- Hypothalamus and pituitary gland
- Preoperative Serum Copeptin Can Predict Delayed Hyponatremia after Pituitary Surgery in the Absence of Arginine Vasopressin Deficiency
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Ho Kang, Seung Shin Park, Yoo Hyung Kim, Hwan Sub Lim, Mi-Kyeong Lee, Kyoung-Ryul Lee, Jung Hee Kim, Yong Hwy Kim
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Endocrinol Metab. 2024;39(1):164-175. Published online January 3, 2024
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DOI: https://doi.org/10.3803/EnM.2023.1792
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Abstract
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- Background
Delayed postoperative hyponatremia (DPH) is the most common cause of readmission after pituitary surgery. In this study, we aimed to evaluate the cutoff values of serum copeptin and determine the optimal timing for copeptin measurement for the prediction of the occurrence of DPH in patients who undergo endoscopic transsphenoidal approach (eTSA) surgery and tumor resection.
Methods This was a prospective observational study of 73 patients who underwent eTSA surgery for pituitary or stalk lesions. Copeptin levels were measured before surgery, 1 hour after extubation, and on postoperative days 1, 2, 7, and 90.
Results Among 73 patients, 23 patients (31.5%) developed DPH. The baseline ratio of copeptin to serum sodium level showed the highest predictive performance (area under the curve [AUROC], 0.699), and its optimal cutoff to maximize Youden’s index was 2.5×10–11, with a sensitivity of 91.3% and negative predictive value of 92.0%. No significant predictors were identified for patients with transient arginine vasopressin (AVP) deficiency. However, for patients without transient AVP deficiency, the copeptin-to-urine osmolarity ratio at baseline demonstrated the highest predictive performance (AUROC, 0.725). An optimal cutoff of 6.5×10–12 maximized Youden’s index, with a sensitivity of 92.9% and a negative predictive value of 94.1%.
Conclusion The occurrence of DPH can be predicted using baseline copeptin and its ratio with serum sodium or urine osmolarity only in patients without transient AVP deficiency after pituitary surgery.
- Adrenal Gland
- A Novel Missense PRKAR1A Variant Causes Carney Complex
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Boram Kim, Han Na Jang, Kyung Shil Chae, Ho Seop Shin, Yong Hwy Kim, Su Jin Kim, Moon-Woo Seong, Jung Hee Kim
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Endocrinol Metab. 2022;37(5):810-815. Published online October 4, 2022
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DOI: https://doi.org/10.3803/EnM.2022.1544
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Abstract
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- The Carney complex (CNC) is an autosomal dominant disorder characterized by endocrine and nonendocrine tumors. Loss-of-function variants of protein kinase A regulatory subunit 1 alpha (PRKAR1A) are common causes of CNC. Here, we present the case of a patient with CNC with a novel PRKAR1A missense variant. A 21-year-old woman was diagnosed with CNC secondary to acromegaly and adrenal Cushing syndrome. Genetic analysis revealed a novel missense heterozygous variant of PRKAR1A (c.176A>T). Her relatives, suspected of having CNC, also carried the same variant. RNA analysis revealed that this variant led to nonsense-mediated mRNA decay. In vitro functional analysis of the variant confirmed its role in increasing protein kinase A activity and cyclic adenosine monophosphate levels. This study broadens our understanding of the genetic spectrum of CNC. We suggest that PRKAR1A genetic testing and counseling be recommended for patients with CNC and their families.
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Citations
Citations to this article as recorded by
- Carney complex: A clinicopathologic study on a single family from several Canadian provinces
Alexandra Lao, Julio Silva, Brian Chiu, Consolato M. Sergi Cardiovascular Pathology.2024; 69: 107599. CrossRef
- Hypothalamus and Pituitary Gland
- Advances in Pituitary Surgery
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Yoon Hwan Byun, Ho Kang, Yong Hwy Kim
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Endocrinol Metab. 2022;37(4):608-616. Published online August 19, 2022
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DOI: https://doi.org/10.3803/EnM.2022.1546
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- Pituitary surgery has advanced considerably in recent years with the exploration and development of various endoscopic approaches and techniques. Different endoscopic skull base approaches are being applied to access sellar tumors in different locations. Moreover, extracapsular dissection and cavernous sinus exploration have enabled gross total resection of sellar tumors where it could not have been achieved in the past. Techniques for skull base reconstruction have also progressed, allowing surgeons to remove larger and more complicated tumors than before. This review article discusses different endoscopic skull base approaches, surgical techniques for removing pituitary adenomas, and reconstruction methods for repairing postoperative low-flow and high-flow cerebrospinal fluid leakage.
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Citations
Citations to this article as recorded by
- Serum and hair steroid profiles in patients with nonfunctioning pituitary adenoma undergoing surgery: A prospective observational study
Seung Shin Park, Yong Hwy Kim, Ho Kang, Chang Ho Ahn, Dong Jun Byun, Man Ho Choi, Jung Hee Kim The Journal of Steroid Biochemistry and Molecular Biology.2023; 230: 106276. CrossRef - Pituitary disease and anaesthesia
Kim Rhodes, Robert John, Astri Luoma Anaesthesia & Intensive Care Medicine.2023; 24(6): 348. CrossRef - Орфанні ендокринні захворювання: сучасні тенденції хірургічного лікування в Україні
M.D. Tronko, B.B. Guda Endokrynologia.2022; 27(4): 287. CrossRef
- Endocrine Research
- Transcriptome Analysis Identifies an Attenuated Local Immune Response in Invasive Nonfunctioning Pituitary Adenomas
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Yong Hwy Kim, Jung Hee Kim
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Endocrinol Metab. 2019;34(3):314-322. Published online September 26, 2019
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DOI: https://doi.org/10.3803/EnM.2019.34.3.314
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Correction in: Endocrinol Metab 2020;35(4):965
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- Background
Invasive nonfunctioning pituitary adenomas (NFPAs) remain challenging due to their high complication rate and poor prognosis. We aimed to identify the distinctive molecular signatures of invasive NFPAs, compared with noninvasive NFPAs, using gene expression profiling by RNA sequencing. MethodsWe obtained frozen fresh tissue samples from 14 patients with NFPAs who underwent primary transsphenoidal surgery. Three non-invasive and 11 invasive NFPAs were used for RNA sequencing. The bioinformatics analysis included differential gene expression, gene ontology analysis, and pathway analysis. ResultsA total of 700 genes were differentially expressed (59 up-regulated and 641 down-regulated genes) between invasive and non-invasive NFPAs (false discovery rate <0.1, and |fold change| ≥2). Using the down-regulated genes in invasive NFPAs, gene ontology enrichment analyses and pathway analyses demonstrated that the local immune response was attenuated and that transforming growth factor-β (TGF-β) RII-initiated TGF-β signaling was down-regulated in invasive NFPAs. The overexpression of claudin-9 (CLDN9) and the down-regulation of insulin-like growth factor-binding protein 5 (IGFBP5), death-associated protein kinase 1 (DAPK1), and tissue inhibitor of metalloproteinase-3 (TIMP3) may be related with invasiveness in NFPAs. ConclusionInvasive NFPAs harbor different gene expression profiles relative to noninvasive NFPAs. In particular, local suppression of the immune response and TGF-β signaling can make PAs prone to invasiveness.
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Citations
Citations to this article as recorded by
- Research status and prospects of pituitary adenomas in conjunction with neurological and psychiatric disorders and the tumor microenvironment
Siyuan Cui, Sainan Chen, Xuechao Wu, Qing Wang Frontiers in Neuroscience.2024;[Epub] CrossRef - Immune landscape and progress in immunotherapy for pituitary neuroendocrine tumors
Xiaopeng Guo, Yiying Yang, Zhihong Qian, Mengqi Chang, Yuanli Zhao, Wenbin Ma, Yu Wang, Bing Xing Cancer Letters.2024; : 216908. CrossRef - Transcriptome of GH-producing pituitary neuroendocrine tumours and models are significantly affected by somatostatin analogues
Rihards Saksis, Olesja Rogoza, Helvijs Niedra, Kaspars Megnis, Ilona Mandrika, Inga Balcere, Liva Steina, Janis Stukens, Austra Breiksa, Jurijs Nazarovs, Jelizaveta Sokolovska, Ilze Konrade, Raitis Peculis, Vita Rovite Cancer Cell International.2023;[Epub] CrossRef - PD-L1 Expression in Pituitary Neuroendocrine Tumors/Pituitary Adenomas
Giulia Cossu, Stefano La Rosa, Jean Philippe Brouland, Nelly Pitteloud, Ethan Harel, Federico Santoni, Maxime Brunner, Roy Thomas Daniel, Mahmoud Messerer Cancers.2023; 15(18): 4471. CrossRef - Aggressive PitNETs and Potential Target Therapies: A Systematic Review of Molecular and Genetic Pathways
Simona Serioli, Ludovico Agostini, Alberto Pietrantoni, Federico Valeri, Flavia Costanza, Sabrina Chiloiro, Barbara Buffoli, Amedeo Piazza, Pietro Luigi Poliani, Maria Peris-Celda, Federica Iavarone, Simona Gaudino, Marco Gessi, Giovanni Schinzari, Pier P International Journal of Molecular Sciences.2023; 24(21): 15719. CrossRef - Muti-omics integration analysis revealed molecular network alterations in human nonfunctional pituitary neuroendocrine tumors in the framework of 3P medicine
Siqi Wen, Chunling Li, Xianquan Zhan EPMA Journal.2022; 13(1): 9. CrossRef - A systematic review of molecular alterations in invasive non-functioning pituitary adenoma
Nazanin Hosseinkhan, Maryam Honardoost, Zahra Emami, Sara Cheraghi, Nahid Hashemi-Madani, Mohammad E. Khamseh Endocrine.2022; 77(3): 500. CrossRef - Medication for Acromegaly Reduces Expression of MUC16, MACC1 and GRHL2 in Pituitary Neuroendocrine Tumour Tissue
Rihards Saksis, Ivars Silamikelis, Pola Laksa, Kaspars Megnis, Raitis Peculis, Ilona Mandrika, Olesja Rogoza, Ramona Petrovska, Inga Balcere, Ilze Konrade, Liva Steina, Janis Stukens, Austra Breiksa, Jurijs Nazarovs, Jelizaveta Sokolovska, Valdis Pirags, Frontiers in Oncology.2021;[Epub] CrossRef - Large Scale Molecular Studies of Pituitary Neuroendocrine Tumors: Novel Markers, Mechanisms and Translational Perspectives
Raitis Peculis, Helvijs Niedra, Vita Rovite Cancers.2021; 13(6): 1395. CrossRef - Nkx3-1 and Fech genes might be switch genes involved in pituitary non-functioning adenoma invasiveness
Nasibeh Khayer, Maryam Jalessi, Amin Jahanbakhshi, Alireza Tabib khooei, Mehdi Mirzaie Scientific Reports.2021;[Epub] CrossRef - The tumour microenvironment of pituitary neuroendocrine tumours
Pedro Marques, Ashley B. Grossman, Márta Korbonits Frontiers in Neuroendocrinology.2020; 58: 100852. CrossRef - The Progress of Immunotherapy in Refractory Pituitary Adenomas and Pituitary Carcinomas
Congxin Dai, Siyu Liang, Bowen Sun, Jun Kang Frontiers in Endocrinology.2020;[Epub] CrossRef
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