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Mass cytometry and type 1 diabetes research in the age of single-cell data science
Purpose of review New single-cell tec. hnologies developed over the past decade have considerably reshaped the biomedical research landscape, and more recently have found their way into studies probing the pathogenesis of type 1 diabetes (T1D). In this context, the emergence of mass cytometry in 2009 revolutionized immunological research in two fundamental ways that also affect the T1D world: first, its ready embrace by the community and rapid dissemination across academic and private science centers alike established a new standard of analytical complexity for the high-dimensional proteomic stratification of single-cell...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - July 30, 2020 Category: Endocrinology Tags: DIABETES AND ENDOCRINE PANCREAS II: Edited by Peter A. Gottlieb Source Type: research

Endotypes in T1D: B lymphocytes and early onset
Purpose of review Although type 1 diabetes (T1D) is characterized by destruction of the pancreatic beta cells by self-reactive T cells, it has become increasingly evident that B cells also play a major role in disease development, likely functioning as antigen-presenting cells. Here we review the biology of islet antigen-reactive B cells and their participation in autoimmune diabetes. Recent findings Relative to late onset, individuals who develop T1D at an early age display increased accumulation of insulin-reactive B cells in islets. This B-cell signature is also associated with rapid progression of disease and resp...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - July 30, 2020 Category: Endocrinology Tags: DIABETES AND ENDOCRINE PANCREAS II: Edited by Peter A. Gottlieb Source Type: research

The role of beta-cell dysfunction in early type 1 diabetes
Purpose of review Emerging data have suggested that β-cell dysfunction may exacerbate the development and progression of type 1 diabetes (T1D). In this review, we highlight clinical and preclinical studies suggesting a role for β-cell dysfunction during the evolution of T1D and suggest agents that may promote β-cell health in T1D. Recent findings Metabolic abnormalities exist years before development of hyperglycemia and exhibit a reproducible pattern reflecting progressive deterioration of β-cell function and increases in β-cell stress and death. Preclinical studies indicate that T1D may be prevented by modifica...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - July 30, 2020 Category: Endocrinology Tags: DIABETES AND ENDOCRINE PANCREAS II: Edited by Peter A. Gottlieb Source Type: research

Lipid management for cardiovascular risk reduction in type 1 diabetes
Purpose of review To review the recent evidence for lipid management in type 1 diabetes (T1D) for cardiovascular risk reduction. Recent findings Individuals with T1D are at increased risk for cardiovascular morbidity and mortality, with atherosclerosis beginning as early as adolescence. Elevated low-density lipoprotein cholesterol (LDL-C), triglycerides, and lipoprotein (a) are associated with increased cardiovascular risk in T1D. Although high-density lipoprotein cholesterol (HDL-C) in T1D is often normal or higher than in nondiabetic controls, HDL in T1D has structural alterations, which make it proatherogenic rathe...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - July 30, 2020 Category: Endocrinology Tags: DIABETES AND ENDOCRINE PANCREAS II: Edited by Peter A. Gottlieb Source Type: research

Pharmacological therapies to address obesity in type 1 diabetes
Purpose of review Obesity is increasing in prevalence among patients with type 1 diabetes (T1D) and is associated with insulin resistance and increased cardiovascular risk. The management of obesity in this population is complicated by defects in pancreatic islet hormone secretion and the effects of exogenous insulin treatment. Here, we review the effects of antiobesity medications and adjunct-to-insulin medications on body weight in T1D. Recent findings There is a profound evidence gap around the use of drugs for the treatment of obesity in T1D since systematic studies have not been performed in this population. Adju...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - July 30, 2020 Category: Endocrinology Tags: DIABETES AND ENDOCRINE PANCREAS II: Edited by Peter A. Gottlieb Source Type: research

Adverse events associated with immune checkpoint inhibitors: a new era in autoimmune diabetes
Purpose of review To summarize a new form of autoimmune diabetes as an adverse event of specific cancer immunotherapies. Immune checkpoint inhibitors are revolutionary treatments in advanced cancers; however, they can cause type 1 diabetes following treatment with these state-of-the-art therapies. Recent findings A review of the literature showed that this new form of autoimmune diabetes has significant similarities with childhood-onset type 1 diabetes but also some distinctions. It frequently presents with severe diabetic ketoacidosis and almost half of the patients have type 1 diabetes-associated antibodies at prese...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - July 30, 2020 Category: Endocrinology Tags: DIABETES AND ENDOCRINE PANCREAS II: Edited by Peter A. Gottlieb Source Type: research

Editorial introduction
No abstract available (Source: Current Opinion in Endocrinology, Diabetes and Obesity)
Source: Current Opinion in Endocrinology, Diabetes and Obesity - July 30, 2020 Category: Endocrinology Tags: EDITORIAL INTRODUCTION Source Type: research

Pediatric adrenocortical tumor – review and management update
Purpose of review Adrenocortical tumor (ACT) is a rare disease with an annual worldwide incidence of 0.3–0.38/million children below 15 years old, and Brazilian population presents the highest incidence because of germline mutation in the TP53. Pediatric ACT is associated with virilizing features and hypercortisolism in most cases. Malignancy is defined when local invasion or metastasis is found, and it is associated with a poor prognosis. However, the correct and early diagnosis and treatment may impact on overall and disease-free survival. Recent findings A complete understanding of the disease and its singulariti...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - May 1, 2020 Category: Endocrinology Tags: ADRENAL CORTEX AND MEDULLA: Edited by Irina Bancos Source Type: research

Update on in-vivo preclinical research models in adrenocortical carcinoma
Purpose of review The aim of this review is to summarize recent advances on development of in vivo preclinical models of adrenocortical carcinoma (ACC). Recent findings Significant progress has been achieved in the underlying molecular mechanisms of adrenocortical tumorigenesis over the last decade, and recent comprehensive profiling analysis of ACC tumors identified several genetic and molecular drivers of this disease. Therapeutic breakthroughs, however, have been limited because of the lack of preclinical models recapitulating the molecular features and heterogeneity of the tumors. Recent publications on geneticall...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - May 1, 2020 Category: Endocrinology Tags: ADRENAL CORTEX AND MEDULLA: Edited by Irina Bancos Source Type: research

High-specific-activity iodine 131 metaiodobenzylguanidine for the treatment of metastatic pheochromocytoma or paraganglioma: a novel therapy for an orphan disease
Purpose of review Pheochromocytomas and paragangliomas represent less than 1% of all endocrine tumors. Approximately 15–20% of these tumors are malignant. The definition of malignancy relies on the presence of metastasis. Metastatic pheochromocytomas and paragangliomas are usually advanced, incurable tumors with limited therapeutic options. About 50–60% of these tumors express the noradrenaline transporter in their cell membranes. Recently, the United States Food and Drug Administration approved high-specific-activity iodine 131 metaiodobenzylguanidine (HSA-I-131-MIBG) for the treatment of metastatic pheochromocytoma...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - May 1, 2020 Category: Endocrinology Tags: ADRENAL CORTEX AND MEDULLA: Edited by Irina Bancos Source Type: research

Long-term cardio-metabolic outcomes in patients with classical congenital adrenal hyperplasia: is the risk real?
Purpose of review Data on the long-term cardio-metabolic outcomes classical congenital adrenal hyperplasia (CAH) patients have been published with controversial results. Conventional treatment recommends hydrocortisone during childhood; and short and/or long-acting glucocorticoid during adulthood, associated or not with mineralocorticoid, in an attempt to simulate normal cortisol secretion and to normalize androgen excess. However, the balance between glucocorticoid over or undertreatment is very challenging, and patients frequently oscillate between hypercortisolism or hyperandrogenism. Considering these data, we review...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - May 1, 2020 Category: Endocrinology Tags: ADRENAL CORTEX AND MEDULLA: Edited by Irina Bancos Source Type: research

Functional imaging in ectopic Cushing syndrome
Purpose of review Ectopic adrenocorticotropic hormone (ACTH)-secreting tumors are commonly small, yet they often lead to fulminant forms of Cushing syndrome. High-resolution functional imaging modalities, such as [68Ga]-DOTATATE, have been recently introduced in clinical practice for the identification of neuroendocrine tumors. In this review, we focus on the performance of [68Ga]-DOTATATE as a tool for localizing primary and metastatic sources of ectopic Cushing syndrome (ECS). Recent findings Prompt surgical removal of ectopic ACTH-secreting tumors is the mainstay of therapy in patients with ECS. Detecting such tumo...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - May 1, 2020 Category: Endocrinology Tags: ADRENAL CORTEX AND MEDULLA: Edited by Irina Bancos Source Type: research

Glucose metabolism in Cushing's syndrome
Purpose of review Impairment of glucose metabolism is commonly encountered in Cushing's syndrome. It is the source of significant morbidity and mortality even after successful treatment of Cushing's. This review is to understand the recent advances in understanding the pathophysiology of diabetes mellitus from excess cortisol. Recent findings In-vitro studies have led to significant advancement in understanding the molecular effects of cortisol on glucose metabolism. Some of these findings have been translated with human data. There is marked reduction in insulin action and glucose disposal with a concomitant, insuffi...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - May 1, 2020 Category: Endocrinology Tags: ADRENAL CORTEX AND MEDULLA: Edited by Irina Bancos Source Type: research

Update on primary micronodular bilateral adrenocortical diseases
Purpose of review Primary micronodular bilateral adrenocortical hyperplasias (MiBAH) are rare challenging diseases. Important progress in understanding its pathophysiology and genetics occurred in the last two decades. We summarize those progress and recent data on investigation and therapy of MiBAH focusing on primary pigmented nodular adrenocortical disease (PPNAD). Recent findings Larger recent cohorts of PPNAD patients from various countries have confirmed their variable Cushing's syndrome phenotypes. Age of onset is earlier than other ACTH-independent Cushing's syndrome causes and the youngest case have now occur...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - May 1, 2020 Category: Endocrinology Tags: ADRENAL CORTEX AND MEDULLA: Edited by Irina Bancos Source Type: research

Approach to patients with bilateral adrenal incidentalomas
Purpose of review The current review provides a summary on the most recent developments regarding the cause, work-up and management of bilateral adrenal incidentalomas (BAI). Recent findings The recent ENS@T/ESE guidelines provide comprehensive directions on the evaluation and management of patients with adrenal incidentalomas with special focus on those with bilateral tumours. Intraadrenal ACTH synthesis that may locally stimulate cortisol secretion challenging the traditionally used term ‘ACTH-independent’. Inactivating mutations of a new tumour suppressor gene, armadillo repeat containing 5 (ARMC5), are implica...
Source: Current Opinion in Endocrinology, Diabetes and Obesity - May 1, 2020 Category: Endocrinology Tags: ADRENAL CORTEX AND MEDULLA: Edited by Irina Bancos Source Type: research