Primary Adrenal Lymphoma: When B Symptoms Appear Hand in Hand with Adrenal Masses

Primary adrenal lymphoma (PAL) is a very rare type of non-Hodgkin’s lymphoma (NHL). Herein, we report a case of NHL of both adrenal glands in a 69-year-old man. The patient was admitted because of a 1-month history of B symptoms and symptomatic hypotension. Biochemical analysis showed normocytic normochromic anaemia, hyponatraemia, hyperkalaemia, and elevated lactate dehydrogenase, C-reactive protein and D-dimers. A computed tomography scan revealed bilateral enlargement of the adrenal glands. There was no evidence of endocrine adrenal dysfunction. The mass in the right adrenal gland was biopsied and histopathology identified a diffuse large B-cell lymphoma of the activated B-cell subtype. A positron emission tomography 18F-fluorodeoxyglucose scan showed intensive hypermetabolic lesions involving both adrenal glands, as well as other locations, with higher uptake in the adrenal glands. Taken together, these findings suggested the diagnosis of PAL. The patient responded favourably to debulking therapy and is currently undergoing chemotherapy.

Morphofunctional state of the medulla and the fascicular zone of the adrenal cortex in modeling Alzheimer's disease by excessive administration of sodium nitrite

Background. Nitrates and nitrites are found in soil, water, human food, dyes, and medicines. In the literature, both positive and negative effects from the ingestion of nitrates and nitrites into the body are considered. A nitrite model of Alzheimer's type dementia of vascular origin was used in the work. Objective. The aim of the study was to study the morphofunctional state of the adrenal glands of experimental animals with prolonged administration of sodium nitrite. The study was carried out on male rats of the WAG population, which were divided into 3 groups: gr. N-14 - received injections of a water solution of sodium nitrite at a dose of 50 mg / kg of body weight daily for 14 days; gr. N-28 - Rats received similar injections for 28 days. Injections are intraperitoneal. Control rats were injected with 0.9% sodium chloride solution. Results. In animals of the main groups, the formation of a morphofunctional picture of the development of a stress reaction takes place, which was also confirmed morphometrically, and in group N-28 - with signs of incipient decompensation of the medulla and the fascicular zone of the adrenal cortex. Conclusion. When simulating Alzheimer's disease in laboratory rats by the introduction of a water solution of sodium nitrite at a dose of 50 mg / kg of body weight by daily intraperitoneal injection for 14 and 28 days, a picture of their morphofunctional activation is formed in the medulla and fascicular zone of the adrenal cortex. In the group with a 28-day course of administration of sodium nitrite solution, morphofunctional signs of decompensation of the medulla and the fascicular zone of the adrenal glands (especially the medulla) appear, which indicates the development of severe distress in animals and the impossibility of restoring homeostasis.

A spatiotemporal steroidogenic regulatory network in human fetal adrenal glands and gonads

Human fetal adrenal glands produce substantial amounts of dehydroepiandrosterone (DHEA), which is one of the most important precursors of sex hormones. However, the underlying biological mechanism remains largely unknown. Herein, we sequenced human fetal adrenal glands and gonads from 7 to 14 GW via the 10× Genomics single-cell transcriptome techniques and reconstructed their location information by Spatial Transcriptome, conducted COOL-seq for the MC2R+ inner zone steroidogenic cells during the time window of sex differentiation (8-12GW). We found that relative to gonads, adrenal glands begin to synthesize steroids early. The coordination among steroidogenic cells and multiple nonsteroidogenic cells promotes adrenal cortex construction and steroid synthesis. Notably, during the time window of sex differentiation (8-12 GW), key enzyme gene expression shifts to accelerate DHEA synthesis in males and cortisol synthesis in females. Furthermore, high SST+ expressions in the adrenal gland and testis amplify androgen synthesis in males. Our research highlights the robustness of the action of fetal adrenal glands on gonads to modify the process of sexual differentiation.

Differentiated approach to surgical treatment of adrenal glands tumors

Objective – to improve the results of treatment of adrenal tumors by optimizing a differentiated approach based on the analysis of the results of various surgical invasions. The paper analyzed the results of treatment of 145 patients with various adrenal tumors, which were divided into 2 groups: І (n=71) - patients after adrenalectomies, II (n=74) – after adrenal resections. Organ-preserving invasions showed better results during the early and long-term postoperative period in patients with corticosteromas, pheochromocytomas and incidentalomas by reducing the severity of fluctuations in hemodynamic parameters and the frequency of adrenal insufficiency. Due to the introduction of the treatment algorithm, the number of adrenal resections increased by 26.6% in patients with neoplasms more than 4,0 cm in diameter (p=0.0001). The choice of surgical invasion should be individualized, taking into account the clinical features of the disease, hormone indicator parameters, the size of tumors, the comprehensiveness of the adrenal gland lesion and the ratio of the latter to nearby organs and structures. Adrenal insufficiency was detected 14.2% more often after adrenalectomies (р=0.044) compared to adrenal resections. Treatment according to the developed algorithm reduced the incidence of adrenal insufficiency by 5.8% (p=0.028). In the long-term postoperative period, contralateral gland tumors occurred with the same frequency (4.8%) among patients after adrenalectomies and resections. Relapse of the neoplasm after resections was detected in 3 (7.1%), as a result of which 2.4% underwent repeated operations with the final removal of the gland. An increase in the size of a single adrenal gland was more common by 21.4% after adrenalectomies.

Homeostatic Regulation of Glucocorticoid Receptor Activity by Hypoxia-Inducible Factor 1: From Physiology to Clinic

Glucocorticoids (GCs) represent a well-known class of lipophilic steroid hormones biosynthesised, with a circadian rhythm, by the adrenal glands in humans and by the inter-renal tissue in teleost fish (e.g., zebrafish). GCs play a key role in the regulation of numerous physiological processes, including inflammation, glucose, lipid, protein metabolism and stress response. This is achieved through binding to their cognate receptor, GR, which functions as a ligand-activated transcription factor. Due to their potent anti-inflammatory and immune-suppressive action, synthetic GCs are broadly used for treating pathological disorders that are very often linked to hypoxia (e.g., rheumatoid arthritis, inflammatory, allergic, infectious, and autoimmune diseases, among others) as well as to prevent graft rejections and against immune system malignancies. However, due to the presence of adverse effects and GC resistance their therapeutic benefits are limited in patients chronically treated with steroids. For this reason, understanding how to fine-tune GR activity is crucial in the search for novel therapeutic strategies aimed at reducing GC-related side effects and effectively restoring homeostasis. Recent research has uncovered novel mechanisms that inhibit GR function, thereby causing glucocorticoid resistance, and has produced some surprising new findings. In this review we analyse these mechanisms and focus on the crosstalk between GR and HIF signalling. Indeed, its comprehension may provide new routes to develop novel therapeutic targets for effectively treating immune and inflammatory response and to simultaneously facilitate the development of innovative GCs with a better benefits-risk ratio.

Study on Morphometry of Adrenal Glands in live fetuses by Ultrasonography

Introduction: Development of adrenal gland is always peculiar as it involves the complex process. It has an intriguing role in the harmonious development of fetus. Ultrasonographic Studies on fetal supra renal glands help in understanding the embryology of Suprarenal glands and are also useful in obstetrics, perinatology and fetopathology. Risk factors associated in the pregnancy like maternal diabetes and hypertension could impair the growth of adrenal glands. The nomograms of adrenal glands observed by ultrasonography are of clinical importance and help us in planning prevention and management of a fetus in high-risk pregnancies. This requires a feasible and repeatable screening test. Objective: To estimate various suprarenal gland measurements such as length, width, thickness, volume, surface area, circumference, thickness of cortex and medulla Materials and methods: Present study conducted with62 live normal human fetuses of different gestational ages ranging from 20 – 40 weeks, through ultrasonographic study using real time 4D and B mode Ge Voluson 730 pro ultra sound macine. Probes used were AB-2-7 Convex 2d abdominal Probe and RABA 4-8 Convex 4D abdominal probe. After obtaining the prior permission from the institutional ethics committee, consent from pregnant woman. Sex of the fetus was not revealed during ultrasonographic study. Fetal parameters of supra-renal gland were recorded and documented. Results: Suprarenal gland length, width, thickness, cortico-medullary thickness, surface area and circumference of both right and left side revealed significant difference (p<0.01). the detailed data analysis was presented in the subsequent headings. Conclusion: The data obtained from this study, may useful to understand the suprarenal morphometry in live fetuses thus the database useful in obstetrics, perinatology and fetopathology.

Glucocorticoid production in lymphoid organs: Acute effects of lipopolysaccharide in neonatal and adult mice

Glucocorticoids (GCs) are critical modulators of the immune system. The hypothalamic-pituitary-adrenal (HPA) axis regulates circulating GC levels and is stimulated by endotoxins. Lymphoid organs also produce GCs; however, it is not known how lymphoid GC levels are regulated in response to endotoxins. We assessed whether an acute challenge of lipopolysaccharide (LPS) increases lymphoid levels of GCs, steroidogenic enzymes expression, and components of the HPA axis (e.g., CRH) expression. We administered LPS (50µg/kg i.p.) or vehicle control to male and female C57BL/6J neonatal (post-natal day (PND) 5) and adult (PND90) mice and collected blood, bone marrow, thymus, and spleen 4 hr later. We measured progesterone, 11-deoxycorticosterone (DOC), corticosterone, and 11-dehydrocorticosterone (DHC) via liquid chromatography tandem mass spectrometry (LC-MS/MS). We measured gene expression of key steroidogenic enzymes (Cyp11b1, Hsd11b1, and Hsd11b2) and HPA axis components (Crh, Crhr1, Pomc, and Mc2r) via qPCR. At PND5, LPS induced greater increases in steroid levels in lymphoid organs than in blood. In contrast, at PND90, LPS induced greater increases in steroid levels in blood than in lymphoid organs. Steroidogenic enzyme transcripts were present in all lymphoid organs, and LPS altered steroidogenic enzyme expression predominately in the spleen. Lastly, we detected transcripts of key HPA axis components in all lymphoid organs, and there was an effect of LPS in the spleen. Taken together, these data suggest that LPS regulates GC production by lymphoid organs, similar to its effects on the adrenal glands, and the effects of LPS might be mediated by local expression of CRH and ACTH.

Stress induced by pre-slaughter farm conditions in pigs

ABSTRACT Cortisol is a steroid hormone, one of the glucocorticoids, made in the cortex of the adrenal glands and then released into the blood, which transports it in the entire body. Almost every cell contains receptors for cortisol and so cortisol can have lots of different actions depending on which sort of cells it is acting upon. These effects include controlling the body’s blood sugar levels and thus regulating metabolism, acting as an anti-inflammatory product, controlling salt and water balance and influencing blood pressure. The study was conducted over a period of 3 months, between March-August 2020, in 2 swine farms in Iasi county, Romania, on a total of 46 pigs, 3 to 4 months old, both males and females, in order to investigate stress levels in finishing facilities. The study revealed higher levels of cortisol while eosinophil counts severely decreased, changes which are associated with a strong reaction to stress for individuals that were housed in finishing facilities.

Adaptive morphogenesis of the adrenal glands of ducks in conditions of hyperthermia

It was found that under conditions of hyperthermia, morphofunctional changes develop in the interrenal part of the adrenal glands, indicating an increase in the functional activity of the gland. The study of ducks on the 5th day of hyperthermia revealed loosening and thickening of the adrenal gland capsule compared to the control. Significant hemodynamic disorders were noted: the phenomena of stasis and erythrocyte sludge in sharply expanded blood capillaries of the adrenal glands. It was found that on the 10th day of hyperthermia, hemodynamic disorders are progressive: the phenomena of sludge and red blood cell stasis are less pronounced, but parenchymal edema and a sharp expansion of sinusoid capillaries persist. Changes in interrenal cells (their high prismatic shape, cytoplasmic vacuolization, apical granularity) are also determined to characterize the high secretory activity of endocrinocytes. The found changes indicate the development of a stress reaction.