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Singer S, Sykiotis G, Al-Ibraheem A, Pinto M, Iakovou I, Østhus AA, Hammerlid E, Locati LD, Gamper EM, Arraras JI, Jordan S, Buettner M, Engesser D, Taylor K, Canotilho R, Ioannidis G, Husson O, Gama RR, Fanetti G, Moss L, Inhestern J, Andry G, Rimmele H, Kiyota N. The impact of electronic versus paper-based data capture on data collection logistics and on missing scores in thyroid cancer patients. Endocrine 2024; 84:635-645. [PMID: 38103143 PMCID: PMC11076317 DOI: 10.1007/s12020-023-03628-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 11/23/2023] [Indexed: 12/17/2023]
Abstract
PURPOSE The purpose of this study was to investigate the impact of the type of data capture on the time and help needed for collecting patient-reported outcomes as well as on the proportion of missing scores. METHODS In a multinational prospective study, thyroid cancer patients from 17 countries completed a validated questionnaire measuring quality of life. Electronic data capture was compared to the paper-based approach using multivariate logistic regression. RESULTS A total of 437 patients were included, of whom 13% used electronic data capture. The relation between data capture and time needed was modified by the emotional functioning of the patients. Those with clinical impairments in that respect needed more time to complete the questionnaire when they used electronic data capture compared to paper and pencil (ORadj 24.0; p = 0.006). This was not the case when patients had sub-threshold emotional problems (ORadj 1.9; p = 0.48). The odds of having the researcher reading the questions out (instead of the patient doing this themselves) (ORadj 0.1; p = 0.01) and of needing any help (ORadj 0.1; p = 0.01) were lower when electronic data capture was used. The proportion of missing scores was equivalent in both groups (ORadj 0.4, p = 0.42). CONCLUSIONS The advantages of electronic data capture, such as real-time assessment and fewer data entry errors, may come at the price of more time required for data collection when the patients have mental health problems. As this is not uncommon in thyroid cancer, researchers need to choose the type of data capture wisely for their particular research question.
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Affiliation(s)
- Susanne Singer
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre Mainz, Mainz, Germany.
- University Cancer Centre, Mainz, Germany.
| | - Gerasimos Sykiotis
- Service of Endocrinology, Diabetology and Metabolism, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Akram Al-Ibraheem
- Department of Nuclear Medicine, King Hussein Cancer Center, Amman, Jordan
| | - Monica Pinto
- Rehabilitation Medicine Unit, Strategic Health Services Department, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Naples, Italy
| | - Ioannis Iakovou
- Department of Nuclear Medicine, Aristotle University, Thessaloniki, Greece
| | - Arild Andre Østhus
- ENT and Head and Neck Department, University Medical Centre Oslo, Oslo, Norway
| | - Eva Hammerlid
- Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Otorhinolaryngology-Head and Neck Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Laura Deborah Locati
- Head and Neck Medical Oncology Unit, Fondazione IRCCS istituto Nazionale dei Tumori, Milan, Italy
| | - Eva Maria Gamper
- Department of Nuclear Medicine and Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, University Hospital Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Susan Jordan
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
| | - Matthias Buettner
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre Mainz, Mainz, Germany
| | - Deborah Engesser
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre Mainz, Mainz, Germany
| | - Katherine Taylor
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre Mainz, Mainz, Germany
| | - Rita Canotilho
- Instituto Português do Oncologia do Porto Francisco Gentil, Porto, Portugal
| | | | - Olga Husson
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | - Giuseppe Fanetti
- Division of Radiotherapy, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, PN, Italy
| | - Laura Moss
- Velindre Cancer Centre, Velindre University NHS Trust, Cardiff, UK
| | - Johanna Inhestern
- Department of Otorhinolaryngology, Oberhavelkliniken, Hennigsdorf, Germany
| | - Guy Andry
- Surgery Department, Jules Bordet Institute, Brussels, Belgium
| | - Harald Rimmele
- Bundesverband Schilddrüsenkrebs - Ohne Schilddrüse leben e. V., Berlin, Germany
| | - Naomi Kiyota
- Department of Medical Oncology and Hematology, Cancer Center, Kobe University Hospital, Kobe, Japan
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2
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Singer S, Al-Ibraheem A, Pinto M, Iakovou I, Østhus AA, Hammerlid E, Locati LD, Gamper E, Ignacio J, Jordan SJ, Kiyota N, Buettner M, Engesser D, Canotilho R, Ioannidis G, Husson O, Gama RR, Fanetti G, Moss L, Inhestern J, Andry G, Fuehrer D, Kuliś D, Rimmele H, Sykiotis G. International Phase IV Field Study for the Reliability and Validity of the European Organisation for Research and Treatment of Cancer Thyroid Cancer Module EORTC QLQ-THY34. Thyroid 2023; 33:1078-1089. [PMID: 37450344 DOI: 10.1089/thy.2023.0221] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
Purpose: The aim of this study was to validate the new European Organisation for Research and Treatment of Cancer Quality of Life Thyroid Cancer Module (EORTC QLQ-THY34). Methods: We enrolled 437 thyroid cancer patients from 17 countries. One group (n = 303), undergoing treatment or best supportive care, completed the questionnaires at three time points (before therapy [t1], 6 weeks later [t2], and 6 months after t2 [t3]). A second group (survivors ≥2 years after diagnosis, n = 134) completed it at a random baseline time point and a second time 1 week later. We determined internal consistency (using Cronbach's alpha), the scale structure (with confirmatory factor analysis), and discriminant validity (using known-group comparisons). Group 1 data were used to assess responsiveness and group 2 data to determine test-retest reliability using intra-class correlations (ICC). Results: All 34 items fulfilled the criteria to be kept in the questionnaire. Cronbach's alpha was >0.70 in 8 of the 9 multi-item scales. All standardized factor loadings exceeded 0.40, confirming the proposed scale structure. The ICC was >0.70 in all scales expressing good test-retest reliability. Differences in scale scores between patients with different histology were >5 points in all scales. In all but one of the pre-specified scales (Dry Mouth), changes over time were ≥|4| points between at least two time points. Conclusion: The EORTC QLQ-THY34 with its 9 multi-item and 8 single-item scales is a reliable and valid tool to measure quality of life in thyroid cancer patients and can be used in future trials and studies.
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Affiliation(s)
- Susanne Singer
- Division of Epidemiology and Health Services Research, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre Mainz, Mainz, Germany
- University Cancer Centre, Mainz, Germany
| | - Akram Al-Ibraheem
- Department of Nuclear Medicine, King Hussein Cancer Center, Amman, Jordan
| | - Monica Pinto
- Rehabilitation Medicine Unit, Strategic Health Services Department, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Naples, Italy
| | - Ioannis Iakovou
- Department of Nuclear Medicine, Aristotle University, Thessaloniki, Greece
| | - Arild Andre Østhus
- ENT and Head and Neck Department, University Medical Centre Oslo, Oslo, Norway
| | - Eva Hammerlid
- Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Otorhinolaryngology-Head and Neck Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Laura Deborah Locati
- Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Eva Gamper
- Department of Nuclear Medicine and Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, University Hospital Psychiatry II, Medical University of Innsbruck, Austria
| | - Juan Ignacio
- Oncology Departments, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Susan J Jordan
- School of Public Health, The University of Queensland, Brisbane, Australia
| | - Naomi Kiyota
- Department of Medical Oncology and Hematology, Cancer Center, Kobe University Hospital, Kobe, Japan
| | - Matthias Buettner
- Division of Epidemiology and Health Services Research, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre Mainz, Mainz, Germany
| | - Deborah Engesser
- Division of Epidemiology and Health Services Research, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre Mainz, Mainz, Germany
| | - Rita Canotilho
- Instituto Português do Oncologia do Porto Francisco Gentil, Porto, Portugal
| | | | - Olga Husson
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, Netherlands
| | | | - Giuseppe Fanetti
- Division of Radiotherapy, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano (PN), Italy
| | - Laura Moss
- Velindre Cancer Centre, Velindre University NHS Trust, Cardiff, United Kingdom
| | - Johanna Inhestern
- Department of Otorhinolaryngology, Oberhavelkliniken, Hennigsdorf, Germany
| | - Guy Andry
- Surgery Department, Jules Bordet Institute, Brussels, Belgium
| | - Dagmar Fuehrer
- Department of Endocrinology, Diabetes and Metabolism, Endocrine Tumour Center at WTZ, Member of ENDO-ERN and EURACAN, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Dagmara Kuliś
- European Organisation for Research and Treatment of Cancer (EORTC), Quality of Life Department, Brussels, Belgium
| | - Harald Rimmele
- Bundesverband Schilddrüsenkrebs-Ohne Schilddrüse leben e. V., Berlin, Germany
| | - Gerasimos Sykiotis
- Service of Endocrinology, Diabetology and Metabolism, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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3
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Matter M, Mateev E, Sykiotis G, Demartines N. Hypocortisolemia following unilateral adrenalectomy. Br J Surg 2022. [DOI: 10.1093/bjs/znac177.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Objective
Unilateral adrenalectomy (UA) is the best option for unilateral functioning and non-functioning adrenal adenomas, localized primary or metastatic carcinomas. Post-operative hypocortisolemia (HC) in Cushing Syndrome is well known, but several studies reported HC after UA for other indications. A systematic full endocrine investigation for all adrenal mass is not systematic and dexamethasone suppression test (DST) is not recommended in non-Cushing functioning tumours. Double secretion (autonomous cortisol co-secretion) is a rare phenomenon. The purpose of the study was to review incidence of postoperative HC in a tertiary centre.
Methods
Retrospective study (2012–2020) looking for hypocortisolemia after UA in patients operated for Cushing Syndrome and other endocrine tumours. Pre- and postoperative laboratory findings were reviewed in a total of 115 patients with UA. Patients receiving perioperative dexamethasone (DEX) for nausea and vomiting prophylaxis were included as well.
Results
UA (51 right and 64 left) were performed in 47 women and 68 men (mean age 53.5 y.), laparoscopically in 97 (84.3%, 3 converted). UA indications included: Cushing (8), autonomous cortisol secretion (10, in 2 with combined Conn), Conn syndrome (37), pheochromocytoma (24), non-functioning adenoma (10, adrenal carcinoma (3), adrenal metastasis (19) and other diagnosis (4). 18 patients had a preoperative DST (15.7%). Anaesthesia reports revealed that 53/115 patients received DEX. 51/115 patients had a control of postoperative cortisol level. Hypocortisolemia was observed overall in 28/51 patients, by excluding Cushing patients in 24/45, in 19/53 patients who received DEX and in 7/48 in those without DEX. Confusion comes when patients receiving DEX had normal postoperative cortisolemia.
Conclusion
The fact that some patients received DEX (ERAS pathway), complicated the interpretation of cortisol levels at postoperative day one (D1). DEX is known to supress the hypothalamic-pituitary-adrenal axis (HPA axis) at D1. Thus, claiming that hypocortisolemia is the result of cortisol co-secretion (adenoma with double secretion), also able to supress the HPA axis, is not possible in patients who received DEX. These results suggests 1) to fully investigate all hormone functions in case of adrenal mass and 2) not administrating DEX in patients undergoing UA, for adequately assessing the HPA axis function postoperatively.
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Affiliation(s)
- M Matter
- Department of Visceral Surgery, Lausanne University Hospital , Lausanne, Switzerland
| | - E Mateev
- Department of Visceral Surgery, Lausanne University Hospital , Lausanne, Switzerland
| | - G Sykiotis
- Department of Endocrinology, Lausanne University Hospital , Lausanne, Lausanne, Switzerland
| | - N Demartines
- Department of Visceral Surgery, Lausanne University Hospital , Lausanne, Switzerland
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Fouchardiere CDL, Fugazzola L, Taylor J, Appetecchia M, Besic N, Bongiovanni A, Buffet C, Costante G, Gay S, Grande E, Kapiteijn E, Krajewska J, Kroiss M, Morreau H, Netea-Maier R, Peeters R, Soares P, Sykiotis G, Blay JY, Locati L. 1750P Molecular genotyping in refractory thyroid cancers: Results of a European survey. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.896] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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5
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Stamatiou A, Herrera-Gómez RG, Szturz P, Bisig B, Romano E, Sykiotis G, Gorostidi F, La Rosa S, Kopp P, Cristina V. [Anaplastic thyroid carcinoma : new therapeutic approaches]. Rev Med Suisse 2021; 17:962-966. [PMID: 34009754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Anaplastic thyroid cancer (ATC) is among the most aggressive cancers with a median overall survival of 4 months and a disease-specific mortality of close to 100%. As soon as the diagnosis is suspected or established, urgent referral to an experienced multidisciplinary center is imperative. Chemotherapy has limited efficacy. Molecular analyses, together with the availability of novel targeted therapies and immunotherapies, now permit to improve outcomes. In particular, targeted therapy with dabrafenib and trametinib is indicated as first-line therapy for BRAF V600E-mutated ATC.
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Affiliation(s)
- Antonia Stamatiou
- Service d'oncologie médicale, Département d'oncologie, CHUV, 1011 Lausanne
| | | | - Petr Szturz
- Service d'oncologie médicale, Département d'oncologie, CHUV, 1011 Lausanne
| | - Bettina Bisig
- Service de pathologie clinique, Département médecine de laboratoire et pathologie, CHUV, et Faculté de biologie et de médecine, Université de Lausanne, 1011 Lausanne
| | - Edouard Romano
- Service de radio-oncologie, Département d'oncologie, CHUV, 1011 Lausanne
| | - Gerasimos Sykiotis
- Service d'endocrinologie, diabétologie et métabolisme, Département de médecine, CHUV, et Faculté de biologie et de médecine, Université de Lausanne, 1011 Lausanne
| | - François Gorostidi
- Service d'ORL et de chirurgie cervico-faciale, Département des services de chirurgie et d'anesthésiologie, CHUV, 1011 Lausanne
| | - Stefano La Rosa
- Service de pathologie clinique, Département médecine de laboratoire et pathologie, CHUV, et Faculté de biologie et de médecine, Université de Lausanne, 1011 Lausanne
| | - Peter Kopp
- Service d'endocrinologie, diabétologie et métabolisme, Département de médecine, CHUV, et Faculté de biologie et de médecine, Université de Lausanne, 1011 Lausanne
| | - Valérie Cristina
- Service d'oncologie médicale, Département d'oncologie, CHUV, 1011 Lausanne
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6
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Chartoumpekis D, Ziros P, Renaud C, Bongiovanni M, Habeos I, Liao XH, Refetoff S, Kopp P, Brix K, Sykiotis G. OR28-01 Constitutive Activation of NRF2 Antioxidant Response Leads to Age-Dependent Goiter and Compensated Hypothyroidism in Male Mice. J Endocr Soc 2020. [PMCID: PMC7207596 DOI: 10.1210/jendso/bvaa046.2042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
Background: Familial non-toxic multinodular goiter (MNG) is a rare disease. KEAP1 gene (Kelch-like ECH-associated protein 1) that encodes the main inhibitor of nuclear factor erythroid 2-related transcription factor 2 (Nrf2), a central mediator of antioxidant responses, has been found to be one of the mutated genes that lead to familial MNG. The proposed association of KEAP1 with familial MNG is based on only two loss-of-function mutations in respective Japanese families, only one of which included proper phenotyping and demonstration of co-segregation of phenotype and mutation. To date, there is no experimental evidence from model organisms to support that decreased Keap1 levels can cause goiter. Hypothesis: We hypothesized that enhanced Nrf2 signaling induced by loss of Keap1 function in mice can lead to goiter. Methods: To this end, male Keap1 hypomorphic C57BL/6J mice that express ~80% less Keap1 in their tissues (Keap1 knockdown mice:“Keap1KD”) were studied at 3 and 12 months of age and compared to wild-type mice (WT). Plasma, thyroids and pituitary glands were collected for assessment of thyroid function by radioimmunoassays and for histology as well as gene and protein expression by quantitative PCR and immunoblotting respectively. Results: Keap1KD showed diffuse goiter that began to develop in early adult life and became highly prominent at the age of 12 months when the thyroids of Keap1KD were 6-fold heavier than WT. Histomorphometry assessment of thyroids showed that Keap1KD had ~3-fold larger follicle area and colloid compartment but no thyroid nodules or hyperplasia was detected. Keap1KD also showed primary hypothyroidism already in early adult life that was eventually well-compensated over time by increased TSH levels (at age of 12 months: WT TSH=47.7±9.1 mU/L, Keap1KD TSH=460±74 mU/L). This was also reflected in the pituitary gland of Keap1KD where Tshb mRNA was ~3-fold higher than WT. Despite a known stimulatory effect of Nrf2 on Tg gene transcription and Tg protein abundance, these measures were decreased in the thyroid of Keap1KD mice. No clear patterns were observed in the expression profiles of other thyroid hormone synthesis-specific factors, such as Duox1, Duoxa1, Duox2, Duoxa2, Tpo, Nis, Dio1, Dio2, Dehal1 mRNA levels, with the exception of Tg-processing and Tg-degrading cathepsins, including an increase in mature forms of cathepsins D, L and S. Conclusions: Keap1KD mice showed age-dependent diffuse goiter and compensated hypothyroidism. The precise mechanism accounting for the thyroidal phenotype remains to be elucidated, but it may involve enhanced Tg solubilization and excessive lysosomal Tg degradation. This study unravels novel roles of the druggable Keap1/Nrf2 pathway in thyroid function and economy. Subclinical hypothyroidism in Keap1KD mice may have broader implications regarding their use in metabolic research.
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Affiliation(s)
- Dionysios Chartoumpekis
- Department of Internal Medicine, Division of Endocrinology, University of Patras and Service of Endocrinology and Diabetology, Lausanne University Hospital (CHUV,Switzerland), Patras, Greece
| | - Panos Ziros
- Service of Endocrinology, Diabetology and Metabolism, Lausanne University Hospital, and Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland, Lausanne, Switzerland
| | - Cédric Renaud
- Service of Endocrinology, Diabetology and Metabolism, Lausanne University Hospital, and Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland, Lausanne, Switzerland
| | | | - Ioannis Habeos
- Department of Internal Medicine, Division of Endocrinology, University of Patras, Patras, Greece
| | - Xiao-Hui Liao
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Samuel Refetoff
- Departments of Medicine, Pediatrics, and Committee on Genetics, University of Chicago, Chicago, IL, USA
| | - Peter Kopp
- Service of Endocrinology, Diabetology and Metabolism, Lausanne University Hospital, and Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Klaudia Brix
- Department of Life Sciences and Chemistry, Jacobs University Bremen, Bremen, Germany
| | - Gerasimos Sykiotis
- Service of Endocrinology, Diabetology and Metabolism, Lausanne University Hospital, and Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
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7
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Werner D, Butticaz C, Sykiotis G, Torrent C, Mooser V. Thyroid function immunoassays: Interferences due to anti-streptavidin or anti-sulfo-ruthenium antibodies. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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8
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Bouilly J, Messina A, Papadakis G, Cassatella D, Xu C, Acierno JS, Tata B, Sykiotis G, Santini S, Sidis Y, Elowe-Gruau E, Phan-Hug F, Hauschild M, Bouloux PM, Quinton R, Lang-Muritano M, Favre L, Marino L, Giacobini P, Dwyer AA, Niederländer NJ, Pitteloud N. DCC/NTN1 complex mutations in patients with congenital hypogonadotropic hypogonadism impair GnRH neuron development. Hum Mol Genet 2019; 27:359-372. [PMID: 29202173 DOI: 10.1093/hmg/ddx408] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 11/16/2017] [Indexed: 12/13/2022] Open
Abstract
Congenital hypogonadotropic hypogonadism (CHH) is a rare genetic disease characterized by absent puberty and infertility due to GnRH deficiency, and is often associated with anosmia [Kallmann syndrome (KS)]. The genetic etiology of CHH is heterogeneous, and more than 30 genes have been implicated in approximately 50% of patients with CHH. We hypothesized that genes encoding axon-guidance proteins containing fibronectin type-III (FN3) domains (similar to ANOS1, the first gene associated with KS), are mutated in CHH. We performed whole-exome sequencing in a cohort of 133 CHH probands to test this hypothesis, and identified rare sequence variants (RSVs) in genes encoding for the FN3-domain encoding protein deleted in colorectal cancer (DCC) and its ligand Netrin-1 (NTN1). In vitro studies of these RSVs revealed altered intracellular signaling associated with defects in cell morphology, and confirmed five heterozygous DCC mutations in 6 probands-5 of which presented as KS. Two KS probands carry heterozygous mutations in both DCC and NTN1 consistent with oligogenic inheritance. Further, we show that Netrin-1 promotes migration in immortalized GnRH neurons (GN11 cells). This study implicates DCC and NTN1 mutations in the pathophysiology of CHH consistent with the role of these two genes in the ontogeny of GnRH neurons in mice.
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Affiliation(s)
- Justine Bouilly
- Endocrinology, Diabetes & Metabolism Service, Centre Hospitalier Universitaire Vaudois (CHUV), Faculty of Biology & Medicine, University of Lausanne, 1005 Lausanne, Switzerland
| | - Andrea Messina
- Endocrinology, Diabetes & Metabolism Service, Centre Hospitalier Universitaire Vaudois (CHUV), Faculty of Biology & Medicine, University of Lausanne, 1005 Lausanne, Switzerland
| | - Georgios Papadakis
- Endocrinology, Diabetes & Metabolism Service, Centre Hospitalier Universitaire Vaudois (CHUV), Faculty of Biology & Medicine, University of Lausanne, 1005 Lausanne, Switzerland
| | - Daniele Cassatella
- Endocrinology, Diabetes & Metabolism Service, Centre Hospitalier Universitaire Vaudois (CHUV), Faculty of Biology & Medicine, University of Lausanne, 1005 Lausanne, Switzerland
| | - Cheng Xu
- Endocrinology, Diabetes & Metabolism Service, Centre Hospitalier Universitaire Vaudois (CHUV), Faculty of Biology & Medicine, University of Lausanne, 1005 Lausanne, Switzerland
| | - James S Acierno
- Endocrinology, Diabetes & Metabolism Service, Centre Hospitalier Universitaire Vaudois (CHUV), Faculty of Biology & Medicine, University of Lausanne, 1005 Lausanne, Switzerland
| | - Brooke Tata
- UMR-S 1172-JPArc-Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer, University of Lille, 59000 Lille, France.,Laboratory of Development and Plasticity of the Neuroendocrine Brain, Inserm, UMR-S 1172, 59000 Lille, France
| | - Gerasimos Sykiotis
- Endocrinology, Diabetes & Metabolism Service, Centre Hospitalier Universitaire Vaudois (CHUV), Faculty of Biology & Medicine, University of Lausanne, 1005 Lausanne, Switzerland
| | - Sara Santini
- Endocrinology, Diabetes & Metabolism Service, Centre Hospitalier Universitaire Vaudois (CHUV), Faculty of Biology & Medicine, University of Lausanne, 1005 Lausanne, Switzerland
| | - Yisrael Sidis
- Endocrinology, Diabetes & Metabolism Service, Centre Hospitalier Universitaire Vaudois (CHUV), Faculty of Biology & Medicine, University of Lausanne, 1005 Lausanne, Switzerland
| | - Eglantine Elowe-Gruau
- Division of Endocrinology, Diabetology and Obesity, Department of Pediatrics, Centre Hospitalier Universitaire Vaudois Lausanne, 1005 Lausanne, Switzerland
| | - Franziska Phan-Hug
- Division of Endocrinology, Diabetology and Obesity, Department of Pediatrics, Centre Hospitalier Universitaire Vaudois Lausanne, 1005 Lausanne, Switzerland
| | - Michael Hauschild
- Division of Endocrinology, Diabetology and Obesity, Department of Pediatrics, Centre Hospitalier Universitaire Vaudois Lausanne, 1005 Lausanne, Switzerland
| | - Pierre-Marc Bouloux
- Center for Neuroendocrinology, Royal Free Campus, University College Medical School, London WC1E6BT, UK
| | - Richard Quinton
- Institute of Genetic Medicine and the Royal Victoria Infirmary, University of Newcastle-upon-Tyne, Newcastle-upon-Tyne NE13BZ, UK
| | - Mariarosaria Lang-Muritano
- Department of Endocrinology/Diabetology and Children's Research Centre, University Children's Hospital Zurich, 8091 Zurich, Switzerland
| | - Lucie Favre
- Endocrinology, Diabetes & Metabolism Service, Centre Hospitalier Universitaire Vaudois (CHUV), Faculty of Biology & Medicine, University of Lausanne, 1005 Lausanne, Switzerland
| | - Laura Marino
- Endocrinology, Diabetes & Metabolism Service, Centre Hospitalier Universitaire Vaudois (CHUV), Faculty of Biology & Medicine, University of Lausanne, 1005 Lausanne, Switzerland
| | - Paolo Giacobini
- UMR-S 1172-JPArc-Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer, University of Lille, 59000 Lille, France.,Laboratory of Development and Plasticity of the Neuroendocrine Brain, Inserm, UMR-S 1172, 59000 Lille, France
| | - Andrew A Dwyer
- Endocrinology, Diabetes & Metabolism Service, Centre Hospitalier Universitaire Vaudois (CHUV), Faculty of Biology & Medicine, University of Lausanne, 1005 Lausanne, Switzerland.,Institute of Higher Education and Research in Healthcare, University of Lausanne, 1005 Lausanne, Switzerland
| | - Nicolas J Niederländer
- Endocrinology, Diabetes & Metabolism Service, Centre Hospitalier Universitaire Vaudois (CHUV), Faculty of Biology & Medicine, University of Lausanne, 1005 Lausanne, Switzerland
| | - Nelly Pitteloud
- Endocrinology, Diabetes & Metabolism Service, Centre Hospitalier Universitaire Vaudois (CHUV), Faculty of Biology & Medicine, University of Lausanne, 1005 Lausanne, Switzerland.,Division of Endocrinology, Diabetology and Obesity, Department of Pediatrics, Centre Hospitalier Universitaire Vaudois Lausanne, 1005 Lausanne, Switzerland
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Virgini V, Baumgartner C, Bischoff T, Haller DM, Frey P, Rosemann T, Collet TH, Sykiotis G, Pitteloud N, Rodondi N. [How do Swiss family physicians treat subclinical hypothyroidism?]. Rev Med Suisse 2014; 10:526-529. [PMID: 24701670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Subclinical hypothyroidism is a common condition, and its prevalence increases with age. Currently, guidelines regarding the screening and treatment of subclinical hypothyroidism are controversial. An international survey of general practitioners (GPs), to which Swiss GPs also contributed, showed large inter-country variations in treatment strategies for subclinical hypothyroidism. These differences are mainly explained by the lack of strong evidence for the management of this condition. The European randomized-controlled clinical trial TRUST should help clarify recommendations for screening and thyroxin replacement for the elderly with subclinical hypothyroidism. Working in close collaboration with GPs in Switzerland for the recruitment of patients will ensure that the findings from this study will be applicable to primary care settings.
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