| Summary: | A rapid accumulation of clinical information about pituitary hormone function in patients with pituitary disease has occurred over the last 25 years. Many new clinical treatments are now available, including the use of GH to treat GHD adults, including GHD cancer survivors, and a GH receptor antagonist to treat acromegaly. These developments have generated new questions about clinical management of patients. Animal models of severe pituitary dysfunction/ablation have led to new questions in relation to the relevance of endocrine deficiency in human diseases. Prolactin has received particular attention in the scientific community for a potential role in immune homeostasis. The development of a prolactin receptor antagonist is currently receiving notable interest because of its potential as a treatment for breast cancer. It is foreseeable that this may ultimately be used in human studies. The first part of this thesis attempts to answer some new questions about the clinical management of pituitary disease that have arisen with recent clinical progress in this field. These include investigation of the QOL impairment in adult GHD cancer survivors, and the effect of GH replacement in these patients and identifying a range of IGF-I values commensurate with GHD, which could be utilised to determine the risk of 'functional' GHD during the treatment of adult GHD with GH, or pegvisomant treatment for acromegaly, As part of the common link of severe hypopituitarism, the later studies aim to begin to bridge a gap between a vast animal literature relating to effects of prolactin on homeostasis, and the paucity of human clinical research in related areas.
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