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DIVERSOS ASPECTOS DE LA EXPERIENCIA CON ADENOMAS HIPOFISARIOS

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.
wasko9.jpg Autor:
Ryszard Wasko
Columnista Experto de SIIC
Artículos publicados por Ryszard Wasko
Coautor
Magdalena Jaskula* 
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 Junio, 2021

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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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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Clasificación en siicsalud
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Especialidades
Principal: Neurología, Oncología
Relacionadas: Anatomía Patológica, Diagnóstico por Imágenes, Diagnóstico por Laboratorio, Endocrinología y Metabolismo, Farmacología, Medicina Interna, Medicina Nuclear, Neurocirugía



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Enviar correspondencia a:
Ryszard Wasko, University of Medical Sciences in Poznan Departament of Endocrinology, Metabolism and Internal Diseases, 60-355, Przybyszewskiego 49, Poznan, Polonia
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