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5 results on '"Marina Michalaki"'

1. Recombinant Human TSH Fails to Induce the Proliferation and Migration of Papillary Thyroid Carcinoma Cell Lines

Author

Georgios Kalampounias, Athina Varemmenou, Christos Aronis, Irene Mamali, Athanasios-Nasir Shaukat, Dionysios V. Chartoumpekis, Panagiotis Katsoris, and Marina Michalaki

Subjects
iatrogenic thyrotoxicosis, thyroid-stimulating hormone receptor, K1, TPC-1, thyroglobulin, TSH suppression, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Thyrotropin (TSH) suppression is required in the management of patients with papillary thyroid carcinoma (PTC) to improve their outcomes, inevitably causing iatrogenic thyrotoxicosis. Nevertheless, the evidence supporting this practice remains limited and weak, and in vitro studies examining the mitogenic effects of TSH in cancerous cells used supraphysiological doses of bovine TSH, which produced conflicting results. Our study explores, for the first time, the impact of human recombinant thyrotropin (rh-TSH) on human PTC cell lines (K1 and TPC-1) that were transformed to overexpress the thyrotropin receptor (TSHR). The cells were treated with escalating doses of rh-TSH under various conditions, such as the presence or absence of insulin. The expression levels of TSHR and thyroglobulin (Tg) were determined, and subsequently, the proliferation and migration of both transformed and non-transformed cells were assessed. Under the conditions employed, rh-TSH was not adequate to induce either the proliferation or the migration rate of the cells, while Tg expression was increased. Our experiments indicate that clinically relevant concentrations of rh-TSH cannot induce proliferation and migration in PTC cell lines, even after the overexpression of TSHR. Further research is warranted to dissect the underlying molecular mechanisms, and these results could translate into better management of treatment for PTC patients.

Published
2024
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2. Low Urinary Free Cortisol as a Risk Factor for Patients with Variceal Bleeding

Author

Ioanna Aggeletopoulou, Efthymios P. Tsounis, Maria Kalafateli, Maria Michailidou, Maria Tsami, Konstantinos Zisimopoulos, Martha Mandellou, Georgia Diamantopoulou, Maria Kouskoura, Marina Michalaki, Catherine K. Markopoulou, Konstantinos Thomopoulos, and Christos Triantos

Subjects
24 h urinary free cortisol, liver cirrhosis, decompensation, 6-week mortality, variceal bleeding, 5-day treatment failure, Medicine (General), R5-920
Abstract

Background and Objectives: Specificity and reliability issues of the current cortisol assessment methods lead to limitations on the accurate assessment of relative adrenal insufficiency. Although free cortisol provides a more accurate evaluation of adrenal cortisol production, the expense and time-consuming nature of these assays make them impractical for routine use. Research has, thus, focused on alternative methods, such as indirectly measuring free cortisol using Coolens’ equation or directly assessing salivary cortisol concentration, which is considered a more favorable approach despite associated challenges like sampling issues and infection risks. The aim of this study was to explore correlations between 24 h urinary free cortisol (UFC), free plasma cortisol, serum total cortisol, and salivary cortisol as potential reliable indices of free cortisol in the setting of variceal bleeding. Additionally, we assessed the predictive value of UFC for 6-week mortality and 5-day treatment failure in patients with liver cirrhosis and variceal bleeding. Materials and Methods: A total of 40 outpatients with liver cirrhosis and variceal bleeding were enrolled. Free cortisol levels in serum, saliva, and urine were assessed using the electrochemiluminescence immunoassay method. For the measurement of plasma-free cortisol, a single quadrupole mass spectrometer was employed. The quantification of free cortisol was fulfilled by analyzing the signal response in the negative ESI-MS mode. Results: UFC was significantly correlated to free plasma cortisol. Negative correlations were demonstrated between UFC, the Child–Pugh (CP) score, and C reactive protein (CRP) levels. In the multivariate analysis, CP stage C was associated with 6-week mortality risk and portal vein thrombosis with 5-day treatment failure using Cox regression and binary logistic regression analyses, respectively. Patients who experienced rebleeding, infection, or death (or any combination of these events) presented with lower levels of UFC. Conclusions: This study suggests that low levels of UFC may impose a risk factor for patients with liver cirrhosis and variceal bleeding. The use of UFC as an index of adrenal cortisol production in variceal bleeding warrants further investigation.

Published
2023
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3. ACTH vs steroids for the treatment of acute gout in hospitalized patients: a randomized, open label, comparative study

Author

Dimitrios Daoussis, Panagiotis Kordas, George Varelas, Marina Michalaki, Anny Onoufriou, Irene Mamali, George Iliopoulos, Konstantinos Melissaropoulos, Konstantinos Ntelis, Dimitrios Velissaris, Giannis Tzimas, Panagiotis Georgiou, Sofia Vamvakopoulou, Fotini Paliogianni, Andrew P. Andonopoulos, and Neoklis Georgopoulos

Subjects
Hypothalamo-Hypophyseal System, Rheumatology, Adrenocorticotropic Hormone, Gout, Arthritis, Gouty, Immunology, Immunology and Allergy, Humans, Pituitary-Adrenal System, Steroids, Prospective Studies, Betamethasone, Aged
Abstract

The management of acute gout in the hospital setting may be challenging since most patients are elderly with multiple unstable comorbidities. However, there are no prospective clinical trials for hospitalized patients with gout to guide optimal management. Evidence indicates that steroids or adrenocorticotropic hormone (ACTH) may be effective and safe therapeutic options for these patients. This study aimed at directly comparing the efficacy and safety of ACTH vs betamethasone for the treatment of gout in hospitalized patients. This is the first prospective clinical trial for hospitalized patients with gout. We designed a randomized, open label study to assess the efficacy and safety of a single intramuscular injection of either ACTH or betamethasone in hospitalized patients with acute gout. Primary efficacy endpoints were the change in intensity of pain as recorded using a Visual Analogue Scale (VAS) at baseline compared to 24 h (ΔVAS24h), and 48 h. Moreover, we assessed safety and effects on the hypothalamic-pituitary-adrenal (HPA) axis, glucose and lipid homeostasis, bone metabolism, electrolytes and renal function. 38 patients were recruited. Both treatments were highly effective. The mean ± SE ΔVAS24h and ΔVAS48h for ACTH was 4.48 ± 0.29 and 5.58 ± 0.26, respectively. The mean ± SE ΔVAS24h and ΔVAS48h for betamethasone was 4.67 ± 0.32 and 5.67 ± 0.28, respectively. Direct comparison between the two groups at 24 h and 48 h did not show statistically significant differences. Both treatments were well tolerated and safe. The effects on all metabolic parameters were mostly minimal and transient for both treatments. However, ACTH may affect less the HPA axis and bone metabolism compared to betamethasone, thus leading to the conclusion that. ACTH and betamethasone are effective and safe for the management of acute gout in hospitalized patients but that ACTH may associate with less disturbance of the HPA axis and bone metabolism. Our data support the use of both drugs as first line treatments for hospitalized patients with gout.Clinical trial registration: ClinicalTrials.gov NCT04306653.

Published
2022

4. Urinary free cortisol is a reliable index of adrenal cortisol production in patients with liver cirrhosis

Author

Maria Michailidou, Ioanna Aggeletopoulou, Maria Kouskoura, Konstantinos Zisimopoulos, Efthymios P. Tsounis, Katerina Karaivazoglou, Evanthia Tourkochristou, Martha Mandellou, Georgia Diamantopoulou, Nikolaos Koutras, Marina Michalaki, Charalampos Gogos, Dimitrios Velissaris, Catherine K. Markopoulou, Konstantinos Thomopoulos, and Christos Triantos

Subjects
Liver Cirrhosis, Endocrinology, Hydrocortisone, Endocrinology, Diabetes and Metabolism, Humans, Adrenal Insufficiency
Abstract

The measurement of total and free cortisol has been studied as a clinical index of adrenal cortisol production in patients with liver cirrhosis. Correlations between free plasma and salivary cortisol have previously been reported in stable cirrhotic patients. Urinary free cortisol constitutes an index of adrenal cortisol production; however, it has never been used in assessing adrenal function in patients with liver cirrhosis.The aim of this observational study was to determine associations between urinary free cortisol, serum total, salivary, measured and calculated plasma free cortisol levels in cirrhotics, determining which of them can be used as an indirect index of free cortisol levels. Moreover, we investigated the potential use of 24 h urinary free cortisol as a prognostic factor for mortality.Seventy-eight outpatients with liver cirrhosis were included. Serum, salivary and urinary free cortisol were measured using the electrochemiluminenscence immunoassay. Plasma free cortisol determination was conducted using a single quadrupole mass spectrometer. The quantification of free cortisol was achieved by determining the signal response on negative ESI-MS mode.Twenty-four hour urinary free cortisol levels correlated with free cortisol determined by mass spectrometer, total cortisol and calculated free cortisol levels. Patients with low levels of urinary free cortisol presented a significantly higher mortality rate compared to those with high levels. The factors associated with death risk were determined by Cox regression. In the multivariate analysis, two models were applied; in the first model, CP score, PVT and urinary free cortisol were found to be significantly related to patients' survival, whereas in the second, MELD score, ascites and urinary free cortisol were independently related to survival.This study suggests that 24 h urinary free cortisol could be considered as a potential index of adrenal cortisol production in patients with liver cirrhosis and it potentially detects patients with a high mortality risk.

Published
2022

5. The impact of metabolic health on non-alcoholic fatty liver disease (NAFLD). A single center experience

Author

Anna Boulouta, Ioanna Aggeletopoulou, Stavros Kanaloupitis, Efthymios P Tsounis, Vasileios Issaris, Konstantinos Papantoniou, Anastasios Apostolos, Paraskevas Tsaplaris, Ploutarchos Pastras, Christos Sotiropoulos, Aggeliki Tsintoni, Georgia Diamantopoulou, Konstantinos Thomopoulos, Marina Michalaki, and Christos Triantos

Subjects
Male, Metabolic Syndrome, Hepatology, Cholesterol, HDL, Gastroenterology, Glucose, Non-alcoholic Fatty Liver Disease, Risk Factors, Case-Control Studies, Diabetes Mellitus, Disease Progression, Humans, Female, Triglycerides
Abstract

The role of patients' metabolic clinical and biochemical profile in NAFLD has not been extensively explored.The aim of the study was to assess the role of metabolic health in NAFLD patients and to examine liver disease progression in these populations.The medical charts of 569 patients diagnosed with fatty liver were thoroughly reviewed; 344 patients were excluded because of other chronic liver diseases. Metabolically healthy people were defined as those who met none of the following criteria: blood pressure ≥ 130/85 mmHg or under hypertension treatment, fasting glucose ≥ 100 mg/dl or under diabetes treatment, serum triglycerides150 mg/dl, high density lipoprotein-cholesterol40/50 mg/dl for men/women. Study participants were followed-up over a median period of 22 months.The present observational case-control study included 225 NAFLD patients; 14 (6.2%) were metabolically healthy. Metabolically healthy participants were younger (p = 0.006), had lower age at diagnosis (p = 0.002), lower levels of γ-GT (p = 0.013), fasting glucose (p 0.001) and triglycerides (p 0.001) and higher HDL-cholesterol (p = 0.005) compared to metabolically non-healthy. By the last follow up assessment, 8 metabolically healthy patients had developed dyslipidemia; 1 patient (14.4%) had presented liver disease progression compared to 8 patients (10.5%) from the unhealthy group (p = 0.567). In multivariate analysis, diabetes mellitus (p = 0.017) and hemoglobin levels (p = 0.009) were the sole independent predictors of disease progression. No significant difference was observed in liver disease progression-free survival rates among the two patient groups (p = 0.503).Metabolically healthy NAFLD patients presented with a favorable biochemical profile; however, they were diagnosed with NAFLD at a younger age and the liver disease progression risk was similar to that of metabolically unhealthy patients. These findings suggest that metabolically healthy NAFLD may not constitute a benign condition and patients could potentially be at increased risk of metabolic syndrome and liver disease progression.

Published
2022

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