thus be given the opportunity to show if they are "responders" at 16 weeks and "super responders" at 52 weeks; the medication would only be continued long-term in those who may benefit most. Future studies with liraglutide 3 mg and other obesity medications will have to assess long-term cost-effectiveness and the budgetary impact of using these medications to address not only body weight loss, but also the effects upon various obesity-related comorbidities. 15The strengths of our data include the large number of patients, the detailed documentation of follow-up, and the routine clinical practice setting from a single centre. Thus, the findings are probably generalizable to other routine care clinics. The limitations include the dependence on medical records to ascertain compliance, and not accounting for possible gaps in treatment. A further limitation is the short duration of treatment in our study of 4 to 8 months compared with 1 to 3 years in the SCALE study. 6In conclusion, we show that liraglutide 3 mg combined with lifestyle advice is effective in reducing body weight in patients from Arab descent attending routine clinical care. The outcomes achieved as regards the amount of weight lost at 3 months and the percentage of patients achieving 5% weight loss were similar to published randomized controlled trials. Our results show that the treatment is also effective and safe in postbariatric surgery patients. This suggests that data from randomized controlled trials using liraglutide 3 mg can be used to inform clinical practice. The question that now needs to be answered is whether the use of this drug is cost-effective for most patients with obesity, or whether cost-effectiveness will only reach the desired level in a sub-cohort of patients, such as those with obesity and prediabetes.
We conclude that not only is leptin stored within the pituitary, but it may also be released from pituitary cells and modulate other pituitary hormone secretion. Pituitary leptin may therefore be a novel paracrine regulator of pituitary function.
Long-term treatment of acromegaly with SR-lanreotide is effective in controlling GH and IGF-I levels and symptoms and is well tolerated in the majority of patients.
These results suggest that p53, p21(WAF--1) and mdm2 are all expressed in pituitary tumours suggesting that the p53 protein detected by immunocytochemistry is wild type. Expression of p53 is associated with tumours which have a higher proliferative status. The p53 activity is probably the result of upstream signals of local stresses mediated through either genetic change, cytokines, hypoxia or hormonal factors. Our results suggest, however, that the downstream pathway mediated through the activities of p21(WAF--1) and mdm2 may be dysfunctional in these tumours.
Several cytokines have been shown to be expressed in normal and adenomatous pituitary tissue. Recently, interleukin-8 (IL-8) mRNA was identified by reverse transcription (RT)-PCR in each of a series of 17 pituitary tumours examined. We have investigated further the presence of IL-8 mRNA, using in situ hybridisation in two normal human anterior pituitary specimens and 25 human pituitary adenomas. IL-8 mRNA was not identified in either of the two normal pituitary specimens. Only three of the 25 adenomas were positive for IL-8 mRNA. In these three tumours, which included two null cell adenomas and one gonadotrophinoma, the majority of tumour cells (>90%) were positive for IL-8 mRNA. The remaining 22 adenomas were completely negative. There was no difference in tumour size or type between the IL-8 positive and the IL-8 negative tumours, and immunocytochemistry for von Willebrandt factor showed that the two groups were also similar in their degree of vascularisation.In conclusion, IL-8 mRNA was found in 12% of pituitary adenomas studied and was histologically identified within the tumour cells. In situ hybridisation is a more appropriate technique for assessing cytokine mRNA production by human pituitary tumours because RT-PCR may be too sensitive, identifying very small, possibly pathologically insignificant, quantities of mRNA that could be produced by supporting cells such as fibroblasts, endothelial cells or macrophages.
European Journal of Endocrinology 140 155-158
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