title: Novel pathway for somatostatin analogs in patients with acromegaly.
abstract: Acromegaly is a chronic disease with increased morbidity and mortality, where usually multiple treatment modalities are used. The somatostatin analogs (SSAs) are the mainstay of medical therapy but, in many patients, including those with a germline mutation in the aryl hydrocarbon receptor-interacting protein (AIP) gene, disease activity cannot be controlled with these drugs. Previous data have suggested the involvement of the tumor-suppressor gene ZAC1 in the mechanism of action of SSAs, and more recent findings suggested that SSAs could regulate AIP, which in turn can stimulate ZAC1, therefore suggesting the existence of a SSA-AIP-ZAC1-somatostatin effect pathway. The current review discusses these novel observations, highlighting their significance in the treatment of sporadic and familial somatotroph adenomas.
authors.affiliation: Division of Endocrinology, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Professor Rodolpho Paulo Rocco street 255, Rio de Janeiro, Brazil.
authors.forename: Mônica R
authors.initials: MR
authors.lastname: Gadelha
authors.forename: Leandro
authors.initials: L
authors.lastname: Kasuki
authors.forename: Márta
authors.initials: M
authors.lastname: Korbonits
mesh_terms: D000172:Acromegaly / Q000188:drug therapy* / Q000209:etiology / Q000235:genetics / Q000378:metabolism; D000818:Animals; D018797:Cell Cycle Proteins / Q000235:genetics / Q000378:metabolism; D003131:Combined Modality Therapy; D004351:Drug Resistance; D005786:Gene Expression Regulation / Q000187:drug effects; D049912:Growth Hormone-Secreting Pituitary Adenoma / Q000235:genetics / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D047908:Intracellular Signaling Peptides and Proteins / Q000378:metabolism; D008099:Liver / Q000187:drug effects / Q000378:metabolism; D008954:Models, Biological; D010902:Pituitary Gland / Q000187:drug effects* / Q000378:metabolism; D015398:Signal Transduction / Q000187:drug effects*; D013004:Somatostatin / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D014157:Transcription Factors / Q000235:genetics / Q000378:metabolism; D025521:Tumor Suppressor Proteins / Q000235:genetics / Q000378:metabolism
chemical_list: D018797:Cell Cycle Proteins; D047908:Intracellular Signaling Peptides and Proteins; C106464:PLAGL1 protein, human; D014157:Transcription Factors; D025521:Tumor Suppressor Proteins; C103265:aryl hydrocarbon receptor-interacting protein; D013004:Somatostatin