Searchable abstracts of presentations at key conferences in endocrinology

ea0085p47 | Adrenal 2 | BSPED2022

Salivary sampling in neonates, infants, and young children: glucocorticoid stability under different conditions and the introduction of a novel collection technique

Tonge Joseph , Keevil Brian , Craig Jessica , Whitaker Martin , Ross Richard , Elder Charlotte

Background: Measurement of salivary glucocorticoids is gaining popularity as it offers a non-invasive collection technique, enabling sampling in the community or home environment, allowing tailored capture of steroid circadian rhythm and improved patient experience. Current popular salivary collection methods cannot be used in very young children due to choking and the requirement for active participation. There is little data on saliva stability during home collection.<p ...

ea0037oc9.3 | Adrenal 2 | ECE2015

Modelling the salivary cortisone to serum cortisol inter-relationship to predict serum cortisol under physiological conditions and after hydrocortisone

Debono Miguel , Harrison Robert , Keevil Brian , Whitaker Martin , Digweed Dena , Arlt Wiebke , Ross Richard

Introduction: Measuring serum cortisol to evaluate the normal circadian rhythm and adequacy of hydrocortisone replacement levels requires multiple readings; an expensive, cumbersome process. Conversely, salivary cortisone, a surrogate marker for free cortisol levels is non-invasive and well suited for out-patient settings. We hypothesised that salivary cortisone predicts circulating cortisol levels and can be used as an alternative marker of serum cortisol in a physiological s...

ea0035p30 | Adrenal cortex | ECE2014

Development of oral hydrocortisone granules with taste masking for the treatment of neonates and infants with adrenal insufficiency

Ross Richard , Whitaker Martin , Digweed Dena , Spielmann Sarah , Huatan Hiep , Eckland David , Blankenstein Oliver , Krude Heiko

Background: Current standard treatment for adrenal insufficiency in neonates and infants is unsatisfactory as unlicensed adult dosage formulations are used. These are generally difficult to administer and may give rise to inconsistencies in dose as the content uniformity of the dosage form cannot be verified.Methods: Infacort is a newly-developed immediate release formulation of hydrocortisone that is provided in appropriate unit dosage units (0.5, 1, 2,...

ea0070aep37 | Adrenal and Cardiovascular Endocrinology | ECE2020

Physiologically based pharmacokinetic modelling to inform dosing in adrenal insufficiency and congenital adrenal hyperplasia

Whitaker Martin J , Bonner Jennifer J , Burt Howard , Johnson Trevor N , Porter John , Ross Richard JM

Background: Replacing physiological cortisol levels is important for the long-term health of patients with adrenal insufficiency and congenital adrenal hyperplasia (CAH). Modified-release formulations of hydrocortisone are one strategy being used to replace the cortisol circadian rhythm in adult patients but there is no data in children. Physiologically based pharmacokinetic (PBPK) modelling is a valuable tool for paediatric drug development1; however, there are no ...

ea0032p1 | Adrenal cortex | ECE2013

Chronocort®, a multiparticulate modified release hydrocortisone formulation, shows dose linearity and twice daily dosing provides physiological cortisol exposure

Ross Richard , Whitaker Martin , Debono Miguel , Huatan Hiep , Arlt Wiebke , Merke Deborah

Cortisol has a distinct circadian rhythm; levels rise from 0300 h to peak within an hour of waking and gradually decline until 1800 h before a quiescent period lasting from 1800 to 0300 h. Current hydrocortisone replacement regimens are unable to replicate this rhythm and we have been investigating modified release technology. Our initial formulation, using tableting technology, demonstrated it was possible to replicate the overnight rise in cortisol but the tablet had reduced...

ea0086p299 | Adrenal and Cardiovascular | SFEBES2022

Screening for adrenal insufficiency using home waking salivary cortisone is accurate and lowers NHS costs

Debono Miguel , Elder Charlotte , Lewis Jen , Jacques Richard , Caunt Sharon , Fearnside Jane , Dixon Simon , Newell-Price John , Whitaker Martin , Keevil Brian , Ross Richard

Introduction: The 250µg Short Synacthen test (SST) is the reference standard for a diagnosis of adrenal insufficiency (AI) in most endocrine centres. The test is expensive and time consuming, requiring clinic attendance. We hypothesised that a cheaper home waking salivary cortisone (WSC) is predictive of the SST 30-minute cortisol >430 nmol/l cut-off and carried out a diagnostic accuracy study to assess the predictive value of the WSC in diagnosing and excluding AI. W...

ea0063p664 | Interdisciplinary Endocrinology 1 | ECE2019

Differential regulation of 5β-reductase (AKR1D1) expression and activity by glucocorticoids in human and rodent liver

Nikolaou Nikolaos , Morgan Stuart , Larner Dean , Sharp Anna , Raouf Zachariah , Hughes Beverly , Digweed Dena , Whitaker Martin , Ross Richard , Lavery Gareth , Arlt Wiebke , Gathercole Laura , Tomlinson Jeremy

The prevalence of metabolic syndrome and its hepatic manifestation, non-alcoholic fatty liver disease (NAFLD), continues to escalate. Glucocorticoids (GCs) and bile acids (BAs) are established regulators of metabolic phenotype. 5β-reductase (AKR1D1) is highly expressed in human and rodent liver, where it inactivates steroid hormones and catalyses a fundamental step in BA synthesis. We have previously demonstrated that AKR1D1 modulates hepatic GC availability and GC recept...

ea0037oc9.2 | Adrenal 2 | ECE2015

Alternative pathway synthesis dominates androgen production in patients with congenital adrenal hyperplasia and is decreased by Chronocort® more than by conventional glucocorticoid therapy

Jones Christopher , Mallappa Ashwini , Reisch Nicole , Hughes Beverley , O'Neil Donna , Krone Nils , Whitaker Martin , Eckland David , Merke Deborah , Ross Richard , Arlt Wiebke

Suppression of excess androgen production poses a considerable clinical challenge in the management of patients with congenital adrenal hyperplasia (CAH). Whilst the major route of androgen synthesis in humans is the classic pathway via androstenedione and testosterone, the relative contribution of the alternative pathway originating from 17-hydroxyprogesterone to androgen excess in CAH has not been defined. Androgen effects of both pathways are elicited in androgen target tis...