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Biomedical subjects

F Girard

Publications and source records attributed to F Girard.

At least 109 records · Page 6Linked to original sources
PubMed1988

Plasma pro-opiomelanocortin fragments and adrenal steroids following administration of metyrapone to normal and hirsute women.

The present study was undertaken to characterize further the adrenal abnormalities in the polycystic ovary syndrome (PCOS) and idiopathic hirsutism (IH). We have previously reported the close association of elevated estrone levels with amenorrhea in hyperandrogenemic patients. In addition we have suggested that high estrone levels in PCOS occur as a consequence of the provision of excess substrate, androstenedione, for conversion to estrone. In the present study plasma estrone levels rose following endogenous adrenal stimulation induced using metyrapone; the highest plasma estrone levels achieved were seen in patients with PCOS and occurred later than peak androstenedione levels. These findings are consistent with the hypothesis that elevated estrone levels occurring in PCOS may arise as a consequence of increased adrenal androgen secretion. In addition, we have examined ACTH and other pro-opiomelanocortin (POMC) fragments in an attempt to identify a factor responsible for the excessive adrenal androgen secretion occurring in hirsute patients. Plasma levels of ACTH, and of immunoreactive beta-endorphin and h-lipotropin were not elevated when androgen levels were raised prior to therapy, although these POMC fragments, and also the 16K fragment, rose in response to metyrapone treatment as did androgen levels. Following treatment with dexamethasone there was more profound suppression of the 16K, beta-endorphin and h-lipotropin responses to metyrapone stimulation, than of the ACTH response, as indicated by decreased POMC-fragment/ACTH ratios; this parallels the dissociation of cortisol from androgens in hirsute patients under similar conditions. However, we have not identified a POMC fragment which consistently parallels changes in androgen levels in patients with idiopathic hirsutism or PCOS.

Administration, Oral↗
PubMed1988

Characterization of human corticotrophin-releasing hormone and pro-opiomelanocortin-related peptides in a thymic carcinoid tumour responsible for Cushing's syndrome.

Severe Cushing's syndrome developed in a man of 35 years. Plasma ACTH and lipotrophin hormone levels were supranormal, and dexamethasone failed to stop their production. An ACTH-producing thymic carcinoid tumour was found to be responsible for the Cushing's syndrome. The tumour tissue contained pro-opiomelanocortin (POMC)-mRNA and POMC-related peptides. In addition, human corticotrophin-releasing hormone (h-CRH) (0.25 ng/mg wet tissue) was identified in the tumour extract. Among a series of extracts from two normal and three tumoral (Nelson's syndrome) pituitary glands, six non-pituitary POMC-producing tumours and five normal thymuses examined, only the extract from the thymic tumour of our patient contained h-CRH. The molecule isolated had the same properties as synthetic h-CRH (dilution, Sephadex G 50 chromatography). Circulating h-CRH levels, however, were normal. The possible involvement of such ectopic CRH production in the aetiology of Cushing's syndrome remains uncertain.

Adult↗
PubMed1988

Long acting somatostatin treatment of paraneoplastic Cushing's syndrome in a case of Zollinger-Ellison syndrome.

Cushing's syndrome, caused by ectopic ACTH production during Zollinger-Ellison syndrome, raises difficult therapeutic problems. We report a case of clinical and biological efficacy of long acting somatostatin (SMS) in this condition. In a short term study with 200 micrograms SMS bid, symptoms of hypercorticism disappeared while cortisol and ACTH serum concentrations fell below the normal values. Longterm treatment was instituted with 50 micrograms SMS bid. Excellent clinical efficacy as well as normal cortisol and ACTH serum concentrations were maintained during the nine month follow up. Lipotrophic hormone (LPH) serum concentration remained raised. No decrease in size of hepatic metastases was observed. Long acting somatostatin analogues may be useful in endocrine paraneoplastic syndromes.

ACTH Syndrome, Ectopic↗
PubMed1988

Transsphenoidal pituitary surgery for the treatment of Cushing's disease: results in 64 patients and long term follow-up studies.

Transsphenoidal pituitary surgery was performed in 64 patients with Cushing's disease in search of a corticotroph adenoma. In 4 patients, profuse local bleeding prevented completion of the exploration. Of the 60 patients who had an adequate exploration, 4 could not be followed after surgery. Short term assessment of the surgical outcome (3-6 months postoperatively) was performed on 60 patients, including the 4 who had incomplete pituitary exploration. Forty-two patients (70%) were judged as immediate successes [urinary cortisol excretion, less than 90 micrograms (less than 248 nmol)/day]; the mean urinary cortisol excretion and plasma ACTH level fell from 463 +/- 70 (+/- SE) to 26.7 +/- 3.6 micrograms/day (1277 +/- 193 to 74 +/- 10 nmol/day; n = 33) and from 111 +/- 33 to 36 +/- 14 pg/mL (24 +/- 7 to 8 +/- 3 pmol/L; n = 23) in patients who had both measurements pre- and postoperatively. Eighteen patients (30%) were judged as immediate failures; neither urinary cortisol excretion nor plasma ACTH levels changed significantly in patients who had both measurements pre- and postoperatively. The preoperative epidemiological, clinical, hormonal, and radiological characteristics of the 2 groups were similar. Histological examination of pituitary fragments removed in 58 of the 60 patients evaluated postoperatively revealed the presence of tumoral tissue in a higher percentage of patients in the immediate success group (72%) than in the immediate failure group (24%; P less than 0.01). The 42 patients in the immediate success group were followed from 6 months to 7 yr (median, 2 yr); 6 patients had recurrences from 2-3 yr after operation. Actuarial analysis indicates that the probability of a patient remaining well 6 yr after surgery is 72 +/- 20% (95% confidence limit). Most of the patients in the immediate success group had transient ACTH deficiency preceding a progressive return to normal pituitary-adrenal function.

Adenoma↗
PubMed1988

Human joining peptide: a proopiomelanocortin product secreted as a homodimer.

The human (h) POMC gene sequence predicts a 30 amino acid joining peptide (JP) separating the N-terminal fragment [POMC(1-76) or hNT] and ACTH within their common precursor. We used an anti-serum directed against the amidated COOH-terminal end of mouse JP to develop a RIA for the predicted hJP molecule. Immunoreactive JP was detected in tissue extracts from human normal pituitary, ACTH-secreting pituitary- and nonpituitary tumors, and in plasma from patients with ACTH hypersecretory syndromes. Its molar concentration was of the same order of magnitude as, and correlated with, that of the other POMC peptides. Gel exclusion chromatography in 1% formic acid and 6 M guanidine-HCl revealed a predominant immunoreactive material with an apparent mol wt of ca. 6000. After reduction with dithiothreitol this material was recovered in an elution volume identical to that of purified hJP and corresponding to a mol wt of ca. 3000. These data show that POMC processing generates a COOH terminally amidated hJP predominantly secreted as a homodimer, probably through disulfide bonding between the single Cys9 residue of two molecules.

Chemical Phenomena↗
PubMed1988

In vitro studies in primary aldosteronism: baseline steroid production and aldosterone responses to ACTH and angiotensin II.

The spontaneous glucocorticoid production in control adrenal cells (N = 10) and in the adenoma cells (N = 15) exhibited comparable geometric mean values: 1.896 nmol/ml/4-5 x 10(5) cells per 2 h (confidence limits: 0.428-8.391) and 1.852 nmol/ml (0.326-12.241), respectively. The same results were obtained for the three samples of nodular hyperplasia cells. When cortisol and corticosterone were measured separately, there was no significant difference between the outputs for control cells and those for pathological cells. Baseline aldosterone production in control cells showed a geometric mean of 2.525 pmol/ml (0.236-27.192). In the 15 adenomas, spontaneous production was extremely important: 57.297 pmol/ml (3.357-976.692). The difference was highly significant (P less than 0.0005). Aldosterone levels in the 3 samples of nodular hyperplasia cells were not different from the control values. In 9 out of the 15 adenomas, aldosterone responses to 10(-10) mol/l ACTH, expressed as stimulated/basal production, were above normal: 3.58 +/- 0.86 (SEM) against 1.48 +/- 0.08 (P less than 0.025). In the remaining 6 and in the 3 samples of nodular hyperplasia cells, there was a slight or no response. Angiotensin II (AII) stimulated both adenoma and nodular hyperplasia cells to varying degrees, without any obvious difference between these two categories. A combination of ACTH (10(-12) mol/l) and AII (10(-12) mol/l) had a synergistic action on aldosterone production in cells classed in the adenoma group. These findings demonstrate that despite the abnormal rate of aldosterone formation in adenoma cells, the production rate of corticosterone and cortisol remains normal. They unmask two functional categories with regard to ACTH in the adenoma group. Finally, they underline the relative insensitivity of nodular hyperplasia cells to ACTH.

Adenoma↗
PubMed1988

[ACTH-secreting tumors. Deregulation of the proopiomelanocortin gene and alterations in processing].

ACTH is produced by proteolysis of a polypeptide precursor, proopiomelanocortin (or POMC). Various POMC-derived peptides are cosecreted with ACTH. Analysis of the ACTH--and its "satellite" peptides--molecular forms establishes the POMC "maturation profile" in different tissues. This profile is identical in normal and tumoral pituitaries (Cushing's disease and/or Nelson's syndrome). It is often altered in non-pituitary tumors responsible for the ectopic ACTH syndrome: abnormal peptides may be generated (CLIP h beta MSH5-22) which can be detected in blood. Analysis of POMC gene transcription in pituitary tumors shows no abnormality. In some non-pituitary tumors the activation of upstream promoters up to 369 nucleotides from the normal (pituitary) transcription initiation site can be shown. In normal non-pituitary tissues a third type of transcription is observed generating a short and probably non-functional messenger RNA limited to a portion of the gene non-coding region.

Adrenal Gland Neoplasms↗
PubMed1988

[Value of the ultrasensitive assay of plasma TSH for the surveillance of replacement treatment in children with congenital hypothyroidism].

This study proposes some improvements in monitoring congenital hypothyroidism (CH) using an ultrasensitive plasma TSH assay (usTSH). Patients were 42 CH treated with levo-thyroxine (L-T4) for at least 6 months. Controls were 25 age-matched children (C). Comparative determinations of plasma TSH with classical radioimmunoassay (RIA), on one hand, and usTSH on the other hand, revealed RIA values to be beneath the sensitivity threshold in 3 C and in 15 CH. With usTSH, all the TSH values were assayed over the sensitivity threshold. Therefore the CH could be placed into 3 subgroups according to whether their values were below (n = 17), equal to (n = 15) or above (n = 10) those determined for C. Mean plasma levels of thyroxine (T4) or free thyroxine (FT4) were higher in the CH group, considered as a whole, than in C (p less than .01). Furthermore these values did not appear to be correlated with those in the TSH subgroups, anymore than they were with those of therapeutic doses of L-T4 administered. These discrepancies may be explained in terms of metabolism of exogenous thyroid hormones. UsTSH plasma values would therefore reflect the action of thyroid hormones on thyreotropic cells. To this extent the assay constitutes a sensitive index in detecting both therapeutic insufficiencies and overtreatments.

Child↗
PubMed1987

A new 5'-non-coding region for human placental insulin-like growth factor II mRNA expression.

A human placenta cDNA library was screened for insulin-like growth factor II (IGF-II). Four clones were selected, which exhibited an IGF-II cDNA coding sequence identical to those previously described for human adult liver IGF-II cDNA. Extensive sequence diversity was observed in the 5'-non-coding region, probably resulting from differential intron splicing.

Amino Acid Sequence↗
PubMed1987

The calmodulin-stimulated (Ca2+ + Mg2+)-ATPase in hemoglobin S erythrocyte membranes: effects of sickling and oxidative agents.

A decrease in the reactivity of erythrocyte membrane (Ca2+ + Mg2+)-ATPase to calmodulin stimulation has been observed in aging red cells and in various types of hemolytic anemias, particularly in sickle red cell membranes. Unlike the aging process, the defect in the (Ca2+ + Mg2+)-ATPase from SS red blood cells is not secondary to a decrease in calmodulin activity and is already present in the least dense SS red blood cells separated on a discontinuous density gradient. Deoxygenated AS red cells were forced to sickle by lowering the pH, raising the osmolarity of the buffer (sickling pulse). Under these conditions an inhibition of the calmodulin-stimulated enzyme was observed only if several cycles of oxygenation/deoxygenation were applied. No alteration of the enzyme could be detected after submitting AS red blood cells to other conditions or in AA red blood cells submitted to the same treatments. This suggests that oxidative processes are involved in the alterations of the (Ca2+ + Mg2+)-ATPase activity. Treatment of membranes from AA erythrocytes by thiol group reagents and malondialdehyde, a by-product of auto-oxidation of membrane unsaturated lipids and a cross-linking agent of cytoskeletal proteins, led to a partial inhibition of the calmodulin-stimulated (Ca2+ + Mg2+)-ATPase. We postulate that the hyperproduction of free radicals described in the SS red blood cells and involved in the destabilization of the membrane may be also responsible for the (Ca2+ + Mg2+)-ATPase failure.

Anemia, Sickle Cell↗
PubMed1987

Lack of prolactin involvement in corticosteroid secretion.

In mammals prolactin can modify adrenal steroidogenesis. Its trophic effect on adrenal cells where prolactin receptors have been identified suggest a direct impact upon corticosteroid biosynthesis. In man, this role of prolactin remains controversial. The purpose of our study was to investigate the effects of chronic hyperprolactinemia on basal and stimulated corticosteroid hormone secretion. Seven women with untreated chronic hyperprolactinemia (HPRL) were included in the study. In each of them, a beta 1-24 ACTH test was performed on a normal and low Na+ diet for 4 days. Basal and ACTH-stimulated cortisol, aldosterone, deoxycorticosterone and 17 hydroxyprogesterone secretion were not significantly different in HPRL and NPRL women. These results do not support evidence for any significant role of prolactin upon corticosteroid biosynthesis in man. They also suggest that prolactin is not the pituitary factor which modulates ACTH or low Na+ diet stimulated corticosteroid secretion.

17-alpha-Hydroxyprogesterone↗
PubMed1987

Functional properties of hemoglobin in human red cells. I. Oxygen equilibrium curves and DPG binding.

Oxygen equilibrium curves (OEC) for human red blood cells (RBC) have revealed a large asymmetry with an nmax value reached at approximately 90% saturation. This contrasts with the symmetrical shape of the OEC for diluted HbA solutions. We prepared resealed red blood cells (RRBC) through controlled hemolysis and resealing in order to obtain a low Hb concentration (approximately equal to 60 g/L) and DPG/Hb4 molar ratio ranging from 0.2 to 4. When the DPG/Hb4 was close to unity, OEC still showed a large asymmetry. On the contrary, the OEC became symmetrical when DPG/Hb4 was either negligible or 3-4 fold the normal value. The asymmetrical OEC for intact RBC can be fitted with a theoretical model taking into account the variations of free DPG concentration during oxygenation. We conclude that the asymmetrical shape of OEC observed in intact fresh RBC is not due to the high protein concentration present in the RBC but to a functional heterogeneity of Hb due to the changes of the free 2,3-diphosphoglycerate (DPG) concentration during oxygenation.

2,3-Diphosphoglycerate↗
PubMed1987

Detection of heterozygous carriers for 21-hydroxylase deficiency by plasma 21-deoxycortisol measurement.

Using a highly specific radioimmunoassay recently described, plasma 21-deoxycortisol levels were measured in 55 heterozygous carriers of 21-hydroxylase deficiency (as demonstrated by HLA typing). Mean baseline 21-deoxycortisol levels were above the normal range, but there was a 38% overlap with control values. In contrast to 17-hydroxyprogesterone levels, which in 71% of the subjects remained within the normal range one hour after ACTH stimulation, 21-deoxycortisol levels increased over stimulated control levels in all but two heterozygous carriers. No differences as to the levels were observed between heterozygous carriers for the classic and the late-onset forms. Plasma 21-deoxycortisol measurement appears to be a valid tool in the biological detection of heterozygosity for 21-hydroxylase deficiency and its implications in genetic counselling.

17-Hydroxycorticosteroids↗