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Current and future treatment options for adrenal insufficiency
Purpose of review Patients with adrenal insufficiency (AI) irrespective of being on glucocorticoid replacement therapy still suffer from increased morbidity and mortality. A major contributing factor is an inability of conventional glucocorticoid treatment to mirror the physiological cortisol rhythm. Novel strategies to replicate the cortisol rhythm using hydrocortisone infusion pumps and oral modified release hydrocortisone have now been developed and confirmed to offer benefits to patients. Recent findings In the DREAM study, when compared to multiple daily dosing of glucocorticoids Plenadren reduced weight, w...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - April 30, 2021 Category: Endocrinology Tags: ADRENAL CORTEX AND MEDULLA: Edited by Irina Bancos and Diane Donegan Source Type: research

Thermal ablation in adrenal disorders: a discussion of the technology, the clinical evidence and the future
Purpose of review To summarise the emerging role of thermal ablation as a therapeutic modality in the management of functioning adrenal tumours and metastases to the adrenal gland. Recent findings Observational evidence has demonstrated the benefit of thermal ablation in (i) resolving adrenal endocrinopathy arising from benign adenomas, (ii) treating solitary metastases to the adrenal and (iii) controlling metastatic adrenocortical carcinoma and phaeochromocytoma/paraganglioma. Summary Microwave thermal ablation offers a promising, minimally invasive therapeutic modality for the management of functioning ...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - April 30, 2021 Category: Endocrinology Tags: ADRENAL CORTEX AND MEDULLA: Edited by Irina Bancos and Diane Donegan Source Type: research

Genetics of pheochromocytoma and paraganglioma
Purpose of review This review summarizes our current understanding of germline and somatic genetics and genomics of pheochromocytomas and paragangliomas (PCC/PGL), describes existing knowledge gaps, and discusses future research directions. Recent findings Germline pathogenic variants (PVs) are found in up to 40% of those with PCC/PGL. Tumors with germline PVs are broadly categorized as Cluster 1 (pseudohypoxia), including those with SDH, VHL, FH, and EPAS1 PVs, or Cluster 2 (kinase signaling) including those with NF1, RET, TMEM127, and MAX PVs. Somatic driver mutations exist in some of the same genes (RET, VHL,...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - April 30, 2021 Category: Endocrinology Tags: ADRENAL CORTEX AND MEDULLA: Edited by Irina Bancos and Diane Donegan Source Type: research

Cardiovascular and metabolic consequences in patients with asymptomatic adrenal adenomas
Purpose of review The incidence of adrenal tumors has increased over the past 20 years, most of which are incidentally discovered nonfunctioning adenomas (NFA) and tumors with mild autonomous cortisol secretion (MACS). This review aimed to summarize recent progress in understanding cardiometabolic risk in patients with NFA and MACS and to provide updates on the effect of treatment on improving outcomes in this population. Recent findings NFA and MACS are associated with adverse cardiovascular risk factors and metabolic derangements, which are likely mediated by excessive glucocorticoid secretion. Recent studie...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - April 30, 2021 Category: Endocrinology Tags: ADRENAL CORTEX AND MEDULLA: Edited by Irina Bancos and Diane Donegan Source Type: research

Approach to large adrenal tumors
Purpose of review To summarize the data concerning approach to large adrenal tumors (LAT's), since recent guidelines published in 2016 recommend individual approach rather than clear size cut-off of a tumor that should be removed. Recent findings Although the risk of malignancy clearly correlates with the size of a lesion, tumor size of more than 4 cm in diameter represents only 31–61% specificity for the diagnosis of malignant tumor. Therefore, the risk of malignancy and decision about surgery should not be based only on the size of a tumor but assessed in terms of imaging studies, growth pattern during fol...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - April 30, 2021 Category: Endocrinology Tags: ADRENAL CORTEX AND MEDULLA: Edited by Irina Bancos and Diane Donegan Source Type: research

Approach to patients with European Network for the Study of Adrenal Tumor stages I and II adrenocortical carcinomas
This article elaborates on the current understanding of the clinical approach to this group of patients. Recent findings Concerning the treatment, complete surgical resection of the tumor provides the only chance for cure. However, even after tumor removal, the risk of recurrence remains high and the main predictors of recurrence include tumor stage, grade (measured by Ki-67 proliferative index), and the tumor resection status. Adjuvant mitotane and/or adjuvant radiotherapy should be considered in patients with high risk of recurrence taking into account potential harmful effects of such treatment. Accordingly, care...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - April 30, 2021 Category: Endocrinology Tags: ADRENAL CORTEX AND MEDULLA: Edited by Irina Bancos and Diane Donegan Source Type: research

Editorial
No abstract available (Source: Current Opinion in Endocrinology, Diabetes and Obesity)
Source: Current Opinion in Endocrinology, Diabetes and Obesity - April 30, 2021 Category: Endocrinology Tags: ADRENAL CORTEX AND MEDULLA: Edited by Irina Bancos and Diane Donegan Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Endocrinology, Diabetes and Obesity)
Source: Current Opinion in Endocrinology, Diabetes and Obesity - April 30, 2021 Category: Endocrinology Tags: EDITORIAL INTRODUCTIONS Source Type: research

Established and emerging roles peptide YY (PYY) and exploitation in obesity–diabetes
Purpose of review The antiobesity effects of activation of hypothalamic neuropeptide Y2 receptors (NPYR2) by the gut-derived hormone, peptide YY (PYY), are established. However, more recent insight into the biology of PYY has demonstrated remarkable benefits of sustained activation of pancreatic beta-cell NPYR1, that promises to open a new therapeutic avenue in diabetes. Recent findings The therapeutic applicability of NPYR2 agonists for obesity has been considered for many years. An alternative pathway for the clinical realisation of PYY-based drugs could be related to the development of NPYR1 agonists for trea...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - March 2, 2021 Category: Endocrinology Tags: GASTROINTESTINAL HORMONES: Edited by H. Christian Weber Source Type: research

Gut peptides and the microbiome: focus on ghrelin
Purpose of review In this review, we present recent insights into the role of the gut microbiota on gastrointestinal (GI) peptide secretion and signalling, with a focus on the orexigenic hormone, ghrelin. Recent findings Evidence is accumulating suggesting that secretion of GI peptides is modulated by commensal bacteria present in our GI tract. Recent data shows that the gut microbiome impacts on ghrelinergic signalling through its metabolites, at the level of the ghrelin receptor (growth hormone secretagogue receptor) and highlights concomitant changes in circulating ghrelin levels with specific gut microbiota ...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - March 2, 2021 Category: Endocrinology Tags: GASTROINTESTINAL HORMONES: Edited by H. Christian Weber Source Type: research

Ghrelin-cell physiology and role in the gastrointestinal tract
Purpose of review Ghrelin was discovered in 1999; extensive research and clinical studies on ghrelin have been published in the last 20 years. Physiological research on ghrelin ranges from its appetite-stimulating effects to its association with energy homeostasis. The physiological effects of ghrelin in the gastrointestinal tract and its relevance in the pathological conditions of the gastrointestinal tract have gradually become clearer. The purpose of the review is to provide current information on ghrelin cell biology and physiology, particularly in the gastrointestinal tract. Recent findings Ghrelin-producin...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - March 2, 2021 Category: Endocrinology Tags: GASTROINTESTINAL HORMONES: Edited by H. Christian Weber Source Type: research

Recent advances in the biology of bombesin-like peptides and their receptors
Purpose of review The current review aims to update the important findings about molecular and cellular biology of mammalian bombesin-like peptides (BLPs) and their receptors. Recent findings Recent identification of synaptic communication between gastrin-releasing peptide (GRP) neurons and GRP receptor (GRPR) neurons in spinal itch relay provides us novel insights into physiology of itch sensation. Neuromedin B (NMB) neurons were found to form connections with subcortical areas associated with arousal, hippocampal theta oscillation, and premotor processing and project to multiple downstream stations to regulate...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - March 2, 2021 Category: Endocrinology Tags: GASTROINTESTINAL HORMONES: Edited by H. Christian Weber Source Type: research

Chemosensing in enteroendocrine cells: mechanisms and therapeutic opportunities
Purpose of review Enteroendocrine cells (EECs) are scattered chemosensory cells in the intestinal epithelium that release hormones with a wide range of actions on intestinal function, food intake and glucose homeostasis. The mechanisms by which gut hormones are secreted postprandially, or altered by antidiabetic agents and surgical interventions are of considerable interest for future therapeutic development. Recent findings EECs are electrically excitable and express a repertoire of G-protein coupled receptors that sense nutrient and nonnutrient stimuli, coupled to intracellular Ca2+ and cyclic adenosine monoph...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - March 2, 2021 Category: Endocrinology Tags: GASTROINTESTINAL HORMONES: Edited by H. Christian Weber Source Type: research

Targeted pharmacotherapy of irritable bowel syndrome
Purpose of review Irritable bowel syndrome (IBS) is a highly prevalent functional gastrointestinal (GI) disorder with negative impact on quality of life and it represents a substantial economic burden on healthcare cost. The medical management of IBS is symptom directed. This review provides an update related to clinical trial data for novel treatment modalities in IBS targeting the gut epithelium secretagogue receptors and channels. Recent findings The new Rome IV criteria define functional gastrointestinal disorders (FGID) as disorders of the gut–brain interaction. Pharmacological treatment modalities for IB...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - March 2, 2021 Category: Endocrinology Tags: GASTROINTESTINAL HORMONES: Edited by H. Christian Weber Source Type: research

Pituitary adenylate cyclase-activating polypeptide/vasoactive intestinal peptide (Part 2): biology and clinical importance in central nervous system and inflammatory disorders
Purpose of review To discuss recent advances of vasoactive intestinal peptide/pituitary adenylate cyclase-activating polypeptide (VIP/PACAP) receptors in the selected central nervous system (CNS) and inflammatory disorders. Recent findings Recent studies provide evidence that PACAP plays an important role in a number of CNS disorders, particularly the pathogenesis of headaches (migraine, etc.) as well as posttraumatic stress disorder and drug/alcohol/smoking addiction. VIP has important therapeutic effects in a number of autoimmune/inflammatory disorder such as rheumatoid arthritis. In some cases, these insights...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - March 2, 2021 Category: Endocrinology Tags: GASTROINTESTINAL HORMONES: Edited by H. Christian Weber Source Type: research