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Patients with adrenoleukodystrophy have a complex, X-linked peroxisomal disease, which is characterized by the development of adrenal insufficiency, myelopathy and progressive cerebral white matter lesions. In this Review Stephan Kemp and colleagues discuss the clinical presentation, natural history, diagnosis and treatment of this disease.
Despite effective treatments for pituitary tumours, chronic syndromes can occur in patients during long-term follow-up. This Review describes these syndromes, which result from the effects of the initial disease, such as hormonal excess or pituitary insufficiency, and the effects of treatment modalities.
Susceptibility to impaired metabolic health in relation to obesity is not necessarily mediated by overall fatness, but is largely dependent on the distribution of body fat and the ability to sufficiently expand adipose tissue depots. A recent study published in Diabetes provides genetic evidence to support the concept of a 'metabolically healthy obese' phenotype.
The sequenced genomes of individuals aged ≥80 years, who were highly educated, self-referred volunteers and with no self-reported chronic diseases were compared to young controls. In these data, healthy ageing is a distinct phenotype from exceptional longevity and genetic factors that protect against disease might be enriched in this population.
Here, Mark Tarnopolsky and colleagues propose that the systemic benefits of exercise are mediated by exosomes containing peptides and nucleic acids (exerkines) that act in an autocrine, paracrine and/or endocrine manner. They also discuss the therapeutic potential of using exerkine-enriched native or modified exosomes to treat metabolic diseases such as obesity and type 2 diabetes mellitus.
Osteocytes have a central role in bone homeostasis, integrating the effects of mechanical and hormonal stimuli on bone. Here, Lilian Plotkin and Teresita Bellido discuss the potential of osteocytic signalling pathways as therapeutic targets to improve bone health and maintain musculoskeletal integrity.
In a new estimate, the global incidence of diabetes mellitus has quadrupled since 1980 and now affects nearly as many individuals as the 'Spanish flu' pandemic of the early 20th century. With such an increasing burden on healthcare systems, what can be done to limit the devastating impact of this disease?
An elaborate neural network integrating many internal homeostatic and external signals governs the onset of puberty and subsequent fertility. Here, Allan Herbison provides an update on the morphology and function of the gonadotropin-releasing hormone neurons, focusing on their role in the onset of puberty and fertility.