Publications by authors named "Touraine P"

Article Synopsis
  • - Premature ovarian insufficiency (POI) is a condition where women's ovaries stop functioning normally before age 40, leading to infertility and hormonal issues, marked by absent menstrual cycles and high follicle-stimulating hormone levels.
  • - POI can be triggered by various factors, including medical treatments, genetic conditions, infections, and autoimmune diseases, affecting around 1 in 100 women, with a higher incidence before age 30.
  • - Recent advances in genetic research have improved our understanding of POI, allowing for better diagnosis and potential treatment options, including oocyte preservation for those with a family history of the condition.
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Article Synopsis
  • - The treatment of classic congenital adrenal hyperplasia (CAH) focuses on hormone replacement and managing androgen levels, but complications and increased mortality remain prevalent even with early diagnosis and ongoing therapy.
  • - An extensive review of literature revealed conflicting data on cardiometabolic risks in CAH patients compared to other adrenal insufficiencies, with various studies indicating risks such as weight gain, insulin resistance, high blood pressure, and cardiovascular issues.
  • - The increased cardiometabolic risk in individuals with classic CAH seems to stem from factors including glucocorticoid overtreatment, inadequate hormone therapy, and hormonal imbalances, highlighting the need for targeted future studies on new treatment strategies.
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Background: Primary ovarian insufficiency (POI) affects around 2-4% of women before the age of 40. Genetic factors play an important role in POI. The GDF9 gene has been identified as a significant genetic contributor of POI.

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Article Synopsis
  • Prednisolone and prednisone are common treatments for adults with congenital adrenal hyperplasia (CAH), but there hasn't been a direct comparison with hydrocortisone until this study.
  • The study was a six-month open-label randomized phase 3 trial, where patients either continued on prednis(ol)one or switched to modified-release hydrocortisone capsules (MRHC).
  • Results showed that MRHC significantly reduced levels of 17-hydroxyprogesterone (17OHP) compared to prednis(ol)one, with a majority of patients able to decrease their MRHC dosage over time and fewer experiencing adrenal crises.
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Premature ovarian insufficiency is a common form of female infertility affecting up to 4% of women and characterised by amenorrhea with elevated gonadotropin before the age of 40. Oocytes require controlled DNA breakage and repair for homologous recombination and the maintenance of oocyte integrity. Biallelic disruption of the DNA damage repair gene, Fanconi anemia complementation group A (FANCA), is a common cause of Fanconi anaemia, a syndrome characterised by bone marrow failure, cancer predisposition, physical anomalies and POI.

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  • APECED syndrome is a rare genetic disorder caused by mutations in the AIRE gene, typically characterized by a triad of symptoms including hypoparathyroidism, adrenal failure, and chronic mucocutaneous candidiasis (CMC), along with other non-endocrine issues.
  • In a national study involving 25 patients from 23 families, researchers identified 11 different variants of the AIRE gene, including two previously unreported variants, and found that a majority of patients displayed multiple clinical manifestations.
  • The study revealed significant immunological disturbances, such as NK cell lymphopenia and altered B lymphocyte homeostasis, and highlighted a variety of non-endocrine symptoms that could potentially be life-threatening, emphasizing the need for
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Pathogenic germline variants in the FOXL2 gene are associated with Blepharophimosis, Ptosis, and Epicanthus Inversus syndrome (BPES) in humans, an autosomal dominant condition. Two forms of BPES have emerged: (i) type I (BPES-I), characterized by ocular signs and primary ovarian failure (POI), and (ii) type II (BPES-II) with no systemic associations. This study aimed to compare the distribution of FOXL2 variants in idiopathic POI/DOR (diminished ovarian reserve) and both types of BPES, and to determine the involvement of FOXL2 in non-syndromic forms of POI/DOR.

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Disruption of meiosis and DNA repair genes is associated with female fertility disorders like premature ovarian insufficiency (POI). In this study, we identified a homozygous missense variant in the gene (c.596 A>C; p.

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Background: Optic pathway gliomas (OPGs) represent 5% of childhood brain tumors. Successive relapses lead to multiple treatments exposing to late complications.

Methods: We included patients treated at Gustave Roussy (GR) between January 1980 and December 2015 for OPG, before 18 years old and alive at 5 years from diagnosis.

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Pituitary deficiency, or hypopituitarism, is a rare chronic disease. It is defined by insufficient synthesis of one or more pituitary hormones (growth hormone, TSH, ACTH, LH-FSH, prolactin), whether or not associated with arginine vasopressin deficiency (formerly known as diabetes insipidus). In adult patients, it is usually acquired (notably during childhood), but can also be congenital, due to abnormal pituitary development.

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Importance: A major issue in the management of craniopharyngioma-related obesity (CRO) is the ineffectiveness of the current therapeutic approaches.

Objective: To study the efficacy of glucagon-like peptide-1 analogs compared with placebo in adults with obesity CRO.

Design: A double-blind multicenter superiority randomized clinical in trial in two parallel arms.

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Introduction: To identify drivers of preference for growth hormone deficiency (GHD) treatment in French children, and their caregivers, and to quantify the relative importance of different aspects of treatment modalities using a discrete choice experiment (DCE).

Materials And Methods: Attributes characterizing GHD treatment modalities were identified through a literature review, qualitative interviews and focus groups with children, adolescents, and caregivers. A DCE questionnaire of 12 choice tasks was administered online to four groups of participants: autonomous adolescents (12 to 18 years), non-autonomous adolescent / caregiver dyads, caregivers of non-autonomous children (3 to 11 years) and autonomous children / caregiver dyads.

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FMR1 premutation female carriers are at risk of developing premature/primary ovarian insufficiency (POI) with an incomplete penetrance. In this study, we determined the CGG repeat size among 1095 women with diminished ovarian reserve (DOR) / POI and characterized the CGG/AGG substructure in 44 women carrying an abnormal FMR1 repeat expansion number, compared to a group of 25 pregnant women carrying an abnormal FMR1 CGG repeat size. Allelic complexity scores of the FMR1 gene were calculated and compared between the two groups.

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Purpose: Premature ovarian insufficiency (POI) affects approximately 1% of women before the age of 40. Genetic contribution is a significant component of POI. The NOBOX gene was considered one of the major genetic causes of POI.

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Objective: Isolated childhood growth hormone deficiency (GHD) can persist into adulthood, and re-testing at the transition period is needed to determine whether continued growth hormone therapy is indicated. Here, our objective was to identify predictors of permanent GHD.

Design: Retrospective single-centre study of patients with childhood-onset GHD who were re-tested after adult height attainment.

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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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Context: Endocrine complications are common in pediatric brain tumor patients.

Objective: To describe hypothalamic-pituitary-gonadal axis (HPGA) function in patients treated in childhood for a primary brain tumor more than 5 years earlier, in order to identify risk factors for HPGA impairment.

Methods: We retrospectively included 204 patients diagnosed with a primary brain tumor before 18 years of age and monitored at the pediatric endocrinology unit of the Necker Enfants-Malades University Hospital (Paris, France) between January 2010 and December 2015.

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Objective: The diagnosis of premature ovarian insufficiency (POI) is a traumatic event for many patients that involves poor fertility prognosis. After such diagnosis, spontaneous pregnancies are rare. The alternatives for building a family are oocyte donation, embryo donation, and adoption.

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Objective: Poorly controlled salt-wasting (SW) congenital adrenal hyperplasia (CAH) patients often require high 9α-fluorocortisol doses as they show high levels of 17-hydroxyprogesterone (17OHP), which is a mineralocorticoid (MC)-receptor antagonist.

Design: We investigated the renin-angiotensin-aldosterone system in patients with SW-CAH receiving twice daily modified-release hydrocortisone (MR-HC, Efmody) compared with standard glucocorticoid (GC) therapy.

Methods: Data were analyzed from the 6-month, phase 3 study of MR-HC (n = 42) versus standard GC therapy (n = 41).

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Background: Classic congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency is a rare autosomal recessive condition characterized by cortisol deficiency and excess androgen production. The current standard of care is glucocorticoid (GC) therapy, and sometimes mineralocorticoids, to replace endogenous cortisol deficiency; however, supraphysiologic GC doses are usually needed to reduce excess androgen production. Monitoring/titrating GC treatment remains a major challenge, and there is no agreement on assessment of treatment adequacy.

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Article Synopsis
  • * A case study describes a patient with premature ovarian insufficiency (POI), sensorineural hearing loss, and Hashimoto's disease, suggesting a link to Perrault syndrome.
  • * Whole exome sequencing identified two novel pathogenic variants in a gene associated with the condition, supporting the connection between mitochondrial ribosome function and ovarian health.
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Introduction: Overall fertility and pregnancy outcomes in patients with nonclassic congenital adrenal hyperplasia (NCCAH) have been poorly studied. It has been suggested that hydrocortisone (HC) may decrease the time to conceive (TTC) and the rate of miscarriage in these patients.

Objectives: To describe fertility and pregnancy outcomes in a large cohort of NCCAH women.

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Article Synopsis
  • Differences of sex development and maturation (SDM) are complex conditions with a strong genetic basis, and improving their management requires better classification of these genetic factors through next-generation sequencing (NGS).
  • A survey conducted with 53 healthcare providers from a European network found that 49% responded, with most using NGS on 6720 patients—over half of whom had differences of sex development, including specific cases of ovarian insufficiency and hypogonadotropic hypogonadism.
  • The results from genetic analyses varied significantly, with detection rates of genetic variants ranging from 7% to 60%, highlighting the need for standardized practices and improved NGS methodologies across Europe for effective diagnosis and treatment.
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Objective: Growth hormone (GH) and insulin-like growth factors (IGFs) are not mandatory for reproductive life, but data suggest their synergistic action with follicle-stimulating hormone throughout ovarian folliculogenesis. We aimed to evaluate the association of IGF-1 level on clinical pregnancy rate after ovarian stimulation, with or without intrauterine insemination, in women with GH deficiency (GHD) treated with GH replacement therapy (GHRT) at conception.

Design And Methods: Data from 19 women with both GHD and hypogonadotropic hypogonadism referred to our reproductive medicine department were retrospectively collected.

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Article Synopsis
  • The study aimed to evaluate the safety and effectiveness of growth hormone (GH) replacement therapy in adults with Langerhans cell histiocytosis (LCH) who also have growth hormone deficiency (GHD), using data from the Pfizer International Metabolic Database (KIMS).
  • Out of 81 patients analyzed, one year of GH treatment showed improvements in metabolic parameters like reduced total cholesterol and increased quality of life scores, with 37 patients providing follow-up data.
  • The safety analysis revealed 36 serious adverse events over 435 patient-years, but no new safety concerns were identified, suggesting that GH treatment is safe and effective for this population.
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