Endocrine Abstracts

Objectives: No immunohistochemical marker has yet been established to reliably differentiate adrenocortical tumors from other adrenal masses (e.g. metastases). Thus, a panel of several markers like melan A and inhibin is currently used for this purpose, but suffers from limited diagnostic accuracy. We hypothesized that expression of steroidogenic factor 1 (SF-1), a nuclear transcription factor involved in adrenal development and steroidogenesis, might hold significant diagnost...

Standard treatment of adrenocortical carcinoma (ACC) comprises adrenolytic therapy with mitotane. Prolongation of bleeding time has previously been observed based on a series of 7 patients (Haak et al. 1991). As patients with ACC frequently undergo surgery for local recurrence or metastases, we have studied the effect of mitotane on coagulation in 44 patients with ACC before and/or during treatment with mitotane (total sample size n=62).Pla...

Adrenal masses are highly prevalent tumours comprising of a variety of entities. Therefore, therapeutic consequences also vary considerably. The CYP11B-specific PET-tracer [11C]metomidate has been shown to be suitable to characterize adrenal lesions. However, its availability is restricted to PET-centers with an on-site cyclotron. Also imaging is hindered by the short tracer half-life (20 min). Therefore, we have developed [123I]iodometomidate as a tracer...

Introduction: Patients with chronic primary adrenal insufficiency (PAI) depend on lifelong gluco- (GC) and mineralocorticoid (MC) replacement therapy. Reduced subjective well-being is however often described by these patients in absence of clinical or laboratory abnormalities and is thus a strong indicator of the gap between the concept of adequate hormone substitution and patients’ requirements. The aim of this study was to investigate the potential role of 23...

Introduction: Methylation of FKBP5, a glucocorticoid(GC)-receptor co-chaperone, negatively correlates with cortisol levels in both healthy and hypercortisolaemic individuals, and may serve as an indicator of GC exposure. We explored whether GC replacement correlates with FKBP5 methylation levels in patients with adrenal insufficiency (AI), aiming to assess the adequacy of substitution therapy.Methods: In 122 patients with chronic primary (n=73) ...

Background: Distinction of benign testicular adrenal rest tumours (TART) and potentially malign Leydig cell tumors (LCT) is challenging but important to prevent unnecessary surgery of TART. Ultrasound or magnetic resonance imaging can reliably detect but not distinguish between both tumour entities.Methods: Functional imaging results using the specific CYP11B1/2-inhibitor 123I-IMAZA were investigated in seven adult male patients with classic c...

Primary aldosteronism (PA) describes the most frequent cause of secondary arterial hypertension. Aldosterone itself represents a BP-independent cardiovascular risk factor associated with increased rates of morbidity and mortality. Recently a worsening of lipid metabolism after treatment has been described.Objective: Our aim was to analyse changes in lipid parameters according to treatment outcome in PA patients. Data of 215 consecutive PA patients with u...

Background: We have recently introduced [123/131I]iodometomidate (IMTO) which selectively binds to the adrenocortical enzymes aldosterone synthase and 11ß-hydroxylase as SPECT tracer. IMTO has been proven to be useful for molecular adrenal imaging and radiotherapy in adrenal cancer (ACC). As IMTO is rapidly inactivated by endogenous esterases which may impair target tissue to background activity and therapeutic efficacy, >50 new IMTO derivatives have been d...

Context: Primary aldosteronism (PA) is the most common cause of secondary hypertension. Aldosterone excess can cause oxidative stress and respectively DNA damage in vitro and in vivo and increased levels of oxidative stress have been demonstrated in PA patients. Single case reports describe a coincidence of PA with renal cell carcinoma (RCC) and other tumours. However, so far no data on the prevalence of benign and malignant neoplasms in patients with PA exis...

Objectives: Endocrine gland-derived vascular endothelial growth factor (EG-VEGF; also termed prokineticin-1) has been identified as a mitogen preferable for the endothelium of steroidogenic glands (1). EG-VEGF and its receptors (prokineticin receptors 1 and 2; PKR1 and 2) are highly expressed in the normal adrenal gland and an autocrine mitogenic loop has been proposed (2). Therefore, we investigated the expression of EG-VEGF and its receptors in adrenocortical carcinoma (ACC)...