The 16th Acromegaly Consensus Conference in September 2024 updated recommendations on diagnosis and treatment of acromegaly comorbidities. Since the 2020 acromegaly comorbidity management guideline was published, new evidence has emerged on novel and known comorbidities and new treatment approaches. Forty-three experts in the management of acromegaly reviewed the current literature and assessed changes in clinical practice standards and management. Current outcome goals were considered and updated, with a focus on the impact of current and emerging treatments of these comorbidities. Participants assessed factors that determine pharmacological choices, as well as use of specific agents in the management of the most relevant acromegaly comorbidities. We present consensus recommendations highlighting optimization of evidence-based acromegaly comorbidities management.
The nervous and the immune system coevolved, and the crosstalk between both is critical for the maintenance of tissue homeostasis and mental health. In recent years, several examples have been revealed that the immune system influences behaviour, emotions, pain and even such fundamental needs as hunger. Reciprocally, several examples have become apparent in which neuronal innervation regulates local immune responses, wound healing and immune-mediated tissue homeostasis. Such findings demonstrate how well these two networks are interconnected with each other to sustain the body’s well-being. Nonetheless, the underlying mechanisms that orchestrate this interconnection remain poorly understood. The Epidermal Growth Factor Receptor (EGFR) signalling pathway exemplifies this connection, being involved in both neuronal development and maintenance as well as in immune regulation and immune mediated wound healing. Particularly two antagonistic and leukocyte-derived EGF-like growth factors, Amphiregulin and HB-EGF, have gained appreciation for their role in the regulation of local immune responses and the maintenance of tissue homeostasis. In this review, we highlight the role of these two leukocyte-derived growth factors in the regulation of the nervous system and their importance in the bi-directional crosstalk between the immune and nervous systems during tissue homeostasis and inflammation. Ultimately, we propose that under inflammatory conditions, these two leukocyte-derived growth factors may substitute typical neurotrophic factors in their function.
Abstract Cardiovascular–kidney–metabolic (CKM) syndrome represents a continuum of interrelated adiposity, insulin resistance, cardiovascular disease, kidney dysfunction, and metabolic disturbances that evolve across the lifespan. Emerging evidence demonstrates that both biological sex and sociocultural gender significantly shape CKM risk, progression, and clinical expression. CKM syndrome pathogenesis reflects complex multisystem interactions involving adipose tissue dysfunction, neurohormonal activation, inflammatory signaling, and vascular impairment, all of which exhibit important sex-specific patterns. This review examines CKM syndrome from a sex- and gender-informed perspective, highlighting how endogenous and exogenous sex hormones, reproductive transitions, pregnancy-related complications, and dietary exposures shape the long-term CKM syndrome risk. Particular attention is given to the roles of estrogen and testosterone in modulating adipose biology, vascular function, and metabolic regulation. Polycystic ovary syndrome is discussed as a model of androgen excess and multisystem metabolic vulnerability that accelerates CKM features. Finally, we address brain vulnerability within CKM syndrome, emphasizing shared inflammatory, vascular, and neuroendocrine mechanisms linking metabolic dysfunction to cognitive decline and neuropsychiatric disorders. Recognizing these interconnected and sex-specific influences is critical for advancing precision prevention and treatment strategies across the CKM syndrome spectrum. Graphical abstract
We introduce a novel automated well plate sampling system (AmbiSampler) using laser ablation-rapid evaporative ionization mass spectrometry (LA-REIMS) for label-free high-throughput biochemical screening for small volume biological fluid samples and cell line panels from multiwell plates. The human blood serum samples featured intensive signals in the low m/z range including fatty acids and metabolites and in the higher (m/z > 600) range associated with complex lipids, peptides, and proteins. We demonstrate the current quantification performance of the system through blood serum samples spiked with labelled amino acid mix. Cell line analysis was demonstrated by analyzing the NCI60 human cell lines panel grown in multiwell plates. Without any sample preparation, these experiments yielded rich metabolic and lipidomic mass spectrometry profiles, with classification results showing a 98.7
Benign prostatic hyperplasia (BPH) is the main cause of lower urinary tract symptoms (LUTS) in aging men. As the incidence of prostate cancer (PCa) increases with age, coexistence of BPO and PCa is a frequent issue. Radical prostatectomy might be considered as the best option for patients presenting with severe obstructive symptoms, allowing to simultaneously treat both diseases. However, not all patients are eligible or prefer surgery, therefore a large number of patients are referred to receive PCa radiotherapy (RT). Preexisting LUTS represent a well-known risk factor to develop severe genito-urinary (GU) toxicity. While improving urinary function before starting irradiation appears to be crucial, the development of new minimally invasive surgical therapies (MIST) for BPH creates new opportunities for treatment personalization in RT patients with LUTS.
