Subcutaneous pulsatile glucocorticoid replacement therapy.

Abstract:

:The glucocorticoid hormone cortisol is released in pulses resulting in a complex and dynamic ultradian rhythm of plasma cortisol that underlies the classical circadian rhythm. These oscillating levels are also seen at the level of tissues such as the brain and trigger pulses of gene activation and downstream signalling. Different patterns of glucocorticoid presentation (constant vs pulsatile) result not only in different patterns of gene regulation but also in different neuroendocrine and behavioural responses. Current 'optimal' glucocorticoid replacement therapy results in smooth hormone blood levels and does not replicate physiological pulsatile cortisol secretion. Validation of a novel portable pulsatile continuous subcutaneous delivery system in healthy volunteers under dexamethasone and metyrapone suppression. Pulsatile subcutaneous hydrocortisone more closely replicates physiological circadian and ultradian rhythmicity.

journal_name

Clin Endocrinol (Oxf)

journal_title

Clinical endocrinology

authors

Russell GM,Durant C,Ataya A,Papastathi C,Bhake R,Woltersdorf W,Lightman S

doi

10.1111/cen.12470

subject

Has Abstract

pub_date

2014-08-01 00:00:00

pages

289-93

issue

2

eissn

0300-0664

issn

1365-2265

journal_volume

81

pub_type

临床试验,杂志文章
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    authors: Facchinetti F,Nappi RE,Sances G,Fioroni L,Nappi G,Genazzani AR

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    更新日期:2014-07-01 00:00:00

  • Acute pancreatitis and parotitis induced by methimazole in a patient with Graves' disease.

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  • Increased IGF-I : IGFBP-3 ratio in patients with hepatocellular carcinoma.

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  • Impaired quality of life in patients with treated acromegaly despite long-term biochemically stable disease: Results from a 5-years prospective study.

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