Endocrine Abstracts

Introduction: Although current medical therapies for acromegaly are highly effective, 30% of patients are left with inadequately controlled growth hormone (GH) levels. To investigate a novel therapeutic strategy we have used RNA interference (RNAi) to target GH coding and promoter sequences in vitro and assessed the effect on gene expression and DNA methylation.Method: A careful bioinformatics approach revealed only one area in the coding sequence...

Background: Proopiomelanocortin gene (POMC) and its cleaved product adrenocorticotrophin hormone (ACTH) play an important role in regulation of the hypothalamo-pituitary-adrenal (HPA) axis. ACTH stimulates the adrenal glands to release glucocorticoids. Glucocorticoid has a suppressive effect on ACTH and POMC. This suppression remains long after withdrawal, and may lead to adrenocortical insufficiency. POMC expression is dependent on the activities of some of the positively act...

Somatostatin analogues are the mainstay of medical therapy for acromegaly. The introduction of ready-to-use Somatuline Autogel (Autogel) raised the possibility of self/partner-injection. This study explored whether patients could administer monthly injections of Autogel, without compromising efficacy. After ethical approval, thirty patients treated with Autogel for acromegaly chose either the Control or Test group. Control group patients (n=15) received injections from ...

BACKGROUND Human and animal evidence indicates that poor maternal nutrition leads to programmed endothelial dysfunction and hypertension in offspring. In humans, endothelial dysfunction has been observed in independent cohorts studied aged 7 and 11, but explanatory molecular mechanisms are lacking. Endothelial function, and synthesis of nitric oxide (NO) by endothelial nitric oxide synthase (eNOS), relies on nutrient supply of L-arginine, with maternal dietary restriction in r...

IGFBP-5 is an important member of the IGF axis in the rodent mammary gland and can function by sequestering IGF-I (insulin-like growth factor-I) - a polypeptide growth factor involved in the growth and differentiation of the mammary gland. Removal of free IGF-I results in inhibition of IGF-I signalling through the cell surface Type-I IGF receptor, and since IGFBP-5 is highly up regulated during mammary gland involution in vivo, it is thought to have a pro-apoptotic role...

Background: Gamma-Knife Stereotactic Radiosurgery (STRS) is a single highly focused dose of radiotherapy used for intracranial pathologies, including pituitary tumours. At the National Centre for Stereotactic Radiosurgery in Sheffield more than 450 patients undergo STRS per year. The UK experience of this modality of treatment for acromegaly is limited because of the few gamma knife units in operation.Objective: To assess the effectiveness and safety of ...

The TRH test is used in the diagnosis of hypothalamic-pituitary (hp) disorders in children. It is unclear how often the result of this test is helpful. We have examined the results of TRH testing in 143 children investigated primarily for disordered growth. Children with hp axis tumours were excluded.The TSH response to TRH (5microg/kg iv) was defined as abnormal if the peak TSH was <5mU/L (pituitary), or if the peak TSH at 60 mins was higher than at ...

Background. Adrenal insufficiency requires life long corticosteroid therapy, but optimal dosing of hydrocortisone replacement has not received adequate attention.Chronic over or under treatment predisposes to morbidity and mortality.Objective.To examine the variables determiming hydrocortisone disposition and develop practical protocols for individualised prescribing and monitoring of treatment.Design. Prospective open study.<p...

Background: Anecdotally patients with chronic pain on opioid analgesia have functional hypopituitarism, and studies in opioid addicts show suppressed pituitary function. We conducted a prospective observational study to determine the endocrine status of patients with chronic pain on opioid analgesia. Methods: 37 consecutive patients with chronic back pain attending the pain clinic were enrolled. 22 patients (age 45+/-9 years) were on long-term opioid analgesia and 15 (age 53 +...

SEVERE HYPERCALCEMIA CAUSED BY A VISIBLE PARATHYROID ADENOMA IN AN ADOLESCENT FEMALEU.Das1, H Iassac1, H Kanchi1, DA Price1, GM Humphrey2 & C M Hall1Departments of 1Endocrinology and 2Surgery, Royal Manchester Children's Hospital, Manchester, Hospital Road, Manchester M27 4HA.A 16-year-old female collapsed following a 24-hour history of severe abdominal pain and vomiting. She was shocked, hypertensive (16...