Biomaterial Database

Pituitary-directed medical therapy in Cushing's disease. 2015

Stephan Petersenn, and Maria Fleseriu

ENDOC Center for Endocrine Tumors, Altonaer Str. 59, 20357, Hamburg, Germany, stephan.petersenn@endoc-med.de.

Transsphenoidal surgery remains the first line therapy in Cushing's disease, but a large number of patients will not be cured or disease will recur over time. Repeat pituitary surgery, bilateral adrenalectomy, and radiation have limitations with respect to efficacy and/or side effects. Therefore, there is a clear need for an effective medical treatment. The studies reviewed here suggest a role for pituitary-directed therapies, applying multireceptor ligand somatostatin analogs like pasireotide or second-generation dopamine agonists. Retinoic acid has been also studied in a small prospective study. These compounds target ACTH-secretion at the pituitary level and possibly inhibit corticotrope proliferation. Specific side effects of these compounds need to be considered, especially when used as long-term therapy. These novel approaches could provide options for treatment of patients in whom surgery has failed or is not possible, and while awaiting effects of radiation therapy. Preoperative use to decrease cortisol excess, potentially reducing perioperative complications, needs to be further studied.

UI	MeSH Term	Description	Entries
D010902	Pituitary Gland	A small, unpaired gland situated in the SELLA TURCICA. It is connected to the HYPOTHALAMUS by a short stalk which is called the INFUNDIBULUM.	Hypophysis,Hypothalamus, Infundibular,Infundibular Stalk,Infundibular Stem,Infundibulum (Hypophysis),Infundibulum, Hypophyseal,Pituitary Stalk,Hypophyseal Infundibulum,Hypophyseal Stalk,Hypophysis Cerebri,Infundibulum,Cerebri, Hypophysis,Cerebrus, Hypophysis,Gland, Pituitary,Glands, Pituitary,Hypophyseal Stalks,Hypophyses,Hypophysis Cerebrus,Infundibular Hypothalamus,Infundibular Stalks,Infundibulums,Pituitary Glands,Pituitary Stalks,Stalk, Hypophyseal,Stalk, Infundibular,Stalks, Hypophyseal,Stalks, Infundibular
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000236	Adenoma	A benign epithelial tumor with a glandular organization.	Adenoma, Basal Cell,Adenoma, Follicular,Adenoma, Microcystic,Adenoma, Monomorphic,Adenoma, Papillary,Adenoma, Trabecular,Adenomas,Adenomas, Basal Cell,Adenomas, Follicular,Adenomas, Microcystic,Adenomas, Monomorphic,Adenomas, Papillary,Adenomas, Trabecular,Basal Cell Adenoma,Basal Cell Adenomas,Follicular Adenoma,Follicular Adenomas,Microcystic Adenoma,Microcystic Adenomas,Monomorphic Adenoma,Monomorphic Adenomas,Papillary Adenoma,Papillary Adenomas,Trabecular Adenoma,Trabecular Adenomas
D000970	Antineoplastic Agents	Substances that inhibit or prevent the proliferation of NEOPLASMS.	Anticancer Agent,Antineoplastic,Antineoplastic Agent,Antineoplastic Drug,Antitumor Agent,Antitumor Drug,Cancer Chemotherapy Agent,Cancer Chemotherapy Drug,Anticancer Agents,Antineoplastic Drugs,Antineoplastics,Antitumor Agents,Antitumor Drugs,Cancer Chemotherapy Agents,Cancer Chemotherapy Drugs,Chemotherapeutic Anticancer Agents,Chemotherapeutic Anticancer Drug,Agent, Anticancer,Agent, Antineoplastic,Agent, Antitumor,Agent, Cancer Chemotherapy,Agents, Anticancer,Agents, Antineoplastic,Agents, Antitumor,Agents, Cancer Chemotherapy,Agents, Chemotherapeutic Anticancer,Chemotherapy Agent, Cancer,Chemotherapy Agents, Cancer,Chemotherapy Drug, Cancer,Chemotherapy Drugs, Cancer,Drug, Antineoplastic,Drug, Antitumor,Drug, Cancer Chemotherapy,Drug, Chemotherapeutic Anticancer,Drugs, Antineoplastic,Drugs, Antitumor,Drugs, Cancer Chemotherapy
D013004	Somatostatin	A 14-amino acid peptide named for its ability to inhibit pituitary GROWTH HORMONE release, also called somatotropin release-inhibiting factor. It is expressed in the central and peripheral nervous systems, the gut, and other organs. SRIF can also inhibit the release of THYROID-STIMULATING HORMONE; PROLACTIN; INSULIN; and GLUCAGON besides acting as a neurotransmitter and neuromodulator. In a number of species including humans, there is an additional form of somatostatin, SRIF-28 with a 14-amino acid extension at the N-terminal.	Cyclic Somatostatin,Somatostatin-14,Somatotropin Release-Inhibiting Hormone,SRIH-14,Somatofalk,Somatostatin, Cyclic,Somatotropin Release-Inhibiting Factor,Stilamin,Somatostatin 14,Somatotropin Release Inhibiting Factor,Somatotropin Release Inhibiting Hormone
D014212	Tretinoin	An important regulator of GENE EXPRESSION during growth and development, and in NEOPLASMS. Tretinoin, also known as retinoic acid and derived from maternal VITAMIN A, is essential for normal GROWTH; and EMBRYONIC DEVELOPMENT. An excess of tretinoin can be teratogenic. It is used in the treatment of PSORIASIS; ACNE VULGARIS; and several other SKIN DISEASES. It has also been approved for use in promyelocytic leukemia (LEUKEMIA, PROMYELOCYTIC, ACUTE).	Retinoic Acid,Vitamin A Acid,Retin-A,Tretinoin Potassium Salt,Tretinoin Sodium Salt,Tretinoin Zinc Salt,Vesanoid,all-trans-Retinoic Acid,beta-all-trans-Retinoic Acid,trans-Retinoic Acid,Acid, Retinoic,Acid, Vitamin A,Acid, all-trans-Retinoic,Acid, beta-all-trans-Retinoic,Acid, trans-Retinoic,Potassium Salt, Tretinoin,Retin A,Salt, Tretinoin Potassium,Salt, Tretinoin Sodium,Salt, Tretinoin Zinc,Sodium Salt, Tretinoin,Zinc Salt, Tretinoin,all trans Retinoic Acid,beta all trans Retinoic Acid,trans Retinoic Acid
D016896	Treatment Outcome	Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.	Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes
D047748	Pituitary ACTH Hypersecretion	A disease of the PITUITARY GLAND characterized by the excess amount of ADRENOCORTICOTROPIC HORMONE secreted. This leads to hypersecretion of cortisol (HYDROCORTISONE) by the ADRENAL GLANDS resulting in CUSHING SYNDROME.	Cushing Disease,Cushing's Disease,Inappropriate ACTH Secretion Syndrome,Inappropriate Adrenocorticotropic Hormone Secretion,Adrenocorticotropic Hormone, Inappropriate Secretion,Cushing Disease, Pituitary,Pituitary Cushing Syndrome,Pituitary-Dependant Cushing Syndrome,Pituitary-Dependant Hypercortisolism,Pituitary-Dependant Hypercortisolism Disorder,Cushing Syndrome, Pituitary,Cushing Syndrome, Pituitary-Dependant,Disease, Cushing,Hypercortisolism Disorder, Pituitary-Dependant,Hypercortisolism, Pituitary-Dependant,Hypersecretion, Pituitary ACTH,Pituitary Cushing Disease,Pituitary Dependant Cushing Syndrome,Pituitary Dependant Hypercortisolism,Pituitary Dependant Hypercortisolism Disorder,Pituitary-Dependant Hypercortisolism Disorders,Pituitary-Dependant Hypercortisolisms
D049913	ACTH-Secreting Pituitary Adenoma	A pituitary adenoma which secretes ADRENOCORTICOTROPIN, leading to CUSHING DISEASE.	Corticotroph Adenoma,Pituitary Adenoma, ACTH-Secreting,Pituitary Corticotropin-Secreting Adenoma,ACTH-Producing Pituitary Adenoma,ACTH Producing Pituitary Adenoma,ACTH Secreting Pituitary Adenoma,ACTH-Producing Pituitary Adenomas,ACTH-Secreting Pituitary Adenomas,Adenoma, Corticotroph,Adenomas, Corticotroph,Corticotroph Adenomas,Corticotropin-Secreting Adenoma, Pituitary,Corticotropin-Secreting Adenomas, Pituitary,Pituitary Adenoma, ACTH Secreting,Pituitary Adenoma, ACTH-Producing,Pituitary Adenomas, ACTH-Producing,Pituitary Adenomas, ACTH-Secreting,Pituitary Corticotropin Secreting Adenoma,Pituitary Corticotropin-Secreting Adenomas
D018491	Dopamine Agonists	Drugs that bind to and activate dopamine receptors.	Dopamine Receptor Agonists,Dopaminergic Agonists,Agonists, Dopamine Receptor,Agonists, Dopaminergic,Dopamine Agonist,Dopamine Receptor Agonist,Dopaminergic Agonist,Receptor Agonists, Dopamine,Agonist, Dopamine,Agonist, Dopamine Receptor,Agonist, Dopaminergic,Agonists, Dopamine,Receptor Agonist, Dopamine