Volume 16 Issue 11, November 2020

Celebrating and reflecting on 15 years of Nature Reviews Endocrinology, and looking towards to next 15 years.

Islet inflammation (insulitis) in type 1 diabetes mellitus is triggered by a deleterious dialogue between β-cells and the immune system, inducing β-cell dysfunction and death. This concept, outlined in our 2009 Review, has been confirmed and extended. Here, we provide a brief update of the field and outline key pending questions.

In 2019, we published a Review on the relevance of gut microbial metabolites in obesity, non-alcoholic fatty liver disease and type 2 diabetes mellitus. Here, we highlight the importance of the balance between colonic proteolytic and saccharolytic metabolite production for metabolic health and the need to focus on more subgroup-based or personalized nutritional approaches.

In the past decade, the prevalence of obesity and related comorbidities has continued to increase across the globe, prompting many countries to adopt policies to improve diet quality. Here, we discuss key nutrition policies that have been implemented in the past few years and consider future priorities for global obesity prevention.

This Comment article provides a behind-the-scenes perspective and update of our 2016 Review, which discussed possible factors contributing to thyroid cancer incidence trends worldwide. We also highlight promising research directions that are improving the understanding of thyroid cancer aetiology.

In 2012, we were invited by Nature Reviews Endocrinology to write a Review titled ‘Muscles, exercise and obesity: skeletal muscle as a secretory organ’. At the time, following our findings in the 2000s, we knew the concept of skeletal muscle as an endocrine organ was important. Eight years on, the magnitude of the importance of this concept surprises us.

The first International Symposium on Phaeochromocytoma in 2005 was followed by considerable progress in the field, largely owing to the many collaborations and networks stimulated by that and subsequent meetings. The rich hereditary background of phaeochromocytomas has since provided for strong interdisciplinary links of genetics with personalized diagnostics, imaging and therapeutic interventions.

Typically, our mechanistic understanding about links between exercise and mortality come from epidemiological and short-period training studies. An initial transcriptomic study shows that decades-long endurance training shifts skeletal muscle gene activity to favour cellular respiration, upholding the consilience of evidence for ‘aerobic’ as a central feature of health and longevity.

With immune checkpoint blockade (ICB) technologies increasingly being used in cancer immunotherapy, early data suggest that ICB therapies could be effective in thyroid cancer. This Review discusses our current knowledge of the immune response in thyroid cancers, the latest and ongoing immune-based approaches and the future of immunotherapies in thyroid cancer.

Dipeptidyl peptidase 4 inhibitors are now widely used in the treatment of patients with type 2 diabetes mellitus. This Review discusses the use of the five main dipeptidyl peptidase 4 inhibitors for this purpose, highlighting their benefits and risks.

Fibroblast growth factor 21 (FGF21) confers considerable pharmacological benefits on a cluster of obesity-related metabolic complications when administered to preclinical models. This Review discusses FGF21 analogues and mimetics and highlights their efficacy in preclinical models and clinical trials. The challenges in developing FGF21-based therapeutics are also considered.

Lipoedema is a disorder characterized by the symmetrical accumulation of mechanically compliant adipose tissue in the proximal extremities. This Perspective article proposes a new mechanism for lipoedema, in which dysfunctional caveolin 1 in adipose tissue becomes uncoupled from key feedback loops with matrix metalloproteinase 14, oestrogen receptor and prospero homeobox 1.