Glucocorticoid Excess in Patients with Pheochromocytoma Compared with Paraganglioma and Other Forms of Hypertension
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
Authors: Constantinescu, Georgiana; Langton, Katharina; Conrad, Catleen; Amar, Laurence; Assie, Guillaume; Gimenez-Roqueplo, Anne-Paule; Blanchard, Anne; Larsen, Casper K.; Mulatero, Paolo; Williams, Tracy Ann; Prejbisz, Aleksander; Fassnacht, Martin; Bornstein, Stefan; Ceccato, Filippo; Fliedner, Stephanie; Dennedy, Michael; Peitzsch, Mirko; Sinnott, Richard; Januszewicz, Andrzej; Beuschlein, Felix; Reincke, Martin; Zennaro, Maria-Christina; Eisenhofer, Graeme; Deinum, Jaap
Abstract
Context: Catecholamines and adrenocortical steroids are important regulators of blood pressure. Bidirectional relationships between adrenal steroids and catecholamines have been established but whether this is relevant to patients with pheochromocytoma is unclear. Objective: This study addresses the hypothesis that patients with pheochromocytoma and paraganglioma (PPGL) have altered steroid production compared with patients with primary hypertension. Design: Multicenter cross-sectional study. Setting: Twelve European referral centers. Patients: Subjects included 182 patients with pheochromocytoma, 36 with paraganglioma and 270 patients with primary hypertension. Patients with primary aldosteronism (n = 461) and Cushing syndrome (n = 124) were included for additional comparisons. Intervention: In patients with PPGLs, surgical resection of tumors. Outcome measures: Differences in mass spectrometry-based profiles of 15 adrenal steroids between groups and after surgical resection of PPGLs. Relationships of steroids to plasma and urinary metanephrines and urinary catecholamines. Results: Patients with pheochromocytoma had higher (P <.05) circulating concentrations of cortisol, 11-deoxycortisol, 11-deoxycorticosterone, and corticosterone than patients with primary hypertension. Concentrations of cortisol, 11-deoxycortisol, and corticosterone were also higher (P <.05) in patients with pheochromocytoma than with paraganglioma. These steroids correlated positively with plasma and urinary metanephrines and catecholamines in patients with pheochromocytoma, but not paraganglioma. After adrenalectomy, there were significant decreases in cortisol, 11-deoxycortisol, corticosterone, 11-deoxycorticosterone, aldosterone, and 18-oxocortisol. Conclusions: This is the first large study in patients with PPGLs that supports in a clinical setting the concept of adrenal cortical-medullary interactions involving an influence of catecholamines on adrenal steroids. These findings could have implications for the cardiovascular complications of PPGLs and the clinical management of patients with the tumors.
The benefits of Vitamin D in the COVID-19 pandemic: biochemical and immunological mechanisms
ARCHIVES OF PHYSIOLOGY AND BIOCHEMISTRY
Authors: Musavi, Hadis; Abazari, Omid; Barartabar, Zeinab; Kalaki-Jouybari, Fatemeh; Hemmati-Dinarvand, Mohsen; Esmaeili, Parisa; Mahjoub, Soleiman
Abstract
In December 2019, a new infectious complication called CoronaVirus Infectious Disease-19, briefly COVID-19, caused by SARS-COV-2, is identified in Wuhan, China. It spread all over the world and became a pandemic. In many individuals who had suffered SARS-COV-2 infection, cytokine storm starts through cytokine overproduction and leads to Acute Respiratory Syndrome (ARS), organ failure, and death. According to the obtained evidence, Vitamin D (VitD) enhances the ACE2/Ang(1-7)/MasR pathway activity, and it also reduces cytokine storms and the ARS risk. Therefore, VitD intake may be beneficial for patients with SARS-COV-2 infection exposed to cytokine storm but do not suffer hypotension. In the present review, we have explained the effects of VitD on the renin-angiotensin system (RAS) function and angiotensin-converting enzyme2 (ACE2) expression. Furthermore, we have reviewed the biochemical and immunological effects of VitD on immune function in the underlying diseases and its role in the COVID-19 pandemic.