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Journal of Internal Medicine Feb 2014Primary adrenal insufficiency (PAI), or Addison's disease, is a rare, potentially deadly, but treatable disease. Most cases of PAI are caused by autoimmune destruction... (Review)
Review
Primary adrenal insufficiency (PAI), or Addison's disease, is a rare, potentially deadly, but treatable disease. Most cases of PAI are caused by autoimmune destruction of the adrenal cortex. Consequently, patients with PAI are at higher risk of developing other autoimmune diseases. The diagnosis of PAI is often delayed by many months, and most patients present with symptoms of acute adrenal insufficiency. Because PAI is rare, even medical specialists in this therapeutic area rarely manage more than a few patients. Currently, the procedures for diagnosis, treatment and follow-up of this rare disease vary greatly within Europe. The common autoimmune form of PAI is characterized by the presence of 21-hydroxylase autoantibodies; other causes should be sought if no autoantibodies are detected. Acute adrenal crisis is a life-threatening condition that requires immediate treatment. Standard replacement therapy consists of multiple daily doses of hydrocortisone or cortisone acetate combined with fludrocortisone. Annual follow-up by an endocrinologist is recommended with the focus on optimization of replacement therapy and detection of new autoimmune diseases. Patient education to enable self-adjustment of dosages of replacement therapy and crisis prevention is particularly important in this disease. The authors of this document have collaborated within an EU project (Euadrenal) to study the pathogenesis, describe the natural course and improve the treatment for Addison's disease. Based on a synthesis of this research, the available literature, and the views and experiences of the consortium's investigators and key experts, we now attempt to provide a European Expert Consensus Statement for diagnosis, treatment and follow-up.
Topics: Acute Disease; Addison Disease; Adrenal Cortex; Adrenal Insufficiency; Algorithms; Autoantibodies; Autoimmunity; Chronic Disease; Consensus; Cortisone; Diagnosis, Differential; Drug Administration Schedule; Drug Interactions; Emergency Treatment; Europe; Female; Humans; Hydrocortisone; Male; Prednisolone; Pregnancy; Pregnancy Complications; Steroid 21-Hydroxylase
PubMed: 24330030
DOI: 10.1111/joim.12162 -
British Medical Journal Oct 1955
Topics: Colitis; Colitis, Ulcerative; Cortisone
PubMed: 13260656
DOI: 10.1136/bmj.2.4947.1041 -
BMC Biotechnology Jan 2021Bacterial degradation/transformation of steroids is widely investigated to create biotechnologically relevant strains for industrial application. The strain of...
BACKGROUND
Bacterial degradation/transformation of steroids is widely investigated to create biotechnologically relevant strains for industrial application. The strain of Nocardioides simplex VKM Ac-2033D is well known mainly for its superior 3-ketosteroid Δ-dehydrogenase activity towards various 3-oxosteroids and other important reactions of sterol degradation. However, its biocatalytic capacities and the molecular fundamentals of its activity towards natural sterols and synthetic steroids were not fully understood. In this study, a comparative investigation of the genome-wide transcriptome profiling of the N. simplex VKM Ac-2033D grown on phytosterol, or in the presence of cortisone 21-acetate was performed with RNA-seq.
RESULTS
Although the gene patterns induced by phytosterol generally resemble the gene sets involved in phytosterol degradation pathways in mycolic acid rich actinobacteria such as Mycolicibacterium, Mycobacterium and Rhodococcus species, the differences in gene organization and previously unreported genes with high expression level were revealed. Transcription of the genes related to KstR- and KstR2-regulons was mainly enhanced in response to phytosterol, and the role in steroid catabolism is predicted for some dozens of the genes in N. simplex. New transcription factors binding motifs and new candidate transcription regulators of steroid catabolism were predicted in N. simplex. Unlike phytosterol, cortisone 21-acetate does not provide induction of the genes with predicted KstR and KstR2 sites. Superior 3-ketosteroid-Δ-dehydrogenase activity of N. simplex VKM Ac-2033D is due to the kstDs redundancy in the genome, with the highest expression level of the gene KR76_27125 orthologous to kstD2, in response to cortisone 21-acetate. The substrate spectrum of N. simplex 3-ketosteroid-Δ-dehydrogenase was expanded in this study with progesterone and its 17α-hydroxylated and 11α,17α-dihydroxylated derivatives, that effectively were 1(2)-dehydrogenated in vivo by the whole cells of the N. simplex VKM Ac-2033D.
CONCLUSION
The results contribute to the knowledge of biocatalytic features and diversity of steroid modification capabilities of actinobacteria, defining targets for further bioengineering manipulations with the purpose of expansion of their biotechnological applications.
Topics: Actinobacteria; Bacterial Proteins; Cortisone; Gene Expression Profiling; Gene Expression Regulation, Bacterial; Metabolic Engineering; Metabolism; Mycobacterium; Nocardioides; Oxidoreductases; Phytosterols; Progesterone; Rhodococcus; Steroids; Transcription Factors; Transcriptome
PubMed: 33441120
DOI: 10.1186/s12896-021-00668-9 -
British Medical Journal Mar 1952
Topics: Arthritis; Arthritis, Rheumatoid; Cortisone; Hydrocortisone
PubMed: 14904993
DOI: No ID Found -
British Medical Journal Sep 1951
Topics: Cortisone; Heredity; Hypersensitivity; Immune System Diseases
PubMed: 14869638
DOI: No ID Found -
History and Philosophy of the Life... Nov 2019Cortisone, initially known as 'compound E' was the medical sensation of the late 1940s and early 1950s. As early as April 1949, only a week after Philip Hench and... (Review)
Review
Cortisone, initially known as 'compound E' was the medical sensation of the late 1940s and early 1950s. As early as April 1949, only a week after Philip Hench and colleagues first described the potential of 'compound E' at a Mayo Clinic seminar, the New York Times reported the drug's promise as a 'modern miracle' in the treatment of rheumatoid arthritis (RA). Given its high profile, it is unsurprising that historians of medicine have been attracted to study the innovation of cortisone. It arrived at the end of a decade of 'therapeutic revolutions', kicked off by penicillin transforming the treatment of bacterial infections and ending with hopes of a revolution in the treatment of non-infectious, chronic inflammatory diseases. Despite these studies of cortisone's introduction, few historians have taken the story forward and considered how cortisone was adopted and adapted into clinical practice. This article tells the longer of how the drug and its derivatives were taken from research laboratories and integrated into clinical practice; what has in recent decades become known as translational medicine (TM). In exploring cortisone's first decade in Britain, we focus specifically on its role in the treatment of RA. Our approach is always to consider cortisone's use in the context of other treatments available to clinicians, and at local and national institutional settings. We do not discuss the many other therapeutic uses of cortisone, which ranged for topical applications for skin diseases to the management of cancers, especially childhood leukaemia, nor do we discuss its close analogue ACTH-AdenoCorticoTropic Hormone. We think there are lessons in our study for TM policies today.
Topics: Arthritis, Rheumatoid; Cortisone; History, 20th Century; Humans; Translational Research, Biomedical; United Kingdom
PubMed: 31701313
DOI: 10.1007/s40656-019-0269-7 -
Journal of Neurology, Neurosurgery, and... Nov 1997A male patient with lymphocytic hypophysitis is reported on. Lymphocytic hypophysitis is a rare disease that may mimic pituitary adenoma and occurs mostly in women in...
A male patient with lymphocytic hypophysitis is reported on. Lymphocytic hypophysitis is a rare disease that may mimic pituitary adenoma and occurs mostly in women in the peripartum period. Only six other cases have been reported in men. Optimal treatment is unclear from the literature, as the results have been inconsistent and the reported cases few. The patient described here was successfully treated by means of transphenoidal surgery and a one year course of treatment with cortisone acetate.
Topics: Adult; Anti-Inflammatory Agents; Cortisone; Humans; Magnetic Resonance Imaging; Male; Pituitary Neoplasms; Pseudolymphoma
PubMed: 9408113
DOI: 10.1136/jnnp.63.5.672 -
The American Journal of Pathology Oct 1972Studies conducted to gain insight into the pathogenesis of experimental aspergillosis indicated that mice pretreated with cortisone acetate and then injected...
Studies conducted to gain insight into the pathogenesis of experimental aspergillosis indicated that mice pretreated with cortisone acetate and then injected intraperitoneally with nongerminating spores of Aspergillus flavus developed a high incidence of lethal visceral hyphal aspergillosis. A similar, high incidence of fatal infections was observed in cortisone-treated animals in which the number of peritoneal macrophages had been increased by prior injection of thioglycollate. To determine whether germination of spores within the host was important to the subsequent development of disseminated hyphal aspergillosis, germinating spores of A flavus were injected intraperitoneally into normal animals. While a similar dose of nongerminating spores, administered intraperitoneally into normal mice, induced a low incidence of lethal injection, germinating spores induced a high incidence of fatal disease associated with widely disseminated visceral hyphal aspergillosis. Our studies indicate that phagocytic cells in the peritoneal cavity of normal mice are able to ingest nonperminating spores of A flavus and kill them, preventing germination. However, the phagocytic cells are unable to cope with early germinating spores, which then continue to proliferate, leading to extensive hyphal invasion of visceral organs and death.
Topics: Adrenal Glands; Animals; Aspergillosis; Aspergillus flavus; Cortisone; Female; Kidney; Lung; Mice; Pancreas; Phagocytosis; Spleen; Spores, Fungal; Stomach; Thioglycolates
PubMed: 4628112
DOI: No ID Found -
British Medical Journal Nov 1955
Topics: Cortisone
PubMed: 13269832
DOI: No ID Found -
Gut Feb 1997
Topics: Adrenocorticotropic Hormone; Animals; Cortisone; Dogs; History, 20th Century; Stomach Ulcer
PubMed: 9071951
DOI: 10.1136/gut.40.2.289-b