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GIP receptor antagonism eliminates paradoxical growth hormone secretion in some patients with acromegaly.
Jensen, Mette H; Gasbjerg, Lærke S; Skov-Jeppesen, Kirsa; Jacobsen, Jens C B; Poulsen, Steen S; Zhou, Cuiqi; Jakubauskaite, Ruta; Poulsen, Frantz R; Bonde, Christian; Albarazi, Mahmoud; Halle, Bo; Christiansen, Charlotte B; Sanni, Samra J; Byberg, Sarah; Hoe, Bjørn; Holst, Jens J; Dela, Flemming; Rasmussen, Aase K; Knop, Filip K; Arlien-Søborg, Mai C; Melmed, Shlomo; Jørgensen, Jens Otto L; Andersen, Marianne S; Hartmann, Bolette; Klose, Marianne C; Feldt-Rasmussen, Ulla; Sparre-Ulrich, Alexander H; Rosenkilde, Mette M.
Afiliación
  • Jensen MH; Antag Therapeutics Aps, Copenhagen, Denmark.
  • Gasbjerg LS; Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
  • Skov-Jeppesen K; Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
  • Jacobsen JCB; Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
  • Poulsen SS; Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
  • Zhou C; Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
  • Jakubauskaite R; Pituitary Center, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA.
  • Poulsen FR; Department of Radiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
  • Bonde C; Department of Neurosurgery, Odense University Hospital, Odense, Denmark.
  • Albarazi M; Department of Neurosurgery, Odense University Hospital, Odense, Denmark.
  • Halle B; Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark.
  • Christiansen CB; Department of Neurosurgery, Odense University Hospital, Odense, Denmark.
  • Sanni SJ; Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
  • Byberg S; Antag Therapeutics Aps, Copenhagen, Denmark.
  • Hoe B; Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
  • Holst JJ; Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.
  • Dela F; Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
  • Rasmussen AK; Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark.
  • Knop FK; Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
  • Arlien-Søborg MC; Department of Human Physiology and Biochemistry, Riga Stradins University, Riga, Latvia.
  • Melmed S; Department of Endocrinology and Metabolism, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
  • Jørgensen JOL; Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.
  • Andersen MS; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
  • Hartmann B; Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark.
  • Klose MC; Pituitary Center, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA.
  • Feldt-Rasmussen U; Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark.
  • Sparre-Ulrich AH; Department of Endocrinology, Odense University Hospital, Odense, Denmark.
  • Rosenkilde MM; Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Article en En | MEDLINE | ID: mdl-39172542
ABSTRACT
CONTEXT About 30% of patients with active acromegaly experience paradoxically increased growth hormone (GH) secretion during the diagnostic oral glucose tolerance test (OGTT). Endogenous glucose-dependent insulinotropic polypeptide (GIP) is implicated in this paradoxical secretion.

OBJECTIVE:

We used the GIP receptor (GIPR) antagonist GIP(3-30)NH2 to test the hypothesis that GIP mediates this paradoxical response when GIPR is abundantly expressed in somatotropinomas. DESIGN, PATIENTS, SETTING,

INTERVENTIONS:

25 treatment-naïve patients with acromegaly were enrolled. Each patient underwent one OGTT during simultaneous placebo infusion and one OGTT during a GIP(3-30)NH2 infusion. Blood samples were drawn at baseline and regularly after infusions to measure GH. We assessed pituitary adenoma size by magnetic resonance imaging and GIPR expression by immunohistochemistry on resected somatotropinomas. For mechanistic confirmation, we applied in vitro and ex vivo approaches. MAIN OUTCOME

MEASURE:

The effect of GIP(3-30)NH2 on paradoxical GH secretion during OGTT as a measure of GIP involvement.

RESULTS:

In four of seven patients with paradoxical GH secretion, GIP(3-30)NH2 infusion completely abolished the paradoxical response (P = 0.0003). Somatotrophs were available from three of four of these patients, all showing abundant GIPR expression. Adenoma size did not differ between patients with and without paradoxical GH secretion.

CONCLUSIONS:

Of 25 patients with acromegaly, seven had paradoxical GH secretion during OGTT, and pharmaceutical GIPR blockade abolished this secretion in four. Corresponding somatotroph adenomas abundantly expressed GIPR, suggesting a therapeutic target in this subpopulation of patients. In vitro and ex vivo analyses confirmed the role of GIP and the effects of the antagonist.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Clin Endocrinol Metab Año: 2024 Tipo del documento: Article País de afiliación: Dinamarca Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Clin Endocrinol Metab Año: 2024 Tipo del documento: Article País de afiliación: Dinamarca Pais de publicación: Estados Unidos