@article{SiebertCiatoMurakamietal.2019,
  author    = {Siebert, Claudia and Ciato, Denis and Murakami, Masanori and Frei-Stuber, Ludwig and Perez-Rivas, Luis Gustavo and Monteserin-Garcia, Jos{\´e} Luis and N{\"o}lting, Svenja and Maurer, Julian and Feuchtinger, Annette and Walch, Axel K. and Haak, Harm R. and Bertherat, J{\´e}r{\^o}me and Mannelli, Massimo and Fassnacht, Martin and Korpershoek, Esther and Reincke, Martin and Stalla, G{\"u}nter K. and Hantel, Constanze and Beuschlein, Felix},
  title     = {Heat Shock Protein 90 as a Prognostic Marker and Therapeutic Target for Adrenocortical Carcinoma},
  series = {Frontiers in Endocrinology},
  volume    = {10},
  journal   = {Frontiers in Endocrinology},
  doi       = {10.3389/fendo.2019.00487},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-238029},
  year      = {2019},
  abstract  = {Background: Adrenocortical carcinoma (ACC) is a rare tumor entity with restricted therapeutic opportunities. HSP90 (Heat Shock Protein 90) chaperone activity is fundamental for cell survival and contributes to different oncogenic signaling pathways. Indeed, agents targeting HSP90 function have shown therapeutic efficacy in several cancer types. We have examined the expression of HSP90 in different adrenal tumors and evaluated the use of HSP90 inhibitors in vitro as possible therapy for ACC. Methods: Immunohistochemical expression of HSP90 isoforms was investigated in different adrenocortical tumors and associated with clinical features. Additionally, a panel of N-terminal (17-allylamino-17-demethoxygeldanamycin (17-AAG), luminespib, and ganetespib) and C-terminal (novobiocin and silibinin) HSP90 inhibitors were tested on various ACC cell lines. Results: Within adrenocortical tumors, ACC samples exhibited the highest expression of HSP90β. Within a cohort of ACC patients, HSP90β expression levels were inversely correlated with recurrence-free and overall survival. In functional assays, among five different compounds tested luminespib and ganetespib induced a significant decrease in cell viability in single as well as in combined treatments with compounds of the clinically used EDP-M scheme (etoposide, doxorubicin, cisplatin, mitotane). Inhibition of cell viability correlated furthermore with a decrease in proliferation, in cell migration and an increase in apoptosis. Moreover, analysis of cancer pathways indicated a modulation of the ERK1/2—and AKT—pathways by luminespib and ganetespib treatment. Conclusions: Our findings emphasize HSP90 as a marker with prognostic impact and promising target with N-terminal HSP90 inhibitors as drugs with potential therapeutic efficacy toward ACC.},
  language  = {en}
}
@article{QuinklerBeuschleinHahneretal.2013,
  author    = {Quinkler, Marcus and Beuschlein, Felix and Hahner, Stefanie and Meyer, Gesine and Sch{\"o}fl, Christof and Stalla, G{\"u}nter K.},
  title     = {Adrenal Cortical Insufficiency-a Life Threatening Illness With Multiple Etiologies},
  series = {Deutsches {\"A}rzteblatt International},
  volume    = {110},
  journal   = {Deutsches {\"A}rzteblatt International},
  doi       = {10.3238/arztebl.2013.0882},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-131662},
  pages     = {51-52},
  year      = {2013},
  abstract  = {Background: The clinical signs of adrenal cortical insufficiency (incidence, ca. 25 per million per year; prevalence, ca. 400 per million) are nonspecific, and misdiagnoses are therefore common. Glucocorticoid substitution therapy has been in use for 50 years but is not a wholly adequate treatment. Our understanding of this disease remains incomplete in many ways. Methods: We selectively searched the Medline database for publications on adrenal cortical insufficiency, with particular attention to studies from the year 2000 onward (search terms: "adrenal insufficiency" or "Addison's disease" or "hypopituitarism"). Results: Hydrocortisone substitution therapy is often given in doses of 10-25 mg/day, timed according to the circadian rhythm. Gastrointestinal and other, febrile infections account for 30-50\% of life-threatening adrenocortical crises. Such crises affect 8 of 100 persons with adrenal cortical insufficiency per year and must be treated by the immediate administration of glucocorticoids and fluids. When persons with adrenal cortical insufficiency are acutely ill or are otherwise under unusual stress, they may need additional amounts of hydrocortisone, often in the range of 5-10 mg but occasionally as high as 200 mg. The sustained administration of excessive amounts of steroid can shorten patients' lives by several years. Inappropriate substitution therapy can cause other major medical conditions, such as metabolic syndrome and osteoporosis. Conclusion: Important measures for the prevention of adrenocortical crises include improved care by treating physicians, education of patients and their families, the provision of emergency identifying documents, and the prescription of glucocorticoid emergency kits.},
  language  = {en}
}