Early postoperative prediction of both disease remission and long-term disease control in acromegaly using the oral glucose tolerance test.

PURPOSE: Transsphenoidal surgery (TSS) is the cornerstone of acromegaly treatment. Two biochemical parameters, growth hormone (GH) and insulin-like growth factor-1 (IGF-1) levels, sometimes diverge postoperatively; however, it is important to maintain disease control without further treatment, regardless of whether these parameters converge. This study investigated whether remission and long-term disease control could be predicted using early postoperative GH and IGF-1 levels. METHODS: We reviewed 36 consecutive surgically treated patients with acromegaly. IGF-1 levels and minimum GH levels during an oral glucose tolerance test (OGTT) were evaluated at 2 weeks, as well as at 3 months postoperatively. After comparison between the remission and nonremission groups, we analyzed whether early postoperative parameters could predict remission and long-term disease control. RESULTS: Twenty-five patients (69.4%, Group A) achieved remission within 1 year postoperatively. Of the remaining patients (median follow-up period, 53 months), seven (19.5%, Group B) maintained normal IGF-1 levels without treatment, whereas four (11.1%, Group C) required additional treatment. GH levels <1.5 ng/mL measured on the morning after surgery and nadir GH levels <0.7 ng/mL during the OGTT conducted at 2 weeks postoperatively were predictive of remission, with the latter demonstrating 95.2% sensitivity and 100% specificity. All group C patients had nadir GH levels ≥0.7 ng/mL during the OGTT and IGF-1 levels ≥SD +3 at 2 weeks postoperatively. CONCLUSION: Early postoperative nadir GH levels during the OGTT and IGF-1 levels at 2 weeks postoperatively demonstrated excellent predictive value for both endocrinological remission and the necessity for additional treatment.

Pasireotide-induced hyperglycemia in a patient with Cushing's disease: Potential use of sodium-glucose cotransporter 2 inhibitor and glucagon-like peptide-1 receptor agonist for treatment.

Pasireotide improves hypercortisolemia and induces hyperglycemia via somatostatin receptor type-5 stimulation. GLP-1RA and SGLT2 inhibitor potentially help regulate hyperglycemia in patients with Cushing's disease, especially after pasireotide administration.

Formation of functional innexin hemichannels, as well as gap junctional channels, in an insect cell line, NIAs-AeAl-2, derived from Asian tiger mosquito Aedes albopictus (Diptera: Culicidae): A partial but significant contribution of innexin 2.

In vertebrates, gap junctions and hemichannels consisting of connexins are important cell surface structures for communication with neighboring cells and for the regulation of various cell functions. To date, various gap-junction-related proteins have been found, including innexins in invertebrates and pannexins in vertebrates. Significant contributions of gap junctions by innexins and (hemi-)channels by pannexins to numerous functions have been reported. Verification of the presence and functional significance of innexin hemichannels, however, remains a gap in our knowledge in innexin physiology. In this study, we revealed the localization of an innexin protein (innexin 2) on the cell surface in mosquito tissues and cultured cells. Furthermore, we demonstrated the presence of functional hemichannels, as well as gap junctions, in mosquito cells using dye transfer assays. The inward uptake of fluorescent dye was inhibited by anti-innexin 2 antibody. These results suggest that innexin hemichannels are formed to function in cultured mosquito cells, in at least a partially innexin 2-dependent manner. Although only a few studies on insect hemichannels have been published, innexin-based hemichannels, as well as innexin gap junctions, could also significantly contribute to insect intercellular signal transduction.