Interest of Chromogranin A for diagnosis and follow-up of endocrine tumours.

OBJECTIVE: To determine the interest of Chromogranin A (CgA) determination for diagnosis and follow-up in patients with gastroenteropancreatic endocrine tumours (GEP-ET) and multiple endocrine neoplasia type 1 (MEN-1). PATIENTS AND METHODS: CgA levels were measured with an immunoradiometric assay in 124 sporadic GEP-ET, 34 MEN-1 and 127 controls. Serial determinations were performed in 56 patients (212 visits). Changes in CgA levels over 25% were considered as significant. RESULTS: Using a cut-off value of 130 micro g/l, established from a receiver-operating characteristic curve, the specificity of CgA was 98.4%, with a sensitivity of 62.9%, higher in secreting than in nonsecreting tumours (73%vs. 45%; P < 0.003) and related to the extent of metastatic spreading (P < 0.001). In nonsecreting tumours, the positive predictive value (PPV) of CgA for the presence of metastases was 100% but the negative predictive value (NPV) was only 50%. In MEN-1, high CgA levels indicated a pancreatic tumour with a 100% specificity but the sensitivity was 59%. During the follow-up, the concordance between CgA and tumour evolution was 80%, whatever the secretory status. In patients with carcinoid tumours, the concordance was higher for CgA than for serotonin (81%vs. 54%; P < 0.001). CONCLUSION: Due to its high specificity, CgA determination may help to discriminate the endocrine character of a GEP tumour and to indicate a pancreatic tumour in MEN-1. However, its low NPV in nonsecreting tumours limits its interest for diagnosis and staging. By contrast, serial evaluation of CgA seems of particular interest for the follow-up of GEP-ET tumours.

Interleukin 1alpha stimulates lactate dehydrogenase A expression and lactate production in cultured porcine sertoli cells.

By using cultured porcine Sertoli cells as a model, the action of interleukin 1alpha (IL-1alpha) on lactate production and the site of this action were studied. IL-1alpha stimulated Sertoli cell lactate production in a time- and dose-dependent manner (with a half-maximal effect [ED50] of 6 pM). Two major sites involved in IL-1alpha action were identified. First, IL-1alpha was shown to increase the uptake of glucose substrate in a time- and dose-dependent manner. The maximal effect, with an ED50 of 10 pM, was observed after 24 h of treatment. Second, IL-1alpha increased the activity of the lactate dehydrogenase (LDH) A4 isoform, which is involved in the conversion of pyruvate into lactate. This increase in LDH A4 activity was detected at 12 h and was maximal, with an ED50 of 9 pM, after 24-h treatment with IL-1alpha. The increase was related to an increase in LDH A4 expression, since IL-1alpha stimulated LDH A mRNA (size: 1.5 kilobases, evidenced through Northern blotting analysis) in a dose- and time-dependent manner. Assuming that IL-1alpha might be produced in the seminiferous tubules by both Sertoli and germ cells, which utilize lactate for their energy metabolism, we suggest that these results together show 1) that the cytokine may represent a signal in the metabolic cooperation existing between Sertoli cells and germ cells, and 2) that a redistribution of LDH isoforms in favor of LDH A4 under IL-1alpha control is a key mechanism(s) in such cooperation used by germ cells to enhance lactate production in Sertoli cells.

Tumor necrosis factor-alpha-stimulated lactate production is linked to lactate dehydrogenase A expression and activity increase in porcine cultured Sertoli cells.

By using, as a model, cultured testicular immature Sertoli cells, the action of tumor necrosis factor-alpha (TNF alpha) and the site of action of the cytokine on lactate production were studied. TNF alpha stimulated in a time- and dose-dependent manner (with an ED50 of 0.1 nM) Sertoli cell lactate production. Two major sites involved in TNF alpha action were identified. Firstly, TNF alpha was shown to increase the uptake of glucose substrate in a time- and dose-dependent manner. The maximal effect was observed after 24 h of treatment, with an ED50 of 0.1 nM. Secondly, TNF alpha increased the activity of lactate dehydrogenase (LDH) A isoform, which is involved in the conversion of pyruvate into lactate. This increase in LDH-A activity was detected at 12 h and was maximal after 24 h of treatment with TNF alpha. The stimulatory effect of the cytokine on the LDH-A isoform was observed with an ED50 of 0.05 nM. Such an increase in LDH-A activity was related to an increase in LDH-A expression, because TNF alpha stimulated LDH-A messenger RNA (size, 1.5 kilobases, determined by Northern blotting analysis). Together, assuming that in the seminiferous tubules, TNF alpha is produced by spermatids that use lactate for their energetic metabolism, we suggest that the cytokine may potentially represent a signal used by germ cells to enhance lactate production in Sertoli cells through, at least, a redistribution of LDH isoforms in favor of LDH-A.

Effect of epidermal growth factor/transforming growth factor alpha on lactate production in porcine Sertoli cells: glucose transport and lactate dehydrogenase isozymes as potential sites of action.

Germ cell development is dependent upon the delivery of essential nutriments such as lactate originating from Sertoli cells. Lactate production is under the systemic control but probably also under a local control exerted via certain growth factors. By using a model of porcine cultured Sertoli cells, we have characterized the action of epidermal growth factor (EGF) on lactate production and further delineated the potential biochemical mechanisms involved in the EGF action. EGF stimulated lactate production in a time and dose dependent manner with a half-maximal (ED50) and maximal effects, respectively with 3.8 (0.6 x 10(-9) M) and 22 ng/ml of EGF. Lactate formation involves several biochemical steps among which the glucose substrate uptake and transport system as well as the lactate dehydrogenase (LDH) activity appear to play key roles. We report here that EGF increased the uptake of glucose evaluated through that of 2-deoxy-D-glucose (2-DOG), a non-metabolizable glucose analog. Such an increase in glucose substrate uptake occurs both after a long term (48 h) and a short term treatment (ED50 = 6.4 ng/ml, 1.1 x 10(-9) M EGF). Moreover, EGF was also able to enhance the activity of the Sertoli cell LDH. The maximal effect of the growth factor on LDH activity was observed after a long term (24 h) treatment with an ED50 of 7 ng/ml (1.2 x 10(-9) M).(ABSTRACT TRUNCATED AT 250 WORDS)