones when compared with the parental cell line. However, medullary-thyroid-carcinoma cells expressing p53 are able to partially overcome the G1 block and progress through the cell cycle. In the search of the mechanism(s) involved in these processes, we describe the interaction of p53 with specific p21WAF1/Cip1 promoter sequences by gel-retardation assays.

Flow cytometry analysis of pituitary adenomas.

UNLABELLED: Using flow cytometry, DNA content and index, and/or proliferative capacity (measuring proliferating cell nuclear antigen PCNA) in operated pituitary tumors, control pituitaries obtained at necropsy, and experimental pituitary hyperplasia induced in rats were analyzed. Simultaneous measurement of cell ploidy and proliferation differentiated normal pituitary (diploid DNA index and negative PCNA) from pituitary hyperplasia (diploid DNA index with intensely positive PCNA, between 30 and 72% of cells). In the tumors 83% (19/ 23) were positive for PCNA (between 3 and 84%) and 73% (17/23) aneuploid; only 1 tumor was diploid and negative for PCNA. CONCLUSIONS: Differentiation between normal and abnormal (neoplastic or hyperplastic) pituitary is possible by flow cytometry, but in the adenomas no correlation with postoperative clinical outcome was observed.