Characteristics of Gut Microbiota in Patients with GH-Secreting Pituitary Adenoma

Dysbiosis of gut microbiota is associated not only with intestinal disorders but also with numerous extraintestinal diseases. Growth hormone-secreting pituitary adenoma (GHPA) is an insidious disease with persistent hypersecretion of GH and IGF-1, causing increased morbidity and mortality.

Evaluation of hyperprolactinemia risk factors in infertile women referred to Yazd Infertility Center: A cross-sectional study

Background: Hyperprolactinemia is one of the most common causes of infertility in women. The prevalence of pituitary tumors is 25-30% among infertile participants with hyperprolactinemia. Objective: The aim of this study was to describe the causes of hyperprolactinemia in infertile women referred to Yazd Infertility Center. Materials and Methods: This cross-sectional study was conducted with 182 infertile women with hyperprolactinemia who were referred to Yazd Infertility Center from February 2018 to October 2019. Serum prolactin was assessed by the human prolactin ELISA kit according to the Padtan Gostar Isar protocol. The age, duration of infertility, causes of hyperprolactinemia, and type of infertility treatment were noted. The MRI findings were added. Results: The mean age of participants was 28.9 ± 0.36 yr and the prolactin level was 76 ± 8.97 ng/ml. The etiology of hyperprolactinemia among the study participants was 35 participants (19.2%) with pituitary adenoma, 47 participants (25.8%) with polycystic ovary syndrome, 14 participants (7.7%) with pituitary adenoma and polycystic ovary syndrome, and 86 participants (47.3%) with idiopathic hyperprolactinemia. The results of this study showed that there was no statistically significant difference between the mean prolactin levels in participants with different causes of hyperprolactinemia (p = 0.31). Conclusion: Idiopathic hyperprolactinemia and polycystic ovary syndrome are the most common reasons for hyperprolactinemia. Key words: Hyperprolactinemia, Infertility, PCOS.

Evaluation of the expression of necroptosis pathway mediators and its association with tumor characteristics in functional and non-functional pituitary adenomas

Background Pituitary adenomas impose a burden of morbidity on patients and characterizing the molecular mechanisms underlying its pathogenesis received remarkable attention. Despite the appealing role of necroptosis as an alternative cell death pathway in cancer pathogenesis, its relevance to pituitary adenoma pathogenesis has yet to be determined that is perused in the current study. Methods The total number of 109 specimens including pituitary adenomas and cadaveric healthy pituitary tissues were enrolled in the current study. Tumor and healthy pituitary tissues were subjected to RNA extraction and gene analysis using Real-Time PCR. The expression levels of necroptosis markers (RIP1K, RIP3K and, MLKL) and their association with the patient’s demographic features were evaluated, also the protein level of MLKL was assessed using immunohistochemistry in tissues. Results Based on our data, the remarkable reduction in RIP3K and MLKL expression were detected in nonfunctional and GH-secreting pituitary tumors compared to pituitary normal tissues. Invasive tumors revealed lower expression of RIP3K and MLKL compared to non-invasive tumors, also the attenuated level of MLKL was associated with the tumor size in invasive NFPA. The simultaneous down-regulation of MLKL protein in pituitary adenoma tissues was observed which was in line with its gene expression. While, RIP1K over-expressed significantly in both types of pituitary tumors which showed no significant correlation with patient’s age, gender and tumor size in GHPPA and NFPA group. Notably, MLKL and RIP3K gene expression was significantly correlated in the GHPPA group. Conclusions According to our data, the reduced expression of necroptosis mediators (RIP3K, MLKL) in pituitary adenoma reinforces the hypothesis that the necroptosis pathway can be effective in regulating the proliferation and growth of pituitary tumor cells and tumor recurrence.

Analysis of risk factors and preventive strategies for intracranial infection after neuroendoscopic transnasal pituitary adenoma resection

Objective To analyse the risk factors for intracranial infection after neuroendoscopic transnasal pituitary adenoma resection (NTPAR) to provide a reference for the prevention and treatment of postoperative intracranial infection. Methods The clinical data of 387 patients who underwent NTPAR in the Department of Neurosurgery of the First People’s Hospital of Yichang from March 2013 to March 2021 were retrospectively analysed. The patients were divided into an infected group and a noninfected group according to the occurrence of intracranial infection. The detailed clinical data of the two groups were collected. Univariate and multivariate logistic regression was used to analyse the risk factors for intracranial infection after NTPAR. Results Among the 387 surgical patients, 32 patients (8.27%) were in the intracranially infected group and 355 patients (91.73%) were in the noninfected group. The results of the univariate analysis suggested that age > 45 years, tumour size > 1 cm, operation time > 240 min, blood loss > 400 ml, Kelly Grade of cerebrospinal fluid (CSF) leakage > Grade 2, postoperative CSF leakage, lumbar cistern drainage and blood transfusion were the influencing factors for postoperative intracranial infection, while the results of multivariate logistic regression analysis implied that intraoperative CSF leakage (Kelly Grade > 2) and postoperative CSF leakage were independent influencing factors for intracranial infection after NTPAR, and perioperative use of antibiotics was an independent protective factor for postoperative intracranial infection. Conclusions There are a variety of risk factors for intracranial infection after NTPAR, which indicates that it is necessary to develop different repair strategies for CSF leakage according to the Kelly Grade, timely treatment of postoperative CSF leakage and perioperative use of antibiotics. These measures have been shown to effectively reduce the probability of intracranial infection after NTPAR.