adrenal insufficiency | Ricerc@Sapienza

Adrenal and pituitary disorders

All glands are created equal, but some glands are more equal than the others. Understanding the complications and the development of new treatments for pituitary and adrenal disorders has exploded in the past decades. We have contributed to investigating and systematically analyzing the available evidence. Our favorite condition is the most difficult of them all, Cushing's syndrome. Nonetheless, the international community has also appreciated our research on obesity, the metabolic effect of GH, and the treatments used to manage its excess.

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Circadian rhythm of glucocorticoid administration entrains clock genes in immune cells: a dream trial ancillary study

Adrenal insufficiency (AI) requires life-long glucocorticoid replacement. Conventional therapies fail to mimic the endogenous cortisol circadian rhythm. Clock genes are essential components of the molecular machinery controlling an organ's circadian function and are influenced by glucocorticoids. However, clock gene expression has never been investigated in AI patients.

Towards the tailoring of glucocorticoid replacement in adrenal insufficiency: the Italian Society of Endocrinology Expert Opinion

Context: Glucocorticoid (GC) replacement therapy in patients with adrenal insufficiency (AI) is life saving. After over 50 years of conventional GC treatment, novel formulations are now entering routine clinical practice. Methods: Given the spectrum of medications currently available and new insights into the understanding of AI, the authors reviewed relevant medical literature with emphasis on original studies, prospective observational data and randomized controlled trials performed in the past 35 years.

The short Synacthen (corticotropin) test can be used to predict recovery of hypothalamo-pituitary-adrenal axis function

Context: The 250-mg short Synacthen (corticotropin) test (SST) is the most commonly used tool to assess hypothalamo-pituitary-adrenal (HPA) axis function. There are many potentially reversible causes of adrenal insufficiency (AI), but no data to guide clinicians as to the frequency of repeat testing or likelihood of HPA axis recovery. Objective: To use the SST results to predict adrenal recovery. Design: A retrospective analysis of 1912 SSTs data. Patients: Seven hundred seventy-six patients with reversible causes of AI were identified who had at least two SSTs performed.