Expert Review of Endocrinology & Metabolism最新文献

{"title":"Resistance of neuroendocrine tumours to somatostatin analogs.","authors":"Anna Angelousi,&nbsp;Anna Koumarianou,&nbsp;Eleftherios Chatzellis,&nbsp;Gregory Kaltsas","doi":"10.1080/17446651.2023.2166488","DOIUrl":"https://doi.org/10.1080/17446651.2023.2166488","url":null,"abstract":"<p><strong>Introduction: </strong>A common feature shared by most neuroendocrine tumors (NETs) is the expression on their surface of somatostatin receptors (SSTRs) that are essential for their pathophysiological regulation, diagnosis, and management. The first-generation synthetic somatostatin analogs (SSAs), octreotide and lanreotide, constitute the cornerstone of treatment for growth hormone secreting pituitary adenomas and functioning, progressive functioning, and non-functioning gastro-entero-pancreatic (GEP-NETs). SSAs exert their mechanism of action through binding to the SSTRs; however, their therapeutic response is frequently attenuated or diminished by the development of resistance. The phenomenon of resistance is complex implicating the presence of additional epigenetic and genetic mechanisms.</p><p><strong>Areas covered: </strong>We aim to analyze the molecular, genetic, and epigenetic mechanisms of resistance to SSA treatment. We also summarize recent clinical data related to the development of resistance on conventional and non-conventional modes of administration of the first-generation SSAs and the second-generation SSA pasireotide. We explore mechanisms used to counteract the resistance to SSAs using higher doses or more frequent mode of administration of SSAs and/or combination treatments.</p><p><strong>Expert opinion: </strong>There is considerable heterogeneity in the development of resistance to SSAs that is tumor-specific necessitating the delineation of the underlying pathophysiological processes to further expand their therapeutic applications.</p>","PeriodicalId":12107,"journal":{"name":"Expert Review of Endocrinology & Metabolism","volume":"18 1","pages":"33-52"},"PeriodicalIF":3.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10704014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review and meta-analysis of the etiology and treatment patterns of thyrotoxicosis in Africa.","authors":"Taoreed Adegoke Azeez,&nbsp;Ayodeji Ogunremi Lamidi,&nbsp;Isaiah Olanrewaju Osin","doi":"10.1080/17446651.2022.2136165","DOIUrl":"https://doi.org/10.1080/17446651.2022.2136165","url":null,"abstract":"<p><strong>Introduction: </strong>Thyrotoxicosis is one of the most common endocrine disorders seen in clinical practice. This study aims to determine the etiologies and treatment modalities of thyrotoxicosis in Africa.</p><p><strong>Areas covered: </strong>The study design is a systematic review with a meta-analysis. Medical databases and the gray literature were systematically searched following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies done in Africa on the etiology and treatment of thyrotoxicosis were selected.</p><p><strong>Expert opinion: </strong>In Africa, it is still believed that autoimmune diseases, generally, are not as common as what is seen in the western world. The frequency of Graves' disease is reportedly lower in Africa. The treatment of thyrotoxicosis depends on the cause. Therefore, it is of substantial importance to establish the etiology following the diagnosis of the clinical syndrome.</p>","PeriodicalId":12107,"journal":{"name":"Expert Review of Endocrinology & Metabolism","volume":"17 6","pages":"563-572"},"PeriodicalIF":3.2,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10473975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facial features of lysosomal storage disorders.","authors":"Andrea D'Souza, Emory Ryan, Ellen Sidransky","doi":"10.1080/17446651.2022.2144229","DOIUrl":"10.1080/17446651.2022.2144229","url":null,"abstract":"<p><strong>Introduction: </strong>The use of facial recognition technology has diversified the diagnostic toolbelt for clinicians and researchers for the accurate diagnoses of patients with rare and challenging disorders. Specific identifiers in patient images can be grouped using artificial intelligence to allow the recognition of diseases and syndromes with similar features. Lysosomal storage disorders are rare, and some have prominent and unique features that may be used to train the accuracy of facial recognition software algorithms. Noteworthy features of lysosomal storage disorders (LSDs) include facial features such as prominent brows, wide noses, thickened lips, mouth, and chin, resulting in coarse and rounded facial features.</p><p><strong>Areas covered: </strong>We evaluated and report the prevalence of facial phenotypes in patients with different LSDs, noting two current examples when artificial intelligence strategies have been utilized to identify distinctive facies.</p><p><strong>Expert opinion: </strong>Specific LSDs, including Gaucher disease, Mucolipidosis IV and Fabry disease have recently been distinguished using facial recognition software. Additional lysosomal disorders LSDs lysosomal storage disorders with unique and distinguishable facial features also merit evaluation using this technology. These tools may ultimately aid in the identification of specific LSDs and shorten the diagnostic odyssey for patients with these rare and under-recognized disorders.</p>","PeriodicalId":12107,"journal":{"name":"Expert Review of Endocrinology & Metabolism","volume":"17 6","pages":"467-474"},"PeriodicalIF":3.2,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9817214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10557322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A current perspective of pituitary adenoma MRI characteristics: a review.","authors":"Mark Gruppetta","doi":"10.1080/17446651.2022.2144230","DOIUrl":"https://doi.org/10.1080/17446651.2022.2144230","url":null,"abstract":"<p><strong>Introduction: </strong>MR imaging is an essential and fundamental tool in the diagnosis, management, and follow-up of patients with pituitary adenomas (PAs). Recent advances have continued to enhance the usefulness of this imaging modality.</p><p><strong>Areas covered: </strong>This article focuses on signal intensity patterns of PAs and associated clinical characteristics, vertical extension patterns, and cavernous sinus invasion with a special focus on the clinical implications that arise. A search using Medline and Google Scholar was conducted using different combinations of relevant keywords, giving preference to recent publications.</p><p><strong>Expert opinion: </strong>A higher proportion of GH-secreting PAs are hypointense on T2 weighted images compared to other tumor subtypes. Hypointense tumors are generally smaller compared to hyperintense ones, and among the GH-secreting subgroup, a better response to somatostatin analogue treatment was noted together with an association for a densely granulated pattern. Nonfunctional PAs show a predilection to extend upwards while GH-secreting PAs and prolactinomas show a predominantly inferior extension growth pattern. Further studies to better understand the mechanisms responsible for this behavior are anticipated. Further development, refining and validation of predictive scoring systems for tumor behavior might be useful adjuncts in the management of patients with PAs.</p>","PeriodicalId":12107,"journal":{"name":"Expert Review of Endocrinology & Metabolism","volume":"17 6","pages":"499-511"},"PeriodicalIF":3.2,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10474213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgery as a first-line option for prolactinomas.","authors":"Adam Mamelak","doi":"10.1080/17446651.2022.2131531","DOIUrl":"https://doi.org/10.1080/17446651.2022.2131531","url":null,"abstract":"<p><strong>Introduction: </strong>Treatment of prolactinomas with dopamine agonists has been the established first-line treatment option for many years, with surgery reserved for refractory cases or medication intolerance. This approach may not be the best option in many cases.</p><p><strong>Areas covered: </strong>Review of the epidemiology, biology, and treatment options available for prolactinomas, including best available data on outcomes, costs, and morbidities for each therapy. These data are then used to propose a 'surgery-first' treatment approach for a subset of prolactinomas as an alternative to primary medical management.</p><p><strong>Expert opinion: </strong>Based on the available data, there is a strong rationale that transsphenoidal surgery should be considered a first-line treatment option for both micro- and macro-prolactinomas that do not demonstrate high grade cavernous sinus invasion on MRI imaging, with dopamine agonists administered as a secondary therapy for tumors not in remission following surgery, and for giant tumors. This 'surgery-first' approach assumes the availability of skilled and experienced pituitary surgeons to ensure optimal outcomes. This approach should result in high cure rates and reduced DA requirements for patients not cured from initial surgery. Further, it will reduce medical costs over a patient's lifetime and the chronic morbidities associated with protracted dopamine agonist usage.</p>","PeriodicalId":12107,"journal":{"name":"Expert Review of Endocrinology & Metabolism","volume":"17 6","pages":"485-498"},"PeriodicalIF":3.2,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10478239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The metabolic role of prolactin: systematic review, meta-analysis and preclinical considerations.","authors":"Giovanni Corona,&nbsp;Giulia Rastrelli,&nbsp;Paolo Comeglio,&nbsp;Federica Guaraldi,&nbsp;Diego Mazzatenta,&nbsp;Alessandra Sforza,&nbsp;Linda Vignozzi,&nbsp;Mario Maggi","doi":"10.1080/17446651.2022.2144829","DOIUrl":"https://doi.org/10.1080/17446651.2022.2144829","url":null,"abstract":"<p><strong>Introduction: </strong>Hyperprolactinemia has been proven to induce hypogonadism and metabolic derangements in both genders, while the consequences of prolactin (PRL) deficiency have been poorly investigated.</p><p><strong>Areas covered: </strong>To systematically review and analyze data from clinical studies focusing on the metabolic consequences of abnormally high prolactin levels (HPRL) and low prolactin levels (LPRL). In addition, data from preclinical studies about underlying pathophysiological mechanisms were summarized and discussed.</p><p><strong>Expert opinion: </strong>PRL contributes to providing the correct amount of energy to support the mother and the fetus/offspring during pregnancy and lactation, but it also has a homeostatic role. Pathological PRL elevation beyond these physiological conditions, but also its reduction, impairs metabolism and body composition in both genders, increasing the risk of diabetes and cardiovascular events. Hence, hypoprolactinemia should be avoided as much as possible during treatment with dopamine agonists for prolactinomas. Patients with hypoprolactinemia, because of endogenous or iatrogenic conditions, deserve, as those with hyperprolactinemia, careful metabolic assessment.</p>","PeriodicalId":12107,"journal":{"name":"Expert Review of Endocrinology & Metabolism","volume":"17 6","pages":"533-545"},"PeriodicalIF":3.2,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10531637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Further understanding of paternal uniparental disomy in Beckwith-Wiedemann syndrome.","authors":"Thomas Eggermann,&nbsp;Dirk Prawitt","doi":"10.1080/17446651.2022.2144228","DOIUrl":"https://doi.org/10.1080/17446651.2022.2144228","url":null,"abstract":"<p><strong>Introduction: </strong>Paternal uniparental disomy of chromosome 11 (upd(11)pat) accounts for up to 20% of molecularly confirmed Beckwith-Wiedemann spectrum (BWSp) cases. It belongs to the BWSp subgroup with the second highest tumor risk, and therefore needs particular awareness in research, diagnostics and clinical management.</p><p><strong>Areas covered: </strong>We overview the contribution of paternal (mosaic) uniparental disomy of chromosome 11 (UPD, upd(11)pat) and mosaic paternal uniparental diploidy in patients with Beckwith-Wiedemann features. The review comprises the current knowledge on their formation and their molecular and clinical consequences. Accordingly, the consequences for diagnostic testing and clinical monitoring are compiled.</p><p><strong>Expert opinion: </strong>The necessity to diagnostically identify and thus discriminate genome-wide paternal uniparental disomy, and upd(11)pat becomes obvious, due to the differences in the clinical course, disease prognosis, and treatment. In particular, monitoring of tumor development by liquid biopsy might be a promising option in the future. From the research point of view, it should be addressed why 11p is prone to mitotic recombination and thus also provide to the role of upd(11) as second hit in tumorigenesis.</p>","PeriodicalId":12107,"journal":{"name":"Expert Review of Endocrinology & Metabolism","volume":"17 6","pages":"513-521"},"PeriodicalIF":3.2,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10474949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the effect of obesity on papillary thyroid cancer: is there a need for tailored diagnostic and therapeutic management?","authors":"Antonio Matrone,&nbsp;Alessio Basolo,&nbsp;Ferruccio Santini,&nbsp;Rossella Elisei","doi":"10.1080/17446651.2022.2131529","DOIUrl":"https://doi.org/10.1080/17446651.2022.2131529","url":null,"abstract":"<p><strong>Introduction: </strong>Several studies have focused on the relationship between obesity and differentiated thyroid carcinoma (DTC), particularly papillary histotype (PTC). However, the association of obesity with both incidence and aggressiveness of PTC is still incompletely understood.</p><p><strong>Areas covered: </strong>We reviewed the mechanisms underlying the cross talk between obesity and thyroid carcinomas and described the most recent evidence evaluating the effect of obesity on the development of PTC, as well as the impact of excessive body weight on the clinicopathologic features and outcome of this type of cancer.</p><p><strong>Expert opinion: </strong>Available evidence suggests that excessive body weight is linked with a higher risk of getting PTC, while its impact on the aggressiveness of the disease, if present, is still not clear. Therefore, while attention should be paid to discover thyroid cancer in patients with obesity earlier, once diagnosed it should be managed following a conventional workup as in normal weight patients, based on the clinical presentation of the disease and including active surveillance if appropriate, as recommended by referral guidelines.</p>","PeriodicalId":12107,"journal":{"name":"Expert Review of Endocrinology & Metabolism","volume":"17 6","pages":"475-484"},"PeriodicalIF":3.2,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10464854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors in thyroid cancer: is the obesity pandemic an important factor?","authors":"Antonio Matrone","doi":"10.1080/17446651.2022.2144832","DOIUrl":"https://doi.org/10.1080/17446651.2022.2144832","url":null,"abstract":"In 2016, the International Agency for Research on Cancer (IARC) supported the evidence that the absence of excess body fat was associated with a reduced risk of several cancers, including thyroid (Figure 1). In this study, the subjects with the highest body mass index (BMI) showed a relative risk of having thyroid cancer of 1.1 (95% CI: 1.0–1.1) [1]. Thyroid cancer, particularly in its differentiated forms (DTC), has been growing worldwide during the last decades [2]. Although several factors that could contribute to this phenomenon cannot be overlooked [3], the routine implementation of the neck ultrasound in clinical practice could be considered a key factor in the increase in early-stage clinically undetectable papillary thyroid cancers (PTCs) [4,5]. Likewise, obesity tripled in men and doubled in women in 200 countries, from 1975 to 2014 [6], and interesting data support the hypothesis that if this trend will continue, by the year 2030, 38% and 20% of the world’s adult population will be overweight or obese, respectively [6]. Obesity is considered to be one of the most common causes of carcinogenesis, along with alcohol and smoking [7,8], and is associated with both increased cancer incidence and progression and could contribute to more than 20% of cancerrelated deaths [9]. Several studies investigated the potential association between BMI and DTC, particularly PTC. Conversely, other indicators of adiposity such as weight circumference and weight gain, although more precise in quantifying visceral adiposity, which could play a key role in carcinogenesis, were less frequently reported in the literature in relation to DTC. Also, the relationship between obesity and other rarer thyroid cancers such as anaplastic, follicular, or medullary thyroid cancer has rarely been evaluated. Therefore, the strengths of evidence regarding obesity and prevalence and aggressiveness of PTC are linked to the evaluation of BMI as a measure of fatness. The pathogenic link between cancers and obesity has been widely studied in recent years [10]. A key role is played by the peculiar function of adipose tissue, an active endocrine organ, which is able to produce not only hormones but also adipokines and growth factors involved in the deregulation of cell growth and survival and in cancer development [9,11]. However, other factors are implicated in thyroid carcinogenesis and could interact with obesity, such as iodine intake, radiation exposure, and endocrine disruptors. To date, the influence of obesity on the increasing rate of PTC is well recognized. Indeed, based on several large prospective cohort or case–control studies, a positive association was observed between BMI, and less frequently also other indicators of adiposity, and the risk of having PTC [12–14]. This is supported by a recent study that estimated that one in six PTC (16.6%), in 2015 in adults (≥60 years) in the USA, was exclusively due to overweight and obesity [15]. The same association was also obs","PeriodicalId":12107,"journal":{"name":"Expert Review of Endocrinology & Metabolism","volume":"17 6","pages":"463-466"},"PeriodicalIF":3.2,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10478760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renal insulin resistance in type 2 diabetes mellitus and progression of chronic kidney disease: potential pathogenic mechanisms.","authors":"Alrataj Alqallaf,&nbsp;Patrick Swan,&nbsp;Neil G Docherty","doi":"10.1080/17446651.2022.2131534","DOIUrl":"https://doi.org/10.1080/17446651.2022.2131534","url":null,"abstract":"<p><strong>Introduction: </strong>A bidirectional association exists between insulin resistance (IR) and chronic kidney disease (CKD) in Type 2 Diabetes Mellitus (T2DM). Baseline measures of IR are predictive of CKD progression, and uremia in progressive CKD is itself, in turn, associated with a worsening of IR. Pre-clinical research reveals that intrinsic IR in glomerular podocytes and the renal tubule may serve as a pathogenic driver of CKD in T2DM.</p><p><strong>Areas covered: </strong>The present manuscript takes as its point of departure, the recently identified prognostic utility of severe insulin resistance as a predictor of CKD in T2DM. Findings from a series of studies describing the association of IR with pathological alterations in both established, and less commonly assessed dynamic measures of renal impairment are discussed. Drawing upon the pre-clinical mechanistic evidence base, the cellular and molecular basis of intrinsic renal IR as a promoter of CKD is considered.</p><p><strong>Expert opinion: </strong>Measurement of insulin sensitivity may add value to profiling of renal risk in T2DM. Rational selection of therapeutic strategies targeting the enhancement of insulin sensitivity merits special attention regarding the personalized management of CKD in insulin resistance predominant T2DM.</p>","PeriodicalId":12107,"journal":{"name":"Expert Review of Endocrinology & Metabolism","volume":"17 6","pages":"523-532"},"PeriodicalIF":3.2,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10828309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}