Neuroendocrine

神经内分泌
  • 文章类型: Journal Article
    阿尔茨海默病(AD),痴呆症最常见的原因之一,主要是零星发生,但由衰老和其他辅因子驱动。研究表明,过量饮酒可能会增加AD风险。
    我们的研究检查了短期中度乙醇暴露导致AD型神经变性的分子病理变化的程度。
    用含有24%或0%热量乙醇的等热量液体饮食喂养LongEvans雄性和雌性大鼠2周(n=8/组)。额叶用于测量对AD生物标志物的免疫反应性,胰岛素相关的内分泌代谢分子,和促炎细胞因子/趋化因子通过双重或多重酶联免疫吸附测定(ELISA)。
    乙醇显着增加了磷tau的额叶水平,但降低了Aβ,ghrelin,胰高血糖素,瘦素,PAI,IL-2和IFN-γ。
    慢性乙醇喂养的短期影响产生了反映代谢失调的神经内分泌分子病理变化,以及可能导致神经可塑性受损的异常。研究结果表明,长期饮酒迅速为AD和酒精相关脑变性的早期能量代谢受损建立了一个平台。
    UNASSIGNED: Alzheimer\'s disease (AD), one of the most prevalent causes of dementia, is mainly sporadic in occurrence but driven by aging and other cofactors. Studies suggest that excessive alcohol consumption may increase AD risk.
    UNASSIGNED: Our study examined the degree to which short-term moderate ethanol exposure leads to molecular pathological changes of AD-type neurodegeneration.
    UNASSIGNED: Long Evans male and female rats were fed for 2 weeks with isocaloric liquid diets containing 24% or 0% caloric ethanol (n = 8/group). The frontal lobes were used to measure immunoreactivity to AD biomarkers, insulin-related endocrine metabolic molecules, and proinflammatory cytokines/chemokines by duplex or multiplex enzyme-linked immunosorbent assays (ELISAs).
    UNASSIGNED: Ethanol significantly increased frontal lobe levels of phospho-tau, but reduced Aβ, ghrelin, glucagon, leptin, PAI, IL-2, and IFN-γ.
    UNASSIGNED: Short-term effects of chronic ethanol feeding produced neuroendocrine molecular pathologic changes reflective of metabolic dysregulation, together with abnormalities that likely contribute to impairments in neuroplasticity. The findings suggest that chronic alcohol consumption rapidly establishes a platform for impairments in energy metabolism that occur in both the early stages of AD and alcohol-related brain degeneration.
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  • 文章类型: Journal Article
    背景:由于胰腺神经内分泌肿瘤的罕见,仅开展了少数人群代表性的发病率和生存率研究.目的是提供神经内分泌(NE)肿瘤总体的最新全国发病率和相对生存率估计,NE肿瘤(NET),NE癌(NEC),和混合NE肿瘤(MiNEN)。
    方法:我们区分了胰腺NETs(功能性和非功能性),NEC和混合NE肿瘤,并分析了2009年至2021年来自德国所有癌症登记处的数据,涵盖了超过8000万的人口。我们计算了粗和年龄标准化的发病率和5年相对生存估计(RS)。
    结果:总共6474、4217和243例胰腺NETs患者,NEC,和混合的NE肿瘤,分别注册。虽然NETs的年龄标准化发病率有所增加(每年+16.4%,95CI12.2;20.7),NEC的发病率下降了(每年约-6.4%,95CI-8.0;-4.8)。无功能NET的粗RS为77.7%(标准误差[SE]0.9),90.3%用于正常运行的NET(SE3.9),和18.5%(SE3.9)的MiNEN。大细胞和小细胞NEC的RS较低(9.1%和6.9%,分别)。G1NET的RS为88.2%,而G3NET只有36.6%。本地化NET的RS为92.8%,而远处转移性NETs的RS为45.0%。
    结论:2009-2021年期间,德国胰腺NETs的发病率显著增加。NETs亚组(G1分级或局部分期)预后良好。MiNEN的RS比NETs更类似于NECs。
    BACKGROUND: Due to the rarity of pancreatic neuroendocrine neoplasms, only few population-representative studies on incidence and survival have been conducted. The aim was to provide up-to-date nationwide incidence and relative survival estimates of neuroendocrine (NE) neoplasms overall, NE tumors (NETs), NE carcinomas (NECs), and mixed NE neoplasms (MiNEN).
    METHODS: We distinguished between pancreatic NETs (functioning versus non-functioning), NECs and mixed NE neoplasms and analyzed data from 2009 through 2021 from all German cancer registries covering a population of more than 80 million. We calculated crude and age-standardized incidence rates and 5-year relative survival estimates (RS).
    RESULTS: Overall 6474, 4217, and 243 patients with pancreatic NETs, NECs, and mixed NE neoplasms, respectively were registered. While the age-standardized incidence of NETs has increased (+16.4 % per year, 95 %CI 12.2;20.7), the incidence of NEC has fallen (about -6.4 % per year, 95 %CI -8.0; -4.8). The crude RS was 77.7 % (standard error [SE] 0.9) for non-functioning NETs, 90.3 % for functioning NETs (SE 3.9), and 18.5 % (SE 3.9) for MiNEN. Large and small cell NECs had a low RS (9.1 % and 6.9 %, respectively). RS for G1 NETs was 88.2 %, while it was only 36.6 % for G3 NETs. Localized NETs had a RS of 92.8 %, while distant metastatic NETs had a RS of 45.0 %.
    CONCLUSIONS: The incidence of pancreatic NETs has increased markedly in Germany in the period 2009-2021. Subgroups of NETs (G1 grading or localized stage) have an excellent prognosis. RS of MiNEN is more similar to NECs than NETs.
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  • 文章类型: Journal Article
    本文介绍了非功能性散发性胰腺神经内分泌肿瘤NET的外科治疗方法。包括评估生物行为以支持决策的考虑因素,手术适应症,以及针对神经内分泌肿瘤独特性质的手术方法。
    This article presents updates in the surgical management of non-functional sporadic pancreas neuroendocrine tumors NET, including considerations for assessment of biologic behavior to support decision-making, indications for surgery, and surgical approaches tailored to the unique nature of neuroendocrine tumors.
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  • 文章类型: Journal Article
    背景:对于大小在10至20mm之间的十二指肠神经内分泌肿瘤(D-NEN)的切除技术缺乏推荐。主要目的是比较内镜切除(ER)和手术切除(SR)后的总生存期(OS)和无进展生存期(PFS)。次要目的是评估与OS相关的发生率和临床变量。
    方法:2008年至2018年D-NENs患者的数据来自荷兰癌症登记处和荷兰全国病理学数据库。
    结果:总共确定了259例患者,其中138例包括:98例(68%)接受了ER,44例(32%)接受了SR。其中,38例患者的D-NENs大小在10至20mm之间。与SR患者相比,ER患者更常见为男性,T分期和肿瘤大小更低(均P<0.05)。与SR相比,ER后更频繁地观察到阳性切除边缘(71%vs15%,P<0.005)。没有肿瘤在10至20mm之间的患者在ER或SR后死亡(中位随访71.8vs.52.0个月)。与SR相比,ER后的PFS率没有显着差异(P=0.672)。ER复发率为13%,SR复发率为7%(P=0.604)。
    结论:在2008年至2018年期间,发病率从每100,000名患者中的0.06增加到0.11。对于D-NEN,ER或SR后的OS在10和20mm之间没有差异。复发率和PFS率无显著差异。这些结果表明,大小在10和20毫米之间的D-NEN可能首先用ER治疗。需要未来的研究来证实这一假设。
    BACKGROUND: Recommendations for resection technique of duodenal neuroendocrine neoplasms (D-NEN) with a size between 10 and 20 mm are lacking. The primary aim was to compare overall survival (OS) and progression-free survival (PFS) after endoscopic resection (ER) with surgical resection (SR). The secondary aim was to assess the incidence and clinical variables correlated with OS.
    METHODS: Data of patients with D-NENs between 2008 and 2018 were extracted from the Netherlands Cancer Registry and the Dutch Nationwide Pathology Databank.
    RESULTS: A total of 259 patients were identified, of which 138 were included: 98 (68 %) underwent ER and 44 patients (32 %) underwent SR. Of these, 38 patients had D-NENs sized between 10 and 20 mm. ER Patients were more frequently male and had a lower T-stage and tumour size than SR patients (all P < 0.05). Positive resection margins were observed more frequently after ER compared to SR (71 % vs 15 %, P < 0.005). No patients with tumours between 10 and 20 mm died after ER or SR (median follow-up 71.8 vs. 52.0 months). PFS rates were not significantly different after ER compared to SR (P = 0.672). Recurrence rates were 13 % for ER and 7 % for SR (P = 0.604).
    CONCLUSIONS: Between 2008 and 2018, the incidence increased from 0.06 to 0.11 per 100,000 patients per year. OS after ER or SR did not differ for D-NEN between 10 and 20 mm. Recurrence and PFS rates were not significantly different. These results suggest that D-NENs sized between 10 and 20 mm could potentially be treated first with ER. Future studies are needed to confirm this hypothesis.
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  • 文章类型: Journal Article
    肺神经内分泌肿瘤(L-NEN)是异质性肿瘤。虽然骨转移(BM)与其他NEN的预后较差有关,它们在L-NEN中的作用值得深入分析。本研究分析了临床表现,L-NEN的治疗和生存结果,与无转移或其他部位转移的患者相比,重点关注BM患者(OtherMtx)。回顾性评估费德里科第二大学收治的L-NEN的临床病理和生存数据。包括50个L-NEN。在27名转移性患者(54%)中,13人(26%)患有BM,更常见于男性比女性和原发性双侧L-NEN或L-NEN>26毫米,更高的Ki67非典型类癌和维生素D缺乏症与BM有关。BM患者的转移部位数量高于OtherMtx。同步转移与较短的总生存期(OS)相关。BM患者的中位无进展生存期(PFS)和OS与OtherMtx相似,但检测到OS较短的风险增加了两倍.BM对PFS或OS的影响不会超过OtherMtx,但应考虑BM患者OS较短的风险增加.应建议对L-NEN进行定期骨评估。
    Lung neuroendocrine neoplasms (L-NEN) are heterogeneous tumors. While bone metastases (BM) have been associated with worse prognosis in other NEN, their role in L-NEN deserves in-depth analysis. This study analyzes the clinical presentation, treatment and survival outcomes of L-NEN, focusing on patients with BM compared with patients without metastases or with metastases in other sites (OtherMtx). The clinicopathological and survival data of L-NEN admitted to the Federico II University were retrospectively evaluated. Fifty L-NEN were included. Among 27 metastatic patients (54%), 13 (26%) had BM, more commonly occurring in males than females and in primary bilateral L-NEN or L-NEN > 26 mm, with higher Ki67. Atypical carcinoid and hypovitaminosis D were associated with BM. The number of metastatic sites was higher in patients with BM than OtherMtx. Synchronous metastases were associated with shorter overall survival (OS). The median progression-free survival (PFS) and OS in patients with BM were similar to OtherMtx, but a two-times increased risk of shorter OS was detected. BM do not impact PFS or OS more than OtherMtx, but the increased risk of shorter OS in patients with BM should be considered. Periodic bone evaluation in L-NEN should be recommended.
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  • 文章类型: Journal Article
    Radiomics通过提供定量分析,通过先进的计算技术补充传统的定性评估,彻底改变了医学成像。在这篇叙述性综述中,我们研究了琥珀酸脱氢酶(SDH)致病变体对18F-FDG放射组学特征的影响,18F-DOPA,和68Ga-DOTA-肽PET在副神经节瘤中,专注于头部和颈部定位(HNPGL)。这种影响表现在摄取强度和质地异质性,揭示可能反映特定肿瘤行为和突变状态的复杂放射学景观。通过将放射学分析与遗传数据相结合,我们将获得PET成像特征与潜在分子变化之间关系的新见解.在未来,我们设想一种整合宏观指标的方法,如病变位置,尺寸,SUV,先进的基于计算机的算法。这种综合分析可以促进SDH致病变异的体内预测,从而鼓励基因检测,并最终改善患者的预后。
    Radiomics revolutionizes medical imaging by providing quantitative analysis that complements traditional qualitative assessments through advanced computational techniques. In this narrative review we have investigated the impact of succinate dehydrogenase (SDH) pathogenic variants on the radiomic profile of 18F-FDG, 18F-DOPA, and 68Ga-DOTA-peptides PET in paragangliomas, focusing on head and neck localizations (HNPGLs). This influence manifests in uptake intensity and textural heterogeneity, revealing a complex radiomic landscape that may reflect specific tumor behaviors and mutation statuses. By combining radiomic analysis with genetic data, we will gain new insights into the relationship between PET imaging features and underlying molecular changes. In the future, we envision an approach integrating macroscopic indices, such as lesion location, size, and SUV, with advanced computer-based algorithms. This comprehensive analysis could facilitate in vivo predictions of SDH pathogenic variants, thereby encouraging genetic testing, and ultimately improving patient outcomes.
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  • 文章类型: Journal Article
    多囊卵巢综合征(PCOS)是妇科最常见的内分泌疾病之一。PCOS的大多数病理生理变化始于青春期,这些病理生理变化会持续影响女性生命后期的健康。PCOS的致病机制尚不清楚。涉及的关键方面,如下丘脑-垂体功能的调节,卵巢细胞功能,雄激素水平,和胰岛素抵抗。在这里,我们从遗传背景的角度总结了PCOS发病机制的最新发现,宫内发育,神经内分泌功能,炎症因子,肠道微生物组,和环境因素。这篇综述将有助于为更深入地了解该病提供新的思路,以及其临床诊断和治疗。
    Polycystic ovary syndrome (PCOS) is one of the most common gynecological endocrine disorders. Most pathophysiological changes of PCOS begin in the peripubertal phase, and these pathophysiological changes will continuously affect women\'s health in the later stages of their lives. The pathogenic mechanisms of PCOS remain unclear, involving key aspects such as the regulation of hypothalamic-pituitary function, ovarian cellular functions, androgen levels, and insulin resistance. Herein, we summarized the latest findings on the pathogenesis of PCOS from the perspectives of the genetic background, intrauterine development, neuroendocrine function, inflammatory factors, gut microbiome, and environmental factors. This review will help provide new ideas for a deeper understanding of the disease, as well as its clinical diagnosis and treatment.
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  • 文章类型: Journal Article
    神经内分泌肿瘤是一种惰性,主要来自胃胰管和肺的异质性肿瘤组。大多数患者在诊断时出现肝转移,由于激素分泌过多而导致大量发病率和死亡率,胆管阻塞,和肝损伤。这些患者中的一小部分有资格通过手术切除获得潜在的治愈。然而,介入放射学提供肝脏定向治疗,如经皮消融,经动脉栓塞,化疗栓塞,和放射性栓塞,用于姑息治疗和潜在的桥接神经内分泌肝转移瘤的切除和手术切除。本文旨在提供这些肝脏定向疗法的简要概述,intra-,和术后影像学检查结果。
    Neuroendocrine tumors are an indolent, heterogeneous group of tumors that primarily arise from the gastropancreatic tract and lungs. Most patients present with liver metastases at the time of diagnosis, which cause significant morbidity and mortality due to excess hormone secretion, bile duct obstruction, and liver damage. A small percentage of these patients are eligible for potential cure through surgical resection. However, interventional radiology provides liver-directed therapies, such as percutaneous ablation, transarterial embolization, chemoembolization, and radioembolization, for palliative care and potential bridging to debulking and surgical resection of neuroendocrine liver metastases. This article aims to provide a brief overview of these liver-directed therapies focusing on the pre-, intra-, and postprocedural imaging findings.
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  • 文章类型: Journal Article
    多囊卵巢综合征(PCOS)是育龄期妇女无排卵性不孕的主要原因,肥胖可增加PCOS表型的严重程度和发展。产前睾酮(T)治疗在妊娠30-90天之间进入青春期,破坏了雌性绵羊的生殖和代谢表型,概括PCOS女性的特征,产后肥胖加剧了其严重程度。另一方面,从妊娠60-90天的产前T治疗导致更温和的表型。我们假设在妊娠60-90天之间通过产前T治疗编程的生殖神经内分泌缺陷被绵羊的产后肥胖放大。萨福克母羊从妊娠60-90天每周两次接受丙酸T(T;100mg)或玉米油(C;载体)。在5个月大的时候,将T羔羊分配给维持饮食(NRC要求的100%)或过量饮食(NRC的130%),并将C羔羊饲喂维持饮食。我们比较了通过每周两次测量孕酮浓度确定的青春期时间(n=15/组),雌二醇正反馈反应性(n=8/组)通过评估外源性雌二醇的LH分泌来确定,与两次注射PGF2α同步后的第二个繁殖季节(n=8/组)的周期排卵LH动力学,和孕酮负反馈(n=8/组),通过表征C之间黄体中期的LH脉冲来确定,T-维持和T-过度供给组。我们的发现表明,产后肥胖:1)在第二个繁殖季节(成年期)加剧了生殖缺陷,并进一步恶化了生殖周期性;2)在延迟LH激增的时间和幅度方面,没有放大雌二醇正反馈的损害,尽管它减少了排卵前LH激增期间分泌的LH总量;3)放大了对孕酮负反馈的反应性降低,表现为LH脉冲振幅和峰值的增加。这些观察,除了支持我们以前的发现,产前T治疗会导致生殖神经内分泌功能障碍和排卵破坏,提供证据表明,母羊出生后肥胖会放大这些在60-90天之间编程的神经内分泌缺陷。
    Polycystic ovary syndrome (PCOS) is the leading cause of anovulatory infertility in women of reproductive age, and obesity can increase the severity and development of the PCOS phenotype. Prenatal testosterone (T) treatment between gestational days 30-90 advanced puberty and disrupted the reproductive and metabolic phenotype in female sheep, recapitulating attributes of women with PCOS, with postnatal obesity amplifying its severity. On the other hand, prenatal T treatment from gestational days 60-90 led to a much milder phenotype. We hypothesized that reproductive neuroendocrine defects programmed by prenatal T treatment between gestational days 60-90 are amplified by postnatal obesity in sheep. Suffolk ewes received T propionate (T; 100 mg) or corn oil (C; vehicle) twice weekly from gestational days 60-90. At 5 months of age, T lambs were assigned to either a maintenance (100% of NRC requirements) or overfed (130% NRC) diet and C lambs were fed the maintenance diet. We compared the timing of puberty (n = 15/group) determined by twice weekly measurement of progesterone concentrations, estradiol positive feedback responsiveness (n = 8/group) determined by assessing LH secretion in response to exogenous estradiol, periovulatory LH dynamics during the second breeding season (n = 8/group) following synchronization with two injections of PGF2α, and progesterone negative feedback (n = 8/group) determined by characterizing LH pulses during the mid-luteal phase between C, T-maintenance and T-overfed groups. Our findings indicate that postnatal obesity: 1) exacerbated reproductive defects and further deteriorated reproductive cyclicity during the second breeding season (adulthood); 2) did not amplify the impairment in estradiol positive feedback in delaying the timing and amplitude of the LH surge, although it reduced the total amount of LH secreted during the preovulatory LH surge; 3) amplified the reduced responsiveness to progesterone negative feedback manifested as an increase in LH pulse amplitude and peak. These observations, in addition to supporting our previous findings that prenatal T treatment results in reproductive neuroendocrine dysfunction and periovulatory disruptions, provide evidence that these neuroendocrine defects programmed between gestational days 60-90 are amplified by postnatal obesity in female sheep.
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  • 文章类型: Journal Article
    代谢健康高度依赖于饮食和内源性脂质和脂蛋白的肠道和肝脏处理。脂质和脂蛋白代谢紊乱通常在肥胖等胰岛素抵抗状态的患者中观察到,代谢综合征,和2型糖尿病。来自动物模型和人类研究的证据表明,代谢或糖尿病性血脂异常的主要潜在因素是含有肝脏和肠道载脂蛋白(apo)B的脂蛋白颗粒的过量产生。这些颗粒被分解代谢成高度致动脉粥样硬化的残留物,可以被吸收到动脉内膜并促进斑块发展。几种肠道衍生肽已被鉴定为能量代谢的关键调节剂;一种这样的肽是肠促胰岛素激素胰高血糖素样肽(GLP)-1。我们的实验室先前已经证明GLP-1可以在中枢和外周发出信号,以减少餐后和空腹脂蛋白的分泌。此外,我们已经证明GLP-1受体(GLP-1R)激动剂可以改善饮食诱导的血脂异常.最近,我们发表了一种新的迷走神经内分泌信号通路的证据,天然GLP-1可能通过该通路发挥其抗血脂作用.此外,我们证明了其他肠道衍生肽在调节肠道脂蛋白产生中的新作用。总的来说,充足的证据支持GLP-1R在门静脉传入神经元和结性神经节中在调节肠道脂肪吸收和脂蛋白产生方面的关键作用,并确定其他肠道衍生肽是餐后血脂血症的新型调节因子.来自这些数据的见解可能支持潜在药物靶标的识别以及针对糖尿病血脂异常的治疗的新疗法的开发。
    Metabolic health is highly dependent on intestinal and hepatic handling of dietary and endogenous lipids and lipoproteins. Disorders of lipid and lipoprotein metabolism are commonly observed in patients with insulin resistant states such as obesity, metabolic syndrome, and type 2 diabetes. Evidence from both animal models and human studies indicates that a major underlying factor in metabolic or diabetic dyslipidemia is the overproduction of hepatic and intestinal apolipoprotein (apo)B-containing lipoprotein particles. These particles are catabolized down into highly proatherogenic remnants, which can be taken up into the arterial intima and promote plaque development. Several gut-derived peptides have been identified as key regulators of energy metabolism; one such peptide is the incretin hormone glucagon-like peptide (GLP)-1. Our laboratory has previously demonstrated that GLP-1 can signal both centrally and peripherally to reduce postprandial and fasting lipoprotein secretion. Moreover, we have demonstrated that GLP-1 receptor (GLP-1R) agonists can ameliorate diet-induced dyslipidemia. Recently, we published evidence for a novel vagal neuroendocrine signalling pathway by which native GLP-1 may exert its anti-lipemic effects. Furthermore, we demonstrated a novel role for other gut-derived peptides in regulating intestinal lipoprotein production. Overall, ample evidence supports a key role for GLP-1R on the portal vein afferent neurons and nodose ganglion in modulating intestinal fat absorption and lipoprotein production and identifies other gut-derived peptides as novel regulators of postprandial lipemia. Insights from these data may support identification of potential drug targets and the development of new therapeutics targeting treatment of diabetic dyslipidemia.
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