Endocrine Abstracts

A 42 year old gentleman presented for a second opinion regarding management of Congenital Adrenal Hyperplasia (CAH) of the salt losing variety. The patient had been under long term follow up elsewhere but had discontinued his medication of his own accord 14 months prior to seeking consultation. Examination revealed a heavily pigmented male patient with protuberant belly. He had easily palpable masses in both flanks. An abdominal CT showed bilateral massive adrenal enlargement ...

An 18 year old young man was first seen in the ENT department with bilateral swelling of the supraclavicular fossae. A clinical diagnosis of Cushing's syndrome was made and the patient was referred to the Endocrine team. Examination showed a BP of 150/100 and clinical features of gross Cushing's syndrome. Initial investigations revealed normal electrolytes, fT4 8.7 pmol/L, TSH 0.69 mIU/L and a basal prolactin of 68280 mIU/ml. A 24 hr urinary free cortisol (UFC) was 3860 nmol/L...

Background: Previously we have demonstrated expression of GH, IGF-1 and ghrelin, but not GHRH, in normal and malignant breast tissue. In vitro studies have suggested an inhibitory effect of ghrelin on proliferation of breast cancer cell lines. However the use of cell lines and dose of ghrelin may not represent physiological conditions.Objectives: (1) To establish a viable method for culturing fresh breast tissue explants, (2) to use this to investigate t...

Background: Recent studies have suggested that an increased level of serum IGF-1 and a decreased level of IGFBP-3 may be associated with an increased risk of developing subsequent breast cancer. However, it is uncertain whether these effects are mediated solely by endocrine actions or whether local effects might also be important. We have previously demonstrated IGF-1 mRNA to be universally expressed in normal breast tissue but in only 50% of cancers. The expression of IGFBP-3...

Background: Acromegalics are at increased risk of developing colorectal neoplasia with an increase of right-sided disease. Several genes are implicated in colorectal neoplasia including components of the GH/IGF-1 axis. It is unclear whether regional variations in neoplasia are explained by variations in local expression of these genes. Aims: To compare the expression of the components of the GH/IGF-1 axis and other putative genes between the left and right colon of patients wi...

Background: Patients with acromegaly have an increased risk of colorectal neoplasia. In non-acromegalic subjects, carcinomas develop from dysplastic tubular adenomas and colonoscopic removal of these reduces the subsequent incidence of carcinoma. The frequency of such screening in acromegaly is controversial and it is uncertain which patients should be considered to be at particular increased risk. Methods: We reviewed the incidence of new colonic lesions amongst our large coh...

Background: We have previously demonstrated colonic expression of the endogenous GH secretagogue, ghrelin, but not the GHS-R, and that ghrelin exerts proliferative effects on colonic epithelial cells. However, whether these are specific to ghrelin, or which genes are affected in response is uncertain.Aims: Determine the specificity of the proliferative effects of ghrelin on colonic epithelial cells, and effects on mRNA levels of the cancer associated ge...

Introduction: Ageing is associated with a decrease in activity of the growth hormone / IGF-1 axis. However, there is little normative data for serum IGF-I levels in the very elderly and the relationship of IGF-1 levels to muscle function and physical performance in geriatric inpatients has not been fully explored. We studied elderly patients rehabilitating after proximal femoral fracture (PFF), hypothesising that patients with lower circulating IGF-1 levels would have poorer p...

Background: IGF-1 is a ubiquitous growth factor that has been shown to play an important role in breast tissue development and tumorigenesis. Previously we have shown that IGF-1 expression is lost in approximately 1/3 of breast carcinomas. It is unsure whether this indicates the existence of a subset of breast cancers that may behave differently clinically and on a molecular level. Aims: To assess and quantify the mRNA expression of (i) Cox-2 and c-myc, genes imp...

Background: We have recently demonstrated universal and high levels of expression of growth hormone in the human colon, despite the absence of GHRH or its receptor. Although ghrelin, recently shown to be an additional endogenous GH secretagogue, is expressed in the human colon, little is known about its distribution within the colon or function and whether any effects are GH-dependent.Aims: To investigate the mRNA expression of ghrelin and ...