PITUITARY RELATED DISORDERS

INTRODUCTION

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

HYPOTHALAMUS AND PITUITARY GLANDS

The pituitary gland, which is about the size of a pea, is located near the base of the brain, behind the bridge of your nose. The hypothalamus, a different region of the brain, is located not far from the pituitary gland.
​
The human body has systems that constantly monitor changes and other vital functions. The pituitary gland and the hypothalamus are a part of some of these systems.​

​The hypothalamus regulates bodily functioning by receiving information from a variety of sources. One of the ways the hypothalamus accomplishes this is by regulating the pituitary gland and interacting with it via its own hormones.

These hormones are transported to the pituitary gland, where they serve as a cue for the pituitary to start producing one or more of its hormones. The endocrine glands that the pituitary hormones are targeting are then stimulated to create their own hormones. These locally made hormones are what actually regulate your body.

Figure 1 shows an example of how hypothalamus and pituitary glands regulate bodily functions

PITUITARY RELATED DISORDERS

Figure 2 shows the position of the pituitary gland in the brain

Pituitary problems often result from either too much or too little activity of the pituitary gland.​ Pituitary adenomas, or pituitary macroadenomas if they are large, are distinct pieces of the pituitary gland that frequently cause complications. Pituitary adenomas can be problematic because they:

• Release excess of one or more hormone
• While not producing any hormones, the pressure on the healthy pituitary tissue interferes with normal function
• Putting pressure on surrounding structures, such as the eye's nerve, which could cause vision blur 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 primarily brought on by non-cancerous pituitary tumors, which make your body produce too much or too little of a certain hormone.
​
Additionally typical causes of pituitary issues include:

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

CURRENT TREATMENTS

Treatment is not necessary for many pituitary tumors. Treatment is based on the type of tumor, 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 excess hormone secretion and sometimes shrink certain types of pituitary tumors

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 ?

Scitron

Scitron is a Mesenchymal Stem Cells (MSCs), derived from human umbilical cords. Upon treatment, the cultured cells are injected intramuscularly / intravenously into the patient.

​The cells are characterized by low immunogenicity. Hence, it is very safe, tolerable and free of side effects.

BENEFITS OF OUR TREATMENTS

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

HOW IT WORKS ?

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 transdifferentiating 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.

 Figure 3 show the potential cell-therapeutic strategies for treatment of hypopituitarism