Publications by authors named "Peter Kamenickỷ"

Article Synopsis
  • Primary generalized glucocorticoid resistance syndrome (GGRS) is a rare condition linked to a mutation in the NR3C1 gene, specifically a missense variant affecting the Glucocorticoid Receptor's DNA Binding Domain.
  • A case study detailed a 59-year-old man with high cortisol levels and a misdiagnosis of Cushing disease, ultimately leading to a correct diagnosis of GGRS at age 68.
  • Functional tests on the identified gene variant indicated it had significantly reduced transcriptional activity, emphasizing the need for increased awareness of GGRS to prevent misdiagnosis and harmful treatments.
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Aberrant G-protein coupled receptor (GPCR) expression is highly prevalent in cortisol-secreting primary bilateral macronodular adrenal hyperplasia (PBMAH) and unilateral adenomas. The aberrant expression of diverse GPCRs and their ligands play an important role in the over-function of various endocrine tumours. Examples include aberrant expression of MC2R, 5-HT4R, AVPR1A, LHCGR, and GnRHR in primary aldosteronism; GCGR, LHCGR, and 5-HT4R in phaeochromocytomas and paragangliomas; TRHR, GnRHR, GIPR, and GRP101 in pituitary somatotroph tumours; AVPR2, D2DR, and SSTR5 in pituitary corticotroph tumours; GLP1R, GIPR, and somatostatin receptors in medullary thyroid carcinoma; and SSTRs, GLP1R, and GIPR in other neuroendocrine tumours.

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X-linked hypophosphataemia is a genetic disease caused by defects in the phosphate regulating endopeptidase homolog X-linked (PHEX) gene and is characterised by X-linked dominant inheritance. The main consequence of PHEX deficiency is increased production of the phosphaturic hormone fibroblast growth factor 23 (FGF23) in osteoblasts and osteocytes. Chronic exposure to circulating FGF23 is responsible for renal phosphate wasting and decreased synthesis of calcitriol, which decreases intestinal phosphate absorption.

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Objectives: X-linked hypophosphatemia (XLH) is characterized by increased concentrations of circulating fibroblast growth factor 23 (FGF-23) resulting in phosphate wasting, hypophosphatemia, atypical growth plate and bone matrix mineralization. Epidemiologic studies suggest a relationship between FGF-23, obesity, and metabolic dysfunction. The prevalence of overweight and obesity is high in children with XLH.

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Article Synopsis
  • * The French Endocrine Society and associated organizations created a reference document to address the complexities of managing these tumors, which can recur and lead to serious health issues, including impaired quality of life for patients, especially those with hypothalamic syndrome.
  • * Recent research has identified two tumor types—papillary and adamantinomatous—with different molecular signatures and treatment strategies, prompting ongoing developments in therapeutic options, including new medications for associated symptoms like hyperphagia.
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Context: X-linked hypophosphatemia (XLH) is a rare genetic bone disease affecting both children and adults, with oral manifestations such as spontaneous dental infections. The main treatments for XLH are conventional treatment (CT) with oral phosphate salts and active vitamin D supplementation, and burosumab, an antibody targeting Fibroblast Growth Factor 23 (FGF23). While the beneficial effect of CT on oral manifestations is established, the effect of burosumab on oral health is unknown, especially in adults.

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Article Synopsis
  • Cavernous sinus invasion by pituitary adenomas makes complete surgical removal difficult, affects recovery outcomes, and raises the chance of tumor recurrence, highlighting the need for accurate preoperative MRIs and intraoperative evaluations.
  • * Research into the genetic factors involved in the invasiveness of these tumors is still limited, but some genes have been linked to their aggressive nature, albeit with challenges in comparison studies.
  • * New surgical techniques, including extended endoscopic procedures and the use of medications like somatostatin agonists, show promise in managing these invasive adenomas, but further understanding of their molecular behavior is crucial for better treatment options.
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Objective: Glucocorticoid resistance is a rare endocrine disease caused by variants of the NR3C1 gene encoding the glucocorticoid receptor (GR). We identified a novel heterozygous variant (GRR569Q) in a patient with uncommon reversible glucocorticoid resistance syndrome.

Methods: We performed ex vivo functional characterization of the variant in patient fibroblasts and in vitro through transient transfection in undifferentiated HEK 293T cells to assess transcriptional activity, affinity, and nuclear translocation.

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The existence, composition, and continuity of the medial wall of the cavernous sinus (MWCS) have been extensively studied and debated. However, the precise nature of this membrane remains unknown. Understanding the anatomical characteristics of the MWCS is crucial, notably in relation to pituitary adenomas, which often invade the cavernous sinus.

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Context: Hypoparathyroidism is a rare disorder characterized by a deficiency in PTH resulting in hypocalcemia, hyperphosphatemia, and hypercalciuria. Eneboparatide is an investigational peptide agonist of the PTH1 receptor for the treatment of chronic hypoparathyroidism (HP).

Objective: To evaluate the efficacy, safety, and tolerability of eneboparatide in HP patients.

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The reserve pool of primordial follicles (PMFs) is finely regulated by molecules implicated in follicular growth or PMF survival. Anti-Müllerian hormone (AMH), produced by granulosa cells of growing follicles, is known for its inhibitory role in the initiation of PMF growth. We observed in a recent in vivo study that injection of AMH into mice seemed to induce an activation of autophagy.

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Importance: A paradoxical increase of growth hormone (GH) following oral glucose load has been described in ∼30% of patients with acromegaly and has been related to the ectopic expression of the glucose-dependent insulinotropic polypeptide (GIP) receptor (GIPR) in somatotropinomas. Recently, we identified germline pathogenic variants and somatic loss of heterozygosity of lysine demethylase 1A (KDM1A) in patients with GIP-dependent primary bilateral macronodular adrenal hyperplasia with Cushing's syndrome. The ectopic expression of GIPR in both adrenal and pituitary lesions suggests a common molecular mechanism.

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Acromegaly is a chronic disease resulting from constantly elevated concentrations of growth hormone (GH) and insulin-like growth factor I (IGF-I). If not adequately treated, GH and IGF-I excess is associated with various cardiovascular risk factors. These symptoms mainly include hypertension and impaired glucose metabolism, which can be observed in approximately one-third of patients.

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Background: Neck ultrasound (US) is a widely used and accessible operator-dependent technique that helps characterize thyroid nodules and pathologic parathyroid glands (PPGs). However, thyroid nodules may sometimes be confused with PPGs. PARATH-US study aims at identifying US characteristics to differentiate PPGs from thyroid nodules, as there is no study, at present, which directly compares the US features of these two common neoplasms.

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Article Synopsis
  • - This study aimed to analyze the final height (FH) trends in French patients with X-linked hypophosphatemia (XLH) over the past decades, as there was limited data on FH's natural history in this condition.
  • - Researchers conducted a retrospective study involving 398 XLH patients, dividing them into three birth groups (1950-1974, 1975-2000, and 2001-2006) to compare their average final heights.
  • - Results showed a significant increase in mean FH over the generations, with men still being shorter than women, indicating ongoing challenges in treating XLH. Despite improvements, many patients continue to have short stature, highlighting the need for continued progress.
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Article Synopsis
  • The study investigates how Cushing's syndrome (CS) impacts the gonadotrope axis and testicular functions in men, particularly focusing on the varying effects based on the severity of hypercortisolism and the underlying cause of the syndrome.
  • Findings suggest that men with intense hypercortisolism, especially those with paraneoplastic or ectopic ACTH secretion, experience greater impairment in reproductive health, indicated by higher rates of hypogonadotropic hypogonadism and disrupted spermatogenesis.
  • This research highlights a gap in understanding the full scope of reproductive impairment in men with CS, which has been under-studied compared to women, despite its potential to worsen related health issues like osteoporosis and myopathy.
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Background: As the population ages, the number of elderly patients with an indication for pituitary surgery is rising. Information on the outcome of patients aged over 75 is limited. This study reports a large series assessing the feasibility of surgical resection in this specific age range, focusing on surgical complications and postoperative results.

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Article Synopsis
  • * The condition is characterized by specific symptoms related to a pituitary tumor, such as headaches and joint pain, and can lead to various complications including cardiovascular and metabolic issues.
  • * Diagnosis involves elevated IGF-I levels and imaging to identify the pituitary tumor; treatment typically starts with surgery, but medication and radiation may be necessary for some patients, and care is best administered by a specialized multidisciplinary team.
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Background: Acromegaly is associated with an increased left ventricular (LV) mass, as reported in echo-based and, more recently, in a few cardiac magnetic resonance imaging (MRI) studies. One possible explanation for this increased LV mass could be water retention and subsequent myocardial edema.

Methods: In this prospective cross-sectional study, 26 patients with active acromegaly before and after treatment and 31 controls of comparable age and sex were investigated using cardiac MRI.

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Context: Musculoskeletal complications are the main manifestations in adults with X-linked hypophosphatemia (XLH). Enthesopathy significantly impairs quality of life.

Objective: To identify the risk factors associated with the development and progression of spinal enthesopathies in adults with XLH.

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Introduction: Pituitary adenomas (PAs) are common, usually benign tumors of the anterior pituitary gland which, for the most part, have no known genetic cause. PAs are associated with major clinical effects due to hormonal dysregulation and tumoral impingement on vital brain structures. PAM encodes a multifunctional protein responsible for the essential C-terminal amidation of secreted peptides.

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Article Synopsis
  • The study examines the effects of continuing burosumab treatment on adults with X-linked hypophosphataemia after a 96-week phase 3 study, focusing on lab tests, patient-reported outcomes, and walking ability.
  • Results showed sustained improvements in serum phosphate levels, vitamin D levels, and overall physical health during the 48-week extension.
  • An analysis indicated that stopping burosumab led to a loss of benefits, highlighting that ongoing treatment is essential for maintaining clinical improvements.
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Article Synopsis
  • A study linked a specific genetic variant to pituitary gigantism and investigated both sporadic and familial PAs among 299 individuals and 17 families, but no major genetic variations were found.
  • Seven potentially harmful genetic variants were identified that affect protein function, which could lead to new treatments that target these genetic changes and improve outcomes for patients with pituitary disorders.
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Patients with primary bilateral macronodular adrenal hyperplasia (PBMAH) usually present bilateral benign adrenocortical macronodules at imaging and variable levels of cortisol excess. PBMAH is a rare cause of primary overt Cushing's syndrome but may represent up to one-third of bilateral adrenal incidentalomas with evidence of cortisol excess. The increased steroidogenesis in PBMAH is often regulated by various G protein-coupled receptors (GPCRs) aberrantly expressed in PBMAH tissues; some receptor ligands are ectopically produced in PBMAH tissues, creating aberrant autocrine/paracrine regulation of steroidogenesis.

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