Glucocorticoid-phenylethanolamine-N-methyltransferase interactions in humans.
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Adenoma↗
Biomedical subjects
R Lanzillotti
Publications and source records attributed to R Lanzillotti.
Role for endogenous dopamine in modulating sympathetic-adrenal activity in humans.
Dopamine (DA) is synthesized and secreted in central as well as peripheral nervous system and in the adrenal medulla. Neuronal DA receptors, which have been characterized as D2 receptors, mediate an inhibition of adenylate cyclase and are located prejunctionally on sympathetic nerve endings and on chromaffin cells. Their pharmacological activation causes an inhibition of in vitro and in vivo norepinephrine (NE) release from sympathetic nerve terminals and an inhibition of in vitro epinephrine (E) release from the adrenal medulla. Endogenous DA, co-secreted with the other catecholamines (CA), modulates sympathetic-adrenal discharge only during high sympathetic stimulation through an autocrine mechanism, limiting excessive sympathetic adrenal discharge. Also pheochromocytoma cells synthesize and express D2 receptors. In patients with pheochromocytoma D2 antagonists cause hypertensive crises but the mechanism mediating this effect is still unknown as well as whether endogenous DA might modulate tumoral secretion.
Adrenal Gland Neoplasms↗
[Diagnostic problems in pheochromocytoma].
Pheochromocytoma is mainly characterized by a great deal of variability in its biological activity and in its clinical manifestations. This special feature has always to be taken into account in any diagnostic procedure. The tumor is generally suspected on clinical ground for the presence of paroxysmal hypertension but this sign is largely aspecific and often absent. The diagnosis of pheochromocytoma has to be based on laboratory tests demonstrating an excess and/or a disregulation in catecholamine (CA) secretion. CA or CA metabolites can be measured in urine or blood. Whatever the sample measured, it is important to correlate its result with the clinical picture found during its collection. Basal plasma CA concentrations are often raised also during periods of normotension but their accuracy is the highest in samples drawn during a hypertensive crisis. When basal measurements are insufficient for a final diagnosis, inhibitory (clonidine) or stimulatory (glucagon) tests can be performed. Clonidine test is recommended in patients showing slight increases in basal plasma CA. Glucagon stimulation test should be performed only in normotensive patients with an incidental adrenal mass, patients with sporadic hypertensive crises or members of families affected by MEN II. Localization procedures are mainly based on CT (or MRI) and on scintigraphy with I131-MIBG. CT possesses high sensitivity (about 96%) while I131-MIBG scintigraphy possesses a very high specificity (about 97%). Therefore, both the procedures should be performed before surgery. Rarely, it is also necessary to perform catheterization of the venous tree and plasma sampling for CA measurement to localize the tumor through the discovery of a secretory gradient.
3-Iodobenzylguanidine↗
Identification, characterization, and biological activity of somatostatin receptors in human neuroblastoma cell lines.
To investigate the presence of biologically active somatostatin (SS) receptors in neural crest-derived tumors, radioligand binding studies, cyclic AMP accumulation, intracellular calcium, and growth assays were performed in eight human neuroblastoma (NB) cell lines. Mathematical modeling of binding experiments strongly indicates the presence of heterogeneity of sites. The first site (SSR1) is present in 40% of the NB cell lines and binds with low capacity (0.5 pmol/mg protein) and high affinity (0.1-1 nM) SS14, SS28, and analogues. The second site (SSR2) is a high capacity site (200 pmol/mg protein), widely distributed in all of the cell lines investigated, that shows relative selectivity yet low affinity (100 nM) for SS14, SS28, and [D-Trp8]SS14 without any apparent biological activity. SSR1 is coupled to a pertussis toxin-sensitive G protein, inhibits forskolin- or VIP-stimulated adenylate cyclase activity, decreases intracellular free calcium, and mediates inhibition (30%) of both DNA synthesis and cell growth. Analysis of cell cycle distribution in aphidicolin-synchronized SSR1-positive NB cells indicated that this inhibitory effect is partially mediated by a transient accumulation in G0-G1. Our data indicate high affinity binding sites for SS14, and analogues are present and biologically active in a subset of NB cells.
Binding Sites↗
Adrenal medulla secretion in Cushing's syndrome.
To investigate whether chronic endogenous hypercortisolism might alter adrenomedullary phenylethanolamine N-methyltransferase activity, we measured epinephrine/norepinephrine (E/NE) ratios in the adrenal venous blood of 8 patients undergoing surgery for Cushing's syndrome and in 12 control subjects undergoing surgery for left kidney diseases. To investigate the adrenomedullary secretory activity in Cushing's syndrome, we measured basal E plasma levels in 24 patients and 32 age- and sex-matched normal control subjects, and we evaluated the adrenomedullary response to glucagon in 9 patients and in 22 age- and sex-matched normal subjects. Last, to clarify whether chronic endogenous hypercortisolism might modify E plasma levels through a modification of E metabolism, we measured the E MCR in four patients and four age-matched controls. Mean (+/- SEM) E/NE ratio in adrenal venous blood was similar in patients with Cushing's syndrome (4.61 +/- 0.78) and in the control group (4.71 +/- 0.74). Mean (+/- SEM) basal plasma E was significantly lower in patients with Cushing's syndrome (98.2 +/- 10.9 vs. 184 +/- 25.1 pmol/L, P < 0.01) than in the control group. Similarly, plasma NE also was reduced (0.75 +/- 0.09 vs. 1.10 +/- 0.07 nmol/L, P < 0.01). In patients with Cushing's syndrome the E response to glucagon was significantly reduced (P < 0.01). E MCR was almost identical in patients with Cushing's syndrome (1.48 +/- 0.10 L/min.m2) and in control subjects (1.51 +/- 0.10 L/min.m2). Our data demonstrate that: 1) chronic endogenous hypercortisolism is not able to change adrenomedullary phenylethanolamine N-methyltransferase activity and therefore the quality of adrenomedullary secretion; and 2) chronic endogenous hypercortisolism causes a decrease in basal and stimulated adrenomedullary activity without altering E MCR significantly. Therefore the adrenal medulla does not seem to play a pathogenetic role in the hypertension of Cushing's syndrome.
Adrenal Medulla↗
Dopamine D2 receptor gene expression and binding sites in adrenal medulla and pheochromocytoma.
To determine whether dopamine D2 receptors are present in normal and neoplastic chromaffin tissues, 10 pheochromocytomas and 5 human adrenal glands were studied. Dopamine D2 receptor messenger ribonucleic acid corresponding to a single band of approximately 2.5 kilobases was detected in both pheochromocytoma and human adrenal gland by Northern blot analysis. D2 receptor messenger ribonucleic acid levels determined by dot blot analysis were 3.1-fold lower in human adrenal medullas than in pheochromocytomas (P < 0.001). Simultaneous Scatchard analysis of [3H]spiperone binding experiments demonstrated the presence of two different binding sites in membrane preparations from bovine adrenal medullas [R1: Kd = 0.14 nmol/L; binding capacity (Bmax) = 6.2 fmol/mg protein: R2: Kd = 16 nmol/L; Bmax = 223 fmol/mg protein]. Similarly, two binding sites were present in membrane preparations from pheochromocytomas (R1: Kd = 0.39 nmol/L; R2: Kd = 61 nmol/L]. Binding capacities were greatly variable among pheochromocytomas (R1: Bmax = 12.0-372.5 fmol/mg protein; R2: Bmax = 1,000-11,586 fmol/mg protein). The relative potencies of different compounds to displace [3H]spiperone were spiperone > domperidone > (+)-butaclamol > quinpirole > SCH 23390 in bovine adrenal medulla, and spiperone >> domperidone > quinpirole > (+)-butaclamol > SCH 23390 in pheochromocytoma. We conclude that dopamine D2 receptors are synthesized in human adrenal medulla and pheochromocytoma tissues.
Adrenal Gland Neoplasms↗
A nonsecreting pheochromocytoma presenting as an incidental adrenal mass. Report on a case.
A 25 year old women presented an incidental adrenal mass which was diagnosed to be a pheochromocytoma before surgery by means of a positive 131-I-MIBG scintigraphy. Urinary vanilmandelic acid resulted repeatedly normal as well as basal plasma norepinephrine (NE), epinephrine (E) and dopamine (DA). Urinary homovannilic acid resulted in the normal range. Stimulation tests with iv glucagone, tyramine and metoclopramide evoked normal NE and E responses while a slight increase in plasma DA was observed after metoclopramide. Oral clonidine suppressed plasma catecholamines (CA) normally. Histologic and immunohistochemical studies confirmed that the tumor was a pheochromocytoma showing positivity for tyrosine hydroxylase but not for dopamine-beta-hydroxylase activity. This case is the first report on a completely asymptomatic pheochromocytoma presenting as an incidental adrenal mass which was investigated with repeated biochemical tests before surgery and demonstrates that, among the extremely variable functional attitudes of pheochromocytomas, a defect in CA synthesis and secretion is also to be included.
Adrenal Gland Neoplasms↗
Dopamine modulation of pathological human chromaffin tissue.
To evaluate the presence of dopamine-2(DA2) binding sites in pheochromocytoma tissue, we performed binding studies and light microscopy autoradiography on sections of 7 different tumors. 3-H-Spiroperidol, a DA2 ligand, bound specifically to tumor sections with a (mean +/- SD) Kd value of 1.93 +/- 0.62 nmol/L. Binding site density (Bmax) was 29.16 +/- 2.33 fmol/mg tissue. Light microscopy autoradiography showed a nonhomogenous localization of silver grains within chromaffin cells. The specific binding was about 50% of total. To investigate whether DA2 binding sites found on pheochromocytoma cells might modulate catecholamine (CA) release, we studied the effects of oral bromocriptine (2.5 mg) on circulating CA of 5 patients with pheochromocytoma. In these patients bromocriptine caused a decrease in blood pressure (P less than .05) but no significant change in plasma CA. Our study shows the presence of DA2 binding sites on tumoral chromaffin tissue. As bromocriptine, a DA2 receptor agonist, was not able to modify tumor CA secretion, the functional role, if any, played by these binding sites on tumor secretion is still to be clarified.
Adrenal Gland Neoplasms↗
Dopaminergic modulation of human adrenal medulla: indirect evidence for the involvement of DA-2 receptors located on the chromaffin cells.
1. Pharmacological blockade of DA-2 receptors causes a significantly higher epinephrine (E) response to physical exercise in normal man. 2. The present study was undertaken to evaluate whether dopaminergic modulation of E secretion is present also for a stimulus such as glucagon which acts directly on chromaffin cells. 3. Seven normal males were studied in a single blind randomized manner on two separate occasions, after pre-treatment with placebo or domperidone (DMP; 20 mg orally). Plasma E and norepinephrine, plasma prolactin, heart rate and blood pressure were measured on two separate occasions (placebo vs DMP) before and after a glucagon (1 mg i.v.) stimulation test. 4. Glucagon caused an increase in plasma E either after placebo (P = 0.043) or after domperidone (P = 0.012). DMP administration caused a significant increase in plasma E (P = 0.0008). Absolute increase in plasma E after glucagon was significantly higher after DMP than after placebo (P = 0.030). 5. As the dopaminergic modulation of human adrenal medulla is confirmed also for a stimulus acting directly on chromaffin cells, the results of the present study suggest that the DA-2 receptors responsible for the modulation are located on medullary cells.
Adrenal Medulla↗
Catecholamines and blood pressure regulation.
Catecholamines (CAs) play a central role in the regulation of blood pressure. Sympathetic adrenal effects are ultimately elicited by the neurotransmitter norepinephrine and the hormone epinephrine. Their release is under the control of higher centers and is finely modulated by several factors such as presynaptic receptors. Recent evidences suggest that also the peripheral dopaminergic system can participate in blood pressure regulation intervening in the blood flow regulation of some regions, and in sodium-water balance. The measurement of CAs in biological fluids has greatly enhanced our knowledge on the mechanisms regulating blood pressure and is widely applied in cardiovascular research. Clinical applications of CA measurement are still limited to the diagnosis of pheochromocytoma and to the differential diagnosis of hypotensive syndromes.
Adrenal Gland Neoplasms↗