Neuro endocrinology letters最新文献

Objectives: Empty sella is the herniation of the subarachnoid space into the sella turcica; either secondary to identifiable causes (e.g., surgery or radiotherapy); or spontaneously, which is termed primary empty sella (PES). The amount of cerebrospinal fluid (CSF) in the sella on imaging classifies PES as partial (<50% filling, pituitary >2 mm) or complete (≥50% filling, pituitary <2 mm). Few investigations have compared hormonal abnormalities in partial and complete PES.

Design: This study aims to determine whether partial and complete PES differ endocrinologically.

Material and methods: Fifty-eight PES patients underwent hormonal evaluation: morning corticotropin (ACTH), cortisol, thyrotropin (TSH), free thyroxine (fT4), follicle‑stimulating hormone (FSH), luteinizing hormone (LH), estradiol (females), total testosterone (males), prolactin (PRL), growth hormone (GH) and insulin‑like growth factor‑1 (IGF‑1). Patients were divided into partial and complete PES groups and endocrinologically assessed.

Results: The proportion of secondary adrenal insufficiency and secondary hypogonadism was significantly higher in the complete PES group (p = 0.021 and p = 0.041, respectively). The proportion of cases with two or more affected axes was higher in complete PES (p = 0.010). Secondary hypothyroidism was significantly more common among males (p = 0.001).

Conclusion: After a diagnosis of complete PES, clinicians should be cautious about secondary adrenal insufficiency and hypogonadism. It is advisable to perform hormonal testing for all PES patients, regardless of type, because affected‑axis rates often exceed 10% and may reach 50%. Prospective multicenter trials are necessary.

Background: Pheochromocytomas and paragangliomas (PPGLs) are rare catecholamine-secreting neuroendocrine tumors originating from the embryonic neural crest. Approximately 30% of PPGLs are hereditary and are frequently associated with genetic syndromes, including neurofibromatosis type 1 (NF1). Composite PPGLs, which include components of both PPGLs and related tumors such as ganglioneuromas, are extremely rare in NF1 patients.

Case presentation: A 40-year-old woman with NF1, identified by multiple neurofibromas, café-au-lait spots, axillary freckling, and Lisch nodules, presented with an incidental mass adjacent to the right adrenal gland. Computed tomography and magnetic resonance imaging revealed a possible PPGL, with additional small nodules suspected to be gastrointestinal stromal tumors or neuroendocrine tumors. Genetic testing revealed a heterozygous NF1 gene mutation, c.2786T>C. The patient underwent successful robotic-assisted laparotomy to remove a 5 cm retroperitoneal tumor. Pathological examination revealed a composite paraganglioma-ganglioneuroma. The patient recovered well postoperatively and was recommended for long-term follow-up.

Conclusion: This report describes the first Chinese case of composite extra-adrenal paraganglioma-ganglioneuroma in an NF1 patient, highlighting the importance of a multidisciplinary approach, including genetic analysis, for the accurate diagnosis and management of composite PGLs in NF1 patients. This unique case underscores the clinical significance of recognizing rare composite tumors in diverse populations to improve diagnosis and personalized treatment strategies. Further research into the genetic and clinical implications of these tumors is important.

Background: Aquaporin-3 (AQP3) water channels are belonging to the aquaporin water channel family, permeable not only to water but also to some small solutes such as glycerol and lactate. The purpose of this study is to investigate the possible functions of AQP3 in peripheral nerve rehabilitation based on AQP3-deficient mice.

Methods: Mature 8-week-old female AQP3-deficient (AQP3-/-) mice and C57BL/6 (WT) mice initially weighing 25~30 g were used in this study. Schwann cells were isolated from sciatic nerves of WT and AQP3-/- mice respectively. AQP3 mRNA and protein expression in sciatic nerve tissues and Schwann cells were detected by RT-PCR, immunoblot analysis, and immunofluorescence staining. Sciatic nerve cross sections from the WT and AQP3-/- mice were stained by toluidine-blue agent to identify the potential influence of AQP3 deficiency to the morphology nerve fibers. The proliferation and migration ability of AQP3-/- and WT Schwann cells were observed in primary cell cultures. To explore the possible role of AQP3 in nerve repair processes, sciatic nerve contusion models were established and walking track analysis was performed on both WT and AQP3-/- mice.

Results: AQP3 was localized in the membrane of Schwann cells. AQP3-deficiency did not alter the morphology of fibers in the sciatic nerve. There was an increase of AQP3 protein expression in the sciatic nerve of wild-type mice after injury. Primary culture of Schwann cells and in vitro wound healing model revealed that AQP3-deficient Schwann cells exhibited the same morphology, while showing lower proliferation and migration ability compared with wild-type Schwann cells. There was obvious delay in motor function rehabilitation in AQP3-deficient mice compared with that of wild-type mice.

Conclusion: Our study suggested that AQP3 localized in the membrane of Schwann cells and facilitated Schwann cells' proliferation and migration. AQP3 deficiency impaired nerve rehabilitation in wound healing model both in vitro and in vivo. The study support our hypothesis that AQP3 participates in myelin damnification and repair course and the mechanisms underlying the AQP3 in the field of myelin repair and regeneration in peripheral nerves deserves further investigation and exploration in detail.

Background: Dysregulated autophagy is linked to abnormal keratinocyte differentiation and persistent psoriatic inflammation. Smart fluids, such as Dead Sea Water (DSW) and saline magnetized water (MW), have emerged as potential non-pharmacological autophagy activators. This study evaluates their effects on psoriasis-like keratinocytes, focusing on calcitonin gene-related peptide (CGRP), a neuropeptide involved in pruritus and inflammation, and secreted frizzled-related protein 4 (SFRP4), whose reduced expression contributes to epidermal hyperplasia. The role of autophagy in mediating these effects was also investigated.

Methods: Polycytokine-stimulated HaCaT keratinocytes were treated with DSW or saline MW. CGRP and SFRP4 expression levels were assessed alongside autophagy markers beclin-1 and LC3B. The involvement of autophagy was confirmed using wortmannin, an autophagy inhibitor.

Results: Both DSW (4.7 ± 1.9 a.u.) and saline MW (3.6 ± 1.6 a.u.) significantly reduced CGRP expression compared to controls (non-magnetized saline: 7.5 ± 2.3 a.u.; distilled water: 7.6 ± 2.5 a.u.; all p< 0.001). While both fluids enhanced SFRP4 expression equally (p = 0.78), saline MW showed superior CGRP inhibition (p< 0.001). Both fluids mitigated polycytokine-induced reductions in beclin-1 and LC3B levels (all p< 0.001), with saline MW showing more pronounced effects (p< 0.05). Wortmannin impaired the effects of both fluids on CGRP and SFRP4, indicating autophagy mediation.

Conclusions: DSW and saline MW show promise as sustainable active ingredients for topical formulations targeting psoriatic inflammation via autophagy activation.

Background: Relapsing-remitting multiple sclerosis (RRMS) is defined by elevated IgG/IgA/IgM responses targeting Epstein-Barr Virus (EBV) nuclear antigen 1 (EBNA) and deoxyuridine-triphosphatases (dUTPases) of Human herpsesvirus-6 (HHV-6) and EBV. These responses suggest that the viruses are being replicated and reactivated. An increased prevalence of chronic fatigue syndrome, depression, and anxiety is associated with signs of immune activation in RRMS. Nevertheless, there is a lack of data regarding the association between viral reactivation and neuropsychiatric symptoms of RRMS.

Methods: This study investigated the IgG/IgA/IgM responses to EBNA, and EBV and HHV-6-dUTPases, in 58 remitted RRMS patients and 63 normal controls. The McDonald criteria were employed to establish the diagnosis of MS. The Expanded Disability Status Scale (EDSS) and the Multiple Sclerosis Severity Score were employed to evaluate disabilities caused by RRMS. We evaluated the scores of the Hamilton Depression (HAMD) and Anxiety (HAMA) Rating Scales, and Fibro-Fatigue (FF) scale. One latent construct was extracted from the EDSS, MSSS, FF, HAMD, and HAMA scores.

Results: We discovered that the combined effects of IgG and IgM-HHV-6-dUTPAses accounted for 63.7% of the variance in this construct. Furthermore, the total FF, HAMA, and HAMD scores were substantially associated with the IgG and IgM-HHV-6-dUTPAses, accounting for approximately 38.7% to 51.0% of the variance. The three neuropsychiatric rating scale scores were also significantly correlated with IgA reactivity directed to both dUTPases and IgG/IgA/IgM to EBNA.

Conclusion: The reactivation and replication of HHV-6 and EBV significantly contributes to chronic fatigue syndrome, as well as symptoms of depression and anxiety due to RRMS.

Background: Power dynamics are fundamental to therapeutic and supervisory relationships in psychotherapy. In cognitive-behavioural therapy (CBT) and schema therapy (ST), the therapist's power management can help the patient make positive changes. On the other hand, the abuse of power can undermine the patient's autonomy and worsen therapeutic outcomes. Understanding these dynamics is essential for effective and ethical practice.

Objectives: This article aims to explore how power and powerlessness manifest themselves in the practice of cognitive behavioural therapy (CBT) and schema therapy (ST), analyse their impact on therapeutic and supervisory processes, identify the risk of abuse of power, and suggest strategies to support patient and supervisee autonomy.

Methods: The text provides a theoretical and practical analysis of the manifestations of power in therapy and supervision, illustrated with case vignettes to explain important processes. The discussion includes a comparison of CBT and ST, focusing on their respective approaches to power dynamics. Ethical principles, supervision practices, and cultural and institutional influences are also examined.

Results: Effective use of power in therapy and supervision increases trust, cooperation, and autonomy for both client and supervisee. In CBT therapy and supervision, collaboration with an appropriate power distribution between therapist and patient or supervisor and supervisee promotes patient or supervisee engagement. Still, excessive directiveness can sometimes threaten the relationship. In ST, where limited reparenting is the main vehicle for the therapeutic and supervisory relationship, therapeutic and supervisory leadership requires increased sensitivity by the therapist or supervisor to avoid reinforcing maladaptive modes. Supervisory approaches that rely on collaborative approaches are more supportive of professional growth than those dominated by hierarchical power structures.

Conclusions: Reflection on power dynamics is vital in cognitive-behavioural and schema therapy for maintaining ethical and effective therapeutic and supervisory relationships. Strategies that help maintain a balance of power include adherence to ethical principles, self-reflection, and regular supervision. Future research should focus on developing innovative methods to capture solutions to power distribution issues in therapy and supervision.

Objectives: Evidence has accumulated that an autoimmune-mediated process may underlie development of schizophrenia, and in two recent studies, we found increased antibody reactivity against the insulin receptor-A (INSR-A) and insulin-like growth factor 1 receptor (IGF1R) and their ligands (insulin and insulin-like growth factor 1) in cerebrospinal fluid (CSF) and/ or serum from patients with schizophrenia or related psychosis. The aim of this study was to analyze antibody reactivity in schizophrenia against the insulin-insulin-like growth factor 2 (INS-IGF2) protein, which hypothetically also may be a ligand to INSR-A and IGF1R and involved in the pathogenesis of schizophrenia.

Material and methods: Patients with schizophrenia or related psychosis and controls were analyzed regarding antibody reactivity against INS-IGF2 in CSF (n = 12/ n = 11) and serum (n = 17/ n = 11), using bead-based antigen arrays of one protein fragment and 24 peptides of this protein. Additionally, the patients were assessed for clinical symptoms with the Positive and Negative Syndrome Scale (PANSS) for schizophrenia.

Results: Significantly higher antibody reactivity against the peptides 11 and 12 was found in patients in partial than full symptom remission. Patients' antibody reactivity against the peptides 5, 11 and 12 correlated positively to their PANSS scores of positive symptoms. Furthermore, significantly higher antibody reactivity against the peptides 2, 3, 10 and 22 was found in patients with, than without, heredity for diabetes mellitus type 1 or 2.

Conclusion: The findings in this study pointed that the INS-IGF2 protein may be present in the CNS and involved in the autoimmune-mediated process underlying the development of schizophrenia.

Objectives: We aimed to investigate the effect of hand therapy (HT) on oxytocin and oxytocin receptor expression in a chemotherapy-induced peripheral neuropathy (CIPN) model mouse.

Methods: CIPN model mouse was induced by intraperitoneal injection of paclitaxel (PTX; 4 mg/kg) on days 0, 2, 4 and 6 of the study. HT was performed on the CIPN mice once daily for 14 consecutive days, starting on day 8 after the PTX injection. Following HT,we observed the oxytocin and oxytocin receptor expressions in the skin and dorsal root ganglion (DRG) and assessed the oxytocin in the serum.

Results: Oxytocin expressions in the skin and DRG significantly increased in the PTX + HT group compared to that in the Non-PTX and PTX groups. Additionally, oxytocin receptor expressions in the skin and DRG significantly increased in the PTX + HT group compared to that in the PTX group. Furthermore, the PTX + HT group showed significantly higher serum oxytocin concentration than the Non-PTX and PTX groups.

Conclusion: The present study showed that HT reversed PTX-induced suppression of oxytocin receptor expressions and HT increased oxytocin expression locally and its systemic level. Such results connect the gap and previous suggestions that HT improving neurological symptoms are related to oxytocin levels.

Objectives: Triple-negative breast cancer (TNBC) is a distinct subtype of breast cancer that has a poor prognosis due to the lack of effective therapeutic agents. Since a significant proportion of human surgical samples of TNBC expressed mRNA for the growth hormone (GH), growth hormone-releasing hormone (GHRH), and gonadotropin-releasing hormone (GnRH) receptors, and the mitogenic proliferative activity of GH, GHRH, and GnRH, have been identified as effective therapeutic targets for somatostatin and its analogs and GnRH analogs, Di Bella Method (DBM), a combination of hormonal analogs and vitamins, was introduced to target and inhibit solid tumors. The present study aimed to improve the prognosis of women with TNBC using DBM.

Methods: This retrospective observational study was done on women with TNBC who were diagnosed based on histology, nuclear grade, and immunohistochemical testing for estrogen receptor, HER2/neu, and progesterone receptor. Patients were either treated with standard oncology protocol, including chemotherapy and radiotherapy plus DBM, or with DBM alone. The DBM included a daily combination of somatostatin, octreotide, melatonin, retinoids solubilized in alpha tocopheryl acetate, dopaminergic agonists, bromocriptine, cabergoline, aromatase inhibitors for anti-estrogen function, and low metronomic doses of cyclophosphamide.

Results: In this study, 35 patients were enrolled, and their survival was monitored for 5 years during which they received DBM and standard chemotherapy/radiotherapy protocol. These patients had a survival rate of 64% at 5 years, 76% at 3 years, 87% at 2 years, and 100% after 1 year of therapy. On the other hand, 13 patients who received only DBM had a survival rate of 60% at 5 years, 67% at 3 years, 75% at 2 years and 100% after 1 year of therapy. None of the patients had significant adverse events.

Conclusions: Compared to published clinical trials, the DBM improved the prognosis of women with TNBC. However, more standardized clinical trials, including DBM with and without standard therapeutic protocols for TNBC, are warranted.

Objectives: This study aimed to examine the relationship between salivary melatonin levels and impulsivity in humans, as the literature has not examined this relationship in healthy individuals.

Methods: We recruited 75 participants aged 18-55 years, measuring their salivary melatonin concentrations using an enzyme immunoassay and their impulsivity using the Barratt Impulsiveness Scale (BIS) scores.

Results: The participants' salivary melatonin levels were positively correlated with impulsivity. With regard to the three main factors of the BIS, melatonin levels were positively correlated with attentional impulsiveness but not with motor impulsiveness or non-planning impulsiveness. Of the six subfactors assessed by the BIS, melatonin levels were positively correlated with attention, motor, and cognitive instability, while negatively correlated with perseverance. They were not correlated with self-control or cognitive complexity.

Conclusion: Individuals exhibiting high melatonin levels are more likely to have impulsive attention and cognitive instability, in addition to lacking perseverance.