Molecular-metabolic interaction of pituitary-adrenal axis with adrenocorticotropic and glucocorticoid hormone in Cushing’s disease

Abstract

\n Purpose\n\nThis study aimed to investigate C-X-C motif chemokine receptor 4 (CXCR4) molecular signaling pathway and the glucose metabolism of pituitary-adrenal axis in Cushing’s disease (CD) by using 68Ga-pentixafor and 18F-FDG PET/CT.\nMethods\n\nWe recruited eleven patients including 4 primary CD, 3 recurrent CD and 4 non-functional pituitary adenoma (NFPA) patients. Both 68Ga-pentixafor PET/CT and 18F-FDG PET/CT were performed. The radio-uptake of pituitary-adrenal axis was correlated with the hormone levels (including serum adrenocorticotropin, serum cortisol and 24-h urine free cortisol).\nResults\n\nThe uptake of pituitary adenomas and bilateral adrenals in primary and recurrent CD patients were significantly higher than NFPA patients in 68Ga-pentixafor PET. Besides, hormone level was significantly correlated with the uptake of 68Ga-pentixafor in pituitary adenomas and adrenal tissue but not with glucose metabolism determined by 18F-FDG PET.\nConclusions\n\nIn this pilot study, we found activated CXCR4 molecular signaling rather than glucose metabolism regulation along the pituitary-adrenal axis in CD patients. 68Ga-pentixafor PET/CT might have the potential in detecting ACTH-producing pituitary microadenoma.