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Lack of a genetic risk continuum between pubertal timing in the general population and idiopathic hypogonadotropic hypogonadism 普通人群的青春期发育时间与特发性性腺功能减退症之间缺乏遗传风险连续性
IF 3.3 4区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-10 DOI: 10.1111/jne.13445
Lacey Plummer, Ravikumar Balasubramanian, Maria Stamou, Mark Campbell, Pranav Dewan, Nora Bryant, Kathryn Salnikov, Margaret Lippincott, Stephanie Seminara

Pubertal timing is a highly heritable trait in the general population. Recently, a large-scale exome-wide association study has implicated rare variants in six genes (KDM4C, MC3R, MKRN3, PDE10A, TACR3, and ZNF483) as genetic determinants of pubertal timing within the general population. Two of the genes (TACR3, MKRN3) are already implicated in extreme disorders of pubertal timing. This observation suggests that there may be a pervasive “genetic risk continuum” wherein genes that govern pubertal timing in the general population, by extension, may also be causal for rare Mendelian disorders of pubertal timing. Hence, we hypothesized that the four novel genes linked to pubertal timing in the population will also contribute to idiopathic hypogonadotropic hypogonadism (IHH), a genetic disorder characterized by absent puberty. Exome sequencing data from 1322 unrelated IHH probands were reviewed for rare sequence variants (RSVs) (minor allele frequency bins: <1%; <0.1%; <0.01%) in the six genes linked to puberty in the general population. A gene-based rare variant association testing (RVAT) was performed between the IHH cohort and a reference public genomic sequences repository—the Genome Aggregation Database (gnomAD). As expected, RVAT analysis showed that RSVs in TACR3, a known IHH gene, were significantly enriched in the IHH cohort compared to gnomAD cohort across all three MAF bins. However, RVAT analysis of the remaining five genes failed to show any RSV enrichment in the IHH cohort across all MAF bins. Our findings argue strongly against a pervasive genetic risk continuum between pubertal timing in the general population and extreme pubertal phenotypes. The biologic basis of such distinct genetic architectures' merits further evaluation.

在一般人群中,青春期时间是一个高度遗传的特征。最近,一项大规模的全外显子关联研究发现,6 个基因(KDM4C、MC3R、MKRN3、PDE10A、TACR3 和 ZNF483)中的罕见变异是普通人群中青春期时间的遗传决定因素。其中两个基因(TACR3、MKRN3)已经与青春期时间的极端紊乱有关。这一观察结果表明,可能存在一种普遍的 "遗传风险连续体",即在普通人群中控制青春期时间的基因,推而广之,也可能与罕见的孟德尔青春期时间紊乱症有关。因此,我们假设,与人群中青春期时间相关的四个新基因也会导致特发性性腺功能减退症(IHH),这是一种以青春期缺失为特征的遗传性疾病。研究人员对 1322 名无亲属关系的 IHH 患者的外显子组测序数据进行了审查,以寻找普通人群中与青春期有关的六个基因中的罕见序列变异(RSV)(小等位基因频率:<1%; <0.1%;<0.01%)。在IHH队列和参考公共基因组序列库--基因组聚合数据库(gnomAD)之间进行了基于基因的罕见变异关联测试(RVAT)。不出所料,RVAT 分析显示,与 gnomAD 队列相比,IHH 队列中已知的 IHH 基因 TACR3 中的 RSVs 在所有三个 MAF 区间都明显富集。然而,对其余五个基因的 RVAT 分析未能显示出在所有 MAF bins 中,IHH 群体中有任何 RSV 富集。我们的研究结果有力地证明,在普通人群的青春期时间和极端青春期表型之间不存在普遍的遗传风险连续体。这种不同遗传结构的生物学基础值得进一步评估。
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引用次数: 0
PTPRJ is a negative regulator of insulin signaling in neuronal cells, impacting protein biosynthesis, and neurite outgrowth PTPRJ 是神经细胞中胰岛素信号的负调控因子,影响蛋白质的生物合成和神经元的生长
IF 3.3 4区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-10 DOI: 10.1111/jne.13446
Jannis Ulke, Simran Chopra, Otsuware Linda-Josephine Kadiri, Peter Geserick, Vanessa Stein, Sahar Cheshmeh, André Kleinridders, Kai Kappert

Central insulin resistance has been linked to the development of neurodegenerative diseases and mood disorders. Various proteins belonging to the enzyme family of protein tyrosine phosphatases (PTPs) act as inhibitors of insulin signaling. Protein tyrosine phosphatase receptor type J (PTPRJ) has been identified as a negative regulator in insulin signaling in the periphery. However, the impact of PTPRJ on insulin signaling and its functional role in neuronal cells is largely unknown. Therefore, we generated a Ptprj knockout (KO) cell model in the murine neuroblast cell line Neuro2a by CRISPR-Cas9 gene editing. Ptprj KO cells displayed enhanced insulin signaling, as shown by increased phosphorylation of the insulin receptor (INSR), IRS-1, AKT, and ERK1/2. Further, proximity ligation assays (PLA) revealed both direct interaction of PTPRJ with the INSR and recruitment of this phosphatase to the receptor upon insulin stimulation. By RNA sequencing gene expression analysis, we identified multiple gene clusters responsible for glucose uptake and metabolism, and genes involved in the synthesis of various lipids being mainly upregulated under PTPRJ deficiency. Furthermore, multiple Ca2+ transporters were differentially expressed along with decreased protein biosynthesis. This was accompanied by an increase in endoplasmic reticulum (ER) stress markers. On a functional level, PTPRJ deficiency compromised cell differentiation and neurite outgrowth, suggesting a role in nervous system development. Taken together, PTPRJ emerges as a negative regulator of central insulin signaling, impacting neuronal metabolism and neurite outgrowth.

中枢性胰岛素抵抗与神经退行性疾病和情绪障碍的发生有关。属于蛋白酪氨酸磷酸酶(PTPs)酶家族的各种蛋白质是胰岛素信号传导的抑制剂。蛋白酪氨酸磷酸酶受体 J 型(PTPRJ)已被确定为外周胰岛素信号转导的负调控因子。然而,PTPRJ 对胰岛素信号转导的影响及其在神经细胞中的功能作用在很大程度上还不为人所知。因此,我们通过CRISPR-Cas9基因编辑技术在小鼠神经母细胞系Neuro2a中产生了Ptprj基因敲除(KO)细胞模型。Ptprj KO 细胞显示出胰岛素信号转导增强,表现为胰岛素受体(INSR)、IRS-1、AKT 和 ERK1/2 的磷酸化增加。此外,近接试验(PLA)显示 PTPRJ 与 INSR 直接相互作用,以及在胰岛素刺激下该磷酸酶被招募到受体上。通过 RNA 测序基因表达分析,我们发现在 PTPRJ 缺乏的情况下,负责葡萄糖摄取和代谢的多个基因簇以及参与各种脂质合成的基因主要上调。此外,在蛋白质生物合成减少的同时,多个 Ca2+ 转运体也出现了差异表达。与此同时,内质网(ER)应激标记也有所增加。在功能层面上,PTPRJ 的缺乏损害了细胞分化和神经元的生长,表明其在神经系统发育中的作用。综上所述,PTPRJ是中枢胰岛素信号传导的负调控因子,影响神经元的新陈代谢和神经元的生长。
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引用次数: 0
Functional diversity along the anteroposterior axis of the ventromedial hypothalamus 沿着腹内侧下丘脑前后轴的功能多样性
IF 3.2 4区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-10 DOI: 10.1111/jne.13447
Nicolas Gutierrez‐Castellanos, Inês C. Dias, Basma F. A. Husain, Susana Lima
Innate behaviors ensure animal survival and reproductive success. Defending their territory, escaping from predators or mating with a sexual partner, are fundamental behaviors determining the ecological fitness of individuals. Remarkably, all these behaviors share a common neural substrate, as they are under the control of the ventromedial hypothalamus (VMH). Decades of research have contributed to understanding the exquisite diversity of functional ensembles underlying the wide array of functions that the VMH carries out. These functional ensembles are usually distributed throughout the dorsoventral and mediolateral axes of this nucleus. However, increasing evidence is bringing to attention the functional diversity of the VMH across its anteroposterior axis. In this review, we will overview our current understanding of how different ensembles within the VMH control a wide array of animal behaviors, emphasizing the newly discovered roles for its anterior subdivision in the context of conspecific self‐defense.
与生俱来的行为确保了动物的生存和繁殖成功。保卫领地、躲避捕食者或与性伴侣交配,这些基本行为决定了个体的生态适应性。值得注意的是,所有这些行为都有一个共同的神经基质,因为它们都受腹侧下丘脑(VMH)的控制。数十年的研究有助于人们了解 VMH 所执行的各种功能背后所蕴含的功能组合的精妙多样性。这些功能组合通常分布在该核的背腹轴和内外侧轴。然而,越来越多的证据表明,VMH 的功能多样性横跨其前后轴。在这篇综述中,我们将概述目前我们对 VMH 内不同组合如何控制一系列动物行为的理解,并强调新发现的其前部分支在同种自卫中的作用。
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引用次数: 0
PRRT in high-grade digestive neuroendocrine neoplasms (NET G3 and NEC). PRRT 治疗高级别消化道神经内分泌肿瘤(NET G3 和 NEC)。
IF 3.3 4区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-07 DOI: 10.1111/jne.13443
Halfdan Sorbye, Grace Kong, Simona Grozinsky-Glasberg, Jonathan Strosberg

Peptide receptor radionuclide therapy (PRRT) has been primarily studied in low and intermediate-grade digestive neuroendocrine tumors (NET G1-G2). The documentation of a similar benefit for high-grade digestive neuroendocrine neoplasms (NEN) has been limited. This review evaluates the use of PRRT for high-grade digestive NEN (well-differentiated NET G3 and poorly differentiated neuroendocrine carcinomas [NEC]). We identified one phase III trial and seven retrospective studies reporting specifically on PRRT outcome of >10 digestive high-grade NEN patients. The retrospective single-arm studies indicate a benefit for PRRT in NET G3. The randomized phase III NETTER-2 trial demonstrates major PFS superiority of PRRT versus somatostatin analog therapy as the first-line treatment for the NET G3 subgroup. PRRT can now be considered a potential first-line treatment for somatostatin receptor-positive NET G3 patients, but whether it should be the first-line standard of care for all NET G3 patients is still not clarified. For NEC, scarce data are available, and pathologic distinction between NEC and NET G3 can be difficult when Ki-67 is below 55%. PRRT could be considered as a treatment for refractory NEC in very selected cases when there is a high uptake on somatostatin receptor imaging, Ki-67 is below 55%, and there is no rapid tumor progression.

肽受体放射性核素疗法(PRRT)主要针对中低度消化道神经内分泌肿瘤(NET G1-G2)进行研究。对高级别消化道神经内分泌肿瘤(NEN)也有类似疗效的文献还很有限。本综述评估了 PRRT 在高级别消化道神经内分泌肿瘤(分化良好的 G3 级 NET 和分化不良的神经内分泌癌 [NEC])中的应用。我们确定了一项 III 期试验和七项回顾性研究,这些研究专门报告了超过 10 例消化道高级别 NEN 患者的 PRRT 治疗结果。回顾性单臂研究表明,PRRT 对 G3 级 NET 有益。随机III期NETTER-2试验表明,在NET G3亚组的一线治疗中,PRRT的PFS优于体生长激素类似物疗法。PRRT 现在可被视为体生长激素受体阳性 NET G3 患者的潜在一线治疗方法,但是否应作为所有 NET G3 患者的一线标准治疗方法仍未明确。对于 NEC,目前可获得的数据很少,而且当 Ki-67 低于 55% 时,病理学上很难区分 NEC 和 NET G3。在体生长抑素受体成像摄取率高、Ki-67低于55%且肿瘤没有快速进展的极个别病例中,可考虑将PRRT作为难治性NEC的治疗方法。
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引用次数: 0
Gastric neuroendocrine tumors: 20-Year experience in a reference center 胃神经内分泌肿瘤:参考中心的 20 年经验。
IF 3.3 4区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-08-27 DOI: 10.1111/jne.13440
Davide Ravizza, Mariangela Giunta, Isabella Sala, Vincenzo Bagnardi, Darina Tamayo, Giuseppe de Roberto, Cristina Trovato, Ivana Bravi, Pietro Soru, Margherita Maregatti, Eleonora Pisa, Emilio Bertani, Guido Bonomo, Francesca Spada, Fazio Nicola

Few studies have been published on the long-term outcomes of patients with gastric neuroendocrine tumors (gNETs). We analyzed their management over a two-decade period, focusing on endoscopic and clinical outcomes. Clinical, laboratory, endoscopic, surgical, and histopathological data from Types 1 and 3 gNETs histologically diagnosed between March 2000 and December 2021 at the European Institute of Oncology (IEO, Milan) were retrospectively collected. Sixty-nine patients were included (60 Type 1, 9 Type 3): 53 (77%) were treated endoscopically, 6 (9%) surgically, and 10 (14%) did not receive any treatment. Overall, 293 lesions were removed endoscopically: 74% by forceps, 20% by endoscopic mucosal resection (EMR), and 5% by endoscopic submucosal dissection (ESD). No differences were observed between EMR and ESD in terms of complete resection rate (p value = .50) and complications rate (p value = .084). The median follow-up period was 5.8 years (range: 0.3–20.5), during which no gNET-related deaths were observed. Metachronous gNETs developed in 60% of patients with Type 1 gNET. Six patients with lymph node metastases (LNM) were younger (p value = .006) and had larger lesions (p value <.001) than patients without LNM. Most Type 1 gNETs were successfully excised using forceps, with EMR and ESD being equally effective. The presence of incomplete resection was not associated with a worse prognosis, which remains excellent in this highly recurrent disease. Younger age and a size ≥10 mm were associated with an increased risk of LNM.

Clinical Trial Registration

Project code UID 2854.

有关胃神经内分泌肿瘤(gNET)患者长期疗效的研究鲜有发表。我们分析了二十年来的治疗情况,重点关注内镜和临床结果。我们回顾性地收集了2000年3月至2021年12月期间在欧洲肿瘤研究所(IEO,米兰)经组织学确诊的1型和3型gNET的临床、实验室、内窥镜、手术和组织病理学数据。共纳入69例患者(60例1型,9例3型):53人(77%)接受了内镜治疗,6人(9%)接受了手术治疗,10人(14%)未接受任何治疗。总共有 293 个病灶在内镜下切除:74%采用镊子,20%采用内镜下粘膜切除术(EMR),5%采用内镜下粘膜下剥离术(ESD)。在完全切除率(p 值 = .50)和并发症发生率(p 值 = .084)方面,EMR 和 ESD 之间未发现差异。中位随访期为 5.8 年(0.3-20.5 年),期间未发现与 gNET 相关的死亡病例。60%的1型gNET患者出现了并发症。六名淋巴结转移(LNM)患者年龄较小(p 值 = .006),病灶较大(p 值 = .007)。
{"title":"Gastric neuroendocrine tumors: 20-Year experience in a reference center","authors":"Davide Ravizza,&nbsp;Mariangela Giunta,&nbsp;Isabella Sala,&nbsp;Vincenzo Bagnardi,&nbsp;Darina Tamayo,&nbsp;Giuseppe de Roberto,&nbsp;Cristina Trovato,&nbsp;Ivana Bravi,&nbsp;Pietro Soru,&nbsp;Margherita Maregatti,&nbsp;Eleonora Pisa,&nbsp;Emilio Bertani,&nbsp;Guido Bonomo,&nbsp;Francesca Spada,&nbsp;Fazio Nicola","doi":"10.1111/jne.13440","DOIUrl":"10.1111/jne.13440","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <p>Few studies have been published on the long-term outcomes of patients with gastric neuroendocrine tumors (gNETs). We analyzed their management over a two-decade period, focusing on endoscopic and clinical outcomes. Clinical, laboratory, endoscopic, surgical, and histopathological data from Types 1 and 3 gNETs histologically diagnosed between March 2000 and December 2021 at the European Institute of Oncology (IEO, Milan) were retrospectively collected. Sixty-nine patients were included (60 Type 1, 9 Type 3): 53 (77%) were treated endoscopically, 6 (9%) surgically, and 10 (14%) did not receive any treatment. Overall, 293 lesions were removed endoscopically: 74% by forceps, 20% by endoscopic mucosal resection (EMR), and 5% by endoscopic submucosal dissection (ESD). No differences were observed between EMR and ESD in terms of complete resection rate (<i>p</i> value = .50) and complications rate (<i>p</i> value = .084). The median follow-up period was 5.8 years (range: 0.3–20.5), during which no gNET-related deaths were observed. Metachronous gNETs developed in 60% of patients with Type 1 gNET. Six patients with lymph node metastases (LNM) were younger (<i>p</i> value = .006) and had larger lesions (<i>p</i> value &lt;.001) than patients without LNM. Most Type 1 gNETs were successfully excised using forceps, with EMR and ESD being equally effective. The presence of incomplete resection was not associated with a worse prognosis, which remains excellent in this highly recurrent disease. Younger age and a size ≥10 mm were associated with an increased risk of LNM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Clinical Trial Registration</h3>\u0000 \u0000 <p>Project code UID 2854.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16535,"journal":{"name":"Journal of Neuroendocrinology","volume":"36 12","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142080550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hypothalamic obesity: Epidemiology in rare sellar/suprasellar tumors—A German claims database analysis 下丘脑肥胖症:罕见蝶鞍/鞍上肿瘤的流行病学--德国索赔数据库分析。
IF 3.3 4区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-08-27 DOI: 10.1111/jne.13439
Julian Witte, Bastian Surmann, Manuel Batram, Markus Weinert, Mathias Flume, Nicolas Touchot, Julia Beckhaus, Carsten Friedrich, Hermann L. Müller

Hypothalamic obesity (HO) is defined as abnormal weight gain resulting in severe persistent obesity due to physical, tumor- and/or treatment-related damage to the hypothalamus. HO epidemiology is poorly understood. We developed a database algorithm supporting the standardized identification of tumor/treatment-related HO (TTR-HO) patients. The algorithm is used to estimate incidence rates of TTR-HO patients in the German healthcare context from a representative claims database (n = 5.42 million) covering 2010–2020. Patients were identified based on surgery/radiotherapy procedures and HO-associated tumor diagnoses (n = 3976). HO was defined by incident obesity and validated based on incident diabetes insipidus diagnoses and desmopressin prescription within a 12-month period after surgery/radiotherapy. Uncertainty due to algorithm definitions is explored in sensitivity analyses. Estimated annual incidence of TTR-HO in Germany is between 0.7 and 1.7 cases per 1,000,000 persons (2019 prevalence: n = 1262 patients). With observed cases in all age groups, two HO-incidence peaks are identified: children/young adults aged 10–24 years and adults aged 40–44 years. Most frequent HO-validated tumor diagnoses are benign sellar/suprasellar tumors (6.1/1,000,000 persons over 9 years), including tumors of the craniopharyngeal duct (1.3/1,000,000), neoplasms of the pituitary gland (4.1/1,000,000), and nonspecific brain tumors of endocrine glands (2.4/1,000,000). This is the first real-world database analysis of TTR-HO epidemiology, refining current estimates of HO epidemiology and early patient identification. A more comprehensive characterization of patients with HO as well as a better understanding of clinical implications will be crucial in developing optimal treatment strategies to improve patient outcomes.

下丘脑性肥胖症(HO)是指由于下丘脑受到物理、肿瘤和/或治疗相关的损伤而导致体重异常增加,并造成严重的持续性肥胖。人们对下丘脑肥胖症的流行病学知之甚少。我们开发了一种数据库算法,支持对肿瘤/治疗相关肥胖症(TTR-HO)患者进行标准化识别。该算法用于估算2010-2020年德国医疗保健领域TTR-HO患者的发病率。根据手术/放疗程序和HO相关肿瘤诊断(n = 3976)确定患者。HO根据肥胖事件进行定义,并根据手术/放疗后12个月内的糖尿病诊断和去氨加压素处方进行验证。敏感性分析探讨了算法定义的不确定性。据估计,TTR-HO 在德国的年发病率为每 100 万人 0.7 至 1.7 例(2019 年发病率:n = 1262 例患者)。在所有年龄组中观察到的病例中,发现了两个HO发病高峰:10-24岁的儿童/年轻人和40-44岁的成年人。最常见的HO验证肿瘤诊断是良性蝶鞍/蝶鞍上肿瘤(9岁以上为6.1/1000000),包括颅咽管肿瘤(1.3/1000000)、垂体肿瘤(4.1/1000000)和内分泌腺的非特异性脑肿瘤(2.4/1000000)。这是首个针对 TTR-HO 流行病学的真实世界数据库分析,完善了目前对 HO 流行病学和早期患者识别的估计。更全面地描述 HO 患者的特征以及更好地了解其临床影响,对于制定最佳治疗策略以改善患者预后至关重要。
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引用次数: 0
Estrogenic regulation of hippocampal inhibitory system across lifespan. 雌激素对海马抑制系统的跨生命周期调控
IF 3.3 4区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-08-15 DOI: 10.1111/jne.13441
Pablo Méndez, Rut de la Vega-Ruiz, Alberto Montes-Mellado

Estrogens produced in peripheral tissues and locally in the brain are potent neuromodulators. The function of the hippocampus, a brain region essential for episodic memory and spatial navigation, relies on the activity of ensembles of excitatory neurons whose activity is temporally and spatially coordinated by a wide diversity of inhibitory neurons (INs) types. Over the last years, we have accumulated evidence that indicates that estrogens regulate the function of hippocampal INs through different mechanisms, including transcriptional regulation and rapid nongenomic signaling. Here, we argue that the well-documented influence of estrogens on episodic memory may be related to the actions of local and peripheral estrogens on the heterogenous populations of hippocampal INs. We discuss how physiological changes in peripheral sex hormone levels throughout lifespan may interact with local brain sources to regulate IN function at different stages of life, from early hippocampal development to the aging brain. We conclude that considering INs as mediators of sex hormone actions in the hippocampus across the healthy life span will benefit our understanding of sex-biased neurodevelopmental disorders and physiological aging.

在外周组织和大脑局部产生的雌激素是一种有效的神经调节剂。海马区是记忆和空间导航的重要脑区,其功能依赖于兴奋性神经元集合体的活动,这些神经元集合体的活动在时间和空间上与多种类型的抑制性神经元(INs)相协调。在过去的几年中,我们积累的证据表明,雌激素通过不同的机制调节海马 INs 的功能,包括转录调节和快速的非基因组信号传导。在此,我们认为,雌激素对表观记忆的影响已得到充分证实,这可能与局部和外周雌激素对海马 INs 的异质群的作用有关。我们讨论了外周性激素水平在整个生命周期中的生理变化如何与大脑局部来源相互作用,从而调节从海马早期发育到大脑衰老等不同生命阶段的 IN 功能。我们的结论是,将 INs 视为性激素在整个健康生命周期中作用于海马的介质,将有助于我们理解具有性别偏见的神经发育障碍和生理衰老。
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引用次数: 0
Understanding negative feedback: Changes in high-molecular-weight adrenocorticotropic hormone in adrenocorticotropic hormone-independent Cushing's syndrome 了解负反馈:肾上腺皮质激素依赖型库欣综合征中高分子量肾上腺皮质激素的变化。
IF 3.3 4区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-08-13 DOI: 10.1111/jne.13438
Yuto Ichinose, Mei Nakatsuji, Hironori Bando, Masaaki Yamamoto, Maki Kanzawa, Kei Yoshino, Hidenori Fukuoka, Wataru Ogawa

Cushing's syndrome is characterized by chronic glucocorticoid oversecretion and diverse clinical manifestations. Distinguishing between adrenocorticotropic hormone (ACTH)-independent and ACTH-dependent forms is crucial for determining treatment options. Plasma ACTH levels aid in the differential diagnosis, with undetectable or low levels suggesting ACTH-independent hypercortisolemia. ACTH is derived from pro-opiomelanocortin, and its processing involves prohormone convertase 1/3. High-molecular-weight ACTH is generally found in ACTH-producing pituitary tumors and ectopic ACTH syndrome. The mechanism of negative feedback and the process of high-molecular-weight ACTH alternation during ACTH-independent Cushing's syndrome remain unclear. A 40-year-old woman with hypertension and multiple fractures developed symptoms suggestive of Cushing's syndrome. Computed tomography revealed a left adrenocortical tumor along with atrophy of the right adrenal gland. ACTH levels were undetectable at the previous clinic, indicating ACTH-independent Cushing's syndrome. However, subsequent measurements at our hospital revealed non-suppressed ACTH (18.1 pg/mL), prompting further investigation. Gel exclusion chromatography confirmed the presence of high-molecular-weight ACTH. Metyrapone treatment decreased the cortisol levels. In this situation, in which ACTH levels should be elevated, a decrease in high-molecular-weight ACTH levels was observed. Histological findings revealed cortisol-producing adenoma without ACTH expression. This case highlights the importance of assay differences in evaluating ACTH concentrations and introduces a novel finding of circulating high-molecular-weight ACTH. The observed decline in high-molecular-weight ACTH levels suggests a potential time lag in the negative feedback within the hypothalamic–pituitary–adrenal axis exhibited by glucocorticoids. This temporal aspect of the regulation of ACTH-related molecules warrants further exploration to enhance our understanding of the hypothalamic–pituitary–adrenal axis feedback mechanism.

库欣综合征的特点是慢性糖皮质激素分泌过多,临床表现多种多样。区分促肾上腺皮质激素(ACTH)依赖型和促肾上腺皮质激素依赖型对于确定治疗方案至关重要。血浆促肾上腺皮质激素(ACTH)水平有助于鉴别诊断,检测不到或水平较低表明ACTH依赖性高皮质醇血症。促肾上腺皮质激素来源于原绒毛膜促皮质素,其加工过程涉及原激素转化酶 1/3。高分子量的促肾上腺皮质激素通常出现在促肾上腺皮质激素分泌垂体瘤和异位促肾上腺皮质激素综合征中。负反馈机制和高分子量 ACTH 在 ACTH 依赖性库欣综合征中的交替过程仍不清楚。一名患有高血压和多发性骨折的 40 岁女性出现了提示库欣综合征的症状。计算机断层扫描发现左侧肾上腺皮质肿瘤和右侧肾上腺萎缩。在之前的诊所检测不到促肾上腺皮质激素水平,这表明促肾上腺皮质激素依赖性库欣综合征。然而,随后在本医院进行的测量显示,患者的促肾上腺皮质激素(ACTH)未受抑制(18.1 pg/mL),因此需要进一步检查。凝胶排阻色谱法证实了高分子量促肾上腺皮质激素的存在。米屈肼酮治疗降低了皮质醇水平。在这种情况下,促肾上腺皮质激素水平本应升高,但却观察到高分子量促肾上腺皮质激素水平下降。组织学检查结果显示,皮质醇分泌腺瘤没有 ACTH 表达。该病例强调了在评估促肾上腺皮质激素浓度时检测方法差异的重要性,并提出了循环中高分子量促肾上腺皮质激素的新发现。观察到的高分子量促肾上腺皮质激素水平的下降表明,糖皮质激素对下丘脑-垂体-肾上腺轴的负反馈可能存在时滞。对 ACTH 相关分子调控的这一时间方面值得进一步探讨,以加深我们对下丘脑-垂体-肾上腺轴反馈机制的理解。
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引用次数: 0
Association of glycosylated hemoglobin concentrations with structural and functional brain changes in the normoglycemic population: A systematic review 糖化血红蛋白浓度与正常血糖人群大脑结构和功能变化的关系:系统综述。
IF 3.3 4区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-08-04 DOI: 10.1111/jne.13437
Yunus Soleymani, Seyed Amir Hossein Batouli, Amin Akbari Ahangar, Ata Pourabbasi

Optimal glucose control is crucial for maintaining brain health and preventing metabolic and cognitive disorders in the general population. Glycosylated hemoglobin (HbA1c) serves as a key marker for assessing glucose intolerance and its impact on brain structure and function in healthy individuals. However, existing literature presents conflicting findings, necessitating a systematic review to consolidate current knowledge in this domain. This systematic review examines 26 English-language studies involving participants aged 15 years and above, investigating the relationship between HbA1c levels and brain health. Studies focusing on normal/general populations and utilizing magnetic resonance imaging (MRI) as the imaging modality were included. Exclusion criteria encompassed review articles, abstracts, letters, animal studies, and research involving neuropsychiatric or metabolic diseases. Data were gathered from PubMed, Scopus, and Web of Science databases up to November 2023. Analysis reveals significant associations between HbA1c levels and various brain metrics, including volume, cortical thickness, fractional anisotropy, mean diffusivity, activity, and connectivity. However, findings exhibit inconsistency, likely attributed to disparities in sample characteristics and study sizes. Notably, hippocampal volume, white matter hyperintensity, and ventral attention network connectivity emerge as frequently affected structures and functions, mirroring trends observed in diabetic populations. Despite inconclusive evidence, glucose intolerance appears to exert considerable influence on select brain structures and functions in individuals without diagnosed metabolic disorders. Understanding these associations is critical for mitigating the risk of cognitive decline and dementia in healthy populations. Future investigations should aim to elucidate the intricate relationship between HbA1c concentrations and brain health parameters in normoglycemic individuals.

最佳的血糖控制对于维持大脑健康、预防代谢和认知障碍至关重要。糖化血红蛋白(HbA1c)是评估葡萄糖不耐受及其对健康人大脑结构和功能影响的关键指标。然而,现有文献的研究结果相互矛盾,因此有必要进行系统综述,以巩固该领域的现有知识。本系统综述研究了 26 项涉及 15 岁及以上参与者的英语研究,调查 HbA1c 水平与大脑健康之间的关系。研究对象为正常/普通人群,采用磁共振成像(MRI)作为成像模式。排除标准包括综述文章、摘要、信件、动物实验以及涉及神经精神或代谢疾病的研究。数据收集自 PubMed、Scopus 和 Web of Science 数据库,截止日期为 2023 年 11 月。分析表明,HbA1c 水平与各种大脑指标(包括体积、皮质厚度、分数各向异性、平均扩散性、活动性和连接性)之间存在重大关联。然而,研究结果并不一致,这可能是由于样本特征和研究规模的差异造成的。值得注意的是,海马体积、白质高密度和腹侧注意网络连通性是经常受到影响的结构和功能,这与在糖尿病人群中观察到的趋势一致。尽管尚无定论,但葡萄糖不耐受似乎对未确诊代谢紊乱的个体的特定大脑结构和功能产生了相当大的影响。了解这些关联对于降低健康人群认知能力下降和痴呆症的风险至关重要。未来的研究应旨在阐明血糖正常者的 HbA1c 浓度与大脑健康参数之间错综复杂的关系。
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引用次数: 0
Intraperitoneal administration of α-melanocyte stimulating hormone (α-MSH) suppresses food intake and induces anxiety-like behavior via the brain MC4 receptor-signaling pathway in goldfish 腹腔注射α-黑色素细胞刺激素(α-MSH)可抑制金鱼的食物摄入量,并通过大脑MC4受体信号通路诱发焦虑样行为。
IF 3.3 4区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-08-02 DOI: 10.1111/jne.13435
Keisuke Watanabe, Norifumi Konno, Tomoya Nakamachi, Kouhei Matsuda

α-Melanocyte stimulating hormone (α-MSH) is a peptide hormone released from the intermediate lobe of the pituitary which regulates body pigmentation. In addition to the pituitary, α-MSH is also produced in the midbrain, and exerts both anorexigenic and an anxiogenic actions. Acyl ghrelin and cholecystokinin are peripheral hormones derived from the digestive tract which affect the brain to control food intake and feeding behavior in vertebrates. In the present study, hypothesizing that plasma α-MSH may also stimulate the brain and exert central effects, we examined whether peripherally administered α-MSH affects food intake and psychomotor activity using a goldfish model. Intraperitoneal (IP) administration of α-MSH at 100 pmol g−1 body weight (BW) reduced food consumption and enhanced thigmotaxis. These α-MSH-induced actions were blocked by intracerebroventricular administration of HS024, an antagonist of the melanocortin 4 receptor (MC4R), at 50 pmol g−1 BW, whereas these actions were not attenuated by pretreatment with an IP-injected excess amount of capsaicin, a neurotoxin that destroys primary sensory (vagal and splanchnic) afferents, at 160 nmol g−1 BW. Transcripts for the MC4R showed higher expression in the diencephalon in other regions of the brain. These results suggest that, in goldfish, IP administered α-MSH is taken up by the brain, and also acts as anorexigenic and anxiogenic factor via the MC4R signaling pathway.

α-促黑素细胞激素(α-MSH)是垂体中间叶释放的一种肽类激素,可调节人体色素沉着。除垂体外,α-MSH 还产生于中脑,具有厌食和焦虑作用。酰胃泌素和胆囊收缩素是来自消化道的外周激素,它们会影响大脑,从而控制脊椎动物的食物摄入量和摄食行为。在本研究中,我们假设血浆α-MSH也可能刺激大脑并产生中枢效应,因此利用金鱼模型研究了外周给药α-MSH是否会影响食物摄入量和精神运动活动。腹腔注射(IP)100 pmol g-1 体重(BW)的α-MSH 可减少食物摄入量并增强趋向性。脑室内注射 50 pmol g-1 体重的黑色素皮质素 4 受体(MC4R)拮抗剂 HS024 后,α-MSH 诱导的这些作用被阻断,而 IP 注射过量 160 nmol g-1 体重的辣椒素(一种破坏初级感觉(迷走神经和脾脏)传入的神经毒素)预处理后,这些作用并没有减弱。与大脑其他区域相比,MC4R 的转录本在间脑的表达量更高。这些结果表明,在金鱼体内,IP 给药的α-MSH 会被大脑吸收,并通过 MC4R 信号途径发挥厌食和致焦虑因子的作用。
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引用次数: 0
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Journal of Neuroendocrinology
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