Pub Date : 2024-01-29DOI: 10.1038/s41574-024-00955-3
S. Rasika, Ruben Nogueiras, Markus Schwaninger, Vincent Prevot
Gonadotropin-releasing hormone is implicated in cognitive functions, and its loss is a factor in pathological brain ageing. There are similarities between these processes and the neurological and cognitive deficits observed in patients with long COVID. Here, we explore the hypothesis that neuroanatomical and transcriptomic alterations associated with long COVID could stem from this neuroendocrine perturbation.
{"title":"Seeing through the fog: a neuroendocrine explanation for post-COVID cognitive deficits","authors":"S. Rasika, Ruben Nogueiras, Markus Schwaninger, Vincent Prevot","doi":"10.1038/s41574-024-00955-3","DOIUrl":"10.1038/s41574-024-00955-3","url":null,"abstract":"Gonadotropin-releasing hormone is implicated in cognitive functions, and its loss is a factor in pathological brain ageing. There are similarities between these processes and the neurological and cognitive deficits observed in patients with long COVID. Here, we explore the hypothesis that neuroanatomical and transcriptomic alterations associated with long COVID could stem from this neuroendocrine perturbation.","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":null,"pages":null},"PeriodicalIF":40.5,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139573604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-25DOI: 10.1038/s41574-023-00929-x
Julie Martin-Grace, Maria Tomkins, Michael W. O’Reilly, Mark Sherlock
Iatrogenic adrenal insufficiency (IAI) is the most common form of adrenal insufficiency in adult patients, although its overall exact prevalence remains unclear. IAI is associated with adverse clinical outcomes, including adrenal crisis, impaired quality of life and increased mortality; therefore, it is imperative that clinicians maintain a high index of suspicion in patients at risk of IAI to facilitate timely diagnosis and appropriate management. Herein, we review the major causes, clinical consequences, diagnosis and care of patients with IAI. The management of IAI, particularly glucocorticoid-induced (or tertiary) adrenal insufficiency, can be particularly challenging, and the provision of adequate glucocorticoid replacement must be balanced against minimizing the cardiometabolic effects of excess glucocorticoid exposure and optimizing recovery of the hypothalamic–pituitary–adrenal axis. We review current treatment strategies and their limitations and discuss developments in optimizing treatment of IAI. This comprehensive Review aims to aid clinicians in identifying who is at risk of IAI, how to approach screening of at-risk populations and how to treat patients with IAI, with a focus on emergency management and prevention of an adrenal crisis. Iatrogenic adrenal insufficiency (IAI) is the most common form of adrenal insufficiency in adult patients. This comprehensive Review aims to aid clinicians in identifying who is at risk of IAI, how to approach screening of at-risk populations and how to treat patients with IAI.
{"title":"Iatrogenic adrenal insufficiency in adults","authors":"Julie Martin-Grace, Maria Tomkins, Michael W. O’Reilly, Mark Sherlock","doi":"10.1038/s41574-023-00929-x","DOIUrl":"10.1038/s41574-023-00929-x","url":null,"abstract":"Iatrogenic adrenal insufficiency (IAI) is the most common form of adrenal insufficiency in adult patients, although its overall exact prevalence remains unclear. IAI is associated with adverse clinical outcomes, including adrenal crisis, impaired quality of life and increased mortality; therefore, it is imperative that clinicians maintain a high index of suspicion in patients at risk of IAI to facilitate timely diagnosis and appropriate management. Herein, we review the major causes, clinical consequences, diagnosis and care of patients with IAI. The management of IAI, particularly glucocorticoid-induced (or tertiary) adrenal insufficiency, can be particularly challenging, and the provision of adequate glucocorticoid replacement must be balanced against minimizing the cardiometabolic effects of excess glucocorticoid exposure and optimizing recovery of the hypothalamic–pituitary–adrenal axis. We review current treatment strategies and their limitations and discuss developments in optimizing treatment of IAI. This comprehensive Review aims to aid clinicians in identifying who is at risk of IAI, how to approach screening of at-risk populations and how to treat patients with IAI, with a focus on emergency management and prevention of an adrenal crisis. Iatrogenic adrenal insufficiency (IAI) is the most common form of adrenal insufficiency in adult patients. This comprehensive Review aims to aid clinicians in identifying who is at risk of IAI, how to approach screening of at-risk populations and how to treat patients with IAI.","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":null,"pages":null},"PeriodicalIF":40.5,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139550917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-22DOI: 10.1038/s41574-023-00942-0
Andrea Giustina, Marise Lazaretti-Castro, Adrian R. Martineau, Rebecca S. Mason, Clifford J. Rosen, Inez Schoenmakers
Vitamin D is precursor of the steroid hormone calcitriol and has important functions throughout the body, including increasing intestinal absorption of calcium, magnesium and phosphate. Vitamin D deficiency has been linked with a range of disorders, including several bone diseases. However, large trials of vitamin D supplementation have produced mixed results. Here, experts from around the world discuss several key questions in the vitamin D research and clinical fields.
维生素 D 是类固醇激素钙三醇的前体，在全身具有重要功能，包括增加肠道对钙、镁和磷酸盐的吸收。维生素 D 缺乏与一系列疾病有关，包括多种骨病。然而，补充维生素 D 的大型试验结果喜忧参半。在此，来自世界各地的专家将讨论维生素 D 研究和临床领域的几个关键问题。
{"title":"A view on vitamin D: a pleiotropic factor?","authors":"Andrea Giustina, Marise Lazaretti-Castro, Adrian R. Martineau, Rebecca S. Mason, Clifford J. Rosen, Inez Schoenmakers","doi":"10.1038/s41574-023-00942-0","DOIUrl":"10.1038/s41574-023-00942-0","url":null,"abstract":"Vitamin D is precursor of the steroid hormone calcitriol and has important functions throughout the body, including increasing intestinal absorption of calcium, magnesium and phosphate. Vitamin D deficiency has been linked with a range of disorders, including several bone diseases. However, large trials of vitamin D supplementation have produced mixed results. Here, experts from around the world discuss several key questions in the vitamin D research and clinical fields.","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":null,"pages":null},"PeriodicalIF":40.5,"publicationDate":"2024-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139510834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-22DOI: 10.1038/s41574-024-00953-5
Zhe Bao Wu
{"title":"The shift of therapeutic strategy for prolactinomas: surgery as the first-line option","authors":"Zhe Bao Wu","doi":"10.1038/s41574-024-00953-5","DOIUrl":"10.1038/s41574-024-00953-5","url":null,"abstract":"","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":null,"pages":null},"PeriodicalIF":40.5,"publicationDate":"2024-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41574-024-00953-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139521471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-22DOI: 10.1038/s41574-024-00954-4
Stephan Petersenn, Maria Fleseriu, Shlomo Melmed
{"title":"Reply to ‘The shift of therapeutic strategy for prolactinomas: surgery as the first-line option’","authors":"Stephan Petersenn, Maria Fleseriu, Shlomo Melmed","doi":"10.1038/s41574-024-00954-4","DOIUrl":"10.1038/s41574-024-00954-4","url":null,"abstract":"","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":null,"pages":null},"PeriodicalIF":40.5,"publicationDate":"2024-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41574-024-00954-4.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139521470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-15DOI: 10.1038/s41574-023-00934-0
Camille Allard, Cristina Miralpeix, Antonio J. López-Gambero, Daniela Cota
In eukaryotic cells, the mammalian target of rapamycin complex 1 (sometimes referred to as the mechanistic target of rapamycin complex 1; mTORC1) orchestrates cellular metabolism in response to environmental energy availability. As a result, at the organismal level, mTORC1 signalling regulates the intake, storage and use of energy by acting as a hub for the actions of nutrients and hormones, such as leptin and insulin, in different cell types. It is therefore unsurprising that deregulated mTORC1 signalling is associated with obesity. Strategies that increase energy expenditure offer therapeutic promise for the treatment of obesity. Here we review current evidence illustrating the critical role of mTORC1 signalling in the regulation of energy expenditure and adaptive thermogenesis through its various effects in neuronal circuits, adipose tissue and skeletal muscle. Understanding how mTORC1 signalling in one organ and cell type affects responses in other organs and cell types could be key to developing better, safer treatments targeting this pathway in obesity. The protein complex mTORC1 is a key regulator of cellular metabolism in response to energy availability. This Review discusses the role of mTORC1 in regulating energy expenditure and the implications for the development and treatment of obesity.
{"title":"mTORC1 in energy expenditure: consequences for obesity","authors":"Camille Allard, Cristina Miralpeix, Antonio J. López-Gambero, Daniela Cota","doi":"10.1038/s41574-023-00934-0","DOIUrl":"10.1038/s41574-023-00934-0","url":null,"abstract":"In eukaryotic cells, the mammalian target of rapamycin complex 1 (sometimes referred to as the mechanistic target of rapamycin complex 1; mTORC1) orchestrates cellular metabolism in response to environmental energy availability. As a result, at the organismal level, mTORC1 signalling regulates the intake, storage and use of energy by acting as a hub for the actions of nutrients and hormones, such as leptin and insulin, in different cell types. It is therefore unsurprising that deregulated mTORC1 signalling is associated with obesity. Strategies that increase energy expenditure offer therapeutic promise for the treatment of obesity. Here we review current evidence illustrating the critical role of mTORC1 signalling in the regulation of energy expenditure and adaptive thermogenesis through its various effects in neuronal circuits, adipose tissue and skeletal muscle. Understanding how mTORC1 signalling in one organ and cell type affects responses in other organs and cell types could be key to developing better, safer treatments targeting this pathway in obesity. The protein complex mTORC1 is a key regulator of cellular metabolism in response to energy availability. This Review discusses the role of mTORC1 in regulating energy expenditure and the implications for the development and treatment of obesity.","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":null,"pages":null},"PeriodicalIF":40.5,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139468672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-11DOI: 10.1038/s41574-024-00952-6
Claire Greenhill
{"title":"Brain–immune networks: a role for GLP1 receptor","authors":"Claire Greenhill","doi":"10.1038/s41574-024-00952-6","DOIUrl":"10.1038/s41574-024-00952-6","url":null,"abstract":"","PeriodicalId":18916,"journal":{"name":"Nature Reviews Endocrinology","volume":null,"pages":null},"PeriodicalIF":40.5,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139425107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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