DIVERSOS ASPECTOS DE LA EXPERIENCIA CON ADENOMAS HIPOFISARIOS

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DIVERSOS ASPECTOS DE LA EXPERIENCIA CON ADENOMAS HIPOFISARIOS
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Descripción de nuestra experiencia en el tratamiento de los tumores hipofisarios de tipo somatotropinoma y prolactinoma, así como de nuestros estudios sobre la aparición de apoptosis y de la expresión de grelina y survivina en pacientes con adenomas hipofisarios.

Autor:
Ryszard Wasko
Columnista Experto de SIIC
Artículos publicados por Ryszard Wasko

Coautor
Jaskula Magdalena*
University of Medical Sciences in Poznan, Poznan, Polonia*

Recepción del artículo
9 de Marzo, 2007

Aprobación
8 de Octubre, 2007

Primera edición
30 de Noviembre, 2007

Segunda edición, ampliada y corregida
7 de Marzo, 2008

Resumen
Presentamos la experiencia que hemos tenido a lo largo de los años sobre el tratamiento de los tumores hipofisarios. Describimos de qué modo, por los cambios constantes en los estándares farmacoterapéuticos, evaluamos la eficacia y la tolerabilidad de diferentes fórmulas (bromocriptina, quinagolida y cabergolina) en prolactinomas y en pacientes con acromegalia (análogos de la somatostatina: octreotide LAR y lanreotida). También se documentó la aparición de apoptosis en somatotropinomas pretratados con lanreotida o con octreotida LAR en los tejidos de nuestros tumores hipofisarios. Observamos que las concentraciones de grelina eran inferiores en los pacientes tratados con análogos de la somatostatina comparados con los pacientes que no recibieron este tratamiento. También examinamos la expresión de grelina en los somatotropinomas hipofisarios. Asimismo investigamos la expresión de survivina -péptido que participa en la inhibición de la apoptosis- en diferentes tipos de adenomas hipofisarios (somatotrofos, no funcionantes y prolactinomas). Observamos que el ARNm de la survivina estaba presente en los tumores hipofisarios, pero no hubo ninguna diferencia en la expresión de survivina entre los grupos de tumores. Actualmente estamos planeando otros estudios con nuevos análogos de la somatostatina (SOM 230) y pegvisomant en casos de pacientes acromegálicos. También nos concentramos en la creación de nuevos métodos isotópicos de diagnóstico y tratamiento de los pacientes con tumores hipofisarios (centellograma hipofisario con análogos de la somatostatina marcados con tecnecio 99 y terapia con uso de isótopos que emiten radiación beta [itrio 90] y alfa).

Palabras clave
tumores hipofisarios, acromegalia, octreotida de acción prolongada, grelina, apoptosis, survivina

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Especialidades

Principal: Oncología, Neurología

Relacionadas: Anatomía Patológica, Diagnóstico por Imágenes, Diagnóstico por Laboratorio, Endocrinología y Metabolismo, Farmacología, Medicina Interna, Medicina Nuclear, Neurocirugía

Enviar correspondencia a:
Ryszard, Wasko, University of Medical Sciences in Poznan Departament of Endocrinology, Metabolism and Internal Diseases, Przybyszewskiego 49, 60-355, Poznan, Polonia, E-mail: rwasko@amp.edu.pl

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The Clinical and Molecular Aspects of our Experience with Pituitary Tumours - The Review

Abstract
We present our experince over the years with the treatment of pituitary tumours. We describe how, with constant changes of pharmacotherapy standarts, we were evaluating the efficacy and tolerability of different formulations (bromocriptine, quinagolide and cabergoline) in prolactinomas as well as in patients with acromegaly (somatostatin analogues - octreotide LAR and lanreotide). The occurence of apoptosis in somatotropinomas pretreated with lanreotide or with octreotide LAR was also documented in our pituitary tumour tissues. Apoptosis was also confirmed to occur under the influence of somatostatin analogues and bromocriptine in GH3 cells in vitro. In further studies we paid more attention to ghrelin in cases of patients with GH hypersecretion, as one of the factors involved in the etiology of pituitary tumours. We found ghrelin concentrations to be lower in patients treated with somatostatin analogues compared to patients who didn't received such treatment. We also examined the expression of ghrelin in pituitary somatotropinomas. We also investigated the expression of survivin - peptide involved into inhibition of apoptosis - in different types of pituitary adenomas (somatotroph, non-functioning and prolactinomas). We found survivin mRNA to be present in pituitary tumours, but there was no difference in survivin expression between pituitary tumours groups. Currently we're also planning other studies with new somatostatin analogues (SOM 230) and pegvisomant in cases of acromegalic patients. We also focus on developing new isotopic methods of diagnosing and treating patients with pituitary tumours (pituitary scintigraphy with somatostatin analogues labeled with Tc99 and the therapy with the use of isotopes that emmiter beta (Ytrium90) and alpha radiation).

Key words
pituitary tumours, acromegaly, long acting octreotide, ghrelin, apoptosis, survivin

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Bibliografía del artículo 1. Aron DC, Ross NS. Pituitary "incidentaloma". Ann Intern Med 113:558-559, 1990.
2. Molitch ME. Medical treatment of prolactinomas. Endocrinol Metab Clin North Am 28:143, 1999.
3. Molitch ME, Elton RI, Blackwell RE et al. Bromocriptine as primary therapy for prolactin-secreting macroadenomas results of a prospective multicenter study. J Clin Endocrinol Metab 82:3574, 1997.
4. Cicarelli E, Cammani F. Diagnosis and drugtherapy of prolactinoma. Drugs 51:954, 1996.
5. Biller BMK, Molitch ME, Vance ML et al. Treatment of prolactin secreting macroadenomas with the once-weekly dopamine agonist Cabergoline. J Clin Endocrinol Metab 81:2338, 1996.
6. Liuzzi A, Dallabonzana D, Oppizzi G et al. Low doses of dopamine agonists in the long treatment of macroprolactinomas. N Engl J Med 313:656, 1985.
7. Bevan JS, Webster J, Burke CW et al. Dopamine agonists and pituitary tumour shrinkage. Endocr Rev 13:221, 1992.
8. Wasko R, Bocian-Sobkowska J, Krzyzagórska E, Kozak W, Horst-Sikorska W. Wyniki leczenia bromokryptyna chorych z guzami przysadki typu prolaktinoma. Med News 63:16-23, 1994.
9. Thorner MO, Fluckinger E, Calne DB. Bromocriptine: a clinical and pharmacological rewiew. New York, Raven Press pp. 1435, 1980.
10. Verhels J, Abs R, Maiter D et al. Cabergoline in the treatment of hyperprolactinaemia: a study in 455 patients. J Clin Endocrinol Metab 84:2518, 1999.
11. Colao A, Annunziato L, Lombardi G. Treatment of prolactinomas. Ann Med 30:452, 1998.
12. Guido R, Valenti S, Foppiani L, De Martini D, Cossu M, Giusti M. Prolactin decrease and shift to a normal-like isoform profile during treatment with quinagolide ina patient affected by an invasive prolactinoma. J Endocrinol Invest 20:289, 1997.
13. Vance ML. New direction in the treatment of hyperprolactinaemia. Endocrinologist 7:153, 1997.
14. Wasko R. Norprolac - nowy lek w leczeniu gruczolaków typu prolactinoma opornych na leczenie bromkryptyna. Pol J Endocrinol 50:139-146, 1999.
15. Brownell J. Quinagolide (Norprolac registered): a novel non-ergot prolactin inhibitor. Drugs Today 7:153, 1997.
16. Sabuncu T, Arikan E, Tasan E, Hatemi H. Comparison of the effects of cabergoline and bromocriptine in hyperprolactinemic patients. Intern Med 40:857, 2001.
17. Ferrari CI, Abs R, Bevan JS et al. Treatment of macroprolactinoma with cabergoline: a study of 85 patients. Clin Endocrinol Oxf 46:409, 1997.
18. Bolko P, Jaskula M, Wasko R, Wolun M, Sowinski J. The assesment of cabergoline efficacy and tolerability In patients with pituitary adenomas prolactinoma type. Pol Arch Int Med 109(5):489-95, 2003.
19. Sassolas G. Medical therapy with somatostatin analogues in acromegaly. J Endocrinol 19:26, 1996.
20. Marek J, Hana V, Krsek M, Justova V, Catus F, Thomas F. Long-term treatment of acromegaly with the slow-release somatostatin analogue lanreotide. Eur J Endocrinol 131:20, 1994.
21. Faggiano A, Merola B, Lombardi G. New medical approaches in pituitary adenomas. Horm Res 53, 2000.
22. Colzzi R, Dallabonzana D, Attanasio R, Barausse M, Oppizzi G. A comparison between octreotide LAR and lanreotide SR in the chronic treatment of acromegaly. Eur J Endocrinol 141:267, 1999.
23. Davies PH, Stewart SE, Lancranjan L, Shepard MC, Stewart PM. Long-term therapy with long acting octreotide (sandostatin LAR) for the management of acromegaly. Clin Endocrinol Oxf 48:311, 1998.
24. Stewart PM. Current therapy for acromegaly. Trends Endocrinol Metab 23:12-18, 2000.
25. Wasko R, Ruchala M, Sawicka J, Liebert W, Kotwicka M, Sowinski J. Short-term presurgical treatment with somatostatin analogues, octreotide and lanreotide in aromegaly. J Clin Endocrinol Invest Metab 23:12-18, 2000.
26. Wasko R, Horst-Sikorska W, Kozak W, Wolun M, Sowinski J. Wplyw podawania Lanreotydu na czynnosc wydzielnicza przysadki u chorych z akromegalia. Pol J Endocrinol 51:413-22, 2000.
27. Wasko R. Apoptoza w leczeniu guzów przysadki typu somatotropinoma. Assistant Proffessor dissertation paper, Karol Marcinkowski University of Medical Sciences, Poznan Poland.
28. Wasko R, Bolko P, Kostrzewski J, Horst-Sikorska W, Liebert W, Sowinski J. Ocena skutecznosci oktreotydu LAR u pacjentów z guzami przysadki typu somatotropinoma. Pol Arch Int Med 106:693-98, 2001.
29. Wasko R, Bolko P, Owecki M, Jaskula M, Sowinski J. The efficacy of octreotide LAR (long acting release) treatment in patients with somatotropinoma, and mixed pituitary tumours. Pharmacy World and Science 26:324-27, 2004.
30. Waligórska J, Wasko R, Bolko P, Jaskula M, Sowinski J. Estimate of influence of the somatostatin analogues administration on the lipid metabolizm in the patients with acroemgaly. Pol J Endocrinol 54(5),545-49, 2003.
31. Colao A, Marzullo P, Lombardi G. Effect of a six-month treatment with lanreotide on cardiovascular risk factors and intima media thickness in patients with acromegaly. Eur J Endocrinol 146:303-309, 2002.
32. Colao A, Cuocolo A, Marzullo P et al. Effects of one-year treatment with octreotide on cardiac performance in patients with acromegaly. J Clin Endocrinol Metab 84:17-23, 1999.
33. Hoyer D, Bell GI, Berelowitz M, Epelbaum L, Feniuk W, Humphrey PPA, O'Carroll AM, Patel YC, Schonbrunn A, Taylor JE, Reisine T. Classification and nomenclature of somatostatin receptors. Elsevier Science 16:86, 1995.
34. Viollet C, Prevost G, Maubert E, Faivre-Bauman A, Gardette R, Kordon C, Loudes C, Slama A, Eperbaum J. Molecular pharmacology of somatostatin receptors. Fundam Clin Pharmacol 9:107, 1995.
35. Yin D, Kondo S, Takeuchi J, Morimura T. Induction of apoptosis in murine ACTH-secreting pituitary adenoma cells by bromocriptine. FEBS lett 339:73-75, 1994.
36. Kontogeorgos G, Sambaziotis D, Piaditis G, Karameris A. Apoptosis in human pituitary adenomas: a morphologic and in situ end labeling study. Mod Pathol 10:921-926, 1997.
37. Saitoh Y, Arita N, Ohnishi T, Ekramullah S, Takemura K, Hayakawa T. Absence of apoptosis in somatotropinomas treated with octreotide. Acta Neurochir (Wien) 139:851-856, 1997.
38. Gruszka A, Pawlikowski M, Kunert-Radek J. Anti-tumoral action of octreotide and bromocriptine on the experimental rat prolactinoma: anti-proliferative and proapoptotic effects. Neuroendocrinol Lett 22:343-348, 2001.
39. Wasko R, Jankowska A, Kotwicka M, Liebert W, Sowinski J, Warchol JB.
Effects of treatment with somatostatin analogues on the occurrence of apoptosis in somatotropinomas. Neuroendocrinology Letters 24(5):334-338, 2003.
40. Wasko R, Wolun-Cholewa M, Bolko P, Kotwicka M. Effect of bromocriptine on cell apoptosis and proliferation in GH3 cell culture. Neuroendocrinology Letters 25:223-228 , 2004.
41. Wasko R, Wolun M, Warchol JB. Induction of apoptosis by bromocriptine in GH3 culture cells. Fol Histoch Cytobiol 37:123-124 , 1999.
42. Wasko R, Jankowska A, Kotwicka M, Warchol JB, Libert W, Gembicki M. Induction of apoptosis in hypophyseal somatotropinoma cells with a long-acting somatostatin analogue (lanreotide). J Endocrinol Invest 20:76, 1997.
43. Wasko R, Jankowska A, Kotwicka M, Liebert W, Gembicki M, Warchol JB. Apoptosis in prolactinomas and somatotropinomas - The Effect of treatment with bromocriptine and somatostatin analogues. IV European Congress of Endocrinology. Sevilla Abstracts. P3-97, 1998.
44. Wasko R, Jankowska A, Wolun M, Kotwicka M, Liebert W, Warchol JB, Sowinski J. Studies of apoptosis in pituitary tumours. European Congress of Cell Biology, Bologna Abstracts p. 63, 1999.
45. Polak U, Jaskula M, Wasko R. The influence of lanreotide and octreotide in proliferation and apoptotic processes in GH3 cells culture. Acta Clinica Morphologica 5:3-9, 2002.
46. Wasko R, Jankowska A, Wolun M, Kotwicka M, Liebert W, Warchol JB, Gembicki M, Sowinski J. Apoptosis in somatotropinoma and prolactinoma type tumours. J Endocrinol Invest 22(Supl.):61, 1999.
47. Arvat E, Di Vito L, Broglio F. Preeliminary evidence that Ghrelin, the natural GH secretagogue (GHS)-receptor ligand, strongly stimulates GH secretion in humans. J Endocrinol Invest 23:493, 2000.
48. Van der Lely AJ, Tschöp M, Heiman ML, Ghigo E. Biological, physiological, pathophysiological, and pharmacological aspects of ghrelin. Endocrine Reviews 25(3):426-457, 2004.
49. Korbonits M, Bustin SA, Kojima M, Jordan S, Adams EF, Lowe DG et al. The expression of the growth hormone secretagogue receptor ligand ghrelin in normal and abnormal human pituitary and other neuroendocrine tumours. J Clin Endocrinol Metab 86:881-887, 2001.
50. Gnanapavan S, Kola B, Bustin SA, Morris DG, McGee P, Fairclough P et al. The tissue distribution of the m RNA of ghrelin and subtypes of its receptor, GHS-R, in humans. J Clin Endocrinol Metab 87:2988, 2002.
51. Korbonits M, Kojima M, Kangawa K, Grossman AB. Presence of ghrelin in normal and adenomatous human pituitary. Endocrine 14:101, 2001.
52. Kim K, Arai K, Sanno N, Osamura RY, Teramoto A, Shibasaki T. Ghrelin and growth hormone (GH) secretagogue receptor (GHSR) mRNA expression in human pituitary adenomas. Clin Endocrinol 54:759, 2001.
53. Nanzer A, Khalaf S, Mozid A, Fowkes R, Patel M, Burrin J, Grossman A, Korbonits M. Ghrelin exerts a proliferative effect on a rat pituitary somatotroph cell line via the mitogen-activated protein kinase pathway. Eur J Endocrinol 151:233-240, 2004.
54. Freda PU, Reyes CM, Conwell IM, Sundeen RE, Wardlaw SL. Serum ghrelin levels in acromegaly: effects of surgical and long-acting octreotide therapy. J Clin Endocrinol Metab 88:2037-44, 2003.
55. CappielloV, Ronchi C, Morpurgo PS, Epaminonda P, Arosio M, Beck-Peccoz P et al. Circulating ghrelin levels in basal conditions and during glucose tolerance test in acromegalic patients. Eur J Endocrinol 147:189-94, 2002.
56. Barkan AL, Dimaraki EV, Jessup SK, Symons KV, Ermolenko M, Jaffe CA. Ghrelin secretion in humans is sexually dimorphic, suppressed by somatostatin, and not affected by the ambient growth hormone levels. J Clin Endocrinol Metab 88:2180-84, 2003.
57. Van der Toorn FM, Janssen JA, Herder WW, Broglio F, Ghigo E, Der Lely AJ. Central ghrelin production does not substantially contribute to systemic ghrelin concentrations: a study in two subjects with active acromegaly. Eur J Endocrinol 147:195-99, 2002.
58. Di Vito L, Broglio F, Benso A, Gottero C, Prodam F, Papotti M et al. The GH-releasing effect of ghrelin, a natural GH secretagogue, is only blunted by the infusion of exogenous somatostatin in humans. Clin Endocrinol 56:643-48, 2002.
59. Norrelund H, Hansen TK, Orskow H, Hosoda H, Kojima M, Kangawa K et al. Ghrelin immunoreactivity in human plasma is suppressed by somatostatin. Clin Endocrinol 57:539-46, 2002.
60. Wasko R, Jaskula M, Komarowska H, Waligorska-Stachura J, Zamyslowska H, Sowinski J. Ghrelin concentrations in acromegalic patients in relation to the administered therapy. Neuroendocrinol Lett 27(1), 2006.
61. Wasko R, Jaskula M, Plewa R, Komarowska H, Poreba E, Gozdzicka-Jozefiak A, Liebert W, Bednarek J, Sowinski J. The evaluation of ghrelin mRNA expression in human somatotroph adenomas. Neuroendocrinol Lett 27(1), 2006.
62. Kamegai J, Tamura H, Shimizu T, Ishii S, Sugihara H. et al. Regulation of the ghrelin gene: growth hormone-releasing hormone upregulates ghrelin mRNA in th epituitary. Endocrinology 142(9):4154-57, 2001.
63. Kim PJ, Plescia J, Clevers H, Fearon ER, Altieri DC. Survivin and molecular pathogenesis of colorectal cancer. Lancet 362(9379):205-9, 2003.
64. Kajiwara Y, Yamasaki F, Hama S, Yahara K, Yoshioka H, Sugiyama K et al. Expression of survivin in astrocytic tumours: correlation with malignant grade and prognosis. Cancer 97(4):1077-83, 2003.
65. Grossman D, McNiff JM, Li F, Altieri DC. Expression and targeting of the apoptosis inhibitor, survivin, in human melanoma. J Invest Dermatol 113(6):1076-81, 1999.
66. Andersen MH, Thor SP. Survivin-a universal tumor antigen. Histol Histopathol 17(2):669-75, 2002.
67. Adida C, Haiou C, Gaulard P, Lepage E, Morel P, Briere J et al. Prognostic significance of survivin expression in diffuse large B-cell lymphomas. Blood 96(5):1921-5, 2000.
68. Adida C, Recher C, Raffoux E, Daniel MT, Taksin AL, Rousselot P et al. Expression and prognostic significance of survivin in the novo acute myeloid leukaemia. Br J Haematol 111(1):196-203, 2000.
69. Wasko R, Jankowska A, Waligorska-Stachura J, Andrusiewicz M, Jaskula M, Sowinski J. Survivin expression in pituitary adenomas. Neuroendocrinol Lett 26(3):209-12, 2005.

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Oncología, Neurología

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Anatomía Patológica

Diagnóstico por Imágenes

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