Doğan Berçem Ayçiçek, Arduc Ayse, Tuna Mazhar Müslüm, Berker Dilek, Demirci Nilgün, Demirtaş Semra, Çiçekcioğlu Hülya, Güler Serdar
Darıca Farabi State Hospital, Department of Endocrinology and Metabolism, Darıca, Kocaeli/Turkey.
Endocr Metab Immune Disord Drug Targets. 2016;16(1):47-55. doi: 10.2174/1871530316666160229120142.
Cabergoline is related to an elevated risk of fibrotic adverse reactions including cardiac valvular and pleuropulmonary fibrosis. We investigated pulmonary and cardiac valve fibrosis and immunological markers before and after 3 and 12 months of treatment with cabergoline in women with prolactinoma.
MATERIAL-METHODS: The study included thirty-two women with newly diagnosed prolactinoma and 28 healthy women. CAB cumulative dose was 7.8±5.5 mg after 3-month therapy, and 31±22 mg after 12-month follow-up. The risk of autoimmune adverse fibrotic reactions related to CAB treatment including cardiac valvulopathy and pulmonary fibrosis were assessed by a transthoracic echocardiography and pulmonary function tests, respectively. Immunological markers including Antistreptolysin O, Rheumatoid factor, Immunglobuline E, Antinuchlear antibody were also evaluated.
Before the start of CAB therapy, the total prevalence of trace grade of mitral, aortic, pulmonic, and tricuspid valve regurgitations were found as 34%, 3%, 6.3%, and 39 % respectively in women with prolactinoma. After improving of prolactin levels with CAB treatment, no change was found in the prevalence of the all valve regurgitations. There was no deterioration in pulmonary function tests. Rheumatoid factor was found higher in newly diagnosed women with prolactinoma than in healthy women (p=0.01), and this was improved by CAB therapy (p=0.005).
The prospective study indicated that sufficient cabergoline doses for a period of one year treatment of prolactinoma were not found to be related to fibrotic adverse reactions including cardiac valvular and pulmonary fibrosis or increased levels of immunological marker, apart from rheumatoid factor. For the first time Rf was found higher in newly diagnosed women with prolactinoma and was improved after cabergoline therapy.
卡麦角林与包括心脏瓣膜和胸膜肺纤维化在内的纤维化不良反应风险升高有关。我们调查了泌乳素瘤女性患者在接受卡麦角林治疗3个月和12个月前后的肺和心脏瓣膜纤维化及免疫标志物情况。
该研究纳入了32例新诊断的泌乳素瘤女性患者和28例健康女性。3个月治疗后卡麦角林累积剂量为7.8±5.5毫克，12个月随访后为31±22毫克。分别通过经胸超声心动图和肺功能测试评估与卡麦角林治疗相关的自身免疫性不良纤维化反应风险，包括心脏瓣膜病和肺纤维化。还评估了包括抗链球菌溶血素O、类风湿因子、免疫球蛋白E、抗核抗体在内的免疫标志物。
在卡麦角林治疗开始前，泌乳素瘤女性患者中二尖瓣、主动脉瓣、肺动脉瓣和三尖瓣反流微量级别的总患病率分别为34%、3%、6.3%和39%。卡麦角林治疗使泌乳素水平改善后，所有瓣膜反流的患病率未发现变化。肺功能测试也没有恶化。新诊断的泌乳素瘤女性患者的类风湿因子高于健康女性（p=0.01），卡麦角林治疗后有所改善（p=0.005）。
这项前瞻性研究表明，为期一年治疗泌乳素瘤的足够剂量卡麦角林未被发现与包括心脏瓣膜和肺纤维化在内的纤维化不良反应或免疫标志物水平升高有关，但类风湿因子除外。首次发现新诊断的泌乳素瘤女性患者类风湿因子较高，卡麦角林治疗后有所改善。
