Acromegaly in humans and cats: Pathophysiological, clinical and management resemblances and differences

IF 1.6 4区 医学 Q4 CELL BIOLOGY Growth Hormone & Igf Research Pub Date : 2024-05-24 DOI:10.1016/j.ghir.2024.101595
Mariana Lopes-Pinto , Patrícia Lunet Marques , Ema Lacerda-Nobre , Diego Miceli , Rodolfo Oliveira Leal , Pedro Marques
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Abstract

Objective

Acromegaly is a disorder associated with excessive levels of growth hormone (GH) and insulin-like growth factor-1 (IGF-1). In general, GH/IGF-1 excess leads to morphologic craniofacial and acral changes as well as cardiometabolic complications, but the phenotypic changes and clinical presentation of acromegaly differ across species. Here, we review the pathophysiology, clinical presentation and management of acromegaly in humans and cats, and we provide a systematic comparison between this disease across these different species.

Design

A comprehensive literature review of pathophysiology, clinical features, diagnosis and management of acromegaly in humans and in cats was performed.

Results

Acromegaly is associated with prominent craniofacial changes in both species: frontal bossing, enlarged nose, ears and lips, and protuberant cheekbones are typically encountered in humans, whereas increased width of the head and skull enlargement are commonly found in cats. Malocclusion, prognathism, dental diastema and upper airway obstruction by soft tissue enlargement are reported in both species, as well as continuous growth and widening of extremities resulting in osteoarticular compromise. Increase of articular joint cartilage thickness, vertebral fractures and spine malalignment is more evident in humans, while arthropathy and spondylosis deformans may also occur in cats. Generalized organomegaly is equally observed in both species. Other similarities between humans and cats with acromegaly include heart failure, ventricular hypertrophy, diabetes mellitus, and an overall increased cardiometabolic risk. In GH-secreting pituitary tumours, local compressive effects and behavioral changes are mostly observed in humans, but also present in cats. Cutis verticis gyrata and skin tags are exclusively found in humans, while palmigrade/plantigrade stance may occur in some acromegalic cats.

Serum IGF-1 is used for acromegaly diagnosis in both species, but an oral glucose tolerance test with GH measurement is only useful in humans, as glucose load does not inhibit GH secretion in cats. Imaging studies are regularly performed in both species after biochemical diagnosis of acromegaly. Hypophysectomy is the first line treatment for humans and cats, although not always available in veterinary medicine.

Conclusion

Acromegaly in humans and cats has substantial similarities, as a result of common pathophysiological mechanisms, however species-specific features may be found.

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人和猫的肢端肥大症:病理生理学、临床和管理方面的相似之处和不同之处
肢端肥大症是一种与生长激素(GH)和胰岛素样生长因子-1(IGF-1)水平过高有关的疾病。一般来说,GH/IGF-1过量会导致颅面和口角的形态变化以及心脏代谢并发症,但不同物种肢端肥大症的表型变化和临床表现各不相同。在此,我们综述了人类和猫科动物肢端肥大症的病理生理学、临床表现和治疗方法,并对这些不同物种的肢端肥大症进行了系统性比较。结果 在这两种动物中,肢端肥大症都与突出的颅面变化有关:人类通常会出现额凸、鼻子、耳朵和嘴唇肥大以及颧骨突出等症状,而猫则常见头部宽度增加和头骨增大。据报道,这两种动物都会因软组织增大而出现咬合不正、前牙反颌、牙齿间隙和上呼吸道阻塞,四肢也会因持续增长和增宽而导致骨关节受损。关节软骨厚度增加、脊椎骨折和脊椎错位在人类中更为明显,而关节病和脊椎变形症也可能发生在猫身上。在这两种疾病中同样可以观察到全身器官肿大。患有肢端肥大症的人和猫的其他相似之处还包括心力衰竭、心室肥大、糖尿病和整体心脏代谢风险增加。在分泌 GH 的垂体瘤中,局部压迫效应和行为变化主要出现在人类身上,但也出现在猫身上。血清 IGF-1 可用于两种动物的肢端肥大症诊断,但口服葡萄糖耐量试验和 GH 测量只对人类有用,因为葡萄糖负荷不会抑制猫的 GH 分泌。生化确诊肢端肥大症后,两种动物都要定期进行影像学检查。猫下腹切除术是人类和猫的一线治疗方法,但在兽医领域并不总是可行。 结论:由于共同的病理生理机制,人类和猫的肢端肥大症具有很大的相似性,但也可能存在物种特异性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Growth Hormone & Igf Research
Growth Hormone & Igf Research 医学-内分泌学与代谢
CiteScore
3.30
自引率
0.00%
发文量
38
审稿时长
57 days
期刊介绍: Growth Hormone & IGF Research is a forum for research on the regulation of growth and metabolism in humans, animals, tissues and cells. It publishes articles on all aspects of growth-promoting and growth-inhibiting hormones and factors, with particular emphasis on insulin-like growth factors (IGFs) and growth hormone. This reflects the increasing importance of growth hormone and IGFs in clinical medicine and in the treatment of diseases.
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