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Book ; Online ; E-Book: Environmental endocrinology and endocrine disruptors

Pivonello, Rosario / Diamanti-Kandarakis, Evanthia

endocrine and endocrine-targeted actions and related human diseases

(Endocrinology ; Springer reference nature)

2023

Abstract: This book describes how exposure to various classes of endocrine disruptors, as well as other environmental chemicals targeting the endocrine system by alternative non-endocrine mechanisms, impact on endocrinological and endocrinological-related diseases. ...

Author's details	Rosario Pivonello, Evanthia Diamanti-Kandarakis editors
Series title	Endocrinology Springer reference nature
Abstract	This book describes how exposure to various classes of endocrine disruptors, as well as other environmental chemicals targeting the endocrine system by alternative non-endocrine mechanisms, impact on endocrinological and endocrinological-related diseases. It includes comprehensive reviews of all aspects of environmental endocrinology, ranging from sources and patterns of exposure and identification of endocrine targets to direct endocrine disruptive mechanisms and indirect actions on the endocrine system, the latter including endocrine cell-directed cytotoxicity, oxidative damage, and genetic and epigenetic aberrations resulting in endocrine damage. It also examines the causal pathways and offers an extensive overview of downstream endocrinological and endocrinological-related disorders. In addition, several chapters focus on transgenerational actions, which are a topic of particular interest. Lastly, evidence from preclinical and clinical studies provides the basis for an in-depth, critical discussion of each topic. The book is part of the SpringerReference program, which provides access to ‘living editions’ that are constantly updated using a dynamic peer-review publishing process.
Keywords	Internal medicine
Language	English
Size	1 Online-Ressource (xxli, 520 Seiten), Illustrationen, Diagramme
Publisher	Springer
Publishing place	Cham
Publishing country	Switzerland
Document type	Book ; Online ; E-Book
Remark	Zugriff für angemeldete ZB MED-Nutzerinnen und -Nutzer
HBZ-ID	HT030017028
ISBN	978-3-030-39044-0 ; 9783030390433 ; 3-030-39044-6 ; 3030390438
DOI	10.1007/978-3-030-39044-0
Database	ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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Article ; Online: Investigational drugs for the treatment of acromegaly: new agents to transform therapy.

Pirchio, Rosa / Auriemma, Renata S / Vergura, Alice / Pivonello, Rosario / Colao, Annamaria

Expert opinion on investigational drugs

2024 , Page(s) 1–14

Abstract: Introduction: Disease control is essential to decrease morbidity burden and mortality in acromegaly patients. In the last decades, the availability of new drugs increased the rate of disease control. However, up to 55% of patients remain uncontrolled ... ...

Abstract	Introduction: Disease control is essential to decrease morbidity burden and mortality in acromegaly patients. In the last decades, the availability of new drugs increased the rate of disease control. However, up to 55% of patients remain uncontrolled despite available treatment strategies in real-world data. The reasons for this finding may include poor adherence, inadequate tolerability, therapeutic inertia, and high costs. Since acromegaly is a chronic disease and medical therapy is usually life-long, patient's adherence to treatment is fundamental in both achieving and maintaining disease control. Less invasive routes of administration could improve adherence and concur to increase disease control rate. Areas covered: The aim of current review is to provide a detailed update about investigational drugs for acromegaly treatment currently under investigation as paltusotine, ONO-5788, AP102, GT-02037, ISIS 766720, CAM2024, Lanreotide PRF, DP1038, MTD201, solid dose injection of octreotide. Expert opinion: Medical therapy of acromegaly is an evolving field. Current studies are addressing patient's need for both new molecules and less invasive routes of administration for already existing drugs. It cannot be ruled out that drugs currently used for other diseases such as cancer could be considered in the future for the treatment of acromegaly.
Language	English
Publishing date	2024-04-30
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1182884-5
ISSN	1744-7658 ; 0967-8298 ; 1354-3784
ISSN (online)	1744-7658
ISSN	0967-8298 ; 1354-3784
DOI	10.1080/13543784.2024.2343056
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Article ; Online: Psychopathology in Acromegaly-Real and Perceived.

Pivonello, Rosario / Neggers, Sebastian J C M M / Imran, Syed Ali

The Journal of clinical endocrinology and metabolism

2023 Volume 108, Issue 10, Page(s) 2470–2474

Abstract: Acromegaly is a chronic condition caused by the excessive production of growth hormone and is characterized by progressive morphological and systemic complications, as well as increased prevalence of psychopathologies, which markedly affect patients' ... ...

Abstract	Acromegaly is a chronic condition caused by the excessive production of growth hormone and is characterized by progressive morphological and systemic complications, as well as increased prevalence of psychopathologies, which markedly affect patients' quality of life. The advancing multimodal therapies, while significantly improving the morbidity and mortality, have limited impact on psychopathologies, which often persist despite disease remission. The most common psychopathologies in acromegaly include depression, anxiety and affective disorders, together with sexual dysfunction, which may be considered as either a consequence or potentially even a contributory factor to these psychopathologies. Approximately one-third of patients with acromegaly manifest depression, whereas two-thirds of patients display anxiety, with both conditions tending to be more prevalent and severe in younger patients with shorter duration of disease. Apparently, a major impact of psychological discomfort in women compared with men appears to be the fact that women tend to internalize whereas men tend to externalize their distress. Personality disorders also commonly associated with acromegaly, especially due to body image suffering, are linked to sexual dysfunction, which seems to affect women more than men. In summary, psychopathology in acromegaly is a major determinant of the quality of life and a complex array of psychological abnormalities are associated with acromegaly.
MeSH term(s)	Male ; Humans ; Female ; Acromegaly/complications ; Acromegaly/epidemiology ; Acromegaly/therapy ; Quality of Life/psychology ; Human Growth Hormone ; Anxiety/epidemiology ; Anxiety/etiology ; Anxiety/psychology ; Sexual Dysfunction, Physiological ; Mental Disorders/etiology ; Mental Disorders/complications
Chemical Substances	Human Growth Hormone (12629-01-5)
Language	English
Publishing date	2023-05-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	3029-6
ISSN	1945-7197 ; 0021-972X
ISSN (online)	1945-7197
ISSN	0021-972X
DOI	10.1210/clinem/dgad237
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Article ; Online: Testis-Specific Genes Deregulation in the Testis of COVID-19 Patients: A Potential Driver of Spermatogenesis Disruption?

Pivonello, Rosario / de Angelis, Cristina / Menafra, Davide / Colao, Annamaria

The Journal of clinical endocrinology and metabolism

2022 Volume 108, Issue 5, Page(s) e195–e196

MeSH term(s)	Male ; Humans ; Testis ; Up-Regulation ; Down-Regulation ; Autopsy ; COVID-19/genetics ; Spermatogenesis/genetics
Language	English
Publishing date	2022-12-13
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	3029-6
ISSN	1945-7197 ; 0021-972X
ISSN (online)	1945-7197
ISSN	0021-972X
DOI	10.1210/clinem/dgac730
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Article ; Online: Cushing's disease: adrenal steroidogenesis inhibitors.

Pivonello, Rosario / Simeoli, Chiara / Di Paola, Nicola / Colao, Annamaria

Pituitary

2022 Volume 25, Issue 5, Page(s) 726–732

Abstract: Cushing's disease (CD), caused by an adrenocorticotropic hormone (ACTH)-secreting pituitary tumor, is the most common form of Cushing's syndrome (CS), accounting for approximately 70% of cases. CD requires a prompt diagnosis, an adequate treatment ... ...

Abstract	Cushing's disease (CD), caused by an adrenocorticotropic hormone (ACTH)-secreting pituitary tumor, is the most common form of Cushing's syndrome (CS), accounting for approximately 70% of cases. CD requires a prompt diagnosis, an adequate treatment selection, and long-term management to limit hypercortisolism duration and long-term complications and improve patient outcomes. Pituitary surgery is the first-line option, which is non-curative in one third of patients, therefore requiring additional treatments. Medical therapy has recently acquired an emerging role, with the availability of several drugs with different therapeutic targets, efficacy and safety profiles. The current review focuses on efficacy and safety of steroidogenesis inhibitors, and particularly the historical drugs, ketoconazole and metyrapone, and the novel drugs levoketoconazole and osilodrostat, which seem to offer a rapid, sustained, and effective disease control. Ketoconazole should be preferred in females and in patients without severe liver disease; levoketoconazole may offer an alternative to classical ketoconazole, appearing characterized by a higher potency and potential lower hepatotoxicity compared to ketoconazole. Metyrapone should be preferred in males and in patients without severe or uncontrolled hypokalemia. Both ketoconazole and metyrapone may be preferred for short-term more than for long-term treatment. Osilodrostat may represent the best choice for long-term treatment, in patients with poor compliance to the multiple daily administration schedule, and in patients without severe or uncontrolled hypokalemia. Steroidogenesis inhibitors may be used alone or in combination, and associated with pituitary directed drugs, to improve the efficacy of the single drugs, allowing a potential use of lower doses for each drug, and hypothetically reducing the rate of adverse events associated with the single drugs. Clinicians may tailor medical therapy on the specific clinical scenario, considering disease history together with patients' characteristics and hypercortisolism's degree, addressing the needs of each patient in order to improve the therapeutic outcome and to reduce the burden of illness, particularly in patients with persistent or recurrent CD.
MeSH term(s)	Male ; Female ; Humans ; Pituitary ACTH Hypersecretion/diagnosis ; Cushing Syndrome/drug therapy ; Metyrapone/therapeutic use ; Ketoconazole/therapeutic use ; Hypokalemia/chemically induced ; Hypokalemia/drug therapy ; Steroid Synthesis Inhibitors/therapeutic use ; Pituitary Neoplasms/drug therapy ; Adrenocorticotropic Hormone
Chemical Substances	Metyrapone (ZS9KD92H6V) ; Ketoconazole (R9400W927I) ; Steroid Synthesis Inhibitors ; Adrenocorticotropic Hormone (9002-60-2)
Language	English
Publishing date	2022-08-29
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1385151-2
ISSN	1573-7403 ; 1386-341X
ISSN (online)	1573-7403
ISSN	1386-341X
DOI	10.1007/s11102-022-01262-8
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Article ; Online: Approach to the Patient With Prolactinoma.

Auriemma, Renata S / Pirchio, Rosa / Pivonello, Claudia / Garifalos, Francesco / Colao, Annamaria / Pivonello, Rosario

The Journal of clinical endocrinology and metabolism

2023 Volume 108, Issue 9, Page(s) 2400–2423

Abstract: Prolactinomas are the most common pituitary tumor histotype, with microprolactinomas being prevalent in women and macroprolactinomas in men. Hyperprolactinemia is among the most common causes of hypogonadotropic hypogonadism in both sexes, prompting ... ...

Abstract	Prolactinomas are the most common pituitary tumor histotype, with microprolactinomas being prevalent in women and macroprolactinomas in men. Hyperprolactinemia is among the most common causes of hypogonadotropic hypogonadism in both sexes, prompting medical advice for hypogonadism (infertility, oligo-amenorrhea, impotence, osteoporosis/osteopenia) in both sexes, and for signs and symptoms of mass effects (hypopituitarism, visual loss, optic chiasm compression, cranial nerve deficits, headaches) predominantly in men. Diagnostic workup involves a single prolactin measurement and pituitary imaging, but some laboratory artifacts (ie, the "hook effect" and macroprolactin) can complicate or delay the diagnosis. The treatment of choice for prolactinomas is represented by dopamine agonists, mainly cabergoline, which are able to induce disease control, restore fertility in both sexes, and definitively cure one-third of patients, thus permitting treatment discontinuation. Pregnancy and menopause may promote spontaneous prolactin decline and anticipate cabergoline discontinuation in women. Surgery and/or radiotherapy are indicated in case of resistance to cabergoline not overcome by the increase in drug dose up to the maximally tolerated or the patient's personal choice of surgery. The evidence of resistance to cabergoline in invasive and proliferative tumors may indicate biological aggressiveness, thus requiring alternative therapeutic approaches mainly based on temozolomide use as monotherapy or combined with radiotherapy. In uncontrolled patients, new medical approaches (alternative hormonal treatments, cytotoxic drugs, peptide receptor radionuclide therapy, mTOR/Akt inhibitors, tyrosine kinase inhibitors, or immunotherapy) may be offered but the experience collected to date is still very scant. This article reviews different facets of prolactinomas and discusses approaches to the condition in more common clinical situations.
MeSH term(s)	Male ; Pregnancy ; Humans ; Female ; Prolactinoma/diagnosis ; Prolactinoma/therapy ; Prolactinoma/complications ; Cabergoline/therapeutic use ; Prolactin ; Ergolines/therapeutic use ; Pituitary Neoplasms/diagnosis ; Pituitary Neoplasms/therapy ; Pituitary Neoplasms/complications ; Dopamine Agonists/therapeutic use ; Hypogonadism/drug therapy
Chemical Substances	Cabergoline (LL60K9J05T) ; Prolactin (9002-62-4) ; Ergolines ; Dopamine Agonists
Language	English
Publishing date	2023-03-27
Publishing country	United States
Document type	Review ; Journal Article
ZDB-ID	3029-6
ISSN	1945-7197 ; 0021-972X
ISSN (online)	1945-7197
ISSN	0021-972X
DOI	10.1210/clinem/dgad174
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Article ; Online: Prolactin effects on the pathogenesis of diabetes mellitus.

Scairati, Roberta / Auriemma, Renata Simona / Del Vecchio, Guendalina / Di Meglio, Sara / Pivonello, Rosario / Colao, Annamaria

European journal of clinical investigation

2024 , Page(s) e14190

Abstract: Background: Prolactin (PRL) is a pituitary hormone promoting lactation in response to the suckling reflex. Beyond its well-known effects, novel tissue-specific and metabolic functions of PRL are emerging.: Aims: To dissect PRL as a critical mediator ... ...

Abstract	Background: Prolactin (PRL) is a pituitary hormone promoting lactation in response to the suckling reflex. Beyond its well-known effects, novel tissue-specific and metabolic functions of PRL are emerging. Aims: To dissect PRL as a critical mediator of whole-body gluco-insulinemic sensitivity. Methods: PubMed-based search with the following terms 'prolactin', 'glucose metabolism', 'type 2 diabetes mellitus', 'type 1 diabetes mellitus', 'gestational diabetes mellitus' was performed. Discussion: The identification of the PRL-glucose metabolism network poses the basis for unprecedented avenues of research in the pathogenesis of diabetes mellitus type 1 or 2, as well as of gestational diabetes. In this regard, it is of timely relevance to define properly the homeostatic PRL serum levels since glucose metabolism could be influenced by the circulating amount of the hormone. Results: This review underscores the basic mechanisms of regulation of pancreatic β-cell functions by PRL and provides a revision of articles which have investigated the connection between PRL unbalancing and diabetes mellitus. Future studies are needed to elucidate the burden and the role of PRL in the regulation of glucose metabolism and determine the specific PRL threshold that may impact the management of diabetes. Conclusion: A careful evaluation and context-driven interpretation of PRL levels (e.g., pregnancy, PRL-secreting pituitary adenomas, drug-related hyper- and hypoprolactinemia) could be critical for the correct screening and management of glucometabolic disorders, such as type 1 or 2 as well as gestational diabetes mellitus.
Language	English
Publishing date	2024-03-12
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	186196-7
ISSN	1365-2362 ; 0014-2972 ; 0960-135X
ISSN (online)	1365-2362
ISSN	0014-2972 ; 0960-135X
DOI	10.1111/eci.14190
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Article ; Online: Hyperprolactinemia after menopause: Diagnosis and management.

Auriemma, Renata S / Pirchio, Rosa / Pivonello, Rosario / Colao, Annamaria

Maturitas

2021 Volume 151, Page(s) 36–40

Abstract: Most prolactinomas are diagnosed in women of reproductive age and are generally microadenomas. Prolactinomas diagnosed in postmenopausal women are less common and are not usually associated with the typical syndrome induced by prolactin excess, including ...

Abstract	Most prolactinomas are diagnosed in women of reproductive age and are generally microadenomas. Prolactinomas diagnosed in postmenopausal women are less common and are not usually associated with the typical syndrome induced by prolactin excess, including infertility and oligo-amenorrhea. This implies that the diagnosis of prolactinomas after menopause may be delayed and require greater clinical effort. Limited data are available on the management and prognosis of prolactinomas in postmenopausal women. However, the physiologic decline of prolactin levels during menopause and the lack of fertility concerns, which represent specific indications for medical treatment with dopamine agonists, might require a careful reassessment of therapeutic management in such patients. Postmenopausal women with microprolactinoma may be successfully withdrawn from medical therapy with dopamine agonists, whereas in those with macroprolactinomas greater caution is advisable before dopamine agonists are discontinued, considering the potential, although rare, tumor enlargement. This review focuses on the diagnostic challenges and therapeutic management of prolactinomas in postmenopausal women.
MeSH term(s)	Aged ; Dopamine Agonists/therapeutic use ; Female ; Humans ; Hyperprolactinemia/diagnosis ; Hyperprolactinemia/drug therapy ; Hyperprolactinemia/etiology ; Menopause ; Middle Aged ; Pituitary Neoplasms/diagnosis ; Postmenopause ; Prolactin/blood ; Prolactinoma/diagnosis ; Prolactinoma/drug therapy
Chemical Substances	Dopamine Agonists ; Prolactin (9002-62-4)
Language	English
Publishing date	2021-07-03
Publishing country	Ireland
Document type	Journal Article ; Review
ZDB-ID	80460-5
ISSN	1873-4111 ; 0378-5122
ISSN (online)	1873-4111
ISSN	0378-5122
DOI	10.1016/j.maturitas.2021.06.014
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Article: Metabolic effects of prolactin.

Pirchio, Rosa / Graziadio, Chiara / Colao, Annamaria / Pivonello, Rosario / Auriemma, Renata S

Frontiers in endocrinology

2022 Volume 13, Page(s) 1015520

Abstract: Over the last years, the metabolic role of PRL has emerged. PRL excess is known to promote weight gain, obesity, metabolic syndrome, and impairment in gluco-insulinemic and lipid profiles, likely due to the suppression of physiologic dopaminergic tone. ... ...

Abstract	Over the last years, the metabolic role of PRL has emerged. PRL excess is known to promote weight gain, obesity, metabolic syndrome, and impairment in gluco-insulinemic and lipid profiles, likely due to the suppression of physiologic dopaminergic tone. Prolactin receptors and dopamine receptors type 2 have been demonstrated to be expressed on both human pancreatic β- cell and adipocytes, supporting a key role of prolactin and dopamine in peripheral metabolic regulation. Medical treatment with the dopamine agonists bromocriptine and cabergoline has been demonstrated to decrease the prevalence of metabolic syndrome and obesity, and significantly improve gluco-insulinemic and lipid profiles. In hyperprolactinemic men with concomitant hypogonadism, correction of hyperprolactinaemia and testosterone replacement has been proven to restore metabolic impairment. In turn, low prolactin levels have also been demonstrated to exert a detrimental effect on weight gain, glucose and lipid metabolism, thus leading to an increased prevalence of metabolic syndrome. Therefore, PRL values ranging from 25 to 100 mg/L, in absence of other recognizable pathological causes, have been proposed to represent a physiological response to the request for an increase in metabolic activity, and nowadays classify the so-called HomeoFIT- PRL as a promoter of metabolic homeostasis. The current review focuses mainly on the effects of hyperprolactinemia and its control by medical treatment with DAs on the modulation of food intake, body weight, gluco-insulinemic and lipid profile. Furthermore, it provides the latest knowledge about the metabolic impact of hypoprolactinemia.
MeSH term(s)	Bromocriptine ; Cabergoline ; Dopamine ; Dopamine Agonists ; Glucose ; Humans ; Hyperprolactinemia/complications ; Hyperprolactinemia/drug therapy ; Hyperprolactinemia/metabolism ; Lipids ; Male ; Metabolic Syndrome/complications ; Metabolic Syndrome/drug therapy ; Obesity/complications ; Prolactin/metabolism ; Receptors, Dopamine ; Receptors, Prolactin ; Testosterone ; Weight Gain
Chemical Substances	Dopamine Agonists ; Lipids ; Receptors, Dopamine ; Receptors, Prolactin ; Bromocriptine (3A64E3G5ZO) ; Testosterone (3XMK78S47O) ; Prolactin (9002-62-4) ; Glucose (IY9XDZ35W2) ; Cabergoline (LL60K9J05T) ; Dopamine (VTD58H1Z2X)
Language	English
Publishing date	2022-09-27
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2592084-4
ISSN	1664-2392
ISSN	1664-2392
DOI	10.3389/fendo.2022.1015520
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Article: Mapping of the current transition of care practice for patients with pituitary disease at Endo-ERN reference centers.

Shishkov, Savi R / Tuccillo, Luigi / Iotova, Violeta M / Pivonello, Rosario / Pelsma, Iris Cm / Pereira, Alberto M / Biermasz, Nienke R

Endocrine connections

2023 Volume 12, Issue 2

Abstract: Rare endocrine conditions present specific diagnostic and management challenges for healthcare providers, one of which is the understudied transition of care. Despite the need for guidance regarding transition, consensus on structured and protocolled ... ...

Abstract	Rare endocrine conditions present specific diagnostic and management challenges for healthcare providers, one of which is the understudied transition of care. Despite the need for guidance regarding transition, consensus on structured and protocolled approaches is lacking. Therefore, we aimed to map the current clinical practice and identify unmet needs regarding transition of care for patients with pituitary disease in the reference centers (RCs) of the European Reference Network on Rare Endocrine Conditions (Endo-ERN). A survey-based, cross-sectional study using the EU Survey tool was performed and completed by 46 physicians (n) from 30 RCs (N). Transition is a common practice among RCs (n = 44/46), usually accomplished by a multidisciplinary team meeting (N = 20/30). Criteria for start and end of transition were defined in half of the RCs, with 16.7% of centers providing dissimilar answers. Transition readiness was assessed by >75% of the RCs, mostly by unvalidated means (e.g. subjective opinions, informal consultations). Pituitary-specific transition assessment tool was applied in one RC only. Transition protocols were present in only 9% of RCs, while in many RCs, transition decisions were taken in combined adult-pediatric meetings or based on clinicians' personal judgment. A minority of physicians evaluated the effectiveness of transition-related interventions (n = 11/46) or medical outcomes (n = 8/46). Patient-reported outcome measures were infrequently used (n = 4/46). Identified unmet needs included the development of guidelines (n = 5/46) and EU-wide approach (n = 2/46). This study exemplifies the unmet needs for a structural definition of the transition period and transition management for patients with rare hypothalamic and pituitary conditions from healthcare providers' perspective.
Language	English
Publishing date	2023-01-27
Publishing country	England
Document type	Journal Article
ZDB-ID	2668428-7
ISSN	2049-3614
ISSN	2049-3614
DOI	10.1530/EC-22-0308
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