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Molecular and Cellular Endocrinology Apr 2021The pituitary gland embodies our endocrine hub and rigorously regulates hormone balances in the body, thereby ruling over vital developmental and physiological... (Review)
Review
The pituitary gland embodies our endocrine hub and rigorously regulates hormone balances in the body, thereby ruling over vital developmental and physiological processes. Pituitary dysfunction and disease strongly impact the organism's biology. Physical damage, tumour development and ageing all negatively affect pituitary state and functionality. On top of its hormone-producing cells, the pituitary contains a population of stem cells. Not only their physiological role is still largely unknown, also whether or how these stem cells are involved in pituitary disease and recovery from defective functionality remains enigmatic. Here, we summarize what is known on the phenotypical and functional behaviour of pituitary stem cells in diseased or dysfunctional gland, as particularly caused by injury, tumourigenesis and ageing.
Topics: Aging; Animals; Carcinogenesis; Humans; Models, Biological; Organoids; Pituitary Diseases; Stem Cells
PubMed: 33503464
DOI: 10.1016/j.mce.2021.111176 -
Cellular and Molecular Life Sciences :... Mar 2021The pituitary plays a pivotal role in maintaining systemic homeostasis by secreting several hormones. During fetal development, the pituitary develops from the oral... (Review)
Review
The pituitary plays a pivotal role in maintaining systemic homeostasis by secreting several hormones. During fetal development, the pituitary develops from the oral ectoderm in contact with the adjacent hypothalamus. This process is regulated by the fine-tuned expression of transcription and growth factors. Impairments of this process result in congenital pituitary hypoplasia leading to dysfunction of the pituitary. Although animal models such as knockout mice have helped to clarify these underlying mechanisms, the developmental processes of the human pituitary gland and the mechanisms of human pituitary disorders have not been fully understood. This is because, at least in part, of the lack of a human pituitary developmental model. Recently, methods for in vitro induction of the pituitary gland from human pluripotent stem cells were developed. These models can be utilized not only for regenerative medicine but also for human pituitary studies on developmental biology and for modeling of pituitary disorders, such as hypopituitarism and pituitary tumors. In this review, we provide an overview of recent progress in the applications of pluripotent stem cells for pituitary research and discuss further perspectives for pituitary studies.
Topics: Animals; Cell Culture Techniques; Cell Differentiation; Cells, Cultured; Humans; Induced Pluripotent Stem Cells; Pituitary Diseases; Pituitary Gland; Pluripotent Stem Cells; Regenerative Medicine
PubMed: 33206204
DOI: 10.1007/s00018-020-03692-8 -
Annales D'endocrinologie Oct 2017Behaviour may be influenced by pituitary hormones or treatments. Dopamine agonist (DA) indicated in prolactinomas treatment can cause side effects, and especially... (Review)
Review
Behaviour may be influenced by pituitary hormones or treatments. Dopamine agonist (DA) indicated in prolactinomas treatment can cause side effects, and especially impulse control disorders. In the context of prolactinomas treatment, impulse control disorders (ICD) have been reported like gambling, compulsive shopping, but mostly hypersexuality. These ICD can occur with low AD doses, and seem to be independent of type of molecule and psychiatric medical history. The main pathophysiologic hypothesis is a dysregulation of dopaminergic pathway involved in reward system. Given the possible devastating social impact of these ICD, they have to be screened in patients treated with DA. Our social behaviour can also be impacted by oxytocin. This hormone secreted on physiologic state at posterior pituitary, but also by others areas of brain and brainstem, has an impact on attachment in pair partners and in parent-child relationship, but also in empathy behaviour. Oxytocin affects as well eating behaviour with an anorexigenic impact. Studies on small populations assessed the relevance of an oxytocin treatment in several endocrine and nutritional pathologies like post-surgery craniopharyngioma, panhypopituitarism and obesity. Despite promising results, several pitfalls prevent yet the oxytocin use in clinical practice.
Topics: Adult; Behavior; Child; Compulsive Behavior; Dopamine Agonists; Empathy; Humans; Interpersonal Relations; Oxytocin; Parent-Child Relations; Pituitary Diseases; Pituitary Gland; Pituitary Hormones
PubMed: 29157488
DOI: 10.1016/S0003-4266(17)30924-1 -
Journal of Clinical Neuroscience :... Jul 2016Fungal infection should be considered in the differential diagnosis of a pituitary or sellar mass, albeit fungal infections involving the pituitary gland and sella are a...
Fungal infection should be considered in the differential diagnosis of a pituitary or sellar mass, albeit fungal infections involving the pituitary gland and sella are a rare occurrence. We report a case of Aspergillus infection involving the pituitary gland and sellar region discovered in a 74-year-old man. The patient had a history of hypertension, chronic renal disease, autoimmune hemolytic anemia and presented with right eye pain, headaches and worsening hemiparesis. Imaging studies revealed a right internal carotid artery occlusion and an acute right pontine stroke along with smaller infarcts in the right middle cerebral artery distribution. Clinically, the patient was thought to have vasculitis. An infectious etiology was not identified. He developed respiratory distress and died. At autopsy, necrotizing meningitis was discovered. A predominantly chronic inflammatory cell infiltrate consisting of benign-appearing lymphocytes, plasma cells and macrophages was accompanied by acute angle branching, angioinvasive hyphae which were highlighted on Gomori methenamine silver staining and were morphologically consistent with Aspergillus species. In previously reported cases of Aspergillus infection involving the pituitary or sella, most presented with headaches or impaired vision and were not immunocompromised. A transsphenoidal surgical approach is recommended in suspected cases in order to minimize the risk of dissemination of the infection. Some patients have responded well to antifungal medications once diagnosed.
Topics: Aged; Anemia, Hemolytic, Autoimmune; Aspergillosis; Comorbidity; Diagnosis, Differential; Fatal Outcome; Humans; Hypertension; Immunocompromised Host; Male; Pituitary Diseases; Renal Insufficiency, Chronic
PubMed: 26896907
DOI: 10.1016/j.jocn.2016.01.010 -
Neurology India 2020The most common sellar pathology that merits neurosurgical attention is the pituitary adenoma. However, some developmental, inflammatory, and neoplastic lesions may... (Review)
Review
The most common sellar pathology that merits neurosurgical attention is the pituitary adenoma. However, some developmental, inflammatory, and neoplastic lesions may primarily or secondarily involve the sella, mimicking pituitary tumors. Advances in imaging and endocrinological assessment have helped in the recognition of these less common sellar, supra sellar pathologies, which may occasionally create confusion in management. The most common developmental anomaly is the Rathke's cleft cyst and an increasingly recognized inflammatory pathology is the spectrum of hypophysitis. Neoplasms, viz. Craniopharyngioma, Germinoma, Langerhans's cell histiocytosis or metastasis, have more distinctive features in various age groups and are more likely to be correctly diagnosed on current imaging and managed accordingly. This review looks at mainly intraparenchymal pathologies, namely Rathke's Cleft Cyst and various hypophysitides, and will discuss their management strategies.
Topics: Central Nervous System Cysts; Craniopharyngioma; Diagnosis, Differential; Humans; Pituitary Diseases; Pituitary Neoplasms
PubMed: 32611908
DOI: 10.4103/0028-3886.287682 -
European Journal of Internal Medicine Oct 2019The pituitary is an endocrine gland with ability to uptake diverse radiopharmaceuticals and, therefore, susceptible to be investigated by nuclear medicine diagnostic... (Review)
Review
The pituitary is an endocrine gland with ability to uptake diverse radiopharmaceuticals and, therefore, susceptible to be investigated by nuclear medicine diagnostic procedures. Although this topic has been scarcely scrutinized, we have data indicating that somatostatin receptor scintigraphy withIn-DTPA-D-Phe-octreotide or Tc-EDDA/HYNIC-TOC may be of clinical utility in the diagnosis of some pituitary adenomas (PA). Only a few studies have evaluated the diagnostic performance of Tc-MIBI and Tc (V)-DMSA scintigraphy in pituitary disease. Scintigraphy using I-methoxybenzamide (I-IBZM) might be useful in macroprolactinomas expressing dopamine D2 receptors. Pituitary gland does not usually accumulate 2-deoxy-2-[F]fluoro-d-glucose (F-FDG) and, therefore, it is not visualized on positron emission tomography (PET) imaging studies with this radiotracer. The pituitary uptake onF-FDG PET/CT scans performed in the follow-up of oncological patients are uncommon. However, 60% of these incidental findings are due to PA, mainly non-functioning pituitary macroadenomas, and a small percentage to metastases or other pituitary lesions. Interestingly, F-FDG PET/CT may identify hypophysitis induced by different immunotherapeutic agents used in cancer patients. Positive F-FDG uptake has been reported in a high percentage of patients with PA, mainly macroadenomas and it seems that there is correlation between tumor size and SUVmax. Ga-DOTA-TATE PET/CT may identify functioning and non-functioning PA, although this technique is more useful in the detection of remaining normal pituitary tissue after transsphenoidal adenomectomy, and in the confirmation of recurrence of functioning PA, such as thyrotroph-secreting PA. Furthermore, Ga-DOTA-TATE uptake has potential therapeutic implications on molecular-targeted therapy. Lastly, other radiopharmaceuticals that have shown to be taken up in some patients with pituitary disease include F-DOPA (prolactinoma), C-methionine (residual or recurrent PA), O-(2-F-fluoroethyl)-l-tyrosine (metastasis), F-choline (silent adenoma, ectopic corticotropinoma), and N-ammonia (hypopituitarism).
Topics: Adenoma; Cysts; Fluorodeoxyglucose F18; Humans; Hypothyroidism; Nuclear Medicine; Pituitary Diseases; Pituitary Gland; Pituitary Neoplasms; Positron-Emission Tomography
PubMed: 31519379
DOI: 10.1016/j.ejim.2019.08.008 -
Comprehensive Physiology Sep 2015Research in neuroendocrinology faces particular challenges due to the complex interactions between cells in the hypothalamus, in the pituitary gland and in peripheral... (Review)
Review
Research in neuroendocrinology faces particular challenges due to the complex interactions between cells in the hypothalamus, in the pituitary gland and in peripheral tissues. Within the hypothalamus alone, attempting to target a specific neuronal cell type can be problematic due to the heterogeneous nature and level of cellular diversity of hypothalamic nuclei. Because of the inherent complexity of the reproductive axis, the use of animal models and in vivo experiments are often a prerequisite in reproductive neuroendocrinology. The advent of targeted genetic modifications, particularly in mice, has opened new avenues of neuroendocrine research. Within this review, we evaluate various mouse models used in reproductive neuroendocrinology and discuss the different approaches to generate genetically modified mice, along with their inherent advantages and disadvantages. We also discuss a variety of versatile genetic tools with a focus on their potential use in reproductive neuroendocrinology.
Topics: Animals; Gene Targeting; Genetic Therapy; Gonadal Disorders; Humans; Pituitary Diseases
PubMed: 26426463
DOI: 10.1002/cphy.c140079 -
The Veterinary Clinics of North... Aug 2018Equine athletes are affected by 2 major endocrine/metabolic disorders, insulin dysregulation (ID) and pituitary pars intermedia dysfunction. ID is a risk factor for... (Review)
Review
Equine athletes are affected by 2 major endocrine/metabolic disorders, insulin dysregulation (ID) and pituitary pars intermedia dysfunction. ID is a risk factor for laminitis in horses, which poses the greatest threat to performance because of the damage that it causes to hoof structures. This article includes an in-depth discussion of ID and other risk factors for laminitis that are grouped together as equine metabolic syndrome. As horses age, the risk of pituitary pars intermedia dysfunction increases, and this endocrine disorder may exacerbate preexisting ID and further increase the risk of laminitis.
Topics: Animals; Horse Diseases; Horses; Insulin Resistance; Pituitary Diseases; Pituitary Gland, Intermediate
PubMed: 29857965
DOI: 10.1016/j.cveq.2018.04.003 -
Vnitrni Lekarstvi 2016Vast majority of thyroid function disturbances have primary (peripheral) etiology due to thyroid gland disorders. Rarely, dysfunction of central regulatory structures,... (Review)
Review
Vast majority of thyroid function disturbances have primary (peripheral) etiology due to thyroid gland disorders. Rarely, dysfunction of central regulatory structures, hypothalamus and pituitary, can be a cause of both, hyperthyroidism and hypothyroidism. Despite being very rare, it is important to be aware of them not to misdiagnose their etiology. Early and correct etiological diagnosis is necessary for proper cure and decrease of morbidity and mortality of affected patients. Present review article summarizes basics and specific features of central disturbances of thyroid function, their clinical signs, diagnosis, differential diagnosis and treatment.Key words: hypothalamus - hyperthyroidism - hypothyroidism - pituitary - thyrotropinoma.
Topics: Adenoma; Humans; Hyperthyroidism; Hypothalamic Diseases; Hypothyroidism; Pituitary Diseases; Pituitary Neoplasms; Thyrotropin
PubMed: 27734697
DOI: No ID Found -
The Medical Clinics of North America Nov 2021Pituitary incidentalomas are discovered in approximately 10% to 40% of brain images. A complete patient history, physical examination, and dedicated pituitary function... (Review)
Review
Pituitary incidentalomas are discovered in approximately 10% to 40% of brain images. A complete patient history, physical examination, and dedicated pituitary function testing are needed, and subsequent results should lead to appropriate patient management. However, most lesions are asymptomatic pituitary adenomas or Rathke cleft cysts with a benign course. Many lesions can be clinically significant, including prolactinomas or other pituitary adenomas that warrant specific pituitary disease treatment. In other cases, mass effect causing visual compromise or refractory headache indicates a need for surgery. Here, various facets of a complex evaluation and treatment algorithm for pituitary incidentalomas are reviewed.
Topics: Adenoma; Diagnosis, Differential; Humans; Incidental Findings; Magnetic Resonance Imaging; Pituitary Diseases; Pituitary Gland; Pituitary Neoplasms
PubMed: 34688416
DOI: 10.1016/j.mcna.2021.05.015