Endocrinology Unit, Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil.
Neuroendocrinology. 2011;93(1):40-7. doi: 10.1159/000322040. Epub 2010 Nov 13.
It has been reported in some series that gsp+ somatotropinomas are more sensitive to somatostatin analogues (SA) and dopamine's actions which may be related to their somatostatin receptor (SSTR) and dopamine receptor (DR) profile. No previous studies have been undertaken to evaluate the SSTR and DR profile related with the gsp status in somatotropinomas.
To determine if (1) gsp status is correlated with response to octreotide LAR (LAR) and tumor expression patterns of SSTR1-5 and DR1-5 and (2) cAMP level can directly modulate SSTR and DR mRNA levels.
Response to SA was evaluated by GH and IGF-I percent reduction after 3 and 6 months of treatment with LAR. Conventional PCR and sequencing were used to identify gsp+ tumors. Quantitative real-time PCR was used to determine SSTR and DR tumor expression. Primary pituitary cell cultures of primates were used to study whether SSTR and DR expression is regulated by forskolin.
The response to LAR did not significantly differ between patients with gsp+ and gsp- tumors; however, gsp+ tumors expressed higher levels of SSTR1, SSTR2, DR2 and a lower level of SSTR3. Forskolin increased SSTR1, SSTR2, DR1 and DR2 expression in cell cultures.
Elevated SSTR1, SSTR2, and DR2 tumor expression may help improve responsiveness to SA and DA therapy; however, this study may not have been appropriately powered to observe significant effects in the clinical response. Elevated cAMP levels could be directly responsible for the upregulation in SSTR1, SSTR2 and DR2 mRNA levels observed in gsp+ patients.
一些研究系列报道 gsp+生长激素腺瘤对生长抑素类似物(SA)和多巴胺的作用更敏感,这可能与它们的生长抑素受体(SSTR)和多巴胺受体(DR)谱有关。以前没有研究评估过与生长激素腺瘤中的 gsp 状态相关的 SSTR 和 DR 谱。
确定(1)gsp 状态是否与奥曲肽 LAR(LAR)的反应和 SSTR1-5 和 DR1-5 的肿瘤表达模式相关,以及(2)cAMP 水平是否可以直接调节 SSTR 和 DR mRNA 水平。
通过 LAR 治疗 3 个月和 6 个月后 GH 和 IGF-I 百分比降低来评估 SA 的反应。使用常规 PCR 和测序来识别 gsp+肿瘤。使用定量实时 PCR 来确定 SSTR 和 DR 肿瘤表达。使用灵长类动物的垂体细胞原代培养来研究 SSTR 和 DR 表达是否受 forskolin 调节。
LAR 反应在 gsp+和 gsp-肿瘤患者之间没有显著差异;然而,gsp+肿瘤表达更高水平的 SSTR1、SSTR2、DR2 和更低水平的 SSTR3。福司可林增加了细胞培养物中的 SSTR1、SSTR2、DR1 和 DR2 表达。
肿瘤中 SSTR1、SSTR2 和 DR2 的表达升高可能有助于提高对 SA 和 DA 治疗的反应性;然而,这项研究可能没有足够的效力来观察临床反应中的显著效果。升高的 cAMP 水平可能直接导致 gsp+患者中观察到的 SSTR1、SSTR2 和 DR2 mRNA 水平上调。