Endocrine Abstracts

Background: The third generation thyrotropin receptor antibodies (TRAb) assay has high sensitivity and specificity in diagnosing Graves’ disease (GD). Circulating levels of TRAbs predict the disease course of Graves’ orbitopathy (GO) and remission rates in GD. However, the relationship between TRAb and thyroxine (FT4) and the factors affecting their interaction are unclear.Method: A prospective cohort study was conducted to evalua...

Background: The third generation thyrotropin receptor antibodies (TRAb) assay has high sensitivity and specificity in diagnosing Graves’ disease (GD). Circulating levels of TRAbs predict the disease course of Graves’ orbitopathy (GO) and remission rates in GD. However, the relationship between TRAb and thyroxine (FT4) and the factors affecting their interaction are unclear.Method: A prospective cohort study was conducted to evalua...

Ipilimumab and tremelimumab are monoclonal antibodies directed against the extracellular domain of cytotoxic T-lymphocyte-associated antigen 4 (CTLA4) and have been used as the immunotherapies against immune checkpoints that suppress T cell activation. These anti-CTLA4 antibody-based therapies are effective in treating various cancers including metastatic melanoma. However, a few immune-related adverse events including hypophysitis and transient thyroiditis have been reported....

Context: Perturbations in thyroid function are common in older people, and subclinical hyperthyroidism has been associated with increased risk of dementia in people aged 55 years and above. The significance of subtle perturbations of thyroid function in the very old remains poorly understood.Objective: This study sought to determine if subtle abnormalities of thyrotropin and variations of free thyroid hormones within the reference range correlate with co...

Background: The melanocortin system is known to be involved in hypothalamic regulation of energy balance, which is implicated in reproductive success. However, the peripheral role for melanocortin receptor (MCR) signalling in the reproductive system has not been described. During a clinical trial of repeated high dose tetracosactide (ACTH1–24) injection, four of nine premenopausal women with Addison’s disease developed menstrual disturbances. We wondered i...

Background: The plasticity of adrenal cortex suggests the presence of adrenocortical stem cells (ACSC) but the exact in vivo identity of ACSC remains elusive. A few studies have demonstrated the differentiation of adipose or bone marrow-derived mesenchymal stem cells (MSC) into steroid-producing cells. We therefore investigated the direct isolation of MSC from human adrenal cortex.Methods: Adrenals were obtained as discarded surgical material. S...

Male hypogonadism is characterised by sexual dysfunction, loss of muscle bulk, central obesity, fatigue, mood and sleep disturbances, osteoporosis and anaemia. Although these features are associated with low serum testosterone concentration, not all men with a low serum testosterone are definitively hypogonadal, and there is a large symptom overlap with obesity and non-endocrine illness. Importantly, testosterone replacement therapy may not be appropriate for men with mild, fu...

Sialic acid acetylesterase (SIAE) has been found to be essential for the maintenance of immune tolerance in mice by negatively regulating B lymphocyte antigen receptor signalling. Recently, numerous rare heterozygous loss-of-function germline variants and a homozygous functionally defective variant of the SIAE gene (M89V) have been identified as conferring a strong genetic susceptibility to several autoimmune disorders, including T1DM and rheumatoid arthritis. We performed a c...

After adrenal insufficiency is confirmed by synacthen testing, lifelong steroid replacement is expected. We report a case of apparent reversal of adrenal insufficiency. Case details: a 66-year-old man was referred for oral pigmentation, and a random cortisol level of 184 nmol/l. He reported a 2-year history of tiredness, nocturia, dry mouth and reduced libido. There was no dizziness, salt-craving, or weight loss. He denied taking any form of steroid or over-the-counter drugs. ...

ACTH is a 39 amino acids polypeptide which stimulates adrenocortical steroid production. The N-terminal segment of ACTH(1–24) is biologically active and the C-terminal is considered to have greater antigenicity. In one previous (‘RoSA’) and one current (‘RADS2’) clinical trial synthetic ACTH (zinc tetracosactide; depot synacthen) was administered to autoimmune Addison’s disease (AAD) patients to stimulate adrenocortical regeneration. 4/13 RoSA pat...