Pituitary Related Condition

INTRODUCTION

Pituitary disorders: Pituitary problems typically result from the pituitary gland being either overactive or underactive.

HYPOTHALAMUS AND PITUITARY GLANDS

The pituitary gland, approximately the size of a pea, is situated near the base of the brain, behind the bridge of your nose. The hypothalamus, located in a different region of the brain, is positioned not far from the pituitary gland.

The human body has systems that continually monitor changes and other vital functions. The pituitary gland and the hypothalamus are part of these systems.

The hypothalamus regulates bodily functions by receiving information from various sources. One way the hypothalamus accomplishes this is by regulating the pituitary gland and interacting with it through its own hormones.

These hormones are transported to the pituitary gland, where they serve as a signal for the pituitary to start producing one or more of its hormones. Subsequently, the endocrine glands targeted by the pituitary hormones are prompted to generate their own hormones. These locally produced hormones are what effectively regulate your body.

Example of how hypothalamus and pituitary glands regulate bodily functions

PITUITARY RELATED DISORDERS

Position of the pituitary gland in the brain

Pituitary problems often result from either excessive or insufficient activity of the pituitary gland. Pituitary adenomas, or pituitary macroadenomas when they are large, are distinct growths on the pituitary gland that frequently lead to complications. Pituitary adenomas can be problematic because they:

Release an excess of one or more hormones
When not producing any hormones, the pressure on the healthy pituitary tissue interferes with normal function
Exert pressure on surrounding structures, such as the optic nerve, which could lead to blurred vision or partial vision loss

SYMPTOMS

Depending on the illness and affected hormone, specific symptoms can vary. The location and size of a tumor also matter. Typical signs include:

Anxiety or depression
Diabetes
Hair loss
High blood pressure
Irregular menstrual periods
Unexpected breast milk production
Low energy or low sex drive
Stunted growth or unusual growth spurts
Unexplained weight gain
Vision changes

WHAT CAUSES THE DISEASE?

Pituitary diseases are mainly caused by non-cancerous pituitary tumors, which lead to the overproduction or underproduction of specific hormones.

Additionally, typical causes of pituitary issues include:

Head injury
Bleeding in or near the pituitary gland
Certain medications and cancer treatments

CURRENT TREATMENTS

Treatment is not necessary for many pituitary tumours. Treatment is based on the type of tumour, its size, and how deep into the brain it has spread. Age and general health are also factors that need to be taken into consideration.

Radiation therapy

Stereotactic radiosurgery
External beam radiation
Intensity-modulated radiation therapy
Proton beam therapy

Surgery

Endoscopic transnasal transsphenoidal approach
Transcranial approach (craniotomy)

Medication

Treatment with medications may help to block excessive hormone secretion and, in some cases, shrink certain types of pituitary tumours.

Type of Disorder	Medication	Function	Side Effects
Prolactin-secreting tumors (prolactinomas)	Cabergoline Bromocriptine (Parlodel, Cycloset)	Reduce prolactin secretion Decrease tumor size	Drowsiness, dizziness, nausea, nasal stuffiness, vomiting, diarrhea or constipation, confusion, and depression Some people may acquire compulsive habits, such as gambling
ACTH-producing tumors (Cushing syndrome)	Ketoconazole, mitotane (Lysodren) and metyrapone (Metopirone) Osilodrostat (Isturisa) Mifepristone (Korlym, Mifeprex)	Limit the adrenal gland's excessive cortisol production Reduces the production of cortisol Inhibits the tissue-damaging effects of cortisol	Severe pulse irregularity caused by a cardiac conduction issue Fatigue, nausea, vomiting, headaches, muscle aches, high blood pressure, low potassium and swelling
Growth hormone-secreting tumors	Somatostatin analogs such as octreotide (Sandostatin, Mycapssa, Sandostatin LAR Depot) Lanreotide (Somatuline Depot) Pegvisomant (Somavert)	Reduce growth hormone production and may cause the tumor to shrink Inhibit effects of excess growth hormone	Nausea, vomiting, diarrhea, stomach pain, dizziness, headache and pain at the site of injection May also cause gallstones and worsen diabetes mellitus

WHAT WE OFFER?

STEM CELL THERAPY - SCITRON

Scitron is a Mesenchymal Stem Cells (MSCs), derived from human umbilical cords. Upon treatment, the cultured cells are injected intramuscularly or intravenously into the patient. The cells are characterized by low immunogenicity, making them very safe, tolerable, and free of side effects.

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BENEFITS OF OUR TREATMENTS

Highly self-renewal
Multi-directional differentiation potential
Low immunogenicity
Less invasive procedure
Anti-inflammation properties

HOW IT WORK?

As shown in Figure (A), pituitary deficit can be corrected by inducing local stem cells in the pituitary to multiply and develop into the desired cell types. As an alternative, stem cells from pituitary tissue can be extracted, grown in a dish, and then either transplanted directly into the hypophysiotropic region beneath the hypothalamus or first differentiated and purified in a dish. The desired cell type can be created by transdifferentiation of adult pituitary cells using the same methods.

As described in Figure B, Pluripotent stem cells, such as embryonic stem cells (ESC) and iPSC, may be injected into the hypophysiotropic region of a patient with hypopituitarism, where they can develop to replace the damaged endocrine cell type. However, due to their tremendous ability for proliferation, the potent ESC and iPSC may result in the development of tumors. To get around this issue, ESC and iPSC could be differentiated in vitro first, followed by the isolation of the desired hormonal cell type and transplantation of only the pure cell type.

The potential cell-therapeutic strategies for treatment of hypopituitarism

TALK TO US

If you believe that our treatment options may be able to improve your condition and enhance your quality of life, please contact us to schedule a complimentary consultation with one of our in-house clinical specialists. Our consultations are available in both Malay and English language.