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Health - Reuters


Diabetes Drugs May Help Cushing's Syndrome

By Keith Mulvihill


NEW YORK (Reuters Health) - A new study in mice is helping researchers zero in on a potential treatment for Cushing's syndrome, a hormone disorder that can be caused by a tumor in the brain's pituitary gland.


While such tumors can be removed surgically, this may not always cure the disease and there are no drugs suitable to treat the condition. The new study suggests that commonly used diabetes drugs may help such patients, according to a report in the November issue of the journal Nature Medicine.


Cushing's syndrome results from high levels of the hormone cortisol, and can cause fat accumulation in the upper body and face, and thinning of the arms and legs. Patients can experience high blood pressure and high blood sugar, along with depression, fatigue, irritability and weakened bones.


Cortisol levels rise when another hormone, called adrenocorticotropic hormone (ACTH), is overproduced by the brain's pituitary gland. ACTH stimulates the adrenal glands, which sit on top of the kidneys, to produce the cortisol, explained lead author Dr. Anthony P. Heaney of the Cedars-Sinai Medical Center in Los Angeles, California during an interview with Reuters Health.


Cushing's syndrome can be caused by a tumor of the pituitary gland, a tumor of the adrenal gland or by long-term use of drugs, called corticosteroids, commonly used to treat illnesses, such as rheumatoid arthritis and asthma.


In the current study, Heaney and colleagues found that a protein called PPAR-gamma, which is found on pituitary gland tumor cells, appears to be linked to overproduction of ACTH.


The researchers injected mice with ACTH-secreting pituitary tumor cells and then treated them with commonly used diabetes drugs, rosiglitazone (Avandia) and troglitazone, or an inactive placebo. Such drugs are known to inhibit PPAR-gamma, which also plays a role in sugar metabolism. Troglitazone (Rezulin) was withdrawn from the US market in 2000 after it was linked to liver damage and deaths in some patients.


The investigators found that production of ACTH, as well as the chemical equivalent of human cortisol in mice, dropped substantially.


"We saw pretty dramatic reduction in ACTH and cortisol-like hormone in the mice that got either of the drugs," Heaney told Reuters Health. "There was an 85% reduction in ACTH and a corresponding 96% reduction in their cortisol-like hormone."


In addition, the drugs caused the tumor cells to die and the overall size of the tumors to shrink, Heaney explained.


"Since we know that PPAR-gamma plays a role in the pituitary tumors that cause Cushing's syndrome, we may be able to treat the illness effectively with (the diabetes drugs)," he added.


The study was funded by the Doris Factor Molecular Endocrinology Laboratory, the Annenberg Foundation, and a National Institutes of Health grant.


SOURCE: Nature Medicine 2002;8:1281-1287

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Guest terry jackon1

I hate to get overly excited but----

Actually I had read the article.

Yes, the doctors have to say the word "Cushings" and use it as much as possible.

I know when I mentioned "cushings" to a nurse or doctor telling them about this website, they said:  "You think you have Cushings?"  Some seemed to know of it; others didn't.

Then my Endo said you don't have Cushings I or II, but symptoms similar because of the excess prednisone taken (needed).  I corrected him.  He even had me squat down without holding on to anything.  I couldn't make it up.  


I tried to explain that I got it from taking prednisone over the years and showed them my hump.  They then shook their heads and made some notes.  Seeing is believing.


:wow:  :wow:  :wow:  :wow:  :wow:

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  • Chief Cushie

What is Cushing's I or II?  Like pituitary and adrenal?  I've never heard of Cushing's described that way.

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This is great.


I had the pleasure of hearing Dr. Heaney speak about this at the UCLA, USC, Ceadar's Physicians conference I attended last Sunday. His presentation was quite informative. He did talk about this being in it's infant stages, never the less, it's wonderful progress.





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  • Over 2000 Posts

More research on this condition the better.  Besides defining Cushings 1 and 2, what does PPAR- gamma mean?


"Since we know that PPAR-gamma plays a role in the pituitary tumors that cause Cushing's syndrome, we may be able to treat the illness effectively with (the diabetes drugs)," he added.


And will the drugs help only Cushing Disease (Pituitary) or will it also shrink the tumors on the adrenal, Cushings Syndrome?

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Guest terry jackon1

Since I could hardly absorb my Endocrinologist's  prognosis, because I was nervous. I'll explain to you in what content he used Cushings I and Cushings II --maybe it will help you to understand what he meant.

After a physical & long discussion, he left the room. ?Came back 5 mins. later with a piece of paper. ?On it he drew 3 columns as such:


? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?Other

?Cushings I ? ? ? ? ? ? ? ? Cushings II ? ? ? ? ? ? Steroid-Induced?



Then he said "you don't have Cushings I because ---- bla-bla-bla". ?Sorry I can't remember his exact words; ?"And you don't have Cushings II" bla-bla-bla-. ?I know not having a tumor on my adrenal was one of the Cushings listed. ?Maybe the other was not having a tumor on my Pituitary. ?I hate to guess. ?But I knew I had neither before I went so I was more interested in the Other column.

He also said I don't or never had adrenal insufficieincy. ?I didn't say anything! ?But I have Cushingoid symptoms due to taking too much prednisone.(hump, leg weakness, thin skin, chin)

But if within the year if I need some surgery, I could come back to him to check on my cortisol level.  Is a colonoscopy considered surgery?  To me it does.  It's invasive and I'd have to have an anesthetic.


:B: ?:B: ?:B: ?:B: ?:B:

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I have never heard any of my doctors or the doctors that speak at my pituitary tumor support group refer to Cushing's 1, or Cushing's 2.


From what I have been told and have read:

It starts off as Cushing's syndrome until a defiant diagnosis is made on the source of the high Cortisol.

It is considered Cushing's syndrome if there is a tumor in the adrenals.


Cushing's disease refers specifically to excessive ACTH-secretion by a pituitary tumor.


Ectopic ACTH producing tumors are from cancer or tumors somewhere else in the body. Still considered Cushing's syndrome.


In some people with severe depression, alcohol abuse, anorexia, high levels of estrogen and people having to use steroids can get "pseudo-Cushing's.


The PNA puts out a great book with tuns of information from some really great doctors. I use my book all the time to answer questions for myself, it is a great tool to have. There is some great information about Cushing's disease and Cushing's syndrome.





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This is really interesting.  Since my doctor went up on my metaformin (same class of drug as the avandia), my urinary cortisols have gone down tremendously (as far as less than 2).  My doc and I had attributted this to intermittent Cushings though, she said she'd never seen them go as low as that before in someone with my problems.  I can't help but wonder if there might not be a connection here.  What do y'all think?

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