Cortisol Dysregulation and Alcoholism: Consequence, Correlation or Causality?

What

The National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health, announces that Gary S. Wand, M.D., will deliver the 7th Annual Jack Mendelson Honorary Lecture. Dr. Wand is an internationally recognized neuroendocrinologist and the inaugural Rivière Professor in Endocrinology and Metabolism at The Johns Hopkins University School of Medicine. The title of his presentation is “Cortisol Dysregulation and Alcoholism: Consequence, Correlation or Causality?”

Who

Dr. Wand’s research has advanced our understanding of the genetic and environmental determinants of the stress response and has elucidated how excessive stress hormone production may contribute to neurobiological conditions such as alcohol or drug disorders.

Some of Dr. Wand’s seminal discoveries include identifying unique pharmacological responses to naloxone in individuals at increased risk for alcohol use disorders, identifying specific hormonal responses in subjects with alcohol use disorders, and characterizing human brain neurochemical changes using imaging in subjects with substance use disorders.

Dr. Wand is studying the epigenetic modulation of stress and cortisol exposure in rodent and human models, based on the hypothesis that specific epigenetic events affect how much cortisol an individual produces, which in turn influences dopamine transmission.

Dr. Wand received his medical degree and subsequent training in internal medicine from the George Washington University. Following post-doctoral training in Endocrinology and Metabolism at The Johns Hopkins University School of Medicine, he was a fellow in the peptide laboratories of Richard Mains, Ph.D. and Betty Eipper, Ph.D. in JHU’s Department of Neuroscience. Dr. Wand then joined the faculty of the Johns Hopkins University School of Medicine.

In 2000, NIAAA and the NIH honored Dr. Wand with a 10-year Merit Award to continue his research on the role of the HPA axis in alcoholism. He has also received numerous local and national “Best Doctor” awards. Dr. Wand is the author of more than 175 articles and chapters and is on the editorial board of several journals.

When

Thursday, March 19th at 1:30 p.m. EDT

Where

Masur Auditorium, NIH Building 10, Bethesda, Maryland

Background

NIAAA established the Jack Mendelson Honorary Lecture Series as a tribute to Dr. Jack Mendelson, who made remarkable scientific contributions to the field of clinical alcohol research. The purpose of this honorary lecture series is to highlight clinical/human research in the alcohol field by an outstanding investigator who has made significant and long-term contributions to our understanding of alcoholism susceptibility, alcohol’s effects on the brain and other organs, and the prevention and treatment of alcohol use disorders. NIAAA is pleased to present this series of scientific lectures to acknowledge the advances researchers are making in a wide range of alcohol-related areas of clinical research, and to honor the memory of an individual whose exciting and pioneering research with human alcoholics remains relevant today.

For additional information about the lecture see: http://www.niaaa.nih.gov/about-niaaa/our-work/research-portfolio/projects-initiatives/keller-and-mendelson-honorary-lecture

The Mendelson Honorary Lecture is free and open to the public. Sign language interpreters will be provided. For other reasonable accommodations or further information call Joanna Mayo, 301-443-3860, or visit www.niaaa.nih.gov. For TTY callers, please call the above number through the Federal Relay Service at 1-800-877-8339.

The National Institute on Alcohol Abuse and Alcoholism, part of the National Institutes of Health, is the primary U.S. agency for conducting and supporting research on the causes, consequences, prevention, and treatment of alcohol abuse, alcoholism, and alcohol problems. NIAAA also disseminates research findings to general, professional, and academic audiences. Additional alcohol research information and publications are available at http://www.niaaa.nih.gov.

About the National Institutes of Health (NIH): NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

Corcept Therapeutics Announces Nine Poster Presentations on Mifepristone for the Treatment of Cushing’s Syndrome at the 97th Annual Endocrine Society Meeting – MarketWatch

ENDO_2015

 

Corcept Therapeutics Incorporated CORT,  a pharmaceutical company engaged in the discovery, development and commercialization of drugs for the treatment of severe metabolic, oncologic and psychiatric disorders, today announced that a variety of posters about Korlym(R) (mifepristone) will be presented at the 97th annual Endocrine Society Meeting (ENDO 2015) being held at the San Diego Convention Center from March 5 – 7, 2015.

“We are pleased to see the breadth of new data being presented at ENDO 2015 about Korlym (mifepristone), which adds to the already substantial literature describing the use of mifepristone to treat Cushing’s Syndrome,” said Joseph K. Belanoff, M.D., Corcept’s Chief Executive Officer. “We are committed to bringing innovative therapies to patients in need, and we look forward to continuing our pivotal role in advancing the scientific understanding of Cushing’s syndrome and other rare and debilitating diseases.”

Multiple endocrinologists, researchers and centers of excellence are presenting a total of nine abstracts.

Read the entire article at Corcept Therapeutics Announces Nine Poster Presentations on Mifepristone for the Treatment of Cushing’s Syndrome at the 97th Annual Endocrine Society Meeting – MarketWatch.

Day 1 Coverage of ENDO 2015

ENDO_2015

 

Late-breaking Neuroendocrinology and Pituitary I

6-month interim safety and efficacy of different dose levels of TransCon HGH administered once weekly versus standard daily human growth hormone replacement therapy in pre-pubertal children with GHD
P Chatelain, O Malievsky, K Radziuk, HH Elsedfy, E Mikhailova, M Beckert


OR01-Clinical Issues in Type 1 and Type 2 Diabetes

Metformin as an adjunct therapy does not improve glycemic control among overweight adolescents with type 1 diabetes (T1D)
I Libman, KM Miller, LA DiMeglio, K Bethin, ML Katz, A Shah, JH Simmons, MJ Haller, S Raman, WV Tamborlane, J Coffey, AM Saenz, RW Beck


Patient-reported outcomes 1 year after randomization to laparoscopic adjustable gastric banding or intensive weight and diabetes management in obese patients with type 2 diabetes mellitus
DC Simonson, SA Ding, F Halperin, M Wewalka, K Foster, K Kelly, J Panosian, A Goebel-Fabbri, O Hamdy, K Clancy, D Lautz, A Vernon, AB Goldfine


Undermanagement of hyperlipidemia in young persons with type 1 diabetes (T1D)
ML Katz, GH Telo, JB Cartaya, CE Dougher, M Ding, LM Laffel


OR01-Clinical Issues in Type 1 and Type 2 Diabetes–Winner: Outstanding Abstract Award

18F-Flouride PET/CT and 18F-FDG labeled autologous leukocyte PET/CT for diagnosis of osteomyelitis in diabetic Charcot’s neuroarthropathy of foot
A Rastogi, A Bhansali


OR11-Thyroid Development, Clinical and Autoimmunity

Long-term outcomes and predictive factors of efficacy of ultrasound-guided ethanol injection for benign cystic thyroid lesions
E Papini, R Guglielmi, I Misischi, FM Graziano, A Persichetti, R Rendina, S Taccogna, G Bizzarri


OR11-Thyroid Development, Clinical and Autoimmunity–Winner: Outstanding Abstract Award

Novel insights into the effects of maternal thyroid function on child IQ reveal detrimental effects of high FT4 levels
TIM Korevaar, M Medici, H Tiemeier, E Visser, TJ Visser, RP Peeters


Oral Presentations in Reproductive Science–Winner: Oral Abstract Award in Reproductive Science

Kisspeptin signaling in the amygdala modulates reproductive hormone secretion
AN Comninos, J Anastasovska, M Sahuri-Arisoylu, X Feng Li, S Li, M Hu, CN Jayasena1, MA Ghatei, SR Bloom, P Matthews, K O’Byrne, JD Bell, WS Dhillo


PP09-Acromegaly

Biochemical control is maintained with pasireotide LAR in patients with acromegaly: Results from the extension of a randomized phase III study (PAOLA)
MR Gadelha, MD Bronstein, T Brue, MG Coculescu, L De Marinis, M Fleseriu, M Guitelman, V Pronin, G Raverot, I Shimon, J Fleck, A Kandra, AM Pedroncelli, A Colao


THR 113-137-Testis Cells: Control, Regulation and Functions

Effects of testosterone level on lower urinary tract symptoms
ED Crawford, W Poage, A Nyhuis, DA Price, SA Dowsett, D Muram

Screening for Cushing’s syndrome: Is it worthwhile?

The data suggests that Cushing is not frequent enough to support the use of routine screening in patients with morbid obesity and type 2 DM. Also only 1 % of hypertensive patients have secondary hypertension due to CS. However, screening should be considered in young patients with resistant DM and/or hypertension. Among patients with osteoporosis and vertebral fractures up to 5 % were diagnosed with subclinical hypercortisolism; most of these had adrenal adenoma. Screening for CS is important in subjects with adrenal incidentaloma, and many studies show a high prevalence (~10 %) of Cushing or subclinical CS in these patients.

Abstract

Introduction

Cushing’s syndrome (CS) is a rare disease characterized by a collection of signs and symptoms, also common in the general population without elevated cortisol secretion. During the last years more patients with CS are identified earlier and with milder disease. Many of these patients are diagnosed during screening efforts performed for certain or isolated complaints like weight gain, diabetes mellitus (DM), hypertension, osteoporosis, elevated white blood cell counts and more.

Methods

In this review article the most popular screening test performed in the studies cited was the 1-mg dexamethasone suppression test.

Conclusions

Cushing is not frequent enough to support the use of routine screening in patients with morbid obesity and type 2 DM. Also only 1 % of hypertensive patients have secondary hypertension due to CS. However, screening should be considered in young patients with resistant DM and/or hypertension. Among patients with osteoporosis and vertebral fractures up to 5 % were diagnosed with subclinical hypercortisolism; most of these had adrenal adenoma. Screening for CS is important in subjects with adrenal incidentaloma, and many studies show a high prevalence (~10 %) of Cushing or subclinical CS in these patients.

Buy this article for $39.00 at http://link.springer.com/article/10.1007%2Fs11102-015-0634-9

After massive weight gain, Cushing’s disease diagnosis saves man’s life – Health – TODAY.com

Donelle Trotman was only in his 30s when his health suddenly took a strange and frightening turn.

He was rapidly gaining weight — more than 100 pounds in one year. His upper torso was getting bigger, but not his legs. And he felt overwhelmingly tired.

“My body just started changing,” the Staten Island, New York, native told TODAY as part of a three-day series, “Medical Mysteries,” looking at people who have recovered from rare diseases.

It was especially puzzling because Trotman had never had weight issues before.

In school, Trotman was never a skinny kid, but he wasn’t overweight. He loved sports, playing both basketball and baseball.

So as he entered adulthood, he was active and in good shape. Then, three years ago, he suddenly began to gain weight.

“It was just specific places: My stomach, under my arms, my back of my neck, my face, the bottom of my back,” Trotman said. “My legs stayed the same for a long time.”

To lose the extra pounds, Trotman began running, working out and lifting weights. Nothing worked.

In the span of one year, Trotman gained more than 120 pounds, topping the scale at 366 pounds, twice the amount he weighed at 18.

“I doubled, like, I got a whole person on me,” he said.

There were other alarming changes. Trotman became so easily tired that he’d get out of breath just by chewing food. When he woke up seeing double three months ago, he knew it was time to go to the hospital.

Doctors ran a flurry of tests, but the results offered few clues, leaving everyone puzzled. Then one day, an intern noticed stretch marks all over Trotman’s body, a telltale sign that solved the mystery. Trotman had Cushing’s disease, a rare condition that affects fewer than 50,000 people in the U.S. every year.

Trotman’s weight gain was being caused by a tiny tumor at the base of his brain, prompting his body to produce too much of the hormone cortisol. He had some of the classic symptoms: major weight gain in his upper body, skin problems and acne, plus fatigue.

Dr. John Boockvar and Dr. Peter Costantino at New York’s Lenox Hill Hospital discovered Trotman had steroid levels ten times higher than normal.

“In Cushing’s disease, the pituitary gland has a small growth that releases a single hormone that causes the body to live with very high levels of steroids. The skin becomes very thin. You get increased acne. You can grow hair. You start sweating. You gain a lot of fat,” Boockvar said.

There was no time to lose: Untreated, Cushing’s is a fatal disease. Trotman was getting close to the point where doctors would not be able to reverse the changes, Costantino noted. He underwent surgery two weeks ago and had the growth successfully removed.

“The tumor was no bigger than the size of the tip of my pen,” Boockvar said. “And that something so small can cause a man to grow to 350 pounds and absolutely destroy his life is rather remarkable.”

These days, Trotman is feeling much better. His main focus now is to lose the weight he gained and regain an active lifestyle. He hopes to play basketball with his son soon.

“It’s wonderful. Every day it’s just like I feel a little stronger,” he said.

Doctors say Trotman will continue to lose weight and can shoot hoops with his son in about three months. There is an 8-10 percent chance the disease could come back, but Trotman said he knows what to look for now.

One of the reasons Trotman wanted to share his story is so others might recognize the symptoms of Cushing’s, although doctors stress it is a very rare illness.

 

Watch the video here: After massive weight gain, Cushing’s disease diagnosis saves man’s life – Health – TODAY.com.