Endocrine Abstracts

Introduction: Previously published UK Cancer Registry data showed incidence of Neuroendocrine Neoplasms rising between 2001 and 2015. This was higher than had been thought (Genus et al.). We report more recent data with more accurate coding (ICD-O-3).Aim: To analyse National Cancer Registration and Analysis Service (NCRAS) data on Neuroendocrine Neoplasias (NENs) in England including years 2015–2017.Methods: Public He...

Introduction: Carcinoid crisis, as an entity is poorly defined, but can be seen in patients with small bowel NET tumours after open bowel surgery or tumour unrelated procedures as cardiovascular instability (CI). Recent evidence suggests that cardiovascular instability (CI) during NET surgery is more common than previously considered.Aims and methods: We audited the incidence of CI during procedures and determined the relationship to perioperative octreo...

Introduction: There remains controversy about which patients benefit from removal of their primary small bowel tumour and whether this should be performed in a specialist tertiary referral hospital as an elective procedure. Part of the decision making and consenting process in patients with metastases will be a shared decision about surgery with the patient in light of symptoms, morbidity from surgery and survival. The aim of this study was to elucidate important institution s...

Adipose tissue inflammation may be an important mechanism in the development of systemic insulin resistance, such that modulation of this system may be a therapeutic target for type 2 diabetes and obesity-related disorders. AMPK has anti-inflammatory properties, yet the anti-inflammatory actions of AMPK in adipocytes remain poorly characterised. We questioned whether AMPK activation influences pro-inflammatory responses in cultured adipocytes in basal and stimulated conditions...

The increasing global prevalence of obesity requires urgent intervention to limit the anticipated surge of associated cardiometabolic morbidity and mortality. The energy sensor AMP-activated protein kinase (AMPK) is one proposed target for treating metabolic disorders and is downregulated in adipose tissue of obese insulin resistant individuals. Given the strong relationship between metabolic syndrome and overactivity of the renin-angiotensin-aldosterone system (RAAS) we inves...

Introduction: In vitro assessments of osilodrostat (LCI699), a potent oral inhibitor of 11β-hydroxylase suggested potential drug–drug interactions (DDIs) with cytochrome P450 (CYP) enzyme metabolism. This clinical study evaluated the effect of osilodrostat on the pharmacokinetics (PK) of CYP1A2, CYP2C19, CYP2D6, and CYP3A4 probe substrates, caffeine, omeprazole, dextromethorphan, and midazolam, respectively.Methods: A single-centre, op...

Small cell lung cancer (SCLC) is distinguished by its neuroendocrine phenotype and secretion of hormone biomarkers. Tumours initially respond well to therapy but almost invariably relapse with a therapy-resistant phenotype. We have previously described pro-opiomelanocortin (POMC) as a potential biomarker of SCLC. In this study, we investigated how POMC acts as a biomarker of tumour response to treatment.SCLC cells (DMS 79) were injected subcutaneously in...

Maternal programming increases the risk of alterations in the offspring’s HPA axis. Previously we showed that maternal undernutrition in sheep induces epigenetic changes in the glucocorticoid receptors (GR) within hypothalamic energy balance pathways, without affecting HPA axis GR. However, these studies focussed on fetal tissues1. Here, we investigated whether GR is epigenetically altered in the HPA axis of adult offspring to determine the status of the pathwa...

Glucocorticoids act on several major neuropeptide networks in the hypothalamus which are important for regulation of energy balance and insulin sensitivity. Active glucocorticoids (cortisol/corticosterone in humans/rodents) can be regenerated from their inactive forms by the enzyme 11β-hydroxysteroid dehydrogenase type one (11β-HSD1) which is expressed in the hypothalamus. Therefore we decreased 11β-HSD1 expression in the brain to investigate the role of regener...

Cushing’s syndrome due to ectopic ACTH production is extremely rare in childhood. Ectopic ACTH secretion is most often due to tumours in the chest, but rare cases of carcinoid tumours, neuroblastoma, phaeochromocytoma and pancreatic and ovarian carcinoma have been reported. We describe a 2 year old girl with ectopic Cushing’s syndrome due to a malignant epithelial abdominal tumour producing POMC. She presented with rapid weight gain, hypertension, body odour, letharg...