Endocrine Abstracts

Objective: After Cushing Syndrome (CS) is cured, up to 70% of patients develop chronic adrenal insufficiency (AI) and hypothalamus-pituitary-adrenal (HPA) axis dysfunction. A long-term treatment with glucocorticoids (GC) is mandatory to overcome AI. However, this treatment implies non-desired complications. Fibroblast growth factor (FGF21), a key regulator of metabolism, has a bidirectional relationship with GC that bypasses the negative feedback of the HPA axis. In this study...

Background: Acinic cell carcinoma of the parotid gland is a rare cancer, and metastatic (M1) disease is uncommon, occurring in around 10% of cases, with ectopic paraneoplastic Cushing being described in only few cases.Clinical case: A 58-year-old woman, with a history of dedifferentiated parotid acinar cell carcinoma, underwent surgery and adjuvant radiotherapy in 2005. In February 2019 the disease recurred with pulmonary, bone and lymph node metastases....

Introduction: Chronic hypercortisolism is marked by an increased cardiovascular risk pattern. Atherosclerosis is a chronic inflammation that involves both innate and adaptive immunity. Glucocorticoids (GC) are immune-suppressors and adrenocorticotrophic hormone (ACTH) possesses immune-modulatory activities. GC and ACTH may act in atherothrombotic inflammatory pathways.Aim: To analyze the immune cells pattern in endogenous Cushing syndrome (CS) in order t...

Introduction: Metabolic dysfunction-associated fatty liver disease (MAFLD) is characterized by the presence of hepatic steatosis, which can progress to non-alcoholic steatohepatitis (NASH), fibrosis, and hepatocellular carcinoma. There are no licensed therapies to halt MAFLD progression, despite it is becoming the most important etiology for advanced liver disease.Aim: The aim of the study was to evaluate the therapeutic potential of inorganic nanopartic...

Introduction: Urine free cortisol measurements are routinely performed to evaluate hypercortisolism. Despite their analytical inaccuracy, immunoassay-based methods are frequently used. Advances in liquid chromatography high resolution mass spectrometry (LC-HRMS) facilitate the incorporation of powerful diagnostic tools into clinical laboratories with high analytical specificity that also allow simultaneous quantification of different metabolites and untargeted compound identif...

Introduction: Visceral adipose tissue (VAT) is the key target tissue of glucocorticoids (GC) during active Cushing Syndrome (CS) and a metabolic tissue associated to insulin-resistance and an increased cardiometabolic risk. Till date there are no data regarding gene expression in VAT in CS and only few data about the mRNA in subcutaneous one. The aim of this study was to study the visceral VAT tissue transcriptional changes in ACTH-independent CS.Methods...

Exosomes are nano-sized vesicles secreted by the cells in the exatracellular fluids representing a novel way of intracellular communication. Exosomes secreted from blood cells like monocytes and platetes have been reported to be checkpoints involved in haemostatic and thrombotic response. Glucocorticoids are inducing a profound alteration of blood cells homeostasis with atherothrombotic, bleeding and immune response alterations. Hereby we quantified for the first time circulat...

Introduction: Clinical observational studies have reported the persistence of a high cardiovascular risk in patients with cured Cushing’s syndrome (CCS) compared with controls of the same age, gender and BMI. It is still at debated whether this is due to the persistence of comorbidities, hormone deficiencies or chronic changes induced by hypercortisolism. The aim of this translational approach was to investigate the interplay in CCS of the cardiovascular disease in vivo a...

Aims: A few studies have shown disturbances in the hypothalamic-pituitary-adrenal (HPA) axis in chronic-kidney-disease (CKD), of unknown extent and clinical implications. We aimed to study the HPA axis in patients with CKD and its association with kidney impairment and metabolic disturbances.Methods: Cross-sectional controlled study. Patients with CKD stages I-II (estimated glomerular filtration rate [eGFR] through CKD-EPI equation >60), stage III (e...

Introduction: Transsphenoidal surgery (TSS) is the procedure of choice in Cushing disease (CD), with immediate post-operative remission rates ranging between 59 and 94% and recurrence rates between 3 and 46%, both depending upon the definition criteria and the duration of the follow-up. Our aim was to assess the rate of remission, recurrence and persistence of the disease after the first treatment and to identify predictors of remission in the CD population of our center durin...