COVID-19 vaccination effectiveness: a review in early vaccine adopters in Asian Countries.

COVID-19 vaccines were designed to stimulate an immunological response, producing neutralizing antibodies against the SARS-CoV-2 spike protein. Vaccine variants such as mRNA, viral vector, whole-cell inactivated virus, and protein subunit vaccines, have been reported to be efficacious in phase III trials and have gained emergency use approval in many countries. However, several adverse effects are reported in certain types of vaccines. All vaccines are being expedited by some Asian countries as part of their national immunization programs. This review primarily discussed the selected manufacturers of the COVID-19 vaccines used and their effectiveness in early-adopting Asian countries. The effectiveness in reducing the infection rate and safety of COVID-19 vaccines in Japan, Thailand, Singapore and Malaysia was also analyzed based on the available data. Strategies that can be used to speed up the vaccination rate in reducing the number of COVID-19 cases were also evaluated.

Recovery of adrenal function after chronic secondary adrenal insufficiency in patients with hypopituitarism.

OBJECTIVE: Previous studies have reported recovery of secondary adrenal insufficiency (SAI) in patients with pituitary disorders, generally immediately after pituitary surgery; however, data regarding recovery of long-term SAI are lacking. We conducted a study to assess the longer term recovery rate of SAI in patients with pituitary disorders. METHODS: We identified all SAI patients in the Halifax Neuropituitary Database from 1 November 2005 to 30 September 2014, who had required glucocorticoid therapy for ≥3 months, and had a minimum follow-up of 6 months. Patients with ACTH-secreting adenomas, those receiving glucocorticoids only in the routine peri-operative period for pituitary surgery and those on glucocorticoids for nonpituitary conditions were excluded. SAI was defined as either basal serum cortisol < 130 nm and/or a subnormal cortisol response to ACTH-(1-24) stimulation test or insulin tolerance test response. RESULTS: Fifty-one patients fulfilled the criteria. Nine (17·6%) patients had complete recovery of SAI over a median of 20 months (range: 8-51) after initiating glucocorticoid replacement. Patients with smaller tumour size had increased likelihood of hypothalamic-pituitary-adrenal (HPA) axis recovery, whereas those with secondary hypogonadism or growth hormone deficiency were less likely to recover. Those with initial cortisol >175 nm had an almost one in two chance of recovery. CONCLUSION: Results from our study show that approximately one in six patients with SAI recover adrenal function, even up to 5 years after diagnosis. We recommend that patients with SAI undergo regular testing to assess recovery in order to prevent unnecessary glucocorticoid therapy.

Tissue-specific effects of valsartan on rstn and fiaf gene expression in the ob/ob mouse.

The RAS is a novel target in the study of diabetes, and clinical trials have indicated that ARBs, such as valsartan, may exert some of their clinical effects through an influence on adipose tissue. We studied the effect of valsartan on adipokine genes resistin (rstn) and fasting-induced adipose factor (fiaf) using obese and diabetic ob/ob mice. In addition to visceral and subcutaneous fat, rstn and fiaf mRNA levels were also measured in several other tissues known to express these adipokines, including the pituitary, cerebral cortex and hypothalamus. The significant findings were that (a) fiaf gene expression was elevated two- to fourfold in visceral and subcutaneous fat from ob/ob mice, compared with lean controls; (b) the increase in fiaf mRNA in subcutaneous, but not visceral, fat from ob/ob mice was returned to lean control levels following 2 weeks of valsartan treatment; (c) fiaf expression was reduced in the hypothalamus, but not in the cortex or pituitary, of ob/ob mice; (d) rstn expression was greatly reduced in visceral fat from ob/ob mice, compared with lean controls, but this was unaffected by valsartan; and (e) rstn expression was unchanged in all other tissues from ob/ob mice, with or without valsartan treatment.

KiSS-1 mRNA in adipose tissue is regulated by sex hormones and food intake.

Hypothalamic KiSS-1 gene expression is critical for the maintenance of reproductive function, and levels are attenuated by sex hormones and by food restriction, providing a link between fat mass and fertility. We hypothesized that adipose tissue (FAT) would express KiSS-1. KiSS-1 mRNA was quantified in FAT, hypothalamus (HYP) and pituitary gland (PIT) using realtime RT-PCR. FAT KiSS-1 expression was sensitive to sex steroids and to nutritional status. Gonadectomized rats given estradiol (E; females) or testosterone (T; males) revealed striking increases in KiSS-1 mRNA in FAT (E: 8-fold, p<0.01; T: 5-fold, p<0.01). In contrast, HYP KiSS-1 expression was reduced by E/T, whereas PIT expression was reduced by gonadectomy only in females, reversed by E. Food restriction (18 h) increased FAT KiSS-1 mRNA in both sexes (2.5-4.0-fold, p<0.01), but decreased levels in male PIT and female HYP. Conversely, FAT expression was reduced in rats fed a high fat diet (HFD), as well as in obese Zucker rats, whereas PIT expression was increased in Zucker rats (p<0.05) but not by HFD. In contrast HYP KiSS-1 mRNA was elevated by HFD. Experiments in which the arcuate nucleus was damaged by an excitotoxic lesion revealed that hypothalamic KiSS-1 mRNA was significantly reduced, whereas FAT levels were unaffected, suggesting that regulation of KiSS-1 in FAT is independent of the hypothalamus. In conclusion, KiSS-1 expression is differentially regulated by sex hormones, food intake and obesity in FAT, HYP and PIT. Kisspeptins of adipose tissue origin may act as adipokines or as local regulators of adipocyte function.