Endocrine Abstracts

Conventional glucocorticoids (GCs) are unable to mimic physiological cortisol rhythm in adrenal insufficiency (AI), with a significant impact on morbidity and mortality. Possible explanations are supra-physiological doses and impaired cortisol profile. In particular, elevated evening cortisol levels were related to glucose tolerance and insulin sensitivity alterations and visceral obesity. Once-daily-dual-release-hydrocortisone (OD-DR-HC), better reproducing the physiological ...

HCC is one of the most common malignancies worldwide. Local approaches are generally preferred for patients whose disease is restricted to the liver. In patients with extrahepatic disease systemic therapy can be considered. Chemotherapy did not demonstrate convincing survival advantages in several trails for HCC patients. Presently, the kinase inhibitor sorafenib is the only approved systemic target therapy for the treatment of advanced HCC. Mitotane (dichlorodiphenildichloroe...

HCC is a difficult-to-treat- cancer with poor prognosis. The recent EVOLVE-1 trial demonstrated that EVE did not improve overall survival in molecularly and clinically unselected patients with advanced HCC resistant to sorafenib treatment. In selected patients, the well-established antitumor effect of EVE could make this drug a potential adjuvant therapy. Unfortunately, the acquired resistance to this molecule due to the tumor adaptation to chronic drug use is a current challe...

Somatostatin analogues (SA) are known to revert acromegalic cardiomyopathy mainly in young patients with short disease duration, whereas pegvisomant (PEG) reportedly improves cardiac structure and performance in patients resistant to SA. To date, no data are available on the effects of long-term SA+PEG on cardiovascular complications. The current study aimed at investigating the effects of long-term SA+PEG on cardiac structure and performance in acromegaly. Thirty-six acromega...

In patients with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency, life-long glucocorticoid (GC) treatment is often required to replace cortisol deficiency and to avoid the ACTH-dependent androgen levels increase. However, in these patients, the multiple daily doses required with conventional GCs can cause cortisol overexposure, leading to an increased risk of metabolic syndrome (MS), an impaired quality of life (QoL), and poor treatment compliance (TC). T...

The mTOR and IGF/insulin pathways are frequently dysregulated in HCC. Antitumoral activity of mTOR inhibitors (mTORi) has been demonstrated in experimental models but in early clinical studies mTORi alone have shown modest antitumoral activity. IGF/insulin-dependent Akt activation, via IGF1R and IR, has been suggested as potential mechanism for mTORi resistance. This study aimed at evaluating the expression of mTOR and IGF/insulin pathway components and the effects of mTORi al...

Background: Several evidences suggested that conventional glucocorticoids (CGCs) used as replacement treatment in adrenal insufficiency (AI) are inadequate to mimic physiological cortisol circadian rhythm (CCR), and that CCR disruption, represented by non-physiological pattern of peaks and troughs and elevated evening GC levels, might be responsible for the increased metabolic and, consequently, cardiovascular risk. It has been demonstrated that once daily dual-release-hydroco...

Obesity is caused by an imbalance between dietary energy intake and expenditure. The expression of dopamine receptors (DRs) in human adipocytes has been already demonstrated. Moreover, the effects of cabergoline, a dopamine agonist, on body weight and glucose homeostasis in obese subjects without hyperprolactinemia has already been reported. The current study investigates the effects of cabergoline on lipid accumulation and on adipogenic factors expression to better define the...

Adrenal insufficiency is a rare endocrine disorder characterized by low levels of cortisol associated with increased mortality, also due to inadequate replacement therapy. The replacement with the thrice-daily immediate release hydrocortisone (IRH), in contrast to the once-daily modified-release hydrocortisone (MRH), more appropriately mimicking the physiological circadian rhythm of cortisol (PCRC), is associated with metabolic disorders, mainly due to the non-physiological pe...

Insulin resistance (IR), characterized by an impairment of target tissues to insulin responsiveness, is the core defect preceding diabetes. Preclinical and clinical data have suggested a role for the dopaminergic system in glucose homeostasis control. The aim of the current study was to investigate the role of the dopamine agonist cabergoline (CAB), displaying high affinity for dopamine type 2 (DR2) receptor and low affinity for serotonin receptors (5-HTRs), in the regulation ...