Frontiers in endocrinology
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Front Endocrinol (Lausanne) · Jan 2017
ReviewThyroid-Stimulating Hormone Receptor Antibodies in Pregnancy: Clinical Relevance.
Graves' disease is the most common cause of thyrotoxicosis in women of childbearing age. Approximately 1% of pregnant women been treated before, or are being treated during pregnancy for Graves' hyperthyroidism. In pregnancy, as in not pregnant state, thyroid-stimulating hormone (TSH) receptor (TSHR) antibodies (TRAbs) are the pathogenetic hallmark of Graves' disease. ⋯ Maternal and fetal thyroid dysfunction (hyperthyroidism as well as hypothyroidism) are in fact associated with several morbidities. Monitoring of the maternal thyroid function, TRAbs measurement, and fetal surveillance are the mainstay for the management of Graves' disease in pregnancy. This review summarizes the biochemical, immunological, and therapeutic aspects of Graves' disease in pregnancy focusing on the role of the TRAbs in maternal and fetal function.
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Under normal physiological conditions, leptin and the leptin receptor (ObR) regulate the body weight by balancing food intake and energy expenditure. However, this adipocyte-derived hormone also directs peripheral processes, including immunity, reproduction, and bone metabolism. ⋯ We provide an extensive overview of current structural insights on the leptin-ObR interface and ObR activation, coupling to signaling pathways and their negative regulation, and leptin functioning under normal and pathophysiological conditions (obesity, autoimmunity, cancer, … ). We also discuss possible cross-talk with other receptor systems on the receptor (extracellular) and signaling cascade (intracellular) levels.
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Front Endocrinol (Lausanne) · Jan 2017
ReviewEarly Microbes Modify Immune System Development and Metabolic Homeostasis-The "Restaurant" Hypothesis Revisited.
The developing infant gut microbiome affects metabolism, maturation of the gastrointestinal tract, immune system function, and brain development. Initial seeding of the neonatal microbiota occurs through maternal and environmental contact. Maternal diet, antibiotic use, and cesarean section alter the offspring microbiota composition, at least temporarily. ⋯ Misregulated development and activity of both the innate and adaptive immune systems, driven by early dysbiosis, could have long-lasting pathologic consequences such as increased autoimmunity, increased adiposity, and non-alcoholic fatty liver disease (NAFLD). This review will focus on factors during pregnancy and the neonatal period that impact a neonate's gut microbiome, as well as the mechanisms and possible links from early infancy that can drive increased risk for diseases including obesity and NAFLD. The complex pathways that connect diet, the microbiota, immune system development, and metabolism, particularly in early life, present exciting new frontiers for biomedical research.
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Front Endocrinol (Lausanne) · Jan 2017
High Glucocorticoid Response to 24-h-Shift Stressors in Male but Not in Female Physicians.
Physicians' daily work is accompanied by emotional and physical stress, and 24-h shifts are considered to be a major stressor. Effects of stressors on the hypothalamic-pituitary-adrenal (HPA) axis can be evaluated by estimating the glucocorticoid excretion in urine samples. We characterized the impact of a 24-h working period on the urinary glucocorticoid excretion of physicians and focused on gender differences. 10 females and 12 male physicians collected 24-h urine samples during a 24-h shift ("on-duty") and on a free weekend ("off-duty") that were analyzed by gas chromatography-mass spectrometry. ⋯ Only male physicians had increased GERs on duty compared to off duty. As a measure of change between being on duty and off duty, the ratio GERs on duty/GERs off duty was significantly higher in males than in females. Thus, the 24-h shift stress factor generates diverging results between female and male subjects with activation of the HPA axis primarily in male physicians.
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Front Endocrinol (Lausanne) · Jan 2017
Out-of-Reference Range Thyroid-Stimulating Hormone Levels in Levothyroxine-Treated Primary Hypothyroid Patients: A Multicenter Observational Study.
Although levothyroxine (LT4) replacement therapy for hypothyroidism has been established as safe, inexpensive and effective, many studies from different countries reported out-of-reference range thyroid-stimulating hormone (TSH) values for the hypothyroid patients under LT4 treatment. The aim of this study was to determine TSH levels of primary hypothyroid patients under LT4 treatment and to assess self-reported compliance with daily LT4 intake in tertiary care centers in Turkey. ⋯ The results of this study revealed that nearly half of the hypothyroid patients had out-of-reference range serum TSH values, despite under LT4 treatment. Compliance with LT4 treatment seems to be one of the major determinants to reach the target TSH levels in hypothyroid patients.