Endocrine Abstracts

Introduction: Activation of the hypothalamic–pituitary–adrenal axis is critical for adaptation to stress and serious illness. The imbalance between anti-inflammatory activity of cortisol and proinflammatory activity of the androgens, dehydroepiandrosterone (DHEA) and dihydroepiandrosterone sulfate (DHEAS) can be an important predictor factor of mortality in sepsis.Material and methods: Patients diagnosed of severe sepsis or septic shock admitte...

Background and aim: Up to now, there is paucity of studies concerning health status in adults with congenital adrenal hyperplasia (CAH). We aimed to examine a group of adult CAH patients from different Czech centers.Methods: Serum lipids, glucose, blood pressure and anhtropometrics were compared in 31 males and 71 females with CAH 21-hydroxylase deficiency and in healthy population from Czech post-MONICA study (1% random population sample).<p class="...

Introduction: Most serum cortisol (SeC) is linked to cortisol binding globulin and albumin. When the synthesis of proteins is reduced or increased, SeC does not reflect the actual free cortisol (FC) (active fraction). Methods for FC analysis are very laborious and expensive, which makes difficult to use them as a routine laboratory tests. Salivary cortisol (SaC) mirrors the FC in serum, being its measurement easier and cheaper. The determination of SaC, instead of tot...

Introduction: Glucocorticoid replacement for adrenal insufficiency (AI) remains inadequate, resulting in high morbidity, premature mortality and quality-of-life (QoL) impairment. This study investigated the long-term safety of dual-release hydrocortisone (DR-HC) in patients with primary AI.Methods: AI patients who completed a randomized, 3-month crossover study of once-daily DR-HC versus thrice-daily conventional immediate-release hydrocortisone plus a 6...

Background: Mutations of 21-hydroxylase (CYP21A2) cause congenital adrenal hyperplasia. Its severe (classic) form constitutes a life-threatening disease. Patients suffer a significant disease burden due to co-morbidities that are often treatment-related. The current therapeutic situation is unsatisfying and demands novel treatment approaches. In silico modelling suggests protein misfolding and intracellular retention to play a significant role in the pathogenesis of C...

Introduction: Patients with adrenal insufficiency (AI) (primary (PAI), secondary to pituitary disease (PIT) and congenital adrenal hyperplasia (CAH)) have reduced life expectancy with reported standardized mortality ratios of ~2:1 but given the rarity of AI, the underlying explanation remains largely unknown.Objective: To evaluate patient characteristics, prevalence of concomitant conditions and hospitalization incidence in patients with AI compared to a...

Conventional glucocorticoids (GCs) are unable to mimic physiological cortisol rhythm in adrenal insufficiency (AI), with a significant impact on morbidity and mortality. Possible explanations are supra-physiological doses and impaired cortisol profile. In particular, elevated evening cortisol levels were related to glucose tolerance and insulin sensitivity alterations and visceral obesity. Once-daily-dual-release-hydrocortisone (OD-DR-HC), better reproducing the physiological ...

Objective: In subclinical Cushing’s syndrome (SC), it is assumed that glucocorticoid production is insufficient to cause a clinically recognizable syndrome. Differences in hormonal levels or recovery time of the hypothalamic–pituitary–adrenocortical (HPA) axis after adrenalectomy between patients with overt Cushing’s syndrome (OC) and SC remain unknown.Design and patients: Thirty seven patients (ten were OC and 27 were SC) with adrena...

In an attempt, to overcome the lack of preclinical models for adrenocortical carcinoma (ACC), we recently aimed at the development of patient-individual tumor models for ACC. During these studies one xenograft (MUC-1), derived from a neck metastasis of an ACC, showed extraordinary engraftment properties and sustained tumor growth over several passages in the murine host. During ongoing studies we investigated and compared all currently available xenograft models for ACC (NCI-H...

Introduction: Luteinizning hormone (LH/hCG) responsiveness has been documented in both normal and pathological adrenal glands, but it is unclear whether chronic exposure to LH could affect adrenal function by increasing LH receptor (LHR) expression.Subjects and methods: We studied 12 postmenopausal women with previously documented adrenal tumor. All patients underwent standard hormonal testing for assessment of tumor functionality. Then hCG test was perf...