Expression of Somatostatin Receptor SST4 in Human Placenta and Absence of Octreotide Effect on Human Placental Growth Hormone Concentration during Pregnancy

Caron, P.

doi:10.1210/jc.82.11.3771

Cited by 35 publications

(29 citation statements)

References 19 publications

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“…Somatostatin receptors are expressed during fetal life (15), and the mechanism of action of SA involves the suppression of growth factors, whose role in fetus development is not yet fully understood, but is certainly crucial. However, it has been suggested previously that somatostatin receptors in the newborn might not be immediately functional (16), and that octreotide administered in pharmacological doses does not bind to placental receptors (17). Most previously reported cases were treated with octreotide only up to pregnancy confirmation and only with the s.c. short-acting analog (18)(19)(20)(21)(22).…”

Section: Discussionmentioning

confidence: 99%

Pregnancy in acromegaly: a one-center experience

2006

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Objective and design: The aim of the study was the retrospective evaluation of pregnancy in acromegalic women attending our center. Patients and methods: Six active acromegalic women (30-35-years old, disease duration 5-17 years) underwent seven pregnancies. Four patients had macroadenoma and two microadenoma; four had surgery; and two had been treated primarily with drugs. Before conception, GH and IGF-I were 5.4G 0.8 and 430G58 mg/l respectively. GH (by an assay unable to distinguish pituitary hormone from placental variant), IGF-I, and prolactin (PRL) levels were assessed before conception, every 3 months, and after delivery; visual field and magnetic resonance imaging were performed before delivery in the only patient with macroadenoma not previously operated on and after delivery in all. Results: All the women conceived normally, after discontinuation of medications in five cases and, while on treatment with depot somatostatin analogs in two (discontinued after confirmation of pregnancy). All patients remained off-treatment throughout pregnancy, had uneventful pregnancies, and term delivery. The babies were healthy and normal in length and weight. Breast-feeding was allowed in four cases. During pregnancy, GH levels showed variable changes; IGF-I, notwithstanding the withdrawal of any GH hypersecretion-suppressive treatment, remained close to normal limits in all subjects and returned to pathological levels after delivery; PRL increased physiologically, returning to baseline level after delivery. In one of the two patients primarily treated with drugs, GH levels increased and the tumor regrew throughout pregnancy, although without visual impairment. Conclusions: Pregnancy in acromegalic women has a normal course leading to a normal delivery, and produces normal babies. GH levels show variable changes, but decrease in most patients. IGF-I levels remain normal without medical treatment.European Journal of Endocrinology 155 279-284

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Section: Discussionmentioning

confidence: 99%

Pregnancy in acromegaly: a one-center experience

2006

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“…The unaffected blood TSH, thyroid hormone and IGF-1 levels in newborns are associated with incomplete somatostatin receptors in newborns [11,18]. On the other hand, placental GH secretion is not inhibited by the administration of octreotide during pregnancy because most of the somatostatin receptors occurring on the placenta are receptor SST4, whose affinity to somatostatin is low [19]. No signs of fetal toxicity were observed in rats and rabbits receiving octreotide at the doses up to 16 times over the maximum human dose calculated based on body surface area (reproduction studies conducted by Novartis Pharma Ltd., unpublished data).…”

Section: Discussionmentioning

confidence: 99%

Normal Delivery Following an Uneventful Pregnancy in a Japanese Acromegalic Patient after Discontinuation of Octreotide Long Acting Release Formulation at an Early Phase of Pregnancy

et al. 2006

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Abstract. We report a 35-year-old woman with active acromegaly despite pituitary surgery and irradiation who received continuous octreotide LAR treatment for the control of GH excess until discovery of her pregnancy. The patient delivered a healthy boy following an uneventful pregnancy after discontinuing octreotide LAR as soon as possible at the early phase of pregnancy. Despite a substantial maternal-fetal transfer of octreotide, postnatal development was normal at 3 years of age. In almost all previously described cases, octreotide was discontinued after pregnancy was confirmed. No side-effects of mother or fetus have been reported. Octreotide treatment in pregnancy seems to be feasible and safe. Due to the stilllimited number of reported cases treated with octreotide LAR, the potential benefits of octreotide LAR treatment should be weighed carefully against its possible risks.

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“…Octreotide can cross the placenta, and the receptors demonstrated on the placental membranes of octreotide-treated and untreated pregnant women displayed low affinity for octreotide, which may explain the lack of changes in GH-V and IGF1 concentrations during octreotide treatment (123). Octreotide has been used successfully in acromegalic pregnant patients until confirmation of pregnancy without any deleterious effect on the fetus (112,124).…”

Section: Diagnosis Of Acromegaly During Pregnancymentioning

confidence: 99%

Pregnancy and pituitary disorders

Karaca¹,

Tanrıverdi²,

Ünlühızarcı³

et al. 2010

European Journal of Endocrinology

158

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Major hormonal changes emerge during pregnancy. The pituitary gland is one of the most affected organs with altered anatomy and physiology. The pituitary gland is enlarged as a result of lactotroph hyperplasia. Due to physiological changes in the pituitary and target hormone levels, binding globulins, and placental hormones, hormonal evaluation becomes more complex in pregnant women. As a consequence of physiological hormonal changes, the evaluation of pituitary functions in pregnant women is quite different from that done in the prepregnant state. Pituitary adenomas may cause problems by their hormone secretion that affects the mother and the fetus besides causing an increased risk of tumor growth. Furthermore, diagnosis, course, and treatment of pituitary diseases point out differences. The changes in anatomy and physiology of the pituitary gland during pregnancy are reviewed. Pituitary disorders namely Cushing's disease; acromegaly; prolactinoma; TSH-secreting, gonadotropin-producing, and clinically nonfunctioning adenomas; craniopharyngioma; and Sheehan's syndrome, which is one of the most common causes of hypopituitarism, lymphocytic hypophysitis, and hypopituitarism, in relation to pregnancy are discussed. Being aware of all this information will prevent any serious problems which mother and child will be exposed to.

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Expression of Somatostatin Receptor SST4 in Human Placenta and Absence of Octreotide Effect on Human Placental Growth Hormone Concentration during Pregnancy

Cited by 35 publications

References 19 publications

Pregnancy in acromegaly: a one-center experience

Pregnancy in acromegaly: a one-center experience

Normal Delivery Following an Uneventful Pregnancy in a Japanese Acromegalic Patient after Discontinuation of Octreotide Long Acting Release Formulation at an Early Phase of Pregnancy

Pregnancy and pituitary disorders

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