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group_5_presentation_1_-_glucocorticoid_hyperfunction_cushing_s_syndrome [2017/10/01 12:30]
mohamesb [Introduction]
group_5_presentation_1_-_glucocorticoid_hyperfunction_cushing_s_syndrome [2018/01/25 15:18] (current)
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 {{youtube>​J6-KRmqimIQ?​medium}} {{youtube>​J6-KRmqimIQ?​medium}}
 +
 +==== Adrenal Glucocorticoid Hyperfunction:​ Cushing'​s Syndrome PowerPoint ====
 +
 +{{:​cushing_s_presentation.pptx|}}
  
 ===== Introduction ===== ===== Introduction =====
-<​box ​30% round right | > {{:hpa_.jpg?nolink&​250|}}  </box| Figure 1: The HPA (stress response) Axis > +<​box ​32% round right | > {{ ::​screen_shot_2017-10-01_at_12.42.47_pm.png?345 |}} </box| Figure 1: The HPA (stress response) Axis > 
  
 Cushing’s syndrome results from excessive, long-term exposure to endogenous or exogenous forms of glucocorticoids (Orth, 1995). Glucocorticoids are a class of steroids, with cortisol being the most important. Glucocorticoids are particularly important in mediating the stress response of the body, and they are also involved in anti-inflammatory actions (Marshall, Bangert & Lapsley, 2012). Normally, the hypothalamic-pituitary-adrenal axis (HPA Axis) releases cortisol from the adrenal glands in response to a stressor (Figure 1). Activation of the HPA axis initiates a cortisol cascade. Various stressors will result in the secretion of corticotropin-releasing hormone (CRH) from the hypothalamus,​ which then stimulates the pituitary gland to release adrenocorticotropic hormone (ACTH). Circulating ACTH acts on the adrenal cortex to release cortisol and exert negative feedback control to restore homeostasis.  ​ Cushing’s syndrome results from excessive, long-term exposure to endogenous or exogenous forms of glucocorticoids (Orth, 1995). Glucocorticoids are a class of steroids, with cortisol being the most important. Glucocorticoids are particularly important in mediating the stress response of the body, and they are also involved in anti-inflammatory actions (Marshall, Bangert & Lapsley, 2012). Normally, the hypothalamic-pituitary-adrenal axis (HPA Axis) releases cortisol from the adrenal glands in response to a stressor (Figure 1). Activation of the HPA axis initiates a cortisol cascade. Various stressors will result in the secretion of corticotropin-releasing hormone (CRH) from the hypothalamus,​ which then stimulates the pituitary gland to release adrenocorticotropic hormone (ACTH). Circulating ACTH acts on the adrenal cortex to release cortisol and exert negative feedback control to restore homeostasis.  ​
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 ====Pasireotide (Signifor)==== ====Pasireotide (Signifor)====
  
-Pasireotide acts as an analog to somatostatin,​ which is known as a growth hormone-inhibiting hormone. The drug inhibits ​corticotropin ​secretion from the hypothalamus, a hormone that leads to the secretion of ACTH and eventually ​the secretion of cortisol (McKeage, 2013).+Pasireotide acts as an analog to somatostatin,​ which is known as a growth hormone-inhibiting hormone. The drug inhibits ​adrenocorticotropin (ACTH) ​secretion from the pituitary gland, a hormone that eventually ​leads to the secretion of cortisol (McKeage, 2013).
  
 A study done by researchers looked at patients with Cushing’s disease and prescribed them with pasireotide for 6 months. At the end of the trials, 25% of all patients have normalized UFC levels and a significant decrease in the mean UFC levels of all patients. Patients that saw a reduction in their UFC levels also saw improvements in clinical symptoms as well, such as blood pressure and body weight. The drug, however, has shown to cause hyperglycemia in patients and is still under further testing (McKeage, 2013). A study done by researchers looked at patients with Cushing’s disease and prescribed them with pasireotide for 6 months. At the end of the trials, 25% of all patients have normalized UFC levels and a significant decrease in the mean UFC levels of all patients. Patients that saw a reduction in their UFC levels also saw improvements in clinical symptoms as well, such as blood pressure and body weight. The drug, however, has shown to cause hyperglycemia in patients and is still under further testing (McKeage, 2013).
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