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Chorti A, Cheva A, Boulogeorgou K, Chatzikyriakidou A, Achilla C, Tsalkatidou D, Krokou D, Bakkar S, Theodossis P. Vitamin D receptor: a possible biomarker for sporadic parathyroid adenoma? Updates Surg 2025:10.1007/s13304-025-02182-5. [PMID: 40186735 DOI: 10.1007/s13304-025-02182-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2025] [Accepted: 03/27/2025] [Indexed: 04/07/2025]
Abstract
Parathyroid adenoma is the main cause of primary hyperparathyroidism. The genetic basis of the disease is still unclear. Vitamin D receptor (VDR) is involved in parathormone regulation. The aim of this study is to evaluate Vitamin D receptor expression in sporadic parathyroid adenoma. Fifty-one patients with parathyroid adenoma and 51 healthy volunteers were enrolled in the study and genetic and immunohistochemical studies were conducted. VDR polymorphism TaqI was correlated with parathyroid adenoma development, while VDR stained positive in immunohistochemical study. Our study suggests VDR as a major contributor to sporadic parathyroid adenoma formation in Greek population.
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Affiliation(s)
- Angeliki Chorti
- 1st Propaedeutic Department of Surgery, Faculty of Health Science, Medical School, AHEPA University Hospital, Aristotle University, St.Kiriakidi 1, 54636, Thessaloniki, Greece.
| | - Angeliki Cheva
- Laboratory of Pathology, Faculty of Health Science, Medical School, Aristotle University, Thessaloniki, Greece
| | - Kassiani Boulogeorgou
- Laboratory of Pathology, Faculty of Health Science, Medical School, Aristotle University, Thessaloniki, Greece
| | - Anthoula Chatzikyriakidou
- Laboratory of Medical Biology - Genetics, Faculty of Health Science, Medical School, Aristotle University, Thessaloniki, Greece
| | - Charoula Achilla
- Laboratory of Medical Biology - Genetics, Faculty of Health Science, Medical School, Aristotle University, Thessaloniki, Greece
| | - Despoina Tsalkatidou
- 1st Propaedeutic Department of Surgery, Faculty of Health Science, Medical School, AHEPA University Hospital, Aristotle University, St.Kiriakidi 1, 54636, Thessaloniki, Greece
| | - Despoina Krokou
- 1st Propaedeutic Department of Surgery, Faculty of Health Science, Medical School, AHEPA University Hospital, Aristotle University, St.Kiriakidi 1, 54636, Thessaloniki, Greece
| | - Sohail Bakkar
- Department of General and Specialized Surgery, Faculty of Medicine, The Hashemite University, Zarqa, Jordan
| | - Papavramidis Theodossis
- 1st Propaedeutic Department of Surgery, Faculty of Health Science, Medical School, AHEPA University Hospital, Aristotle University, St.Kiriakidi 1, 54636, Thessaloniki, Greece
- Minimal Invasive Endocrine Surgery Department, Kyanos Stavros, Euromedica, Thessaloniki, Greece
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Arya AK, Kumari P, Singh P, Bhadada SK. Molecular basis of symptomatic sporadic primary hyperparathyroidism: New frontiers in pathogenesis. Best Pract Res Clin Endocrinol Metab 2025; 39:101985. [PMID: 40057423 DOI: 10.1016/j.beem.2025.101985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/17/2025]
Abstract
Primary hyperparathyroidism is a common endocrine disorder characterized by inappropriate elevation of parathyroid hormone and hypercalcemia. While predominantly an asymptomatic disease in Western populations, symptomatic presentations are more prevalent in Eastern countries. The molecular pathogenesis of sporadic PHPT primarily involves genetic and epigenetic alterations leading to abnormal parathyroid cell proliferation and altered calcium sensing mechanism. To date, MEN1 and cyclin D1 are the only established drivers of sporadic PHPT. Somatic MEN1 gene mutations occur in 30-40 % of sporadic parathyroid adenomas (PA), with a recent study on symptomatic cases reporting germline variants.Cyclin D1 overexpression in sporadic PA has been observed in 20-40 % of cases in Western populations and 80 % of cases in Eastern populations, with an inverse association with cyclin-dependent kinase inhibitors CDKN2A and CDKN2B expression. The calcium-sensing receptor expression was significantly lower in symptomatic compared to asymptomatic PHPT, strongly supported by epigenetic deregulation (promoter hypermethylation and histone methylation). Recent studies have highlighted the potential involvement of EZH2, a histone methyltransferase, in parathyroid tumorigenesis. Additionally, parathyroid-specific transcription factors like GCM2, PAX1, and GATA3 are emerging as putative tumor suppressors, especially from the symptomatic PHPT. Next-generation sequencing has identified novel potential drivers such as PIK3CA, MTOR, and NF1 in sporadic PC, alongside CDC73. The molecular landscape of sporadic PHPT appears to differ between Eastern and Western populations. This heterogeneity underscores the need for further large-scale studies, particularly in symptomatic cases from developing nations, to comprehensively elucidate the molecular drivers of parathyroid tumorigenesis.
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Affiliation(s)
- Ashutosh Kumar Arya
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi 110029, India.
| | - Poonam Kumari
- Department of Endocrinology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
| | - Priyanka Singh
- Department of Systems Biology, City of Hope, Monrovia, CA 91016, USA.
| | - Sanjay Kumar Bhadada
- Department of Endocrinology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
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Goldfarb M, Bustos MA, Moon J, Jackson K, Singer FR, Hoon DSB. Pilot Study of Plasma miRNA Signature Panel for Differentiating Single vs Multiglandular Parathyroid Disease. J Clin Endocrinol Metab 2025; 110:758-770. [PMID: 39163258 DOI: 10.1210/clinem/dgae577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 04/02/2024] [Accepted: 08/16/2024] [Indexed: 08/22/2024]
Abstract
CONTEXT The ability to differentiate sporadic primary hyperparathyroidism (sPHPT) caused by a single parathyroid adenoma (PTA) from multiglandular parathyroid disease (MGD) preoperatively, as well as definitely diagnose sPHPT in difficult patients, would enhance surgical decision-making. OBJECTIVE This work aimed to identify miRNA (miR) signatures for MGD, single- and double-PTA, as well as cell-free miRNA (cfmiR) in plasma samples from patients with single-PTAs to use as biomarkers. METHODS A total of 47 patients with sPHPT (single-PTA n = 32, double-PTA n = 12, MGD n = 9). Preoperative plasma samples from 16 single-PTA and 29 normal healthy donors (NHDs). All specimens were processed and analyzed for 2083 miRs using HTG EdgeSeq miR whole-transcriptome assay and normalized using DESeq2 to identify differentially expressed (DE) miRs. MiR classifiers were identified using Random Forest. Main outcome measures were receiver operating characteristic curves and areas under the curve. RESULTS MiR signatures distinguished normal parathyroid from MGD and PTA as well as MGD from PTA in tissue samples. Common miRs were found in the single-PTA and double-PTAs. Data integration identified a 27-miR signature in single-PTA tissue samples compared to the rest of the tissue samples. In plasma samples analysis, significant cfmiRs were DE in single-PTA patients compared to NHD. Of those, only 9 miRNAs/cfmiRs were found DE both in tissue and plasma samples from patients diagnosed with a single PTA (AUC = 76%). CONCLUSION Twenty-seven miRs were consistently found DE in single-PTA tissue and plasma samples. Data integration showed a 9-cfmiR signature with potential clinical utility to preoperatively diagnose sPHPT caused by a single PTA, which could decrease more invasive parathyroid explorations.
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Affiliation(s)
- Melanie Goldfarb
- Center for Endocrine Tumors and Disorders, Saint John's Cancer Institute (SJCI) at Providence Saint John's Health Center (SJHC), Santa Monica, CA 90404, USA
| | - Matias A Bustos
- Department of Translational Molecular Medicine, SJCI at SJHC, Santa Monica, CA 90404, USA
| | - Jamie Moon
- Department of Translational Molecular Medicine, SJCI at SJHC, Santa Monica, CA 90404, USA
| | - Katherine Jackson
- Center for Endocrine Tumors and Disorders, Saint John's Cancer Institute (SJCI) at Providence Saint John's Health Center (SJHC), Santa Monica, CA 90404, USA
| | - Frederick R Singer
- Center for Endocrine Tumors and Disorders, Saint John's Cancer Institute (SJCI) at Providence Saint John's Health Center (SJHC), Santa Monica, CA 90404, USA
| | - Dave S B Hoon
- Department of Translational Molecular Medicine, SJCI at SJHC, Santa Monica, CA 90404, USA
- Department of Genomic Sequencing Center, SJCI at Providence SJHC, Santa Monica, CA 90404, USA
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Cheva A, Chorti A, Boulogeorgou K, Chatzikyriakidou A, Achilla C, Bontinis V, Bontinis A, Milias S, Zarampoukas T, Bakkar SY, Papavramidis T. Sporadic Parathyroid Adenoma: A Pilot Study of Novel Biomarkers in Females. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1100. [PMID: 39064529 PMCID: PMC11279064 DOI: 10.3390/medicina60071100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 06/28/2024] [Accepted: 07/03/2024] [Indexed: 07/28/2024]
Abstract
Background and Objectives: Parathyroid adenoma is a distinct cause of primary hyperparathyroidism, with the vast majority being sporadic ones. Proteomic analysis of parathyroid adenomas has proposed a large number of related proteins. The aim of this study is to evaluate the immunohistochemical staining of ANXA2, MED12, MAPK1 and VDR in parathyroid adenoma tissue. Materials and Methods: Fifty-one parathyroid adenomas were analyzed for ANXA2, MED12, MAPK1 and VDR expressions. Tissue was extracted from formalin-fixed paraffin-embedded parathyroid adenoma specimens; an immunohistochemical study was applied, and the percentage of allocation and intensity were evaluated. Results: ANXA2 stained positively in 60.8% of all cell types, while MED12 had positive staining in 66%. MAPK1 expression was found to be negative in total, although a specific pattern for oxyphil cells was observed, as they stained positive in 17.7%. Finally, VDR staining was positive at 22.8%, based on nuclear staining. Conclusions: These immunohistochemical results could be utilized as biomarkers for the diagnosis of sporadic parathyroid adenoma. It is of great importance that a distinct immunophenotype of nodule-forming cells in a positive adenoma could suggest a specific pattern of adenoma development, as in hereditary patterns.
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Affiliation(s)
- Angeliki Cheva
- Laboratory of Pathology, Faculty of Health Science, Medical School, Aristotle University, 541 24 Thessaloniki, Greece
| | - Angeliki Chorti
- 1st Propaedeutic Department of Surgery, Faculty of Health Science, Medical School, AHEPA University Hospital, Aristotle University, 546 36 Thessaloniki, Greece
| | - Kassiani Boulogeorgou
- Laboratory of Pathology, Faculty of Health Science, Medical School, Aristotle University, 541 24 Thessaloniki, Greece
| | - Anthoula Chatzikyriakidou
- Laboratory of Medical Biology—Genetics, Faculty of Health Science, Medical School, Aristotle University, 546 36 Thessaloniki, Greece
| | - Charoula Achilla
- Laboratory of Medical Biology—Genetics, Faculty of Health Science, Medical School, Aristotle University, 546 36 Thessaloniki, Greece
| | - Vangelis Bontinis
- Department of Vascular Surgery, Faculty of Health Science, Medical School, AHEPA University Hospital, Aristotle University, 546 36 Thessaloniki, Greece
| | - Alkis Bontinis
- Department of Vascular Surgery, Faculty of Health Science, Medical School, AHEPA University Hospital, Aristotle University, 546 36 Thessaloniki, Greece
| | - Stefanos Milias
- Minimal Invasive Endocrine Surgery Department, Kyanos Stavros, Euromedica, 546 36 Thessaloniki, Greece
| | - Thomas Zarampoukas
- Laboratory of Pathology, Interbalkan Medical Center, 546 26 Thessaloniki, Greece
| | - Sohail Y. Bakkar
- Endocrine & General Surgery, The Hashemite University, Amman 13133, Jordan
| | - Theodosios Papavramidis
- 1st Propaedeutic Department of Surgery, Faculty of Health Science, Medical School, AHEPA University Hospital, Aristotle University, 546 36 Thessaloniki, Greece
- Minimal Invasive Endocrine Surgery Department, Kyanos Stavros, Euromedica, 546 36 Thessaloniki, Greece
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Chorti A, Cheva A, Chatzikyriakidou A, Achilla C, Boulogeorgou K, Despoina K, Milias S, Zarampoukas T, Papavramidis T. Sporadic parathyroid adenoma: an updated review of molecular genetics. Front Endocrinol (Lausanne) 2023; 14:1180211. [PMID: 37223014 PMCID: PMC10200975 DOI: 10.3389/fendo.2023.1180211] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 04/07/2023] [Indexed: 05/25/2023] Open
Abstract
Introduction Primary HPT (PHPT) is a common disorder, affecting approximately 1% of the general population. Parathyroid adenomas emerge as non-familial sporadic in 90% of cases. The aim of this review is to give a detailed update of molecular genetics of sporadic parathyroid adenoma reported in international literature. Methods A bibliographic research was conducted in PubMed, Google Scholar, and Scopus. Results Seventy-eight articles were included in our review. CaSR, MEN1, CCND1/PRAD, CDKI, angiogenic factors like VEGF, FGF, TGFβ, and IGF1, and apoptotic factors are important genes in parathyroid adenomas pathogenesis that have been established by several studies. A huge list of proteins is differently expressed in parathyroid adenomas measured by Western Blotting, MALDI/TOF, MS spectrometry, and immunohistochemistry. These proteins take part in several cell processes such as cell metabolism, cytoskeleton structural stability, cell oxidative stress regulation, cell death, transcription, translation, cell connection, and cell signaling transmission, while they can be found over- or underexpressed in abnormal tissues. Conclusion This review gives a detailed analysis of all reported data on genomics and proteomics of parathyroid adenoma. Further studies should be applied on understanding parathyroid adenoma pathogenesis and introducing new biomarkers for early detection of primary hyperparathyroidism.
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Affiliation(s)
- Angeliki Chorti
- 1st Propedeutic Department of Surgery, AHEPA University Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Angeliki Cheva
- Laboratory of Pathology, Faculty of Medicine, School of Health Sciences, Aristotle University, Thessaloniki, Greece
| | - Anthoula Chatzikyriakidou
- Laboratory of Medical Biology - Genetics, Faculty of Medicine, School of Health Sciences, Aristotle University, Thessaloniki, Greece
| | - Charoula Achilla
- Laboratory of Medical Biology - Genetics, Faculty of Medicine, School of Health Sciences, Aristotle University, Thessaloniki, Greece
| | - Kassiani Boulogeorgou
- Laboratory of Pathology, Faculty of Medicine, School of Health Sciences, Aristotle University, Thessaloniki, Greece
| | - Krokou Despoina
- 1st Propedeutic Department of Surgery, AHEPA University Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stefanos Milias
- Minimal Invasive Endocrine Surgery Department, Kyanos Stavros, Euromedica, Thessaloniki, Greece
| | - Thomas Zarampoukas
- Laboratory of Pathology, Interbalkan Medical Center, Thessaloniki, Greece
| | - Theodossis Papavramidis
- 1st Propedeutic Department of Surgery, AHEPA University Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Minimal Invasive Endocrine Surgery Department, Kyanos Stavros, Euromedica, Thessaloniki, Greece
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Hormones Secretion and Rho GTPases in Neuroendocrine Tumors. Cancers (Basel) 2020; 12:cancers12071859. [PMID: 32664294 PMCID: PMC7408961 DOI: 10.3390/cancers12071859] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 07/03/2020] [Accepted: 07/06/2020] [Indexed: 12/14/2022] Open
Abstract
Neuroendocrine tumors (NETs) belong to a heterogeneous group of neoplasms arising from hormone secreting cells. These tumors are often associated with a dysfunction of their secretory activity. Neuroendocrine secretion occurs through calcium-regulated exocytosis, a process that is tightly controlled by Rho GTPases family members. In this review, we compiled the numerous mutations and modification of expression levels of Rho GTPases or their regulators (Rho guanine nucleotide-exchange factors and Rho GTPase-activating proteins) that have been identified in NETs. We discussed how they might regulate neuroendocrine secretion.
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Arya AK, Singh P, Saikia UN, Sachdeva N, Dahiya D, Behera A, Rao SD, Bhadada SK. Dysregulated mitogen-activated protein kinase pathway mediated cell cycle disruption in sporadic parathyroid tumors. J Endocrinol Invest 2020; 43:247-253. [PMID: 31535356 DOI: 10.1007/s40618-019-01098-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Accepted: 08/07/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVES The study was designed to evaluate expression profiling of mitogen-activated protein kinase (MAPK) signalling pathway genes in sporadic parathyroid adenoma. METHODS Expression of MAPK signalling pathway genes including activated transcription factors and cell cycle regulatory genes was analysed by real-time PCR- based array in parathyroid adenoma (N = 20) and normal parathyroid tissue (N = 4). RESULTS MAPK signalling pathway as studied by PCR array revealed that a total of 22 genes were differentially expressed (≥ twofold change, p ≤ 0.05) in parathyroid adenoma. Up-regulated genes were ARAF, MAPK12, CREBBP, MYC, HSPB1, HRAS, CDK4, CCND1, and E2F1, and down-regulated genes were MAP4K1, DLK1, MAP3K4, MAPK10, MAPK8, ATF2, SMAD4, MEF2C, LAMTOR3, FOS, CDKN2A CDKN2B, and RB1. The present study revealed that ERK1/2 signalling pathway with up-regulation of HRAS, ARAF, and MEK1 genes and up-regulation of positive regulators of cell cycle (CCND1, CDK4, and E2F1) and down-regulation negative regulators of cell cycle (CDKN2A, CDKN2B, and RB1) made highly dysregulated MAPK signalling pathway in parathyroid adenoma. Expression of CDK4 was positively associated with plasma PTH level (r = 0.60, p = 0.04) and tumor weight (r = 0.80, p = 0.02) of the adenoma patients, respectively. Expression of CDKN2A was correlated negatively with PTH level (r = - 0.52, p = 0.04) of the adenoma patients. CONCLUSION The current study revealed that ERK pathway and associated cell cycle regulator genes are dysregulated in sporadic parathyroid adenoma.
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Affiliation(s)
- A K Arya
- Department of Endocrinology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - P Singh
- Department of Endocrinology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - U N Saikia
- Department of Histopathology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - N Sachdeva
- Department of Endocrinology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - D Dahiya
- Department of General Surgery, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - A Behera
- Department of General Surgery, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - S D Rao
- Bone and Mineral Research Laboratory, Henry Ford Hospital, Detroit, MI, USA
| | - S K Bhadada
- Department of Endocrinology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.
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