Endocrine Abstracts

Cellular sensitivity to circulating glucocorticoids is critical and is principally determined by the level of glucocorticoid receptor (GR). GR expression is most potently regulated by glucocorticoids themselves, although the mechanism is unknown. The rat GR gene encodes at least eleven alternate and untranslated exons 1, eight of which lie in a 3kb CpG island close to exon 2. We have recently shown that individual exons 1 are subject to tissue specific expression and regulatio...

Annexin I (ANXA1), a Ca2+- and phospholipid-binding protein is an important mediator of glucocorticoid (GC) action in the host defence and neuroendocrine systems. In the anterior pituitary ANXA1 is highly expressed by the folliculo-stellate (FS) cells (1). We have shown that GCs cause the externalization of annexin I in a FS cell line (murine TtT/GF) despite the fact that ANXA1 lacks a signal sequence and is not packaged in secretory granules. In bacteria and yeast ...

Childhood obesity is a serious public health challenge. Bariatric surgery is gaining popularity as a treatment modality for severely obese adolescents.Backgrounds: To report the safety and 1 year outcome data on morbidly obese adolescents that underwent bariatric surgery at a tertiary hospital in the UK.Methods: A retrospective review of patients (mean preoperative BMI 50.4 kg/m2; mean BMI SDS +4.2) who underwent bariatr...

Background: Self-management is essential for patients with adrenal insufficiency (AI) to achieve optimal outcomes of glucocorticoid (GC) replacement therapy by minimising adverse effects from over- or under-replacement and appropriately adjusting the dose in intercurrent illness to prevent adrenal crisis. Evidence suggests that many patients report deficits in self-management especially concerning ‘sick day rules’, prevention and management of adrenal crisis and have...

Synthetic glucocorticoids are administered to pregnant women at risk of pre-term delivery to mature organs and improve neonatal survival. We have shown that glucocorticoid action is essential to mature the fetal heart. Here, we tested the hypotheses that antenatal glucocorticoid exposure, prior to the normal increase in glucocorticoid levels, will advance fetal heart maturation and this will depend on cardiovascular glucocorticoid receptor (GR).Male SMGR...

Steroid hormones and bile acids are potent regulators of metabolic phenotype. The enzyme 5β-Reductase (AKR1D1) has a crucial role in bile acid synthesis and also generates 5β-reduced dihydrosteroid metabolites, regulating intra-cellular steroid availability though the clearance of cortisol, testosterone, androstenedione and progesterone. As AKR1D1 sits at the interface of bile acid synthesis and steroid metabolism, we have hypothesised that it plays a key role in met...

Steroid hormones and bile acids are potent regulators of metabolic phenotype. The enzyme 5β-reductase (AKR1D1) has a crucial role in bile acid synthesis and also generates 5β-reduced dihydrosteroid metabolites, regulating intra-cellular steroid availability though the clearance of cortisol, testosterone, androstenedione, and progesterone. As AKR1D1 sits at the interface of bile acid synthesis and steroid metabolism, we have hypothesised that it plays a key role in me...

Glucocorticoids are routinely administered to pregnant women at risk of pre-term delivery to mature foetal organs and improve neonatal survival. Previous work in glucocorticoid receptor (GR)-deficient mice showed that GR activation is essential for maturation of the foetal heart. Here, we tested the hypotheses that i) antenatal glucocorticoid exposure, prior to the normal increase in glucocorticoid levels, will advance foetal heart maturation and ii) this would depend on mater...

Introduction: Humans with glucocorticoid receptor (GR) deficiency and global heterozygous GR knockout (GR+/−) show compensatory activation of the hypothalamic-pituitary-adrenal axis, resulting in salt-sensitive hypertension due to increased mineralocorticoid activity. Previous studies suggest renal mechanisms, including changes in cell proliferation, gene expression and electrolyte transport, may contribute to this phenotype but underlying adaptive adrenal responses have...

Introduction: Daytime support from the diabetes-team reduces pressure on acute services however out-of-hours less support exists and diabetes related attendances to A&E are a potentially avoidable burden on resources. With the introduction of paediatric diabetes best-practice-tariff, recommendations included 24 h access to trained diabetes professionals for patients with known diabetes. In 2013 our three institutions created a consultant led out-of-hours paediatric diabete...