Expression of progenitor markers is associated with the functionality of a bioartificial adrenal cortex

This work was in part supported by the International Fund Congenital Adrenal Hyperplasia (IFCAH) (to SRB), by the Deutsche Forschungsgemeinschaft (CRC-TRR 127 (to SRB and BL), CRC-TRR 205 (to SRB, BL and CS), IRTG 2251 (to SRB, BL and CS), and CRU 252 (to SRB and BL)), the German Academic Exchange Service (DAAD) (to GRB) and The TransCampus initiative between TU Dresden and King’s College London (to SRB). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

Progress in islet transplantation is more important than ever.

It is increasingly clear that pancreatic islet replacement is needed to provide a comprehensive treatment for the growing numbers of patients with type 1 diabetes mellitus. Advances from the past year suggest that this goal might now be within reach

The interface of COVID-19, diabetes, and depression.

Comorbid diabetes with depression is a challenging and often under-recognized clinical problem. During the current COVID-19 pandemic, a communicable disease is thriving on the increasing incidences of these non-communicable diseases. These three different health problems are bidirectionally connected forming a vicious cycle. Firstly, depressed individuals show a higher risk of developing diabetes and patients with diabetes have a higher risk of developing symptoms of depression. Secondly, patients with diabetes have a higher risk of developing severe COVID-19 as well as of experiencing breakthrough infections. Thirdly, in both patients with type 2 diabetes and in COVID-19 survivors the prevalence of depression seems to be increased. Fourthly, lockdown and quarantine measurements during the COVID-19 pandemic has led to an increase in depression. Therefore, it is of importance to increase the awareness of this interface between depression, diabetes and COVID-19. Finally, as symptoms of post-COVID, diabetes and depression may be overlapping, there is a need for educating skilled personnel in the management of these comorbidities

Stress-inducible-stem cells: a new view on endocrine, metabolic and mental disease?

“Stress may be defined as a mechanism of acute and chronic adaptation necessary for evolution and survival. The integrated stress response is part of the homoeostatic balance, and dysfunction of such response may contribute to disease. Alternations of the endocrine, neural and immune responses to stress are involved both in etiology and the pathophysiology of the most common health problems in modern society.” (World Health Organization_WHO/RPS/98.3)

Hypertensive crisis in pregnancy due to a metamorphosing pheochromocytoma with postdelivery Cushing's syndrome

Pheochromocytomas in pregnancy are rare but potentially lethal. Even rarer is the combination of pheochromocytoma in pregnancy with subsequent development of ectopic Cushing's syndrome. We report a 36-year-old woman, previously diagnosed with essential hypertension, who developed severe hypertension in pregnancy complicated by insulin-dependent gestational diabetes. A cesarean section was performed at 32 weeks following a hypertensive crisis after routine administration of betamethasone. Postnatal persistence of signs and symptoms of catecholamine excess led to the diagnosis of a left adrenal pheochromocytoma. Between diagnosis and planned tumor removal, the patient developed signs and symptoms of Cushing's syndrome (facial edema and hirsutism, myopathy and fatigue). Biochemical testing confirmed hypercortisolism with extremely elevated levels of plasma adrenocorticotropin, urinary cortisol and multiple steroids of a plasma panel that were all normal at previous testing. The previously noradrenergic tumor also started producing epinephrine. Histopathological examination confirmed the pheochromocytoma, which was also immunohistochemically positive for adrenocorticotropin. Full post-surgical recovery was sustained with normal blood pressure and biochemical findings after one year. This report not only underlines the chameleon behavior of pheochromocytoma but also illustrates its potential for a metamorphosing presentation. Corticosteroid administration in pregnancy requires a cautious approach in patients with hypertension

Management von Diabetespatienten in der COVID-19-Pandemie: Bidirektionale Beziehungen, pathophysiologische Mechanismen und Empfehlungen.

Über 10 % der deutschen Bevölkerung leiden an metabolischen Krank-heiten wie Diabetes, Adipositas, oder nicht alkoholischer Steatohepa-titis. Betroffene sind während der COVID-19-Pandemie einem beson-deren Risiko ausgesetzt, gibt es doch zahlreiche Hinweise auf eine bidirektionale Beziehung zwischen diesen Krankheiten und COVID-19. Einerseits besteht ein deutlich erhöhtes Risiko für das Auftreten schwerer Krankheitsverläufe bis hin zum Tod, andererseits kann eine COVID-19-Infektion bereits bestehende metabolische Störungen verschlimmern oder neu hervorrufen. Wir werden hier die aktuelle Datenlage bezüglich der pathophysiologischen Mechanismen, die zu dieser bidirektionalen Beziehung führen, zusammenfassen und Emp-fehlungen für den Umgang mit solchen Patienten während und nach einer Infektion aussprechen