Article
Pediatrics
Lekshmi Sambhu Hema, Prawin Kumar, Jagdish Prasad Goyal, Varuna Vyas, Kuldeep Singh
Summary: This study aims to assess the effect of long-term use of inhaled corticosteroids (ICS) on the hypothalamic-pituitary-adrenal (HPA) axis. By measuring cortisol levels and conducting adreno-corticotropic hormone (ACTH) stimulation tests, it was found that only a few asthmatic children using ICS showed HPA axis suppression, and there was no clinical evidence supporting this suppression.
INDIAN JOURNAL OF PEDIATRICS
(2023)
Review
Biochemistry & Molecular Biology
Maria Francesca Birtolo, Simone Antonini, Andrea Saladino, Benedetta Zampetti, Elisabetta Lavezzi, Iacopo Chiodini, Gherardo Mazziotti, Andrea G. A. Lania, Renato Cozzi
Summary: Secondary Adrenal Insufficiency (SAI) is a condition characterized by low ACTH secretion due to hypothalamus or pituitary disease or injury. The evaluation of SAI is challenging due to non-specific symptoms, rarity, and pitfalls associated with laboratory tests. The gold standard test for assessing the HPA axis is the insulin tolerance test, but the ACTH stimulation test is safer and well-tolerated, although its diagnostic accuracy varies.
Article
Endocrinology & Metabolism
Emre Durcan, Aysa Hacioglu, Zuleyha Karaca, Kursad Unluhizarci, Mustafa Sait Gonen, Fahrettin Kelestimur
Summary: The outbreak of COVID-19 has had a significant impact globally, with over 500 million people affected and more than 6 million deaths since 2019. The virus primarily affects the lungs but can also have systemic effects on multiple endocrine organs. Dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis is particularly important, as it may lead to death if not diagnosed. COVID-19 may cause both primary and secondary adrenal insufficiencies, and the clinical manifestations are non-specific, often attributed to complications of the infection. This article reviews the evaluation of the HPA axis in COVID-19 patients and highlights the importance of repeated cortisol measurements and ACTH stimulation tests for diagnosis.
NEUROIMMUNOMODULATION
(2023)
Article
Endocrinology & Metabolism
Hasan Husni, Mohammed S. Abusamaan, Roshan Dinparastisaleh, Lori Sokoll, Roberto Salvatori, Amir H. Hamrahian
Summary: This study aimed to evaluate the appropriate cortisol values during the standard dose CST in patients with normal HPA axis when using the Roche Elecsys (R) Cortisol II assay. The results showed that the lowest cortisol levels at 30 and 60 minutes after cosyntropin administration were lower than the previously recommended cutoff values, suggesting the importance of considering the timing of cortisol draw after cosyntropin administration.
FRONTIERS IN ENDOCRINOLOGY
(2022)
Article
Endocrinology & Metabolism
Ali S. Alzahrani, Noha Mukhtar, Abeer Aljomaiah, Hadeel Aljamei, Abdulmohsen Bakhsh, Nada Alsudani, Tarek Elsayed, Nahlah Alrashidi, Roqayh Fadel, Eman Alqahtani, Hussein Raef, Muhammad Imran Butt, Othman Sulaiman
Summary: This study aimed to investigate the adrenocortical response to COVID-19 infection. The results revealed that patients with more severe disease had lower cortisol and ACTH levels, indicating a direct link between COVID-19 infection and impaired glucocorticoid response.
ENDOCRINE PRACTICE
(2021)
Review
Endocrinology & Metabolism
C. E. Lam-Chung, D. Cuevas-Ramos
Summary: Despite the challenges in screening for Cushing syndrome, the development and validation of clinical models may help in accurately predicting the presence of the disease, particularly in high-risk populations, and thereby reducing the time to diagnosis.
FRONTIERS IN ENDOCRINOLOGY
(2022)
Article
Endocrinology & Metabolism
Regin Jay Mallari, Jai Deep Thakur, Garni Barkhoudarian, Amy Eisenberg, Amanda Rodriguez, Sarah Rettinger, Pejman Cohan, Lynnette Nieman, Daniel F. Kelly
Summary: This study describes the predictive performance of preoperative biochemical and imaging data on postoperative remission and clinical characteristics in patients with presumed Cushing's disease. The use of strict biochemical thresholds can improve surgical remission rates and avoid recommending surgery to patients with equivocal biochemical data.
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
(2022)
Review
Endocrinology & Metabolism
Jody A. Rusch, Brian T. Layden, Lara R. Dugas
Summary: Cognitive function in humans relies on the complex interplay between multiple body systems, including the HPA axis. The gut microbiota, which outnumbers human cells and has a greater genetic potential, plays a crucial role through the MGB axis, a bidirectional communication pathway. Stress can affect the MGB axis through the HPA axis and other pathways, and animal research has contributed to a paradigm shift in understanding the influence of microbiota on human health and disease. Preclinical and human trials are currently investigating the applicability of these findings in humans.
FRONTIERS IN ENDOCRINOLOGY
(2023)
Article
Endocrinology & Metabolism
Li Zha, Jieli Li, Subhashree Mallika Krishnan, Michael R. Brennan, Yan Victoria Zhang, Patrick Povse, Rae Kerlin, Kevin Shively, Felicia Oleksik, JoAnna Williams, Elizabeth Sykes, Qian Sun
Summary: This study established the specific cutoffs for the level of cortisol in the Abbott Architect immunoassay by comparing it with other immunoassays. The results showed that the cortisol concentrations measured using the Abbott assay were similar to those measured using liquid chromatography-tandem mass spectrometry and the Roche Elecsys II assay but significantly lower than those measured using the Siemens assay. The recommended threshold for cortisol using the Abbott assay is 14.6 μg/dL at 60 minutes after ACTH stimulation.
ENDOCRINE PRACTICE
(2022)
Article
Allergy
Wisdom Alemya Akurugu, Carel Jacobus Van Heerden, Nicola Mulder, Ekkehard Werner Zollner
Summary: This study found that some SNPs of the CRHR1 and NR3C1 genes are associated with HPAS in asthmatic children, with the C allele of rs41423247 potentially having a protective effect on HPAS, and the CC genotype being associated with the highest PMTP ACTH response.
PEDIATRIC ALLERGY AND IMMUNOLOGY
(2021)
Review
Biochemistry & Molecular Biology
Mojca Jensterle, Rok Herman, Andrej Janez, Wael Al Mahmeed, Khalid Al-Rasadi, Kamila Al-Alawi, Maciej Banach, Yajnavalka Banerjee, Antonio Ceriello, Mustafa Cesur, Francesco Cosentino, Massimo Galia, Su-Yen Goh, Sanjay Kalra, Peter Kempler, Nader Lessan, Paulo Lotufo, Nikolaos Papanas, Ali A. Rizvi, Raul D. Santos, Anca P. Stoian, Peter P. Toth, Vijay Viswanathan, Manfredi Rizzo
Summary: The article reviews the rationale for glucocorticoid use in COVID-19 and emphasizes the need to be cautious about glucocorticoid-induced adrenal insufficiency. The authors also discuss other mechanisms that may affect HPA axis function and the increased risk and severity of COVID-19 in patients with pre-existing HPA axis disorders.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2022)
Article
Clinical Neurology
Seungeun Choi, Yoon Jung Kim, Hyongmin Oh, Nayoung Kim, Yong Hwy Kim, Hee-Pyoung Park
Summary: This study found that the use of sevoflurane anesthesia and postoperative steroid administration were associated with the development of 3-month postoperative hypocortisolism in NFPA patients with preoperative normal HPA axis.
ACTA NEUROCHIRURGICA
(2022)
Article
Endocrinology & Metabolism
Christina Tatsi, Megan Neely, Chelsi Flippo, Maria-Eleni Bompou, Meg Keil, Constantine A. Stratakis
Summary: The recovery of adrenal function in pediatric patients with CD after TSS may not be influenced by most clinical and biochemical factors, except for an increase in urinary free cortisol which may prolong the recovery time. Patients who recover adrenal function earlier are at a higher risk for CD recurrence, highlighting the importance of close follow-up and counseling for these patients.
CLINICAL ENDOCRINOLOGY
(2021)
Article
Endocrinology & Metabolism
Nasrin Al-Shamkhi, Katarina Berinder, Henrik Borg, Pia Burman, Per Dahlqvist, Charlotte Hoybye, Daniel S. Olsson, Oskar Ragnarsson, Bertil Ekman, Britt Eden Engstrom
Summary: Objective data on pituitary function before and after transsphenoidal surgery in nonfunctioning pituitary adenomas were inconsistent. This study found that adrenocorticotrophic hormone deficiency increased significantly at 1 year postoperatively, while other axis function changes were not significant. Therefore, continuous individual evaluations are needed during longer follow-up of patients operated for NFPA.
EUROPEAN JOURNAL OF ENDOCRINOLOGY
(2023)
Review
Endocrinology & Metabolism
Nada Younes, Isabelle Bourdeau, Andre Lacroix
Summary: Primary adrenal insufficiency is a rare but potentially fatal disease characterized by destruction of the adrenal cortex leading to hormone deficiencies. Patients often present with fatigue, weight loss, melanoderma, and hypotension. Diagnosis requires testing hormone levels and concentrations.
FRONTIERS IN ENDOCRINOLOGY
(2021)