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Serum proteome changes in acromegalic patients following transsphenoidal surgery: novel biomarkers of disease activity.

ABSTRACT: Transsphenoidal adenomectomy is the primary treatment for acromegaly. However, assessment of the therapeutical outcome remains problematic since the existing biomarkers of disease activity frequently show discordant results.To discover novel serum biomarkers of disease activity in acromegalic patients before and after surgery.Serum samples of eight newly diagnosed acromegaly patients before and after transsphenoidal surgery were analyzed for proteomic changes by two-dimensional gel electrophoresis. Protein spots displaying statistically significant changes, pre- versus post-surgery, were identified by mass spectrometry (MS), tandem MS (MS/MS), and western blot analysis.Six protein spots displaying decreased intensities after surgery were identified as transthyretin (two isoforms), haptoglobin ?2, ?-hemoglobin, and apolipoprotein A-1 (two isoforms). One protein spot, identified as complement C4B precursor, was increased after the surgery.Seven serum protein spots were differentially expressed following surgery in acromegalic patients. The identified proteins represent potential novel biomarkers to assess the effectiveness of surgical treatment in acromegalic individuals. Future studies will validate the use of the identified proteins as biomarkers of disease activity after medical treatment of acromegaly.

SUBMITTER: Cruz-Topete D

PROVIDER: S-EPMC4074021 | biostudies-literature | 2011 Feb

REPOSITORIES: biostudies-literature

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Serum proteome changes in acromegalic patients following transsphenoidal surgery: novel biomarkers of disease activity.

Cruz-Topete Diana D Christensen Britt B Sackmann-Sala Lucila L Okada Shigeru S Jorgensen Jens Otto L JO Kopchick John J JJ

European journal of endocrinology 20101108 2

<h4>Context</h4>Transsphenoidal adenomectomy is the primary treatment for acromegaly. However, assessment of the therapeutical outcome remains problematic since the existing biomarkers of disease activity frequently show discordant results.<h4>Objective</h4>To discover novel serum biomarkers of disease activity in acromegalic patients before and after surgery.<h4>Design</h4>Serum samples of eight newly diagnosed acromegaly patients before and after transsphenoidal surgery were analyzed for prote ...[more]

PMID: 21059862

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Project description:BackgroundT ranssphenoidal surgery (TSS) is the standard approach for resection of pituitary lesions. Historically, this has utilized the microscopic approach (mTSS); however, the past decade has seen widespread uptake of the endoscopic approach (eTSS). The purported benefits of this include improved visualization and illumination, resulting in improved surgical and endocrinological patient outcomes. It is also believed that eTSS results in fewer post-operative nasal symptoms compared to mTSS; however, few papers have directly compared these groups.ObjectivesWe sought to compare nasal symptoms after endoscopic uninostril (eTSS-uni), endoscopic binostril (eTSS-bi) and microscopic endoscopic transsphenoidal surgery (mTSS).MethodsThe General Nasal Patient Inventory (GNPI) was prospectively administered to 136 patients (71 non-functioning adenomas, 26 functioning adenomas, 39 other pathology) undergoing transsphenoidal surgery at multiple time points (pre-operatively; days 1, 3 and 7-14; months 1, 3 and 6 and 1 year post-operatively). All surgeries were performed by subspecialist pituitary surgeons in three subgroups - mTSS (25), eTSS-uni (74) and eTSS-bi (37). The total GNPI scores (0-135) and subscores for the 45 individual components were compared across three groups assessing for temporal and absolute changes.ResultsIrrespective of surgical approach used, GNPI scores were significantly higher on post-operative day 1 (p < 0.001) and day 3 (p ≤ 0.03) compared to pre-treatment baseline (mixed-effects model). By 1 month post-operatively, however, post-operative GNPI scores were no different from pre-treatment (p > 0.05, mixed-effects model). Whilst the eTSS-uni group demonstrated significantly lower GNPI scores at day 1 post-op compared to the mTSS group (p = 0.05) and eTSS-bi group (p < 0.001), there was no significant difference in post-operative scores between approaches beyond 1-2 weeks post-operatively. Similar results were obtained when the non-functioning tumour group was analysed separately.ConclusionsTranssphenoidal pituitary surgery is well tolerated. Post-operative nasal symptoms transiently worsen but ultimately improve compared to pre-operative baseline. Operative approach (microscopic, endoscopic uninostril or endoscopic binostril) only has a transient effect on severity of post-operative nasal symptoms.

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Serum proteome changes in acromegalic patients following transsphenoidal surgery: novel biomarkers of disease activity.

Publications

Serum proteome changes in acromegalic patients following transsphenoidal surgery: novel biomarkers of disease activity.

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