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E. Seregni S.S. Terapia Medico-Nucleare ed Endocrinologia Inquadramento diagnostico e approccio terapeutico dei tu

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E. Seregni S.S. Terapia Medico-Nucleare ed Endocrinologia Inquadramento diagnostico e approccio terapeutico dei tu

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    2. Marcatori specifici di istotipo Marcatori generici di neuroendocrinia

    3. Carcinoide intestinale serotonina e metaboliti Gastrinoma gastrina, secrezione acida gastrica Insulinoma insulina, glucosio plasmatico VIPoma VIP, elettroliti plasmatici Glucagonoma glucagone, glucosio plasmatico Somatostatinoma somatostatina, glucosio, cloro

    4. Biosintesi e metabolismo della serotonina

    5. Valutazione escrezione urinaria giornaliera dell’acido 5’ idrossi-indol acetico (5’HIAA)

    7. Biosintesi e metabolismo delle catecolamine

    10. Enolasi Neurone-Specifica (NSE) Polipeptide Pancreatico (PP) Cromogranina A

    12. Cellule del sistema nervoso centrale e periferico neuroni del cervelletto, corteccia, setto, amigdala, astrociti (?), retina, glomo carotideo, aortico etc. Cellule endocrine midollare surrene, adenoipofisi, tratto GEP, bronchi, paratiroidi, cellule C Cellule a differenziazione nuroendocrina prostata, mammella

    13. Cromogranina A Cromogranina B Secretogranina II (Cromogranina C) Secretogranina III (1B1075) Secretogranina IV (HISL-19) Secretogranina V (7B2) Secretogranina VI (NESP55)

    17. Pompa protonica ATP-asi di tipo vacuolare Aggregazione e precipitazione sostenute da elevato Ca++ e basso pH Granulogenesi

    18. Figure 3. Peptide-Encoding Regions and Putative Functional Domains of Human Chromogranin A (CgA). Arabic numbers designate amino acids in the mature protein (minus signal peptide). Roman numerals designate exon numbers. The intron-exon structure is not drawn to scale.Figure 3. Peptide-Encoding Regions and Putative Functional Domains of Human Chromogranin A (CgA). Arabic numbers designate amino acids in the mature protein (minus signal peptide). Roman numerals designate exon numbers. The intron-exon structure is not drawn to scale.

    20. Inibizione secrezione di insulina Riduzione uptake muscolare di glucosio Stimolazione glicogenolisi epatica Inibizione secrezione amilasi pancreatica Inibizione secrezione acida cellule parietali gastriche Inibizione secrezione di PTH

    21. Figure 4. Autocrine-Paracrine Regulation of Catecholamine Release from Sympathoadrenal Chromaffin Cells by Catestatin. The physiologic secretagogue acetylcholine binds to the agonist pocket on the nicotinic cholinergic receptor, triggering sodium influx and consequent membrane depolarization, which activates calcium influx through voltage-gated channels and leads to exocytotic release of the chromaffin-granule cargo. After the cargo has been released, catestatin exerts potent antagonistic effects on nicotinic cholinergic signaling, resulting in negative-feedback modulation of catecholamine release. Arrows with plus signs indicate stimulation, and the arrow with a minus sign inhibition.Figure 4. Autocrine-Paracrine Regulation of Catecholamine Release from Sympathoadrenal Chromaffin Cells by Catestatin. The physiologic secretagogue acetylcholine binds to the agonist pocket on the nicotinic cholinergic receptor, triggering sodium influx and consequent membrane depolarization, which activates calcium influx through voltage-gated channels and leads to exocytotic release of the chromaffin-granule cargo. After the cargo has been released, catestatin exerts potent antagonistic effects on nicotinic cholinergic signaling, resulting in negative-feedback modulation of catecholamine release. Arrows with plus signs indicate stimulation, and the arrow with a minus sign inhibition.

    30. Metodi di dosaggio della CgA Metodo ELISA DAKO A/S (Glostrup, Denmark) Anticorpi policlonali contro il frammento C-terminale di 23 kDa Concentrazioni espresse in U/L Valore soglia 37 U/L Metodo IRMA CIS Bio Intern (Gif sur Yvette, France) Anticorpi monoclonali contro epitopi nella regione 145-245 Concentrazioni espresse in ng/mL Valore soglia 100 ng/mL

    32. Concentrazioni di CgA1-17, CgA116-130, CgA324-337 in 10 pazienti con carcinoide (C) e tumore endocrino del pancreas (E)

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