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Ectopic CRH/ACTH-Co-Secreting Neuroendocrine Tumors Leading to Cushing's Disease - A Case Presentation and Literature Review.
IF 3.2 2区 医学
Neuroendocrinology Pub Date : 2025-02-14 DOI: 10.1159/000544727
Jasmin Ewert, Maximilian Seidl, Jann Achim Hommen, Matthias Schott, Norbert Gattermann
{"title":"Ectopic CRH/ACTH-Co-Secreting Neuroendocrine Tumors Leading to Cushing's Disease - A Case Presentation and Literature Review.","authors":"Jasmin Ewert, Maximilian Seidl, Jann Achim Hommen, Matthias Schott, Norbert Gattermann","doi":"10.1159/000544727","DOIUrl":"https://doi.org/10.1159/000544727","url":null,"abstract":"<p><p>Adrenocorticotropic hormone (ACTH) and corticotropin-releasing hormone (CRH) are essential regulators of cortisol production within the hypothalamic-pituitary-adrenal (HPA) axis. Elevated cortisol levels, resulting from excessive ACTH, can lead to Cushing's syndrome, a condition with significant morbidity. Neuroendocrine tumors (NETs) can ectopically produce both ACTH and CRH, contributing to this syndrome. This review discusses the pathophysiology, types, clinical presentation, diagnosis, and management of these tumors. Emphasis is placed on the importance of identifying dual CRH/ACTH secretion, which complicates diagnosis and necessitates tailored therapeutic strategies. Furthermore, the review highlights the prognosis, common complications, and future directions for research in this area. We report the case of a 53-year-old female patient who presented with severe Cushing's syndrome and was diagnosed with ectopic ACTH syndrome. Despite initial indications pointing towards pituitary-dependent hypercortisolism, further investigations revealed the presence of a highly differentiated atypically located tumor in the upper lobe of the left lung, adjacent to the mediastinum. Immunohistochemistry of the tumor tissue demonstrated not only ACTH but also CRH and CRH-R1 expression. The simultaneous expression of these molecules supports the hypothesis of the presence of a positive endocrine feedback loop within the NET, in which the release of CRH stimulates the expression of ACTH via binding to CRH-R1. This case report highlights the challenges in diagnosing and managing ectopic ACTH syndrome, emphasizing the importance of a comprehensive diagnostic approach to identify secondary factors impacting cortisol production, such as CRH production and other contributing neuroendocrine mechanisms.</p>","PeriodicalId":19117,"journal":{"name":"Neuroendocrinology","volume":" ","pages":"1-29"},"PeriodicalIF":3.2,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Factors influencing costs of cancer care for patients with neuroendocrine neoplasms.
IF 3.2 2区 医学
Neuroendocrinology Pub Date : 2025-02-12 DOI: 10.1159/000544050
Martin O Weickert
{"title":"Factors influencing costs of cancer care for patients with neuroendocrine neoplasms.","authors":"Martin O Weickert","doi":"10.1159/000544050","DOIUrl":"https://doi.org/10.1159/000544050","url":null,"abstract":"<p><strong>Background: </strong>Neuroendocrine neoplasms (NENs) are comparatively rare tumours. However, prevalence is increasing steeply, related to rising incidence, earlier detection, and prolonged survival in many cases of metastatic NENs; with implications on health care resources.</p><p><strong>Summary: </strong>This commentary/narrative review extracts the relatively scare, available literature related to costs of NEN cancer care, which is mainly based on studies performed in the Unites States. Key, now implemented or evolving NEN related treatment options over the last 15 years are summarised. The commentary further highlights in part preventable aspects that can further contribute to cost pressure in NEN cancer care, including issues related to inappropriate use of available diagnostic tools; and not considering differential diagnoses when assessing people with suspected carcinoid syndrome - with these risks being minimised with access to centres with multi-specialty expertise in the management of people with NENs. Issues observed in people with exocrine and/or endocrine pancreatic deficiencies caused by a NEN or treatment of the NEN are mentioned, as well as some specific aspects related to diagnostics involving 68Ga PET-CT scans and treatment with Lutetium peptide-receptor radionuclide therapy (Lu-PRRT).</p><p><strong>Key messages: </strong>This commentary summarises factors influencing cost of NEN cancer care, and highlights in part preventable issues mostly related to delayed involvement of a NEN multidisciplinary team, observed in a UK NEN referral centre (ENETS Centre of Excellence certified since 2015) over the last 15 years; resulting in sub-optimal management of people with NENs and ultimately adding to cost pressure.</p>","PeriodicalId":19117,"journal":{"name":"Neuroendocrinology","volume":" ","pages":"1-26"},"PeriodicalIF":3.2,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143409434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The French Neuroendocrinology is enriched by its diversity.
IF 3.2 2区 医学
Neuroendocrinology Pub Date : 2025-02-05 DOI: 10.1159/000543954
David Vaudry
{"title":"The French Neuroendocrinology is enriched by its diversity.","authors":"David Vaudry","doi":"10.1159/000543954","DOIUrl":"https://doi.org/10.1159/000543954","url":null,"abstract":"<p><p>No abstract.</p>","PeriodicalId":19117,"journal":{"name":"Neuroendocrinology","volume":" ","pages":"1-4"},"PeriodicalIF":3.2,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cabozantinib in the Treatment of Neuroendocrine Neoplasms: Insights Across Different Tumor Origins.
IF 3.2 2区 医学
Neuroendocrinology Pub Date : 2025-02-04 DOI: 10.1159/000543953
Giovanni Vitale, Ilona Rybinska, Giulia Arrivi, Vincenzo Marotta, Gianfranco Di Iasi, Alessia Filice, Christopher Nardi, Annamaria Colao, Antongiulio Faggiano
{"title":"Cabozantinib in the Treatment of Neuroendocrine Neoplasms: Insights Across Different Tumor Origins.","authors":"Giovanni Vitale, Ilona Rybinska, Giulia Arrivi, Vincenzo Marotta, Gianfranco Di Iasi, Alessia Filice, Christopher Nardi, Annamaria Colao, Antongiulio Faggiano","doi":"10.1159/000543953","DOIUrl":"https://doi.org/10.1159/000543953","url":null,"abstract":"<p><strong>Background: </strong>Neuroendocrine neoplasms (NENs) are a heterogeneous group of tumors arising from neuroendocrine cells, exhibiting a wide range of behaviours from indolent to highly aggressive forms. Treatment options remain limited, particularly for progressive cases. Cabozantinib, a multitarget tyrosine kinase inhibitor, has demonstrated potential in targeting key pathways related to tumor growth, angiogenesis, and metastasis.</p><p><strong>Summary: </strong>This review provides a comprehensive analysis of cabozantinib's therapeutic role across various NEN subtypes, including gastroenteropancreatic NENs, lung NENs, pheochromocytomas/paragangliomas, Merkel cell carcinoma, presacral NENs, pituitary neuroendocrine tumors, and neuroendocrine prostate cancer.</p><p><strong>Key messages: </strong>The paper discusses several preclinical and clinical studies that demonstrate the efficacy of cabozantinib in slowing tumor progression and improving progression-free survival, particularly in patients with progressive, well-differentiated NENs. However, cabozantinib's complex toxicity profile limits its broad application, necessitating further research to optimize dosing, particularly in syndromic NENs. Ongoing trials are investigating cabozantinib in combination with somatostatin analogues, peptide receptor radionuclide therapy, temozolomide and immunotherapies in order to overcome treatment resistance and expanding therapeutic strategies for advanced NENs.</p>","PeriodicalId":19117,"journal":{"name":"Neuroendocrinology","volume":" ","pages":"1-26"},"PeriodicalIF":3.2,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The hypothalamus and pituitary gland regulate reproduction and are involved in the development of polycystic ovary syndrome.
IF 3.2 2区 医学
Neuroendocrinology Pub Date : 2025-01-31 DOI: 10.1159/000543877
Bin-Yang Long, Xipeng Liao, Xin Liang
{"title":"The hypothalamus and pituitary gland regulate reproduction and are involved in the development of polycystic ovary syndrome.","authors":"Bin-Yang Long, Xipeng Liao, Xin Liang","doi":"10.1159/000543877","DOIUrl":"https://doi.org/10.1159/000543877","url":null,"abstract":"<p><p>Background Polycystic ovary syndrome is a complex condition with unclear mechanisms, posing a challenge for prevention and treatment of PCOS. The role of the hypothalamus and pituitary gland in regulating female reproduction is critical. Abnormalities in the hypothalamus and pituitary can impair reproductive function. It is important to study hypothalamic and pituitary changes in patients with polycystic ovary syndrome. Summary This article reviews articles on the hypothalamus and polycystic ovary syndrome with the goal of summarizing what abnormalities of the hypothalamic-pituitary-ovarian axis are present in patients with polycystic ovary syndrome and to clarify the pathogenesis of polycystic ovary syndrome. We find that the mechanisms by which the hypothalamus and pituitary regulate reproduction in girls are complex and are associated with altered sex hormone levels, obesity and insulin resistance. Different animal models of polycystic ovary syndrome are characterized by different alterations in the hypothalamus and pituitary, and respond differently to different treatments, which correspond to the complex pathogenesis of patients with polycystic ovary syndrome. Key Messages ARC is associated with luteinizing hormone (LH) surges SCN, ARC and RP3V are associated with LH surges Animal models of PCOS have different characteristics.</p>","PeriodicalId":19117,"journal":{"name":"Neuroendocrinology","volume":" ","pages":"1-26"},"PeriodicalIF":3.2,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of indoleamine 2,3-dioxygenase enzyme activity in neuroendocrine tumors. 吲哚胺2,3-双加氧酶活性对神经内分泌肿瘤的影响。
IF 3.2 2区 医学
Neuroendocrinology Pub Date : 2025-01-21 DOI: 10.1159/000543658
Camilla Mancini, Giulia Pecora, Gerardo Salerno, Luana Lionetto, Donatella De Bernardini, Giuseppe Costanzi, Saverio Gabrielli, Domenico Veroli, Vincenzo Visco, Maurizio Simmaco, Virginia Zamponi, Rossella Mazzilli, Antongiulio Faggiano
{"title":"Impact of indoleamine 2,3-dioxygenase enzyme activity in neuroendocrine tumors.","authors":"Camilla Mancini, Giulia Pecora, Gerardo Salerno, Luana Lionetto, Donatella De Bernardini, Giuseppe Costanzi, Saverio Gabrielli, Domenico Veroli, Vincenzo Visco, Maurizio Simmaco, Virginia Zamponi, Rossella Mazzilli, Antongiulio Faggiano","doi":"10.1159/000543658","DOIUrl":"https://doi.org/10.1159/000543658","url":null,"abstract":"<p><strong>Introduction: </strong>Indoleamine-2,3-dioxygenase (IDO) converts L-tryptophan (T) to L-kynurenine (K) resulting in an immunosuppressive microenvironment. Aim of the current study is to evaluate in patients with neuroendocrine tumor (NET): 1) T and K concentrations; 2) correlation with clinical outcome; 3) relationship between IDO activity and inflammatory cytokines.</p><p><strong>Methods: </strong>A cross-sectional study was performed to investigate the IDO pathway in patients in follow-up for NET. Clinico-pathological features, serum levels of K and T through liquid chromatography and serum assay of cytokines (IL-6, IL-10, IL-17A, IL-22, IL-23, TNF-α) through MAGPIX were evaluated.</p><p><strong>Results: </strong>78 NET patients were enrolled (66 lung, 12 pancreatic): 69.2% were in postoperative remission, 14.1% in stable disease and 16.7% in disease progression. T was significantly lower in patients older than 65 years (p=0.003). K and T were significantly lower in patients with progression (p=0.03, p=0.004, respectively). T was an independent predictor factor of progression in multivariable analysis (p=0.041). A cut-off of 7.74 μg/ml significantly differentiates patients with progression and those with stable disease. IL-6 and IL-10 were significantly associated with tumor progression on univariate analysis (p=0.005, p=0.001, respectively), but not at the multivariable. A statistically significant negative correlation was found between T and IL-10 (r=-0.366, p-value=0.04).</p><p><strong>Conclusion: </strong>The K/T pathway may play a role as a potential predictor of tumor progression in NET. These findings need to be validated in large prospective studies investigating its metabolites as both prognostic and predictive factors for treatment response.</p>","PeriodicalId":19117,"journal":{"name":"Neuroendocrinology","volume":" ","pages":"1-22"},"PeriodicalIF":3.2,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Genetic associations between obesity and brain cortical thickness: combined genetic correlation, multi-trait meta- analysis and Mendelian randomization. 肥胖与大脑皮质厚度之间的遗传关联:综合遗传相关、多性状荟萃分析和孟德尔随机化。
IF 3.2 2区 医学
Neuroendocrinology Pub Date : 2025-01-20 DOI: 10.1159/000543574
Jiankun Chen, Simin Pan, Yingfei Tan, Yuan Wu, Taoliang Huang, Bin Huang, Changcai Xie, Shubin Cai, Jiqiang Li, Yue Lu, Yu Chen
{"title":"Genetic associations between obesity and brain cortical thickness: combined genetic correlation, multi-trait meta- analysis and Mendelian randomization.","authors":"Jiankun Chen, Simin Pan, Yingfei Tan, Yuan Wu, Taoliang Huang, Bin Huang, Changcai Xie, Shubin Cai, Jiqiang Li, Yue Lu, Yu Chen","doi":"10.1159/000543574","DOIUrl":"https://doi.org/10.1159/000543574","url":null,"abstract":"<p><strong>Introduction: </strong>Obesity may lead to cognitive impairment and neuropsychiatric disorders, which are associated with changes in the brain cortical structure, particularly in cortical thickness. However, the exact genetic association between obesity and brain cortical thickness remains inconclusive. We aimed to identify the relationship between obesity-related traits [body mass index (BMI), waist-hip ratio (WHR), and waist-hip ratio adjusted for BMI (WHRadjBMI)] and brain cortical thickness.</p><p><strong>Methods: </strong>Leveraging summary statistics of large-scale GWAS(s) conducted in European-ancestry populations on BMI(N=806,834), WHR(N=697,734), WHRadjBMI (N=694,649), and brain cortex thickness (N=33,709), we performed GWAS combining genetic correlation, multi-trait meta-analysis and Mendelian randomization analysis.</p><p><strong>Results: </strong>Our findings revealed a strong genetic correlation between BMI and brain cortical thickness(rg=-0.0542, P=0.0435), and a significant result was also observed for WHR and brain thickness (rg=-0.0744, P=0.009). In addition, we identified three loci between obesity-related traits. MR analysis supported the causal role of BMI (IVW beta=-0.006, 95% CI=-0.011- -3.85E-04;weighted median beta=-0.006, 95% CI=-0.013- -0.002), WHR (IVW beta=-0.011, 95% CI=-0.018- -0.005; weighted median beta=-0.008, 95% CI=-0.018- -0.003) and WHRadjBMI (IVW beta =0.011 95% CI=-0.018- -0.005; weighted median beta=-0.008, 95% CI=-0.018- -0.002) in brain cortical thickness.</p><p><strong>Conclusion: </strong>This study has shown that genetically predicted obesity-related traits have a causal relationship with reduced cortical thickness. These findings provide genetic evidence for a link between obesity and structural changes in the brain, and suggest that obesity may be associated with neuropsychiatric disorders by affecting brain structure, particularly cortical thickness.</p>","PeriodicalId":19117,"journal":{"name":"Neuroendocrinology","volume":" ","pages":"1-11"},"PeriodicalIF":3.2,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Impact of SGLT2 Inhibitors on Dementia Onset in Patients with Type 2 Diabetes: A Meta-Analysis of Cohort Studies. SGLT2抑制剂对2型糖尿病患者痴呆发病的影响——队列研究的荟萃分析
IF 3.2 2区 医学
Neuroendocrinology Pub Date : 2025-01-11 DOI: 10.1159/000543533
Jiani Pan, Huiping Yang, Jiatong Lu, Ling Chen, Tian Wen, Shijie Zhao, Liye Shi
{"title":"The Impact of SGLT2 Inhibitors on Dementia Onset in Patients with Type 2 Diabetes: A Meta-Analysis of Cohort Studies.","authors":"Jiani Pan, Huiping Yang, Jiatong Lu, Ling Chen, Tian Wen, Shijie Zhao, Liye Shi","doi":"10.1159/000543533","DOIUrl":"10.1159/000543533","url":null,"abstract":"<p><strong>Introduction: </strong>Sodium-glucose cotransporter 2 (SGLT2) inhibitors have demonstrated neuroprotective effects and hold potential advantages in enhancing cognitive function. This study aimed to clarify the association between SGLT2 inhibitors and the risk of dementia among individuals diagnosed with type 2 diabetes (T2D).</p><p><strong>Methods: </strong>All cohort studies concerning the impact of SGLT2 inhibitors on dementia onset in patients with T2D were identified. The literature search encompassed PubMed, Embase, Cochrane Library, and Web of Science from establishment to March 2024, with no language restriction. The quality of the literature was evaluated using the Newcastle-Ottawa Scale (NOS). Meta-analysis was conducted using RevMan 5.4 software, calculating pooled risk ratio (RR) with 95% confidence intervals (CIs) for dichotomous outcomes.</p><p><strong>Results: </strong>Five cohort studies encompassing a total of 331,908 patients were included in the analysis. The findings showed that individuals receiving SGLT2 inhibitors had a lower risk of dementia (I2 = 42%, p = 0.14; RR: 0.77; 95% CI: 0.71-0.84) compared to the control group. Subgroup analyses confirmed the consistent beneficial effects of SGLT2 inhibitors across different study regions (I2 = 0%, p = 0.60) and genders (I2 = 0%, p = 0.50).</p><p><strong>Conclusions: </strong>SGLT2 inhibitors may reduce the dementia risk in T2D patients. Given the limitations of the study, further investigations were warranted to confirm the benefits.</p>","PeriodicalId":19117,"journal":{"name":"Neuroendocrinology","volume":" ","pages":"1-9"},"PeriodicalIF":3.2,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Maternal diet and vulnerability to cognitive impairment in adulthood: possible link with Alzheimer's disease? 母亲的饮食和成年后认知障碍的易感性:可能与阿尔茨海默病有关?
IF 3.2 2区 医学
Neuroendocrinology Pub Date : 2025-01-10 DOI: 10.1159/000543499
Laetitia Merle, Marialetizia Rastelli, Frédérique Datiche, Anne Véjux, Agnès Jacquin-Piques, Sébastien G Bouret, Alexandre Benani
{"title":"Maternal diet and vulnerability to cognitive impairment in adulthood: possible link with Alzheimer's disease?","authors":"Laetitia Merle, Marialetizia Rastelli, Frédérique Datiche, Anne Véjux, Agnès Jacquin-Piques, Sébastien G Bouret, Alexandre Benani","doi":"10.1159/000543499","DOIUrl":"https://doi.org/10.1159/000543499","url":null,"abstract":"<p><p>Aging is the main risk factor for developing cognitive impairments and associated neurodegenerative diseases. However environmental factors, including nutritional health, are likely to promote or reduce cognitive impairments and neurodegenerative pathologies. An intricate relationship exists between maternal nutrition; and adult eating behavior, metabolic phenotype and cognitive abilities. The objective of the present review was to collect available data suggesting a link between maternal overnutrition and latter impairment of cognitive functions in the progeny, and to related this relationship with Alzheimer's disease (AD). Indeed, cognitive impairments are major behavioral signs of AD. We first reviewed studies showing an association between unbalanced maternal diet and cognitive impairments in the progeny in humans and rodent models. Then we looked for cellular and molecular hallmarks which could constitute a breeding ground for AD in those models. With this end, we focused on synaptic dysfunction, altered neurogenesis, neuroinflammation and oxidative stress, and pathological protein aggregation. Finally, we proposed an indirect mechanism linking maternal unbalanced diet and progeny's vulnerability to cognitive impairments and neurodegeneration through promoting metabolic diseases. We also discussed the involvement of progeny's gut microbiota in the maternal diet-induced vulnerability to metabolic and neurodegenerative diseases. Further investigations are needed to fully decipher how maternal diet programs the fetus and infant brain. Addressing this knowledge gap would pave the way to precise nutrition and personalized medicine to better handle cognitive impairments in adulthood.</p>","PeriodicalId":19117,"journal":{"name":"Neuroendocrinology","volume":" ","pages":"1-36"},"PeriodicalIF":3.2,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Temozolomide Treatment in Refractory Pituitary Adenomas and Pituitary Carcinomas. 替莫唑胺治疗难治性垂体腺瘤和垂体癌。
IF 3.2 2区 医学
Neuroendocrinology Pub Date : 2025-01-08 DOI: 10.1159/000543427
Congcong Deng, Shuangjian Yang, Changqin Pu, Xuexue Bai, Chenxin Tian, Ming Feng
{"title":"Temozolomide Treatment in Refractory Pituitary Adenomas and Pituitary Carcinomas.","authors":"Congcong Deng, Shuangjian Yang, Changqin Pu, Xuexue Bai, Chenxin Tian, Ming Feng","doi":"10.1159/000543427","DOIUrl":"10.1159/000543427","url":null,"abstract":"<p><strong>Background: </strong>Temozolomide (TMZ), a nonclassical alkylating agent, possesses lipophilic properties that allow it to cross the blood-brain barrier, making it active within the central nervous system. Furthermore, the adverse reactions of the TMZ are relatively mild, which is why it is currently recommended as a first-line chemotherapy drug for refractory pituitary adenomas (RPAs) and pituitary carcinomas (PCs).</p><p><strong>Summary: </strong>Systematic evaluations indicate a radiological response rate of 41% and a hormonal response rate of 53%, underscoring TMZ clinical efficacy, particularly when combined with radiotherapy. Functional tumors demonstrate a higher response rate compared to nonfunctional tumors. While the optimal duration of TMZ treatment remains undetermined, studies suggest that longer therapy durations may lead to better prognoses. Additionally, prior to TMZ administration, it is advisable to conduct immunohistochemical analysis of O6-methylguanine-DNA methyltransferase, MSH2, MSH6, MLH1, PMS2, and N-methylpurine DNA glycosylase to assess the potential impact of repair mechanisms such as direct repair, mismatch repair pathway, and base excision repair on TMZ treatment. The efficacy of TMZ analogs, combined TMZ therapies, and TMZ with nanomaterials following TMZ treatment failure remains uncertain.</p><p><strong>Key messages: </strong>The involvement of experienced multidisciplinary pituitary teams in all management decisions for RPAs/PCs patients is essential.</p>","PeriodicalId":19117,"journal":{"name":"Neuroendocrinology","volume":" ","pages":"1-16"},"PeriodicalIF":3.2,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142952345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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