Endocrine Abstracts

The seminal studies of Harvey Cushing informed us of the deleterious consequences of circulating cortisol excess – hypertension, osteoporosis and obesity that contributes to diabetes and premature mortality. As such Cushing’s syndrome offers an excellent paradigm for the metabolic syndrome. However circulating cortisol concentrations are invariably normal in patients with metabolic syndrome. The tissue-specific generation of cortisol, independent of circulating level...

Nuclear pore complexes (NPCs) facilitate the transport of macromolecular cargoes across the nuclear envelope by carrier molecules. The energy for this active transport mechanism is provided by the Ras-family GTPase, Ran, that orchestrates most nuclear trafficking cycles. The RanGEF (RCC1) is located in the nucleus while its GAP is located in the cytoplasm. The nuclear import of steroids, bound to their receptor, is mediated by importins alpha and beta. In the cytoplasm, import...

Adrenal insufficiency may occur because of primary failure of the adrenal cortex but can also arise through a secondary failure of ACTH drive to the adrenal. 'Endogenous' suppression of the adrenal cortex may occur in patients with structural abnormalities affecting the hypothalamus/pituitary and in other patients with deficiency of pituitary ACTH secretion and action including those recovering from successful treatment of Cushing's syndromes. 'Exogenous' suppression is found ...

A series of reports have highlighted the lack of career structure and incentive for both clinical and non-clinical scientists wishing to pursue an academic career. For non-clinical personnel this is particularly critical as Endocrinology risks losing some of its identity to newer disciplines such as cell biology and signalling. The current inability to train clinical academics and basic scientists in Endocrinology represents a major threat to the discipline as a whole and must...

A greater understanding of mineralocorticoid hormone action in recent years has facilitated the elucidation of the molecular basis of several 'salt-wasting' and 'salt-retaining' disorders.In mineralocorticoid-responsive salt transporting epithelial cells of the distal nephron, colon and salivary gland, aldosterone or, depending upon the activity of 11beta hydroxysteroid dehydrogenase type 2 (11beta HSD2), cortisol, interacts with the mineralocorticoid re...

A new role for the endocrine nurse within a multidisciplinary approach to neuro-endocrine tumours.Historically patients with neuroendocrine tumours have been looked after either by the gastrointestinal team, the oncologists or the endocrinologists. Here, we demonstrate the need for a multidisciplinary approach to managing these rare tumours and a new role for the endocrine nurse.Our newly evolved, multi-disciplinary neuroendocrine tumour (NET) clinic comprises an endoc...

Patients with Cushing's syndrome emphasize the importance of cortisol in regulating body fat mass and distribution, bone mineral density and intraocular pressure. However, patients with the prevalent diseases, obesity, osteoporosis and glaucoma, invariably have normal circulating cortisol concentrations. We have focussed on the concept of 'pre-receptor' metabolism as a mechanism of modulating the action of cortisol in a tissue-specific fashion. Two isozymes of 11b-hydroxystero...

Clinical observations on patients with Cushing's syndrome highlight the importance of cortisol in regulating blood pressure and body fat mass. However, most patients with hypertension and obesity have normal circulating cortisol concentrations. We have focussed on the concept of 'pre-receptor' metabolism as a mechanism of modulating the action of cortisol in a tissue-specific fashion. Two isozymes of 11b-hydroxysteroid dehydrogenase (11b-HSD) catalyse the interconversion of ac...

Background: Population data has shown an increased incidence in Type 1 Diabetes Mellitus (T1DM) following pandemic influenza A (H1N1). Worldwide studies have shown an increase in the incidence of T1DM in 2020 and 2021. Both locally and regionally in Northern Ireland we noticed a similar increase and decided to investigate further.Method: From March 2021 we tested newly diagnosed T1DM patients in Antrim Area Hospital for Anti-SARS-CoV-2 antibodies. If ant...

1% of western populations take chronic oral corticosteroids and this rises to 3% in subjects aged over 70 years old. When inhaled, topical and parenteral steroids are added to this burden, iatrogenic Cushing’s becomes a major health issue. High doses of medroxyprogesterone acetate can cause glucocorticoid effects and drug interactions may impair the metabolism of some glucocorticoids (eg fluticasone), thereby increasing their potency. Patients may develop the classical fe...