The pituitary gland plays a central role in maintaining physiological homeostasis by secreting multiple hormones that regulate diverse body functions. Dysregulation of pituitary hormones can arise from various conditions, such as pituitary tumors and autoimmune diseases, leading to a broad spectrum of symptoms. During embryonic organogenesis, the pituitary gland originates from the oral ectoderm in close contact with the adjacent hypothalamus. This tissue interaction is essential for proper development. Although the molecular mechanisms underlying pituitary development and related disorders have been extensively studied using animal models, such as rodents and zebrafish, species-specific differences limit the translatability of these findings to humans. Moreover, the scarcity of established human pituitary cell lines has hindered the investigation of human-specific mechanisms. Recent biotechnological advances have addressed these limitations by enabling the long-term culture of human pituitary tumor tissues and in vitro generation of pituitary hormone-producing cells from human pluripotent stem cells. These emerging platforms provide powerful tools for deepening our understanding of pituitary biology and diseases. In this review, we summarize current in vitro experimental models derived from pituitary tissues and pluripotent stem cells and discussed their applications in the study of pituitary development, physiology, and related disorders.
Recommendation from the Editor
The pituitary gland is a master endocrine
organ regulating diverse physiological functions via coordinated hormone
secretion. Although the molecular mechanisms underlying pituitary development
and disorders have been extensively studied in animal models, significant
species-specific differences limit the direct translation of these findings to
human biology. In this issue, Dr. Ryusaku Matsumoto at Kyoto University and his
colleagues contribute an excellent review comprehensively summarizing current
human cell-based in vitro models for investigating pituitary development and
disorders. They systematically discuss the advantages and limitations of
available experimental platforms, ranging from conventional two-dimensional
cell lines and primary tumor cultures to cutting-edge three-dimensional
organoid systems derived from pituitary tumor tissues and human pluripotent
stem cells. Our editorial team is confident that this timely and insightful
review will provide readers with up-to-date knowledge of this rapidly evolving
field and serve as a valuable resource for researchers and clinicians engaged
in pituitary biology and endocrine medicine.
Unilateral primary aldosteronism (UPA) is characterized by a severe clinical phenotype and can be cured by adrenalectomy. Establishing accurate cutoff values that indicate the need for adrenal venous sampling (AVS) is crucial. Therefore, we aimed to identify appropriate cutoff values for screening and confirmatory testing to predict UPA by LC–MS/MS-equivalent plasma aldosterone concentration (PAC) using chemiluminescent enzyme immunoassay (CLEIA). A retrospective cohort analysis was conducted as part of the JPAS-II study of 443 patients diagnosed with PA using CLEIA-measured PAC, of whom 179 were confirmed by AVS as having UPA. The screening aldosterone-to-renin ratio (sARR), screening PAC, post-captopril challenge test (CCT) aldosterone-to-renin ratio (ARR), post-CCT PAC, and post-saline infusion test (SIT) PAC were significantly higher in patients with UPA than in those with bilateral PA (p < 0.05). Receiver operator characteristic curve analysis yielded an sARR cutoff value of >183 pg/mL/ng/mL/h (sensitivity of 0.95). The post-CCT ARR (AUC: 0.824 ± 0.022) and post-CCT PAC (AUC: 0.845 ± 0.021) were superior predictors of UPA to post-SIT PAC (AUC: 0.782 ± 0.037). When the cutoff values were designed to maximize sensitivity without a significant reduction in specificity, cutoff values for post-CCT ARR of >153 pg/mL/ng/mL/h (sensitivity: 0.85, specificity: 0.55) and for post-SIT PAC of >48 pg/mL (sensitivity: 0.80, specificity: 0.61) were obtained. Importantly, these cutoff values contributed to a diagnosis of UPA when the presence of hypokalemia or adrenal tumor was also considered. In conclusion, LC–MS/MS-equivalent CLEIA-measured cutoff values for post-CCT ARR of >153 pg/mL/ng/mL/h and for post-SIT PAC of >48 pg/mL are considered to indicate AVS. Study registration number: UMIN ID: 000046631.
Recommendation from the Editor
Establishing the cutoff values that indicate the need for adrenal venous sampling (AVS) for accurate diagnosis of unilateral primary aldosteronism (UPA) has been desired. In this issue, Dr Shoichiro Izawa in Tottori University and the JPAS-II Study Group members conducted a retrospective cohort analysis of 443 patients with PA and clearly identified the cutoff values for AVS, based on LC–MS/MS-equivalent CLEIA-measured, as aldosterone-to-renin ratio(ARR)of >153 pg/mL/ng/mL/h after captopril challenge test (CCT) and plasma aldosterone concentration (PAC) of >48 pg/mL after saline infusion test (SIT). Our editorial team is confident that this excellent paper will be helpful for clinicians and endocrinologists in deciding whether or not to perform AVS.
Congenital nephrogenic diabetes insipidus (CNDI) is characterized by resistance of the distal nephrons and collecting ducts to arginine vasopressin (AVP). High doses of 1-deamino-8-D-arginine vasopressin (DDAVP), a V2-receptor-selective agonist, are effective in some cases. The present study aimed to demonstrate the use, efficacy, and safety of DDAVP and the characteristics of patients who responded to this treatment. The present, retrospective, multicentric, observational survey of patients with CNDI receiving DDAVP was based on a previous, nationwide survey conducted by the Japanese Society for Pediatric Endocrinology (JSPE) and collected data on the use (formulation, dosage, and treatment duration), efficacy (change in urine output and height SDS), and safety of DDAVP. In the initial survey, 43 of 123 JSPE council members (35.0%) observed the patients. The secondary survey of 13 patients found DDAVP to be effective in five patients (38.5%), as evidenced by a 12.6–31.6% decrease in urine output. The maximum urine osmolality on a water deprivation test and urine osmolality after vasopressin injection were lower in patients who were unresponsive to DDAVP than in those who were responsive to the drug (106 vs. 206 mOsm/H2O/kg, 140 vs. 525 mOsm/H2O/kg). The AVPR2 variants identified in the DDAVP-responsive group were p.Ala37Pro, p.Leu44Phe, p.Arg104Cys, and p.Tyr128Ser. DDAVP was effective against CNDI with residual V2R function. The water deprivation test with vasopressin injection and genetic testing may be useful for predicting responsiveness to DDAVP.
Recommendation from the Editor
Congenital
nephrogenic diabetes insipidus (CNDI) is a rare genetic disorder characterized
by polyuria, growth retardation, and dehydration. Japanese guidelines indicate that DDAVP is
effective in some cases when used in combination with conventional therapies.
However, until now, no studies have investigated the CNDI patients who were
responsive to DDAVP. In this issue, Dr Kento Ikegawa in Tokyo Metropolitan
Children’s Medical Center and his colleagues aimed to clarify the use,
efficacy, and safety, and characteristics of the patients who were responsive
to DDAVP. They clearly demonstrated that DDAVP is effective for CNDI with
residual V2R function and the water deprivation test with vasopressin injection
and genetic testing may be useful in predicting responsiveness to DDAVP.
Our editorial team is confident that this excellent report provides readers
with the latest knowledge on the treatment of CNDI with DDAVP.
The Fukushima prefectural government is implementing the Thyroid Ultrasound Examination (TUE) program for residents aged 18 years or younger living in Fukushima Prefecture at the time of the nuclear accident. The results of the first-round survey showed that the prevalence of thyroid cysts was approximately half the total number of participants. Therefore, we analyzed the detection rate and maximum diameter of thyroid cysts in more detail, based on the results of second- and third-round surveys, to determine their characteristics. We analyzed 284,074 participants who completed Full-scale Surveys (FSSs). The second and third-round surveys were considered the 1st and 2nd FSSs, respectively. The detection rate of thyroid cysts was 57.4% in males and 61.0% in females, with the highest prevalence observed at 11 and 13 years of age, respectively. The median maximum diameter of thyroid cysts was 2.7 mm (interquartile range [IQR]: 2.1–3.3) in males and 2.8 mm (IQR: 2.2–3.6) in females, with a tendency to increase with age. Both the detection rate and maximum diameter were associated with BSA. Among participants who underwent both the 1st and 2nd FSSs, cysts appeared in 10.9% and disappeared in 6.1% at the 2nd FSS. The appearance of cysts was associated with younger age, female sex, and the presence of nodules. Disappearance of cysts was associated with older age, female sex, larger BSA, and smaller maximum cyst diameter. This study is expected to help advance the TUE program and elucidate the mechanisms underlying the formation and disappearance of thyroid cysts.
Recommendation from the Editor
The 2011 Great East Japan Earthquake and subsequent tsunami damaged the
reactors at the Fukushima Nuclear Power Plant and caused the release of
radioactive materials. In response, Fukushima Prefecture launched a
Prefectural Health Management Survey to monitor the health status of
Fukushima residents, including a thyroid ultrasound examination (TUE)
program targeting residents aged 18 or younger who were living in
Fukushima at the time of the nuclear accident. In this issue, Dr Mahiro
Asano and her colleague analyzed the survey data from 284,074
individuals and reported highly significant results regarding the
detection rate and maximum diameter of thyroid cysts, especially
association factors with appearance and disappearance of cysts. This
valuable report is expected to shed light on the mechanisms underlying
the formation and disappearance of thyroid cysts.
The biological clock enables organisms to align their intrinsic rhythms with daily environmental cycles thereby maintaining homeostasis and imparting resilience against metabolic derangements. Endocrine hormones and neural networks are key mediators of temporal coordination across remote tissues. The potential impact of maternal-fetal synchronization during pregnancy has been extensively studied, as alterations in maternal circadian rhythms because of mistimed food intake, sleep disturbances, and jet-lagged conditions appear to influence organ development, maturation, and behavior, leading to enduring metabolic consequences in offspring. In support, the in utero environment and maternal nutritional state influence long-term health outcomes, as proposed in the developmental origins of health and disease. While the molecular mechanisms connecting maternal circadian disruption to sustained alterations in progeny are still under investigation, endocrine hormones and metabolites may engage in temporal communication between the mother and fetus and induce epigenetic changes. This review outlines recent discoveries on maternal circadian rhythms as an external input for the fetus and discusses future strategies to strengthen metabolic fitness in subsequent generations.
Recommendation from the Editor
Although alterations in maternal circadian rhythms are thought to affect the metabolic state of offspring, the mechanism linking maternal circadian disruptions to offspring remain unclear. In this issue, Drs Kenichiro Kinouchi and Hiroshi Itoh in Keio University contribute an excellent review focusing on maternal circadian rhythms, hormones, metabolism and the microbiota, all of which are involved in maternal-fetal communication. Our editorial team believes this excellent review provides all readers with up-to-date knowledge of maternal-fetal synchronization and susceptibility to metabolic diseases.
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公開日: 2024/03/28 | 71 巻 3 号 p. 223-231
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Japan Endocrine Society Clinical Practice Guideline for the Diagnosis and Management of Pheochromocytoma and Paraganglioma 2025
公開日: 2026/01/06 | 73 巻 1 号 p. 115-157
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The effect of acute sleep deprivation on cortisol level: a systematic review and meta-analysis
公開日: 2024/08/08 | 71 巻 8 号 p. 753-765
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