Endocrine Abstracts

The brain is critically involved in the regulation of energy balance and glucose homeostasis. Depending on the levels of energy available in our body, the activity of a group of hypothalamic neurons expressing the neuropeptidergic marker proopiomelanocortin (POMC) changes and it plays a key role in maintaining energy balance. When POMC neuronal activity is altered, this can lead to impaired energy homeostasis and therefore to obesity. However, POMC neurons are highly diverse, ...

Case History: 29 year old lady presented with profuse diarrhoea, lethargy and hypokalaemia in 2010. CT scan confirmed mass lesion in tail of pancreas. Chromogranin A and 24 hour urinary 5HIAA were normal. Fasting Gut hormone level showed elevated level of Vasoactive Intestinal Peptide (VIP), suggesting diagnosis of VIPoma. Further investigations confirmed hyperparathyroidism and microprolactinoma. Investigations: Adjusted calcium 2.98 mmol/l (<2.55), ...

The brain plays a crucial role in maintaining the body’s energy needs, a process involving the activity of a group of hypothalamic neurons that express the neuropeptidergic marker pro-opiomelanocortin (POMC). POMC neuronal dysfunction can cause obesity and its associated metabolic sequelae. However, this population of neurons is highly diverse at a molecular and functional level, and whether or not such heterogeneity is implicated in disease establishment or progression h...

Regulators are concerned about the potential for environmental chemicals such as agrochemicals and their metabolites to perturb hormone systems. This has led to recommendations for the testing of potential endocrine disrupting chemicals1. The Steroidogenesis H295R assay is an in vitro cell model used to investigate compound effects on steroid hormone biosynthesis, specifically 17β-estradiol (E2) and testosterone (T). The human H295R adreno-carcinoma ce...

We present a case of a 44-year-old female with fluctuating thyroid function over 12-14 years. The patient originally presented with a high TSH, normal free T3/T4 and a negative anti-TPO antibody. She was initially monitored, then went onto Levothyroxine replacement in an antenatal setting. Subsequently, 12-18 months later, she presented with hyperthyroid symptoms and vastly elevated TSH-receptor-antibody (TSHR-ab) titre of >10 IU/L, the upper limit of normal being 2.9 IU/L...

A recent case series commented on adverse COVID-19 outcomes among patients with Cushing’s syndrome, despite minimal symptoms and low inflammatory markers. Excessive glucocorticoids can impede adaptive immune response to viruses, leading to increased infection risks (1). Sarker et al discussed glucocorticoids binding to viral spike-proteins, inhibiting receptor interactions and contributing to prolonged positive swabs, in the absence of symptoms (2). We report the c...

Bile acids (BA) are cholesterol-derived molecules that are mostly known for their involvement in lipid digestion and absorption. Recent evidence recognizes them as metabolic integrators able to reduce body weight (BW), increase energy expenditure (EE) and improve glycemic control by activating their specific receptor, the Takeda G protein-coupled receptor 5 (TGR5) in peripheral organs. These outcomes have increased importance in the context of diet-induced obesity and associat...

Background: Children with hyperinsulinaemic hypoglycaemia (HH) are at a high risk of brain injury, while children with ketotic hypoglycaemia (KH) are believed to be neurologically normal, due to the absence and presence respectively of ketone bodies that act as an alternate fuel during hypoglycaemia. Our objective was to ascertain if children with HH sustain greater white matter (WM) injury in comparison to children with KH.Methods: Neurologically normal...

Recently, rare loss-of-function mutations of melanocortin-2-receptor accessory protein 2 (MRAP2) have been associated with severe, early-onset obesity in humans. In addition, whole body deletion and targeted brain specific deletion of the Mrap2 gene resulted in severe obesity in mice. In vitro data have shown Mrap2 interaction with the melanocortin-4-receptor (MC4R) affecting receptor signalling as a consequence. However, the mechanism by which Mrap2...

The overproduction of ACTH, in conditions such as Congenital Adrenal Hyperplasia (CAH) leads to significant morbidity. Current treatment with glucocorticoids does not adequately suppress plasma ACTH, resulting in excess adrenal androgen production. At present, there is no effective medical treatment that would directly block ACTH action. Such a therapy, especially one that can be orally administered, would be of great clinical value allowing a ‘block and replace’ tre...