Influence of various doses of Cabergoline in dynamics of long-term treatment on the level of blood soluble apoptosis markers in patients with inactive pituitary adenomas
Z. Khalimova & D. Kholova
Aim: Studying of influence of various doses of cabergoline in dynamics of 6, 12 and 24 months of treatment on level of blood serum soluble apoptosis markers P53, Bcl-2 and TNF-α in patients with IPA.
Materials and methods: One hundred and twenty-seven patients with IPA (38 men, 89 women) were observed, among them 65 (51.2%) with microadenoma and 62 (48.8%) with macroadenoma/ patients were at the age from 35 till 60 years.Patients with pituitary micro-and macroadenomas were divided into two groups by method of casual sample: the 1st group was made by 34 patients with microadenoma and 31 patients with macroadenoma which in course of treatment were prescribed small doses of Cabergoline by 0.40.6 mg/week. The 2nd group was made by 31 patients with microadenoma and 31 with macroadenoma (doses of Cabergoline from 1.0 to 3.0 mg/week).
Results: In patients with IPA with microadenoma before treatment the level of blood serum soluble apoptosis markers exceeded similar indicators in the control group: P 53, Bcl-2 and TNF-α in 1st and 2nd groups on the average by 25.4, 26.0 and 38.3% (P<0.01), and in patients with macroadenoma by 43.1, 47.2 and 59.5% (P<0.001). It is established, that increase of TNF-α was associated with increase of P 53 (r=0.73; P<0.01) and Bcl-2 (r=0.75; P<0.01), and P 53 with Bcl-2 had stronger association - r=0.86 (P<0.001). Long-term use of Cabergoline in patients with IPA promoted the expressed decrease in all observed apoptosis factors. In patients of the 1st and 2nd groups with microadenoma apoptosis indices r53 and Bcl-2 were basically within the control level in 612 months of treatment and maintained in such condition up to 24 months of therapy, whereas TNF-α only by 24 month of Cabergoline therapy. At the same time in patients with macroadenoma restoration of level of apoptosis indices depended on the dose of Cabergoline prescribed.
Conclusion: In blood of 127 patients with IPA with pituitary micro-and macroadenoma high level of apoptosis markers P 53, Bcl-2 and TNF-α was revealed. Cabergoline prescribed during 6, 12, 24 months in big doses (from 1.0 to 3.0mg/week) restored apoptosis markers in blood of patients with IPA with pituitary micro-and macroadenoma more effectively and by 12 months earlier, than at prescription of small doses of the drug (from 0.4 to 0.6 mg/week).
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.