Endocrine Connections最新文献

{"title":"Depression and Distress in Pediatric Type 1 Diabetes: A Latin American Multicenter Study.","authors":"Valeria Hirschler, Claudio D Gonzalez, Amanda Benitez, Andrea Escalante Marassi, Angela Figueroa Sobrero, Ernesto Bogado, Adriana Roussos, Laura Gaete, Angeles Arrigo, Grabois Florencia, Eugenia Andres, Maria Laura Arzamendia, Juan Pablo Rojas Godoy, Etel Codner, Luciana Araujo, Luis F Palacios Porta, Claudia Molinari, Daniel R Witte","doi":"10.1530/EC-26-0512","DOIUrl":"https://doi.org/10.1530/EC-26-0512","url":null,"abstract":"<p><strong>Objective: </strong>To determine (1) the prevalence of depressive symptoms and diabetes-related distress and (2) the association between their combined presence and metabolic outcomes in Latin American children with type 1 diabetes mellitus (T1DM).</p><p><strong>Methods: </strong>This cross-sectional study included children with T1DM of> 1 year's duration from 10 diabetes centers in Argentina and Chile. Age, sex, socioeconomic status (SES), and HbA1c were evaluated. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D; range 0-60; depression ≥16) and diabetes distress using the Problem Areas in Diabetes (PAID; range 0-80; distress ≥40). Spearman correlation, Phi coefficient, and multivariable logistic regression were used for statistical analysis.</p><p><strong>Results: </strong>Among 244 children (50% female), median age was 13.4 years (IQR 11.3-15.0), and median HbA1c was 8.3% (IQR 7.2-9.5). Depressive symptoms were present in 52% of participants and diabetes-distress in 26.6%. The agreement between CES-D and PAID categorical thresholds was fair (Phi = 0.39). The Both-1 group (n = 55; 22.5%) (high CES-D and PAID ) showed an inverse Spearman correlation with SES (r = -0.32, p < 0.01) and a positive correlation with HbA1c (r = 0.30, p < 0.01). In multivariable logistic regression, higher HbA1c (OR 1.34; 95% CI 1.1-1.6) and lower SES (OR 0.36; 95% CI 0.2-0.6) were independently associated with the Both-1 group (high CES-D and PAID), adjusted for age, sex, and BMI.</p><p><strong>Conclusion: </strong>In Latin American children with T1DM, the combined presence of depressive symptoms and diabetes-related distress was associated with poorer metabolic control and lower SES.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148760006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The extragonadal biology of gonadotropin hormones: should we rename these?","authors":"Se-Min Kim, Funda Korkmaz, Sorang Kang, Fazilet Sen, Steven L Sims, Judit Gimenez-Roig, Uliana Cheliadinova, Darya Vasilyeva, Orly Barak, Susan Hutchison, Anne Macdonald, Rauf Latif, Ki Goosens, Tal Frolinger, Anusha Pallapati, Satish Rojekar, Vitaly Ryu, Daria Lizneva, Tony Yuen, Mone Zaidi","doi":"10.1530/EC-26-0232","DOIUrl":"10.1530/EC-26-0232","url":null,"abstract":"<p><p>Over recent years, gonadotropins and their receptors have been shown to exert non-traditional actions that bypass the classical hypothalamic-pituitary-gonadal axis. Findings of the expression of receptors for follicle-stimulating hormone (FSH) and luteinizing hormone (LH) in skeletal, fat, and immune cells and in neurons suggest that their functions are much broader than their classical roles. FSH, once believed solely to regulate procreation-gonadal development and maturation at puberty and gamete production during the fertile phase, has been found to regulate body composition, bone metabolism, and cognition, providing the underpinnings of complex integrative physiology, and, in turn, opening potential new therapeutic opportunities. Pre-clinical evidence from genetic and pharmacologic interventions in rodent models and human data from population-based observations, genetic studies, and a small number of interventional studies together support the independent skeletal, adipogenic, and cognitive actions of gonadotropins. Here, we review our current understanding of direct actions of FSH and LH on bone, adipose tissue, and brain and focus specifically on the detrimental health burden during and after the menopause: osteoporosis, obesity, and dementia.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13506522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148619154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-bariatric hypoglycaemia: from altered gut physiology to targeted therapies.","authors":"Wei Yang, Tricia M-M Tan","doi":"10.1530/EC-25-0850","DOIUrl":"10.1530/EC-25-0850","url":null,"abstract":"<p><p>Post-bariatric hypoglycaemia (PBH) is an increasingly recognised complication of bariatric and metabolic surgery, which can markedly impair quality of life and jeopardise the long-term benefits of surgery. This review summarises the current evidence on the epidemiology, pathophysiology, and management of PBH, with a particular focus on mechanism-based treatment strategies. We first point out the limitations of existing epidemiological data and then outline a practical diagnostic framework. We next review the evolving understanding of PBH as a heterogeneous, pathophysiology-driven syndrome arising from rapid nutrient delivery, exaggerated incretin responses, excessive insulin secretion, impaired glucagon secretion, and emerging contributors, such as postprandial serotonin hypersecretion, bile acid signalling, and microbiome change. On this basis, we review therapeutic options by mechanistic target, covering dietary and lifestyle interventions, acarbose, SGLT inhibition, somatostatin analogues, GLP-1 receptor antagonists, diazoxide, glucagon-based approaches, and experimental serotonin receptor antagonism, and briefly discuss agents with limited supportive evidence. Finally, we explore key knowledge gaps and future directions, including the need for long-term prospective data, precision medicine approaches, rational combination therapy, and greater integration of continuous glucose monitoring and digital decision support. Mechanism-based, multidisciplinary care from bariatric physicians, dietitians, and surgeons offers the best prospect of managing PBH, preserving quality of life, and safeguarding the metabolic benefits of bariatric surgery.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13452044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148344326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"11-deoxycortisol, other hormones and pituitary function characteristics in the diagnosis of adrenal insufficiency in the overnight oral metyrapone test.","authors":"Alexander Krawzow, Mirko Peitzsch, Manuela Bastian, Till Postrach, Lisa Johanna Harms, Elena Novikova, Graeme Eisenhofer, Holger S Willenberg","doi":"10.1530/EC-26-0261","DOIUrl":"10.1530/EC-26-0261","url":null,"abstract":"<p><strong>Abstract: </strong>The oral metyrapone test is utilized to assess pituitary adrenal axis function. We asked whether 17-hydroxyprogesterone, androstenedione or corticotropin are similarly as useful as 11-deoxycortisol to detect adrenal insufficiency. Of the SHIP-PAGE study participants, 190 patients underwent an oral metyrapone test. The diagnosis of adrenal insufficiency included information from the clinical course, concentrations of adrenal steroids and ACTH before or after metyrapone as well as results of other pituitary function tests. Of the 190 patients, 67 had adrenal insufficiency and 123 had not. ROC analysis showed the highest sensitivity (83%), specificity (>90%) and area under the curve (0.9) for 11-deoxycortisol at a cutoff of 197 nmol/L. Surges in 11-deoxycortisol were related to those of 17-hydroxyprogesterone, androstenedione and corticotropin that displayed lower sensitivities, specificities and areas under the curve with cutoff values of 5.55 nmol/L, 8.11 nmol/L and 89.60 pg/mL, respectively. The presence of gonadal dysfunction had a high sensitivity of 61% and prolactin deficiency a high specificity (96%) for prediction of adrenal insufficiency as had a combined dysfunction of the gonadal, growth hormone and thyroid axes (97%). In conclusion, 11-deoxycortisol is an already established parameter with a good performance in the oral metyrapone test, which was not outperformed by 17-hydroxyprogesterone, androstenedione or corticotropin. However, there may be a substantial bias to this result. Therefore, determination of pituitary-end-organ axes functions is likewise helpful to provide probability information in the assessment of adrenal insufficiency, which remains a diagnosis based on clinical information and endocrine function tests.</p><p><strong>Significance statement: </strong>The oral metyrapone test is very useful for the characterization of adrenal function. If available, analysis of 11-deoxycortisol is better than measurements of other adrenal steroid hormones or corticotropin. However, there may be a bias from previous studies on the metyrapone test. Therefore, analysis of corticotropin, androstenedione and 17-hydroxyprogesterone concentrations at baseline and the day after metyrapone administration is also very helpful for the evaluation of adrenal function when the results from other pituitary function tests are included in the diagnostic process.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13459089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148619096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of burosumab on macrophage polarization and TRPV1 expression in children with XLH.","authors":"Alessandra Di Paola, Stefania Palumbo, Lucia Argenziano, Giuseppe Di Feo, Francesca Aiello, Oriana Di Domenico, Grazia Cirillo, Gaia Pietropaolo, Maria Maddalena Marrapodi, Emanuele Miraglia Del Giudice, Francesca Rossi, Anna Grandone","doi":"10.1530/EC-26-0183","DOIUrl":"10.1530/EC-26-0183","url":null,"abstract":"<p><strong>Purpose: </strong>X-linked hypophosphatemia (XLH) is a rare genetic disorder caused by PHEX mutations, leading to hypophosphatemia and impaired bone mineralization. Burosumab, a monoclonal antibody targeting FGF23, improves phosphate levels and bone health. Although burosumab improves musculoskeletal pain, it remains unclear whether this benefit results solely from restoration of phosphate homeostasis or also involves immunomodulatory mechanisms. Given the role of FGF23 in modulating macrophage function and the involvement of TRPV1 - expressed by macrophages - in pain transmission, we investigated the effects of burosumab on macrophage polarization and TRPV1 expression in children with XLH.</p><p><strong>Methods: </strong>Macrophages were isolated from untreated XLH patients (n = 4), burosumab-treated XLH patients (n = 8), and healthy donors (n = 5). Western blot was used to assess M1 (CCR7, CD86, iNOS) and M2 (CD206, p-STAT6) markers, as well as TRPV1 expression. To evaluate burosumab's direct effects, macrophages from healthy donors were stimulated with LPS and treated with 1.5 or 3 μg/mL burosumab, followed by the same analyses.</p><p><strong>Results: </strong>Untreated XLH macrophages predominantly exhibited an M1 phenotype with higher TRPV1 protein levels compared with healthy controls. In contrast, macrophages from burosumab-treated patients showed a tendency to acquire an M2-like phenotype and reduced TRPV1 expression. Similar effects were observed in vitro, with LPS-stimulated healthy macrophages shifting toward the M2 phenotype and showing decreased TRPV1 after burosumab exposure.</p><p><strong>Conclusion: </strong>In untreated XLH patients, macrophages exhibit a pro-inflammatory M1 phenotype with upregulated TRPV1 expression. Burosumab reverses this profile, driving M2 polarization and reducing TRPV1 levels, thereby suggesting that it exerts therapeutic effects beyond phosphate homeostasis through immunomodulation.</p><p><strong>Plain summary: </strong>X-linked hypophosphatemia (XLH) causes rickets and chronic pain. We found that immune cells from untreated patients show a pro-inflammatory profile. Treatment with burosumab shifted these immune cells toward an anti-inflammatory state and reduced the expression of TRPV1, a molecule involved in neuroimmune signaling, suggesting that burosumab may exert biological effects beyond bone health.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13505342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Learning curve of blood pressure management during phaeochromocytoma surgery without preoperative alpha-blockade dose escalation.","authors":"Isabelle Holscher, Mahsoem Ali, Koen M A Dreijerink, Markus W Hollmann, Tijs J van den Berg, Wouter D Lubbers, Els J M Nieveen van Dijkum, Anton F Engelsman","doi":"10.1530/EC-26-0158","DOIUrl":"10.1530/EC-26-0158","url":null,"abstract":"<p><strong>Background: </strong>Adrenalectomy without preoperative dose escalation of α-blockade is gaining popularity for managing phaeochromocytoma, showing comparable outcomes but shorter hospital stays and less postoperative hypotension. However, recent data showed an initial significant increase in intraoperative hypotension after transitioning to this approach, suggesting a learning curve. We evaluated this learning curve for the safe use of our α-blockade non-escalation workflow employing a risk-adjusted CUSUM (RA-CUSUM) analysis.</p><p><strong>Method: </strong>This single-centre cohort study included phaeochromocytoma resections without preoperative α-blockade dose escalation from 2019 until 2023. All procedures were performed by an experienced operating theatre team, including anaesthesiologists and surgeons dedicated to phaeochromocytoma treatment. Intraoperative hypotension (time-weighted average (TWA) of mean arterial pressure (MAP) < 60 mmHg) was identified as primary learning curve outcome. RA-CUSUM analysis consisted of predicting intraoperative hypotension using a multivariable linear regression model corrected for established risk factors and modelling the relationship between the number of procedures and the cumulative difference in predicted and observed outcomes.</p><p><strong>Results: </strong>A total of 44 procedures were evaluated employing the new preoperative α-blockade non-escalation strategy. RA-CUSUM analysis showed that the learning curve was completed after 19 surgeries. The median TWA of MAP < 60 mmHg was 2.29 (IQR: 0.45-4.16) mmHg. No perioperative complications related to haemodynamic instability occurred in the cohort. Time in the operating theatre and length of hospital stay remained consistent over time.</p><p><strong>Conclusion: </strong>Our results confirm that transitioning to phaeochromocytoma resection without α-blockade dose escalation follows a learning curve. To ensure safe implementation, centres adopting the non-escalation workflow should meet certain conditions, with structured guidance or proctoring as possible measures.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13545747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of desmopressin stimulation test specificity in healthy volunteers.","authors":"Henrik Elenius, Brielle M Brown, Raven McGlotten, Casey Moore, Lynnette K Nieman","doi":"10.1530/EC-26-0270","DOIUrl":"10.1530/EC-26-0270","url":null,"abstract":"<p><strong>Objective: </strong>The desmopressin stimulation test (DesST) is used to identify Cushing disease (CD). Reportedly, most healthy people and patients with non-neoplastic hypercortisolism lack a significant response. We aimed to evaluate and improve DesST specificity (Sp).</p><p><strong>Design: </strong>Prospective evaluation of four DesST protocols in healthy volunteers.</p><p><strong>Methods: </strong>Twenty healthy volunteers underwent four DesST protocols in a randomized order. Protocols involved fluid restriction with desmopressin 10 µg (10NPO; 'standard'), 4 µg (4NPO), and 10 µg preceded by dexamethasone 1 mg (10+DexNPO); and desmopressin 10 µg without fluid restriction (10H2O). We evaluated Sp for each protocol, using established response criteria.</p><p><strong>Results: </strong>Previous criteria of relative increases of 35% and/or 20% for ACTH and cortisol, respectively, had low Sp: 50% (95% CI: 28-72%; 10NPO) to 85% (95% CI: 69-100%; 10+DexNPO). Using absolute ACTH increase >8.1 pmol/L (37 pg/mL) improved Sp to 100% across all protocols. Compared with 10NPO, median ACTH and cortisol were lower throughout during 10+DexNPO and also at +15 min during 4NPO (ACTH: 4.4 vs 4.9 pmol/L (19.9 vs 22.1 pg/mL), P = 0.06; cortisol: 248 vs 284 nmol/L (9.0 vs 10.3 µg/dL), P = 0.01). 10H2O and 10NPO results were similar. Adverse events were mild; hyponatremia occurred after 5/80 tests.</p><p><strong>Conclusion: </strong>After desmopressin, healthy volunteers have small absolute increases in ACTH and cortisol that equate to large relative changes from baseline. Optimized response criteria should likely incorporate absolute values. Fluid restriction did not impact Sp, but using a lower desmopressin dose and dexamethasone pre-treatment are promising ways to improve diagnostic accuracy, if sensitivity is maintained in CD.</p><p><strong>Significance statement: </strong>Half of healthy volunteers had a response consistent with Cushing disease (CD) during a commonly used 10 µg desmopressin stimulation test, interpreted using relative ACTH and/or cortisol increases. This puts the test's reliability for excluding CD in question, particularly in settings of mild hypercortisolism. These situations include differentiating CD from non-neoplastic hypercortisolism, identifying cyclic ectopic ACTH-producing tumors during nadir phases, and establishing early CD recurrence. Optimized response criteria likely require absolute ACTH and/or cortisol cutoffs. Using a reduced 4 µg dose of desmopressin or pre-treatment with 1 mg dexamethasone improved test specificity, offering promising ways to improve test performance if sensitivity is maintained in CD.</p><p><strong>Clinical trial registration number: </strong>NCT06635629.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13482792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148629492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A blood-draw timing- and season-adjusted PTH-calcium model for predicting post-endoscopic/robotic thyroidectomy hypocalcemia.","authors":"Junyu Cao, Jianjun Wang, Chenjun Guo, Hairui Wang, Xin Wei, Juan Li, Xuelian Chen, Zuyi Zhou, Dayang Zhou, Jie Wang, Li Li","doi":"10.1530/EC-26-0294","DOIUrl":"10.1530/EC-26-0294","url":null,"abstract":"<p><strong>Background: </strong>Post-thyroidectomy hypocalcemia is a common complication after endoscopic/robotic surgery and may delay discharge. Early postoperative parathyroid hormone (PTH) and calcium (Ca) are useful predictors, but their circadian and seasonal variation is rarely considered. We assessed whether incorporating blood-draw timing and season improves prediction of hypocalcemia within 48 h.</p><p><strong>Methods: </strong>In this single-center cohort, we developed the model retrospectively (January 2019-December 2023) and validated it prospectively (January 2024-June 2025) in adults undergoing endoscopic or robotic total/completion thyroidectomy. The primary outcome was biochemical hypocalcemia within 48 h after the earliest postoperative blood draw, defined as corrected Ca < 2.10 mmol/L or ionized Ca < 1.10 mmol/L. We compared Model A (PTH only), Model B (PTH + total Ca), and Model C (Model B plus hours since surgery, diurnal and seasonal terms, clinical covariates, and a prespecified PTH × hours interaction).</p><p><strong>Results: </strong>Among 1,052 patients (derivation n = 784; validation n = 268), biochemical hypocalcemia occurred in 24.9%. In derivation, Model C achieved an AUROC of 0.87 (95% CI: 0.84-0.89; optimism-corrected: 0.85), outperforming Model B (0.81) and Model A (0.78; all P < 0.001). Calibration was excellent (intercept: -0.01, slope: 0.99, Brier: 0.13). In temporal validation, Model C maintained strong performance (AUROC: 0.84, 95% CI: 0.80-0.88; intercept: 0.03, slope: 0.97, Brier: 0.14). Decision curve analysis showed a greater net benefit; at a 20% threshold, Model C reduced unnecessary prophylactic supplementation by about 11 per 100 patients versus Model A.</p><p><strong>Conclusion: </strong>Modeling blood-draw timing and season improves early prediction of post-thyroidectomy hypocalcemia beyond standard PTH/Ca measures and may support more efficient postoperative management.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13452045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148445045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inhibitory mechanism of ANP on aldosterone production in human adrenocortical cells.","authors":"Noriko Morishima, Atsuhiro Ichihara, Daisuke Watanabe, Noriyoshi Takano, Satoshi Morimoto, Yasufumi Seki","doi":"10.1530/EC-26-0107","DOIUrl":"10.1530/EC-26-0107","url":null,"abstract":"<p><strong>Objective: </strong>The aldosterone-suppressing effect of natriuretic peptides (NPs) has been demonstrated in experiments using adrenocortical cells from various animal species. 3',5'-cyclic guanosine monophosphate (cGMP), which is produced by atrial natriuretic peptide (ANP), is recognized as a suppressor of aldosterone production. However, it has also been reported that cGMP does not exhibit the same aldosterone-suppressing effect as ANP. Therefore, we examined the effect of ANP on aldosterone suppression using various inhibitors and agonists, including a cGMP agonist.</p><p><strong>Design: </strong>We investigated the expression of ANP receptors in human adrenocortical cells. Next, we examined aldosterone synthesis gene expressions and the effects of various inhibitors, agonists, and siRNAs for the two ANP receptors on the aldosterone-suppressing action of ANP using human adrenocortical H295R cells, precultured with Ang-II. We also investigated inhibitory G (Gi) protein signaling as a cGMP-independent factor.</p><p><strong>Results: </strong>The human adrenocortical cell line H295R was shown to express the guanylyl cyclase A receptor (NPR1). Treatment with a neprilysin inhibitor ameliorated ANP-induced suppression of aldosterone production. Aldosterone production elevated by cyclic adenosine monophosphate (cAMP) agonist was significantly reduced by inhibitors of cAMP signaling. Conversely, cGMP alone had no significant aldosterone-suppressing effect. By suppressing the expression of receptors NPR1 and guanylyl cyclase C receptor (NPR3), aldosterone production increased in the presence of ANP. The suppression of aldosterone production by ANP was abolished by blocking Gi signaling by pertussis toxin (PTX).</p><p><strong>Conclusion: </strong>These results suggest that ANP suppresses aldosterone production in H295R cells through NPR1 and NPR3, and this suppression is partially mediated by a cGMP-independent Gi signaling.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13482795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148629561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence in thyroid nodules and cancer: clinical validation and real-world performance.","authors":"Mustafa Sahin, Nikolaos George Angelopoulos, Rodis D Paparodis","doi":"10.1530/EC-26-0415","DOIUrl":"10.1530/EC-26-0415","url":null,"abstract":"<p><p>Thyroid nodules are detected in a large proportion of adults undergoing high-resolution ultrasonography, yet only a minority harbor clinically significant cancer. The clinical problem is therefore not only cancer detection but calibrated risk stratification: avoiding delayed diagnosis of aggressive disease while limiting unnecessary biopsies, molecular testing and diagnostic surgery. Artificial intelligence (AI) has moved rapidly from experimental image classification to clinically deployed decision support. This invited review synthesizes current evidence for AI applications in the evaluation and management of thyroid nodules and differentiated thyroid cancer, emphasizing ultrasound-based computer-aided diagnosis, indeterminate cytology, molecular integration, cytopathology and histopathology, lymph node assessment, report quality control, surveillance and emerging multimodal large language models. Commercial and near-commercial systems, including S-Detect, AmCAD-UT, Koios DS Thyroid, AIBx and newer deep-learning systems, show that AI can improve consistency, support less experienced readers and, in selected settings, reduce low-yield fine-needle aspiration without unacceptable loss of sensitivity. A particularly important future role may be AI-enabled de-escalation, in which image-derived estimates of benignity help support surveillance when clinical, sonographic, cytologic or molecular risk signals are concordantly low. However, performance varies by case mix, cancer prevalence, scanner platform, operator experience, geographic cohort, reference standard and whether the model is used as a stand-alone classifier or second reader. The strongest evidence supports AI as an adjunct to standardized ultrasound risk stratification and shared decision-making, not as a replacement for expert clinical judgment. Future progress will depend on prospective multicenter validation, transparent reporting, local calibration, workflow design, regulation, post-market surveillance and assessment of patient-centered outcomes.</p>","PeriodicalId":11634,"journal":{"name":"Endocrine Connections","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13545745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}