Volume 3 Issue 2, February 2007

Although niacin reduces cardiovascular events in patients with type 2 diabetes mellitus or the metabolic syndrome, it is considered a reserve therapeutic agent because of adverse effects on glycemic control. The author of this Viewpoint argues, however, that the lipoprotein-altering effects of niacin might outweigh the potential hazards of niacin-mediated hyperglycemia.

Pheochromocytomas are rare, often hereditary, catecholamine producing tumors that can be difficult to diagnose and manage. This Review summarizes the recommendations for biochemical and genetic testing, localization and treatment, and is based on discussions at the First International Symposium on Pheochromocytoma, held in October 2005.

Polycystic ovary syndrome (PCOS) is a common endocrine disease with a strong genetic component. Genetic dissection of PCOS is being intensively investigated and over 70 genes have been evaluated for their role in its etiology. This Review details results obtained from analyzing four of the best-characterized candidate genes and gene regions.

This review describes the use of 2-[¹⁸F]-fluoro-2-deoxyglucose (FDG)-PET to localize recurrence of differentiated thyroid carcinoma. It focuses on patients with persistent disease and normal results from conventional imaging, on changes in therapeutic management because of FDG-PET results and on the role of TSH stimulated FDG-PET scanning, Finally, it focuses on the prognostic significance of FDG uptake in patients with differentiated thyroid carcinoma.

In the parathyroid gland, in thyroid C-cells and in many other tissues, the calcium-sensing receptor (CaR) plays a crucial role in calcium homeostasis. The molecular basis of several diseases resulting from abnormalities in the CaR has been characterized; this has provided the framework for the development of pharmacologic CaR activators for clinical use.

Chronic kidney disease can lead to secondary hyperparathyroidism, affecting vitamin D metabolism, the calcium and phosphate balance, and causing coronary artery disease. Vitamin D analogs are used to treat secondary hyperparathyroidism in these patients; early treatment can prevent or slow the progression of secondary hyperparathyroidism and increase patient survival.

Peroxisome proliferator-activated receptors (PPARs) are important regulators of energy homeostasis and inflammation. They modulate cardiovascular disease, type 2 diabetes and the metabolic syndrome. This Review describes these mechanisms, and the drugs that modulate PPARs and are in current clinical use, as well as potential new drug-development strategies targeting PPARs.

Both agonists and antagonists of luteinizing-hormone-releasing hormone (LHRH) are in clinical use for a wide range of cancers, benign prostatic hypertrophy, fibroids and reproductive disorders. This article describes the existing applications, those under investigation, and potential applications for this type of drug to target diseases such as Alzheimer's.

The actions of cortisol in the brain are mediated by mineralocorticoid and glucocorticoid receptors, which operate in a complementary way in reacting to and recovering from stress. Certain genetic backgrounds and early-life events might, however, cause inappropriate cortisol responses and/or imbalances between the receptors, predisposing to depression later in life.

G-protein-coupled receptors play a crucial role in the signaling of many hormones, and the techniques of fluorescence or bioluminescence resonance energy transfer (FRET or BRET) have given insights into the role of multimer formation in receptor function. This Review outlines the principles behind these techniques and potential biological consequences.