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1.
JAMA ; 329(16): 1386-1398, 2023 04 25.
Article in English | MEDLINE | ID: mdl-37097352

ABSTRACT

Importance: Pituitary adenomas are neoplasms of the pituitary adenohypophyseal cell lineage and include functioning tumors, characterized by the secretion of pituitary hormones, and nonfunctioning tumors. Clinically evident pituitary adenomas occur in approximately 1 in 1100 persons. Observations: Pituitary adenomas are classified as either macroadenomas (≥10 mm) (48% of tumors) or microadenomas (<10 mm). Macroadenomas may cause mass effect, such as visual field defects, headache, and/or hypopituitarism, which occur in about 18% to 78%, 17% to 75%, and 34% to 89% of patients, respectively. Thirty percent of pituitary adenomas are nonfunctioning adenomas, which do not produce hormones. Functioning tumors are those that produce an excess of normally produced hormones and include prolactinomas, somatotropinomas, corticotropinomas, and thyrotropinomas, which produce prolactin, growth hormone, corticotropin, and thyrotropin, respectively. Approximately 53% of pituitary adenomas are prolactinomas, which can cause hypogonadism, infertility, and/or galactorrhea. Twelve percent are somatotropinomas, which cause acromegaly in adults and gigantism in children, and 4% are corticotropinomas, which secrete corticotropin autonomously, resulting in hypercortisolemia and Cushing disease. All patients with pituitary tumors require endocrine evaluation for hormone hypersecretion. Patients with macroadenomas additionally require evaluation for hypopituitarism, and patients with tumors compressing the optic chiasm should be referred to an ophthalmologist for formal visual field testing. For those requiring treatment, first-line therapy is usually transsphenoidal pituitary surgery, except for prolactinomas, for which medical therapy, either bromocriptine or cabergoline, is usually first line. Conclusions and Relevance: Clinically manifest pituitary adenomas affect approximately 1 in 1100 people and can be complicated by syndromes of hormone excess as well as visual field defects and hypopituitarism from mass effect in larger tumors. First-line therapy for prolactinomas consists of bromocriptine or cabergoline, and transsphenoidal pituitary surgery is first-line therapy for other pituitary adenomas requiring treatment.


Subject(s)
Adenoma , Pituitary Neoplasms , Adult , Child , Female , Humans , Pregnancy , Adenoma/complications , Adenoma/diagnosis , Adenoma/metabolism , Adenoma/therapy , Adrenocorticotropic Hormone/biosynthesis , Bromocriptine/therapeutic use , Cabergoline/therapeutic use , Human Growth Hormone/biosynthesis , Hypopituitarism/diagnosis , Hypopituitarism/etiology , Hypopituitarism/metabolism , Hypopituitarism/therapy , Pituitary Neoplasms/complications , Pituitary Neoplasms/diagnosis , Pituitary Neoplasms/metabolism , Pituitary Neoplasms/therapy , Prolactinoma/diagnosis , Prolactinoma/etiology , Prolactinoma/metabolism , Prolactinoma/therapy
2.
Anticancer Drugs ; 33(1): e28-e35, 2022 01 01.
Article in English | MEDLINE | ID: mdl-34348358

ABSTRACT

To date, there are no standardized systemic treatment options for patients with metastatic pituitary carcinoma progressed to chemo and radiation therapy. Immune-checkpoint inhibitors (ICIs) have been successfully assessed in other solid malignancies and could be a concrete hope for these patients. We performed a critical review of the literature aimed to evaluate studies assessing ICIs in pituitary malignancies. We also conducted research about published translational data assessing immune-contexture in these malignancies. Some preliminary reports reported a successful administration of pembrolizumab or the combination between nivolumab and ipilimumab in patients with metastatic ACTH-secreting pituitary carcinomas. Translational data suggest that adenomas secreting growth hormone and ACTH have a suppressed immune-microenvironment, which could be more likely to benefit from ICIs. Immune-checkpoint inhibitors can be an effective treatment in patients with pituitary carcinoma and maybe also recurrent adenoma. Tumors secreting growth hormone and ACTH are more likely to benefit from ICIs due to a different immune-microenvironment.


Subject(s)
Immune Checkpoint Inhibitors/therapeutic use , Pituitary Neoplasms/drug therapy , Pituitary Neoplasms/pathology , Adrenocorticotropic Hormone/biosynthesis , Antibodies, Monoclonal, Humanized/therapeutic use , Antineoplastic Combined Chemotherapy Protocols , Growth Hormone/biosynthesis , Humans , Immune Checkpoint Inhibitors/administration & dosage , Immune Checkpoint Inhibitors/adverse effects , Ipilimumab/therapeutic use , Neoplasm Metastasis , Nivolumab/therapeutic use , Tumor Microenvironment/drug effects
4.
Biomolecules ; 11(2)2021 02 16.
Article in English | MEDLINE | ID: mdl-33669305

ABSTRACT

This study demonstrates how exposure to psychosocial crowding stress (CS) for 3, 7, and 14 days affects glutamate synapse functioning and signal transduction in the frontal cortex (FC) of rats. CS effects on synaptic activity were evaluated in FC slices of the primary motor cortex (M1) by measuring field potential (FP) amplitude, paired-pulse ratio (PPR), and long-term potentiation (LTP). Protein expression of GluA1, GluN2B mGluR1a/5, VGLUT1, and VGLUT2 was assessed in FC by western blot. The body's response to CS was evaluated by measuring body weight and the plasma level of plasma corticosterone (CORT), adrenocorticotropic hormone (ACTH), and interleukin 1 beta (IL1B). CS 3 14d increased FP and attenuated LTP in M1, while PPR was augmented in CS 14d. The expression of GluA1, GluN2B, and mGluR1a/5 was up-regulated in CS 3d and downregulated in CS 14d. VGLUTs expression tended to increase in CS 7d. The failure to blunt the effects of chronic CS on FP and LTP in M1 suggests the impairment of habituation mechanisms by psychosocial stressors. PPR augmented by chronic CS with increased VGLUTs level in the CS 7d indicates that prolonged CS exposure changed presynaptic signaling within the FC. The CS bidirectional profile of changes in glutamate receptors' expression seems to be a common mechanism evoked by stress in the FC.


Subject(s)
Frontal Lobe/metabolism , Receptors, Glutamate/biosynthesis , Adrenocorticotropic Hormone/biosynthesis , Animals , Body Weight , Corticosterone/biosynthesis , Crowding , Electrophysiology , Glutamic Acid , Interleukin-1beta/biosynthesis , Long-Term Potentiation , Male , Models, Animal , Motor Cortex , Organ Size , Rats , Rats, Wistar , Receptors, AMPA/biosynthesis , Receptors, Metabotropic Glutamate/biosynthesis , Receptors, N-Methyl-D-Aspartate/biosynthesis , Spleen/pathology , Stress, Psychological , Synaptic Transmission/drug effects , Vesicular Glutamate Transport Protein 1/biosynthesis , Vesicular Glutamate Transport Protein 2/biosynthesis
5.
Peptides ; 138: 170504, 2021 04.
Article in English | MEDLINE | ID: mdl-33539873

ABSTRACT

Stress impairs the hypothalamic-pituitary-gonadal (HPG) axis, probably through its influence on the hypothalamic-pituitary-adrenal (= interrenals in the teleost, HPI) axis leading to reproductive failures. In this study, we investigated the response of hypothalamic neuropeptides, gonadotropin-inhibitory hormone (GnIH), a component of the HPG axis, and corticotropin-releasing hormone (CRH) a component of the HPI axis, to acute social defeat stress in the socially hierarchical male Nile tilapia (Oreochromis niloticus). Localization of GnIH cell bodies, GnIH neuronal processes, and numbers of GnIH cells in the brain during acute social defeat stress was studied using immunohistochemistry. Furthermore, mRNA levels of GnIH and CRH in the brain together with GnIH receptor, gpr147, and adrenocorticotropic hormone (ACTH) in the pituitary were quantified in control and socially defeated fish. Our results show, the number of GnIH-immunoreactive cell bodies and GnIH mRNA levels in the brain and the levels of gpr147 mRNA in the pituitary significantly increased in socially defeated fish. However, CRH and ACTH mRNA levels did not change during social defeat stress. Further, we found glucocorticoid type 2b receptor mRNA in laser captured immunostained GnIH cells. These results show that acute social defeat stress activates GnIH biosynthesis through glucocorticoid receptors type 2b signalling but does not change the CRH and ACTH mRNA expression in the tilapia, which could lead to temporary reproductive dysfunction.


Subject(s)
Corticotropin-Releasing Hormone/genetics , Gonadotropin-Releasing Hormone/biosynthesis , Stress, Psychological/genetics , Tilapia/physiology , Adrenocorticotropic Hormone/biosynthesis , Adrenocorticotropic Hormone/physiology , Animals , Brain/physiology , Corticotropin-Releasing Hormone/physiology , Female , Gonadotropin-Releasing Hormone/genetics , Gonadotropin-Releasing Hormone/physiology , Gonadotropins/biosynthesis , Gonadotropins/genetics , Male , Pituitary Gland/metabolism , Reproduction/genetics , Reproduction/physiology , Social Defeat , Tilapia/genetics
6.
J Cell Mol Med ; 25(5): 2404-2417, 2021 03.
Article in English | MEDLINE | ID: mdl-33491272

ABSTRACT

Drug options for the life-threatening Cushing's disease are limited, and surgical resection or radiation therapy is not invariably effective. Testicular receptor 4 (TR4) has been identified as a novel drug target to treat Cushing's disease. We built the structure model of TR4 and searched the TR4 antagonist candidate via in silico virtual screening. Bexarotene was identified as an antagonist of TR4 that can directly interact with TR4 ligand binding domain (TR4-LBD) and induces a conformational change in the secondary structure of TR4-LBD. Bexarotene suppressed AtT-20 cell growth, proopiomelanocortin (POMC) expression and adrenocorticotropin (ACTH) secretion. Mechanism dissection revealed that bexarotene could suppress TR4-increased POMC expression via promoting the TR4 translocation from the nucleus to the cytoplasm. This TR4 translocation might then result in reducing the TR4 binding to the TR4 response element (TR4RE) on the 5' promoter region of POMC. Results from in vivo mouse model also revealed that oral bexarotene administration markedly suppressed ACTH-secreting tumour growth, adrenal enlargement and the secretion of ACTH and corticosterone in mice with already established tumours. Together, these results suggest that bexarotene may be developed as a potential novel therapeutic drug to better suppress Cushing's disease.


Subject(s)
Bexarotene/pharmacology , Nuclear Receptor Subfamily 2, Group C, Member 2/antagonists & inhibitors , Pro-Opiomelanocortin/metabolism , Signal Transduction/drug effects , ACTH-Secreting Pituitary Adenoma , Adrenocorticotropic Hormone/biosynthesis , Animals , Bexarotene/chemistry , Binding Sites , Cell Line, Tumor , Disease Models, Animal , Drug Discovery , Gene Expression , Humans , Mice , Models, Molecular , Molecular Conformation , Nuclear Receptor Subfamily 2, Group C, Member 2/chemistry , Nuclear Receptor Subfamily 2, Group C, Member 2/metabolism , Pituitary ACTH Hypersecretion , Pro-Opiomelanocortin/genetics , Protein Binding , Protein Transport , Structure-Activity Relationship , Transcription, Genetic , Xenograft Model Antitumor Assays
7.
Peptides ; 136: 170441, 2021 02.
Article in English | MEDLINE | ID: mdl-33181265

ABSTRACT

Cushing's disease is mainly caused by autonomous production of adrenocorticotropic hormone (ACTH) from pituitary adenomas. In our previous study, a histone deacetylase (HDAC) inhibitor, trichostatin A, inhibited cell proliferation and ACTH production via decreased pituitary tumor-transforming gene 1 (PTTG1) in AtT-20 mouse corticotroph tumor cells. In the present study, we examined the effects of romidepsin, a potent and selective HDAC1/2 inhibitor, on cell proliferation and ACTH synthesis. To elucidate further potential mechanisms of romidepsin, we examined the effects of HDAC1/2 on proopiomelanocortin (Pomc) and Pttg1 mRNA levels and cell proliferation. Small interfering RNA-mediated knockdown was used to decrease HDAC1 or 2. Romidepsin treatment decreased Pomc and Pttg1 mRNA levels, and cell proliferation. The drug also increased Hdac1 and decreased Hdac2 mRNA levels. Hdac1 knockdown decreased basal Pttg1 mRNA levels and cell proliferation, but not Pomc mRNA levels. Romidepsin treatment decreases ACTH synthesis in corticotroph tumor cells. Romidepsin suppresses cell proliferation via PTTG1. HDAC1 is also involved in the proliferation of corticotroph cells via PTTG1.


Subject(s)
Adrenocorticotropic Hormone/genetics , Depsipeptides/pharmacology , Histone Deacetylase 1/genetics , Histone Deacetylase 2/genetics , Pituitary ACTH Hypersecretion/drug therapy , Securin/genetics , Adrenocorticotropic Hormone/biosynthesis , Animals , Cell Line, Tumor , Cell Proliferation/drug effects , Disease Models, Animal , Histone Deacetylase 1/antagonists & inhibitors , Histone Deacetylase 2/antagonists & inhibitors , Humans , Hydroxamic Acids/pharmacology , Mice , Pituitary ACTH Hypersecretion/genetics , Pituitary ACTH Hypersecretion/pathology , Pituitary Neoplasms/drug therapy , Pituitary Neoplasms/genetics , Pituitary Neoplasms/pathology , Pro-Opiomelanocortin/genetics , RNA, Messenger/genetics , RNA, Small Interfering/genetics , Securin/antagonists & inhibitors
8.
Int J Mol Sci ; 21(23)2020 Nov 30.
Article in English | MEDLINE | ID: mdl-33266265

ABSTRACT

Cushing's disease caused due to adrenocorticotropic hormone (ACTH)-secreting pituitary adenomas (ACTHomas) leads to hypercortisolemia, resulting in increased morbidity and mortality. Autonomous ACTH secretion is attributed to the impaired glucocorticoid negative feedback (glucocorticoid resistance) response. Interestingly, other conditions, such as ectopic ACTH syndrome (EAS) and non-neoplastic hypercortisolemia (NNH, also known as pseudo-Cushing's syndrome) also exhibit glucocorticoid resistance. Therefore, to differentiate between these conditions, several dynamic tests, including those with desmopressin (DDAVP), corticotrophin-releasing hormone (CRH), and Dex/CRH have been developed. In normal pituitary corticotrophs, ACTH synthesis and secretion are regulated mainly by CRH and glucocorticoids, which are the ACTH secretion-stimulating and -suppressing factors, respectively. These factors regulate ACTH synthesis and secretion through genomic and non-genomic mechanisms. Conversely, glucocorticoid negative feedback is impaired in ACTHomas, which could be due to the overexpression of 11ß-HSD2, HSP90, or TR4, or loss of expression of CABLES1 or nuclear BRG1 proteins. Genetic analysis has indicated the involvement of several genes in the etiology of ACTHomas, including USP8, USP48, BRAF, and TP53. However, the association between glucocorticoid resistance and these genes remains unclear. Here, we review the clinical aspects and molecular mechanisms of ACTHomas and compare them to those of other related conditions.


Subject(s)
Adrenocorticotropic Hormone/biosynthesis , Cushing Syndrome/etiology , Cushing Syndrome/metabolism , Disease Susceptibility , ACTH Syndrome, Ectopic/diagnosis , ACTH Syndrome, Ectopic/etiology , ACTH Syndrome, Ectopic/metabolism , ACTH-Secreting Pituitary Adenoma/diagnosis , ACTH-Secreting Pituitary Adenoma/etiology , ACTH-Secreting Pituitary Adenoma/metabolism , Adrenocorticotropic Hormone/genetics , Biomarkers , Cushing Syndrome/diagnosis , Diagnosis, Differential , Female , Gene Expression Regulation , Glucocorticoids/metabolism , Humans , Male , Signal Transduction
9.
J Cell Mol Med ; 24(24): 14571-14582, 2020 12.
Article in English | MEDLINE | ID: mdl-33174363

ABSTRACT

Cranial radiotherapy induces endocrine disorders and reproductive abnormalities, particularly in long-term female cancer survivors, and this might in part be caused by injury to the pituitary gland, but the underlying mechanisms are unknown. The aim of this study was to investigate the influence of cranial irradiation on the pituitary gland and related endocrine function. Female Wistar rat pups on postnatal day 11 were subjected to a single dose of 6 Gy whole-head irradiation, and hormone levels and organ structure in the reproductive system were examined at 20 weeks after irradiation. We found that brain irradiation reduced cell proliferation and induced persistent inflammation in the pituitary gland. The whole transcriptome analysis of the pituitary gland revealed that apoptosis and inflammation-related pathways were up-regulated after irradiation. In addition, irradiation led to significantly decreased levels of the pituitary hormones, growth hormone, adrenocorticotropic hormone, thyroid-stimulating hormone and the reproductive hormones testosterone and progesterone. To conclude, brain radiation induces reduction of pituitary and reproduction-related hormone secretion, this may due to reduced cell proliferation and increased pituitary inflammation after irradiation. Our results thus provide additional insight into the molecular mechanisms underlying complications after head irradiation and contribute to the discovery of preventive and therapeutic strategies related to brain injury following irradiation.


Subject(s)
Cranial Irradiation , Hypopituitarism/etiology , Hypopituitarism/metabolism , Pituitary Gland/metabolism , Pituitary Gland/radiation effects , Pituitary Hormones/biosynthesis , Adrenocorticotropic Hormone/biosynthesis , Animals , Biomarkers , Cell Proliferation/radiation effects , Computational Biology/methods , Cranial Irradiation/adverse effects , Disease Models, Animal , Estrous Cycle/radiation effects , Female , Gene Expression Profiling , Gene Expression Regulation/radiation effects , Hypopituitarism/pathology , Immunohistochemistry , Pituitary Gland/pathology , Pituitary Hormones/deficiency , Radiation Injuries/complications , Rats , Signal Transduction/radiation effects , Transcriptome , Tumor Suppressor Protein p53/metabolism
10.
Protein Expr Purif ; 176: 105731, 2020 12.
Article in English | MEDLINE | ID: mdl-32871252

ABSTRACT

Adrenocorticotropic hormone (ACTH) is an old medicine derived from porcine pituitary gland that has been marketed for more than 60 years. In this study, we present a recombinant approach to produce ACTH in Escherichia coli (E. coli). The SUMO-tagged fusion protein was cloned and expressed after induction with isopropyl-ß-d-thiogalactopyranoside (IPTG) at 25 °C for 8 h. The fusion protein was extracted and purified by anion exchange chromatography, and the SUMO tag was subsequently removed by digestion with ubiquitin-like protease 1 (ULP1). Approximately 95.3 mg of recombinant ACTH with 94.2% purity was obtained after cation exchange purification performed on a 5 mL column, from 286 mL fermentation broth based on the amount of pellets homogenized. The molecular mass of the recombinant ACTH was confirmed by mass spectrometry to equal 4567.32 Da.


Subject(s)
Adrenocorticotropic Hormone , Cloning, Molecular , Gene Expression , Recombinant Fusion Proteins , Swine/genetics , Adrenocorticotropic Hormone/biosynthesis , Adrenocorticotropic Hormone/chemistry , Adrenocorticotropic Hormone/genetics , Adrenocorticotropic Hormone/isolation & purification , Animals , Escherichia coli/genetics , Escherichia coli/metabolism , Recombinant Fusion Proteins/biosynthesis , Recombinant Fusion Proteins/chemistry , Recombinant Fusion Proteins/genetics , Recombinant Fusion Proteins/isolation & purification
11.
J Clin Endocrinol Metab ; 105(12)2020 12 01.
Article in English | MEDLINE | ID: mdl-32946562

ABSTRACT

OBJECTIVE: To characterize the inferior adrenal artery (IAA) pulsatility index (PI) in intrauterine growth-restricted (IUGR) fetuses without brain sparing. METHODS: Twenty-three IUGR fetuses with a normal Doppler cerebroplacental ratio (CPR) and 23 normal controls were included in this prospective cross-sectional study. The PI of the IAA was recorded using routine transabdominal Doppler ultrasound. The differences in Doppler characteristics, perinatal outcomes, and steroidogenesis in the umbilical vein at birth (adrenocorticotropic hormone [ACTH] and cortisol [F] levels) were compared between the 2 groups. The correlations between IAA-PI and steroidogenesis were assessed in the IUGR group. RESULTS: IAA-PI was significantly lower in IUGR fetuses than in normal controls (0.85 vs 1.18 at first scan, 0.78 vs 0.92 at last scan; both P < 0.001). The plasma F and ACTH levels in IUGR cases were significantly higher than those of the normal controls (18.2 vs 12.4 µg/dL and 280.5 vs 125.6 pg/mL for F and ACTH, respectively; both P < 0.001). There were negative correlations between IAA-PI and plasma F values and between IAA-PI and ACTH values in the IUGR group (r = -0.774 and -0.82 at first scan, r = -0.525 and -0.45 at last scan, respectively; P < 0.001). CONCLUSION: Increased adrenal gland blood flow with concomitant increases in ACTH and F levels were observed in IUGR fetuses. IAA-PI is useful to assess early blood redistribution and may be beneficial for evaluating the steroidogenic response in high-risk pregnancies.


Subject(s)
Adrenal Cortex Hormones/biosynthesis , Adrenal Glands/blood supply , Arteries/physiology , Fetal Growth Retardation , Fetus/blood supply , Umbilical Veins/metabolism , Adolescent , Adrenal Cortex Hormones/blood , Adrenocorticotropic Hormone/biosynthesis , Adrenocorticotropic Hormone/blood , Adult , Arteries/diagnostic imaging , Blood Circulation/physiology , Blood Flow Velocity/physiology , Case-Control Studies , China , Cross-Sectional Studies , Female , Fetal Growth Retardation/diagnostic imaging , Fetal Growth Retardation/metabolism , Fetal Growth Retardation/physiopathology , Fetus/diagnostic imaging , Fetus/metabolism , Health Status Indicators , Humans , Hydrocortisone/biosynthesis , Hydrocortisone/blood , Infant, Newborn , Male , Pregnancy , Pulsatile Flow , Ultrasonography, Doppler , Ultrasonography, Prenatal , Umbilical Veins/diagnostic imaging , Young Adult
12.
J Investig Med High Impact Case Rep ; 8: 2324709620918080, 2020.
Article in English | MEDLINE | ID: mdl-32410474

ABSTRACT

Acinic cell carcinoma is a rare, typically indolent, neoplasm that arises in the salivary glands. Metastatic disease is uncommon, occurring in around 10% of cases. We report the case of a 46-year-old male in whom the first sign of disseminated disease was increased skin pigmentation due to paraneoplastic Cushing's syndrome. He underwent 3 cycles of chemotherapy with carboplatin and paclitaxel with no symptomatic improvement and a mixed response on imaging. There is no evidence that systemic therapy prolongs survival in metastatic acinic cell carcinoma, and we lack a consensus as to which treatment options are most beneficial. A summary of published evidence regarding choice of palliative chemotherapy regimens and response is discussed in relation to the case.


Subject(s)
ACTH Syndrome, Ectopic/etiology , Carcinoma, Acinar Cell/complications , Cushing Syndrome/etiology , Parotid Neoplasms/complications , Adrenocorticotropic Hormone/biosynthesis , Carcinoma, Acinar Cell/metabolism , Carcinoma, Acinar Cell/pathology , Humans , Male , Middle Aged , Parotid Neoplasms/metabolism , Parotid Neoplasms/pathology
13.
Endocr Relat Cancer ; 27(3): 163-174, 2020 03.
Article in English | MEDLINE | ID: mdl-31935194

ABSTRACT

Medical treatments for corticotrophinomas are limited, and we therefore investigated the effects of epigenetic modulators, a new class of anti-tumour drugs, on the murine adrenocorticotropic hormone (ACTH)-secreting corticotrophinoma cell line AtT20. We found that AtT20 cells express members of the bromo and extra-terminal (BET) protein family, which bind acetylated histones, and therefore, studied the anti-proliferative and pro-apoptotic effects of two BET inhibitors, referred to as (+)-JQ1 (JQ1) and PFI-1, using CellTiter Blue and Caspase Glo assays, respectively. JQ1 and PFI-1 significantly decreased proliferation by 95% (P < 0.0005) and 43% (P < 0.0005), respectively, but only JQ1 significantly increased apoptosis by >50-fold (P < 0.0005), when compared to untreated control cells. The anti-proliferative effects of JQ1 and PFI-1 remained for 96 h after removal of the respective compound. JQ1, but not PFI-1, affected the cell cycle, as assessed by propidium iodide staining and flow cytometry, and resulted in a higher number of AtT20 cells in the sub G1 phase. RNA-sequence analysis, which was confirmed by qRT-PCR and Western blot analyses, revealed that JQ1 treatment significantly altered expression of genes involved in apoptosis, such as NFκB, and the somatostatin receptor 2 (SSTR2) anti-proliferative signalling pathway, including SSTR2. JQ1 treatment also significantly reduced transcription and protein expression of the ACTH precursor pro-opiomelanocortin (POMC) and ACTH secretion by AtT20 cells. Thus, JQ1 treatment has anti-proliferative and pro-apoptotic effects on AtT20 cells and reduces ACTH secretion, thereby indicating that BET inhibition may provide a novel approach for treatment of corticotrophinomas.


Subject(s)
ACTH-Secreting Pituitary Adenoma/drug therapy , Adenoma/drug therapy , Epigenesis, Genetic/drug effects , Proteins/antagonists & inhibitors , ACTH-Secreting Pituitary Adenoma/genetics , ACTH-Secreting Pituitary Adenoma/pathology , Adenoma/genetics , Adenoma/pathology , Adrenocorticotropic Hormone/biosynthesis , Animals , Apoptosis/drug effects , Azepines/pharmacology , Cell Line, Tumor , Cell Proliferation/drug effects , Mice , Triazoles/pharmacology
14.
Head Neck Pathol ; 14(2): 562-569, 2020 Jun.
Article in English | MEDLINE | ID: mdl-31363907

ABSTRACT

We report a rare case of Cushing's syndrome in a 59-year-old man who initially presented with concurrent acinic cell carcinoma of the parotid with high-grade transformation and co-existing papillary and medullary thyroid carcinomas, without noticeable cushinoid symptoms. Six-months later, he developed clinical features of Cushing's syndrome which coincided with disease progression in the form of lung metastasis and mediastinal lymphadenopathy. Ectopic adrenocorticotropic hormone (ACTH) production and protein expression was limited to the high-grade transformed component of acinic cell carcinoma and in the lymph node metastasis, and was absent in the conventional acinic cell carcinoma as well as in the papillary and medullary thyroid carcinoma. He received adjuvant chemotherapy and supportive management with interval improvement for 8 months followed by disease progression with increasing serum cortisol levels and bone metastasis. He was offered palliative chemotherapy, however, declined further therapy and was lost to follow up. We discussed clinical and pathologic implications of ectopic ACTH production associated with acinic carcinoma and also reviewed the literature of this rare paraneoplastic syndrome.


Subject(s)
Adrenocorticotropic Hormone/biosynthesis , Carcinoma, Acinar Cell/complications , Cushing Syndrome/etiology , Paraneoplastic Syndromes/etiology , Parotid Neoplasms/complications , Carcinoma, Acinar Cell/metabolism , Carcinoma, Acinar Cell/pathology , Carcinoma, Neuroendocrine , Cell Transformation, Neoplastic/metabolism , Cell Transformation, Neoplastic/pathology , Humans , Male , Middle Aged , Neoplasms, Multiple Primary/metabolism , Neoplasms, Multiple Primary/pathology , Parotid Neoplasms/metabolism , Parotid Neoplasms/pathology , Thyroid Cancer, Papillary , Thyroid Neoplasms
15.
Medicine (Baltimore) ; 98(30): e16610, 2019 Jul.
Article in English | MEDLINE | ID: mdl-31348308

ABSTRACT

The purpose of this study was to investigate the influences of varied anesthetic methods and depths on inflammatory cytokines and stress hormone levels in radical operation among colon cancer patients during perioperative period.A total of 120 patients were collected in the study and randomly divided into 4 groups, A: general anesthesia + Narcotrend D1, B: general anesthesia + Narcotrend D2, C: general anesthesia + epidural anesthesia + Narcotrend D1, D: general anesthesia + epidural anesthesia + Narcotrend D2. The levels of tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-10, cortisol (Cor), adrenocorticotropic hormone (ACTH), and endothelin-1 (ET-1) were measured adopting commercial kits before anesthesia (T0), 4 hours after surgery (T1), 24 hours after surgery (T2), and 72 hours after surgery (T3).There was no significant difference in basic clinical characteristics among the groups. In comparison with group A, B and C, group D showed significantly lower levels of TNF-α, IL-6, IL-10, Cor, ACTH, and ET-1 at T1 and T2 (all, P < .05). Significantly higher levels of TNF-α, IL-6, IL-10, Cor, and ACTH were detected at T1 and T2 than those at T0 (all, P < .05), whereas, at T3, the levels of inflammatory cytokines and stress hormones were all decreased near to preoperation ones.General anesthesia combined with epidural anesthesia at Narcotrend D2 depth plays an important role in reducing immune and stress response in patients with colon cancer from surgery to 24 hours after surgery.


Subject(s)
Anesthesia, Epidural/methods , Anesthesia, General/methods , Colonic Neoplasms/surgery , Cytokines/biosynthesis , Inflammation Mediators/metabolism , Adrenocorticotropic Hormone/biosynthesis , Cytokines/blood , Drug Therapy, Combination , Endothelin-1/biosynthesis , Female , Humans , Hydrocortisone/biosynthesis , Inflammation Mediators/blood , Interleukins/biosynthesis , Male , Middle Aged , Tumor Necrosis Factor-alpha/biosynthesis
16.
Intern Med ; 58(20): 2977-2982, 2019 Oct 15.
Article in English | MEDLINE | ID: mdl-31243230

ABSTRACT

A 72-year-old man was admitted to a general hospital with progressive liver dysfunction, hypokalemia, hyperglycemia, and nodules in the lung and liver and then transferred to our institution on the seventh hospital day. Plasma levels of adrenocorticotropic hormone (ACTH), cortisol, and neuron-specific enolase concentrations were extremely high. He developed acute liver failure, his consciousness and general condition deteriorated rapidly, and he died on Day 11. At the postmortem examination, he was found to have extensive metastases from small-cell lung cancer, including advanced hepatic metastases. This is the first reported case of acute liver failure caused by metastases derived from an ACTH-producing pulmonary small-cell carcinoma.


Subject(s)
Adrenocorticotropic Hormone/biosynthesis , Cushing Syndrome/complications , Liver Failure, Acute/etiology , Liver Neoplasms/secondary , Small Cell Lung Carcinoma/secondary , ACTH Syndrome, Ectopic/complications , Aged , Fatal Outcome , Humans , Hydrocortisone/blood , Hyperglycemia/etiology , Hypokalemia/etiology , Liver Neoplasms/complications , Liver Neoplasms/diagnostic imaging , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/pathology , Male , Small Cell Lung Carcinoma/complications , Small Cell Lung Carcinoma/diagnostic imaging , Tomography, X-Ray Computed , Ultrasonography
17.
Neuroendocrinology ; 109(4): 362-373, 2019.
Article in English | MEDLINE | ID: mdl-30995664

ABSTRACT

BACKGROUND: Cushing's disease (CD) is caused by adrenocorticotropic hormone (ACTH)-secreting pituitary tumours. They express high levels of heat shock protein 90 and heat shock factor 1 (HSF1) in comparison to the normal tissue counterpart, indicating activated cellular stress. AIMS: Our objectives were: (1) to correlate HSF1 expression with clinical features and hormonal/radiological findings of CD, and (2) to investigate the effects of HSF1 inhibition as a target for CD treatment. PATIENTS/METHODS: We examined the expression of total and pSer326HSF1 (marker for its transcriptional activation) by Western blot on eight human CD tumours and compared to the HSF1 status of normal pituitary. We screened a cohort of 45 patients with CD for HSF1 by immunohistochemistry and correlated the HSF1 immunoreactivity score with the available clinical data. We evaluated the effects of HSF1 silencing with RNA interference and the HSF1 inhibitor KRIBB11 in AtT-20 cells and four primary cultures of human corticotroph tumours. RESULTS: We show that HSF1 protein is highly expressed and transcriptionally active in CD tumours in comparison to normal pituitary. The immunoreactivity score for HSF1 did not correlate with the typical clinical features of the disease. HSF1 inhibition reduced proopiomelanocortin (Pomc) transcription in AtT-20 cells. The HSF1 inhibitor KRIBB11 suppressed ACTH synthesis from 75% of human CD tumours in primary cell culture. This inhibitory action on Pomc transcription was mediated by increased glucocorticoid receptor and suppressed Nurr77/Nurr1 and AP-1 transcriptional activities. CONCLUSIONS: These data show that HSF1 regulates POMC transcription. Pharmacological targeting of HSF1 may be a promising treatment option for the control of excess ACTH secretion in CD.


Subject(s)
Heat Shock Transcription Factors/antagonists & inhibitors , Pituitary ACTH Hypersecretion/drug therapy , Pro-Opiomelanocortin/biosynthesis , Pro-Opiomelanocortin/genetics , Adrenocorticotropic Hormone/biosynthesis , Adult , Aminopyridines/pharmacology , Cell Cycle Checkpoints/drug effects , Cell Line, Tumor , Cell Survival/drug effects , Female , Gene Silencing , Heat Shock Transcription Factors/genetics , Humans , Immunohistochemistry , Indazoles/pharmacology , Male , Pituitary ACTH Hypersecretion/metabolism , RNA Interference , Transcription Factor AP-1/pharmacology , Transcriptional Activation/drug effects , Young Adult
18.
Pol Przegl Chir ; 91(2): 45-47, 2019 Feb 07.
Article in English | MEDLINE | ID: mdl-31032808

ABSTRACT

INTRODUCTION: Endocrine and metabolic paraneoplastic syndromes in the course of malignant tumors result from ectopic production of hormones or hormone precursors in tumor cells. Production of hormones by endocrine tumors is relatively frequent, while such production by adenocarcinoma cells is definitely rare. The study presents a case of triple-negative invasive breast cancer, with the ectopic secretion of ACTH (adrenocorticotropic hormone), which provokes serious metabolic disorders. MATERIALS AND METHODS: The patient was admitted to hospital with symptoms of Cushing`s syndrome. Diagnostic tests revealed that the cause of metabolic disorders was breast cancer. After proper preparation, the patient was qualified for surgery. RESULTS: After the mastectomy, the patient's metabolism stabilized. The patient underwent adjuvant chemotherapy and radiotherapy. Four months after the last cycle of systemic treatment, cancer dissemination was found. The patient was treated with second-line chemotherapy, however, control CT revealed progression. The patient died 20 months after surgery and two months after the last cycle of chemotherapy. CONCLUSIONS: The case reported in this study - triple-negative invasive breast cancer, responsible for ectopic production of ACTH and causing Cushing's syndrome - is a rare phenomenon. Treatment of patients with breast cancer showing hormonal activity should not differ from general rules applied for breast cancer. However, due to accompanying metabolic disturbances, the patients need individualized oncological approach, precise diagnostic tests, and adequate preoperative preparation.


Subject(s)
Adenocarcinoma/physiopathology , Adrenocorticotropic Hormone/biosynthesis , Cushing Syndrome/diagnosis , Cushing Syndrome/surgery , Mastectomy/methods , Triple Negative Breast Neoplasms/physiopathology , Triple Negative Breast Neoplasms/surgery , Fatal Outcome , Female , Humans , Middle Aged , Triple Negative Breast Neoplasms/mortality
19.
J Anim Sci ; 97(2): 631-643, 2019 Feb 01.
Article in English | MEDLINE | ID: mdl-30476104

ABSTRACT

The goal of this study was to test the hypothesis that sodium selenite (inorganic Se, ISe), SEL-PLEX (organic forms of Se, OSe), vs. a 1:1 blend (MIX) of ISe and OSe in a basal vitamin-mineral (VM) mix would differentially alter pituitary transcriptome profiles in growing beef steers grazing an endophyte-infected tall fescue (E+) pasture. Predominately Angus steers (BW = 183 ± 34 kg) were randomly selected from fall-calving cows grazing E+ pasture and consuming VM mixes that contained 35 ppm Se as ISe, OSe, or MIX forms. Steers were weaned, depleted of Se for 98 d, and subjected to summer-long common grazing of a 10.1 ha E+ pasture containing 0.51 ppm ergot alkaloids. Steers were assigned (n = 8 per treatment) to the same Se-form treatments on which they were raised. Selenium treatments were administered by daily top-dressing 85 g of VM mix onto 0.23 kg soyhulls, using in-pasture Calan gates. As previously reported, serum prolactin was greater for MIX (52%) and OSe (59%) steers vs. ISe. Pituitaries were collected at slaughter and changes in global and selected mRNA expression patterns determined by microarray and real-time reverse transcription PCR analyses, respectively. The effects of Se treatment on relative gene expression were subjected to one-way ANOVA. The form of Se affected the expression of 542 annotated genes (P < 0.005). Integrated pathway analysis found a canonical pathway network between prolactin and pro-opiomelanocortin (POMC)/ACTH/α-melanocyte-stimulating hormone (α-MSH) synthesis-related proteins and that mitochondrial dysfunction was a top-affected canonical pathway. Targeted reverse transcription-PCR analysis found that the relative abundance of mRNA encoding prolactin and POMC/ACTH/α-MSH synthesis-related proteins was affected (P < 0.05) by the form of Se, as were (P ≤ 0.05) mitochondrial dysfunction-related proteins (CYB5A, FURIN, GPX4, and PSENEN). OSe steers appeared to have a greater prolactin synthesis capacity (more PRL mRNA) vs. ISe steers through decreased dopamine type two receptor signaling (more DRD2 mRNA), whereas MIX steers had a greater prolactin synthesis capacity (more PRL mRNA) and release potential by increasing thyrotropin-releasing hormone concentrations (less TRH receptor mRNA) than ISe steers. OSe steers also had a greater ACTH and α-MSH synthesis potential (more POMC, PCSK2, CPE, and PAM mRNA) than ISe steers. We conclude that form of Se in VM mixes altered expression of genes responsible for prolactin and POMC/ACTH/α-MSH synthesis, and mitochondrial function, in pituitaries of growing beef steers subjected to summer-long grazing an E+ pasture.


Subject(s)
Cattle/genetics , Endophytes/physiology , Ergot Alkaloids/analysis , Festuca/chemistry , Selenium/pharmacology , Vitamins/pharmacology , Adrenocorticotropic Hormone/biosynthesis , Adrenocorticotropic Hormone/genetics , Animal Feed/analysis , Animals , Cattle/physiology , Festuca/microbiology , Male , Minerals/pharmacology , Mitochondria/metabolism , Pituitary Gland/metabolism , Prolactin/biosynthesis , Prolactin/genetics , RNA, Messenger/metabolism , Seasons , Sodium Selenite/pharmacology , Transcriptome , alpha-MSH/biosynthesis , alpha-MSH/genetics
20.
J Pineal Res ; 66(2): e12545, 2019 Mar.
Article in English | MEDLINE | ID: mdl-30586198

ABSTRACT

While physiological levels of glucocorticoids are required to ensure proper functions of the body, consistently high levels may engender several deleterious consequences. We have previously shown an increase in the activity of the hypothalamic-pituitary-adrenal (HPA) axis in rats fed sucrose-rich diets (SRD). The main goal of this study was to analyze the processes involved in the modulation of the pituitary production of ACTH by SRD, and to test melatonin as a possible therapeutic agent for the prevention of the HPA axis dysfunction. Male Wistar rats were fed standard chow and either SRD (30% sucrose in the drinking water) or plain water for three weeks. Melatonin was administered as subcutaneous pellets. Results showed that SRD treatment induced an increase in systemic ACTH and corticosterone levels and a decrease in melatonin levels. In the pituitary gland, we also detected an increase in the expression levels of proopiomelanocortin (POMC) that was accompanied by increased levels of: lipoperoxides, nitro-tyrosine modified proteins, catalase, heme oxygenase-1, interleukin-1ß mRNA, and by an increase in the tissue number of inflammatory cells (F4/80 and Iba-1 positive cells). Melatonin treatment prevented all these systemic and pituitary changes as well as the increase in POMC expression induced by incubation of AtT-20 corticotrophs with conditioned media obtained from stimulated macrophages. In conclusion, stimulation of POMC/ACTH production in rats fed a SRD could involve the generation of oxidative stress and inflammation in the pituitary gland. Melatonin treatment prevented these effects and normalized the activity of the HPA axis.


Subject(s)
Adrenocorticotropic Hormone/biosynthesis , Dietary Sucrose/toxicity , Melatonin/pharmacology , Pituitary Gland/drug effects , Animals , Hypothalamo-Hypophyseal System/drug effects , Hypothalamo-Hypophyseal System/metabolism , Male , Pituitary Gland/metabolism , Pituitary-Adrenal System/drug effects , Pituitary-Adrenal System/metabolism , Rats , Rats, Wistar
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