Hofland Leo J
Department of Internal Medicine, Division Endocrinology, Erasmus MC, Rotterdam, The Netherlands.
Mol Cell Endocrinol. 2008 May 14;286(1-2):199-205. doi: 10.1016/j.mce.2007.10.015. Epub 2007 Nov 22.
Cushing's disease is caused by an ACTH secreting pituitary adenoma. Surgery is the treatment of choice and cure rates between 60 and 90% are reported. For patients in which surgery fails, effective medical treatment options are needed. Somatostatin (SS) receptors (sst) are expressed on normal and tumoral corticotroph cells. However, the role of somatostatin and in particular the current clinically available sst(2)-preferring SS analogs in the regulation of normal ACTH secretion, as well as in lowering ACTH and cortisol hypersecretion in patients with Cushing's disease, has been shown to be limited. Recent studies have provided renewed insights into the expression of sst subtypes, as well as into the functional role of SS-analogs in the regulation of ACTH secretion by corticotroph tumors. Sst(2) and sst(5) seem the predominantly expressed sst in corticotroph adenoma cells and targeting both these receptors with a new generation of multiligand SS analogs showed promising effects in terms of lowering ACTH release and urinary free cortisol (UFC) levels in patients with Cushing's disease. In this review an overview of the current insights into the role of SS and sst in the regulation of normal and pathological ACTH secretion is provided.
库欣病由分泌促肾上腺皮质激素（ACTH）的垂体腺瘤引起。手术是首选治疗方法，据报道治愈率在60%至90%之间。对于手术失败的患者，需要有效的药物治疗选择。生长抑素（SS）受体（sst）在正常和肿瘤性促肾上腺皮质激素细胞上表达。然而，生长抑素的作用，尤其是目前临床上可用的优先作用于sst(2)的SS类似物在调节正常ACTH分泌以及降低库欣病患者ACTH和皮质醇分泌过多方面的作用，已被证明是有限的。最近的研究对sst亚型的表达以及SS类似物在调节促肾上腺皮质激素肿瘤ACTH分泌中的功能作用有了新的认识。Sst(2)和sst(5)似乎是促肾上腺皮质激素腺瘤细胞中主要表达的sst，用新一代多配体SS类似物靶向这两种受体在降低库欣病患者ACTH释放和尿游离皮质醇（UFC）水平方面显示出有前景的效果。在这篇综述中，概述了目前对SS和sst在调节正常和病理性ACTH分泌中作用的认识。
