Could low prolactin levels after radiotherapy predict the onset of hypopituitarism?

Hypopituitarism Hypoprolactinemia Prolactin Radiotherapy

Journal

Reviews in endocrine & metabolic disorders
ISSN: 1573-2606
Titre abrégé: Rev Endocr Metab Disord
Pays: Germany
ID NLM: 100940588

Informations de publication

Date de publication:
22 Aug 2024
Historique:
accepted: 08 08 2024
medline: 22 8 2024
pubmed: 22 8 2024
entrez: 22 8 2024
Statut: aheadofprint

Résumé

Both local and external cranial radiotherapy (RT) can induce neurotoxicity and vascular damage of the hypothalamic-pituitary area, which can promote neuroendocrine alterations. While anterior pituitary insufficiency after RT has been extensively characterized, data on the effect of RT on prolactin (PRL) secretion are limited and heterogeneous, with different patterns of PRL behavior described in the literature. A progressive decline in PRL levels, reflecting a time-dependent, slowly evolving radiation-induced damage to the pituitary lactotroph cells has been reported. To date, the association between hypopituitarism and hypoprolactinemia in patients undergoing RT has not yet been fully investigated. The few available data suggest that lower PRL levels can predict an extent damage of the pituitary tissue and a higher degree of hypothalamic dysfunction. However, most studies on the effect of RT on pituitary function do not properly assess PRL secretion, as PRL deficiency is usually detected as part of hypopituitarism and not systematically investigated as an isolated disorder, which may lead to an underestimation of hypoprolactinemia after RT. In addition, the often-inadequate follow-up over a long period of time may contribute to the non-recognition of PRL deficiency after RT. Considering that hypoprolactinemia is associated with various metabolic complications, there is a need to define appropriate diagnostic and management criteria. Therefore, hypoprolactinemia should enter in the clinical investigation of patients at risk for hypopituitarism, mainly in those patients who underwent RT.

Identifiants

pubmed: 39172174
doi: 10.1007/s11154-024-09900-1
pii: 10.1007/s11154-024-09900-1
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024. The Author(s).

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Auteurs

Chiara Mele (C)

Department of Translational Medicine, University of Piemonte Orientale, Via Solaroli 17, Novara, 28100, Italy.

Stella Pigni (S)

Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy.
Endocrinology, Diabetology and Medical Andrology Unit, IRCCS Humanitas Research Hospital, Rozzano, MI, Italy.

Marina Caputo (M)

Department of Health Sciences, University of Piemonte Orientale, Novara, Italy.

Maria Francesca Birtolo (MF)

Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy.
Endocrinology, Diabetology and Medical Andrology Unit, IRCCS Humanitas Research Hospital, Rozzano, MI, Italy.

Carola Ciamparini (C)

Department of Health Sciences, University of Piemonte Orientale, Novara, Italy.

Gherardo Mazziotti (G)

Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy.
Endocrinology, Diabetology and Medical Andrology Unit, IRCCS Humanitas Research Hospital, Rozzano, MI, Italy.

Andrea Gerardo Antonio Lania (AGA)

Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy.
Endocrinology, Diabetology and Medical Andrology Unit, IRCCS Humanitas Research Hospital, Rozzano, MI, Italy.

Paolo Marzullo (P)

Department of Translational Medicine, University of Piemonte Orientale, Via Solaroli 17, Novara, 28100, Italy.

Flavia Prodam (F)

Department of Health Sciences, University of Piemonte Orientale, Novara, Italy.

Gianluca Aimaretti (G)

Department of Translational Medicine, University of Piemonte Orientale, Via Solaroli 17, Novara, 28100, Italy. gianluca.aimaretti@med.uniupo.it.

Classifications MeSH