Day 1 :
Slovak Academy of Sciences, Slovak Republic
Keynote: Role of pancreatic thyrotropin releasing hormone in directing insulin secretion to regulatory pathway
Time : 09:00-09:45
Vladimír Štrbák has worked at Institute of Experimental Endocrinology, Slovak Academy of Sciences. He was Organizer and Chairman of the five International Symposia on Hormones in Milk, resident of the International Symposium on Cell Volume and function 1997. He was Organizer and Chairman Symposium Cell Volume, physiological and pathophysiological aspects, 5th International Congress of Pathophysiology, June 28-July 1, 2006, Beijing, China, published in Chinese Journal of Pathophysiology, June 2006, Volume 22, No 13, Supplement p. 167. Organizer and Chairman of the session Cell Volume Regulation and Cell Functions The Physiology of Anion Transport and Cell Volume Regulation (August 3-6, 2009, Okazaki, Japan) Symposium following the IUPS Congress (Kyoto). His most important activities in last three years: 6th Global Diabetes Summit and Medicare Expo, November 02-04, 2015, Dubai, UAE, Organizing Committee Member, Keynote Speaker, 13th Global Diabetes Conference and Medicare Expo, August 8-10, 2016, Birmingham, UK: Organizing Committee Member Keynote Speaker and 16th Global Diabetes Conference and Medicare Expo, March 22-23, 2017 Rome, Italy Organizing Committee Member, Keynote Speaker, Chair of the Session.
Thyrotropin releasing hormone (TRH; pGlu-His-ProNH2) is colocalized in pancreatic β cells in secretory granules with insulin. TRH secretion from pancreatic islets is stimulated by glucose and inhibited by insulin. Disruption of the TRH gene in knockout mice results in hyperglycemia accompanied by impaired insulin secretory response to glucose. To understand role of TRH we blocked the last step of biosynthesis of α−amidated peptides, including TRH by Disulfiram (DS) treatment of adult male rats subcutaneously with 200 mg/kg for five days. TRH in physiological concentration (1 nM) does not affect basal insulin secretion from intact islets. In contrast, basal insulin secretion from islets of DS-treated rats is four times higher compared to controls and could not be stimulated by high-glucose. The addition of 1 nM TRH into medium decreased immediately basal insulin secretion in DS (TRH lacking) islets to control level and normalized also their response to glucose. Absence of the secretory response to glucose in islets from TRH depleted rats is connected with their increase of insulin content. Glucose stimulation together with 1 nM TRH normalized also insulin content in DS islets. Apparently, high insulin content in islets from TRH depleted animals is a result of block of regulatory secretion pathway which is corrected by the addition of TRH. In conclusion, presence of TRH in β cells ensures appropriate low basal (constitutive) insulin secretion and high response to stimulation. Release of TRH induced by glucose has autocrine effect resulting in directing insulin secretion to regulatory pathway.
University of Pisa, Italy
Time : 09:45-10:30
Francesco Lippi was graduated in Medicine, Surgery at the University of Pisa, Albo Pisa 1879/79, and specialization in Endocrinology at the University of Pisa July 1982 and specialization in Nuclear Medicine at the University of Florence July 1987. He has taught at the Institute of Clinical Methodology and the Institute of Endocrinology of the University of Pisa. From 1990 as a Professor of Endocrinology at the University Hospital of Pisa, he conducted the study (pahe se III) on effects of recombinant human TSH (rhTSH) adjuvant therapy in compassionate use program for patients with differentiated thyroid carcinoma.
Thyroid cancer is represented in most cases by differentiated thyroid carcinoma (DTC) (papillary or follicular), although the histological prevalence is papillary (90%). DTC is not particularly frequent, affecting only one in 25,000 people in Europe but increasing in the world, and has a higher incidence in women than in men (ratio 3-5:1). The DTC is asymptomatic, since in the great majority of cases the thyroid function appears normal. Secondary lymphadenopathy may rarely occur as a first event. Therefore the prevention, in particular the palpation and the ultrasound of the neck, becomes particularly important. A first cause is the area of origin (iodine deficiency). Another ascertained cause is the previous irradiation on the neck in pediatric age for benign pathologies. Other causes are the familiarity and genetic predisposition. It’s often the same patient who becomes aware of a swelling in the neck region. However, many of the nodules are so small in size that they are not discovered by the patient or the doctor, but require an adequate instrumentation (ultrasound). As soon as a thyroid nodule is discovered, it is advisable to carry out a specialist examination, blood test to measure serum FT3, FT4, TSH, anti-thyroglobulin antibodies and anti-thyroperoxidase (AbTg and AbTPO), and calcitonin (Ct). Following this phase, the neck ultrasound study follows. Often the ultrasound finding can already be suggestive of a suspicious nodule due to the presence of "spray" microcalcifications or to an incomplete halo sign or an increase in intra-nodular vascularity. The examination that still allows the diagnosis is the fine needle aspiration biopsy with cytological examination and international classification. In case of DTC, surgical therapy (total thyroidectomy) was generally followed by radioiodine therapy (RIT) which allows the elimination of residual thyroid tissues (ablation) and reduces the recurrences. Recently the new anatomopathological staging has reduced the RIT. Therefore, both papillary microcarcinoma and multifocal carcinoma, and papillary carcinoma with focal infiltration of the peri-thyroid soft tissues, are not treated with RIT if there are not different variants to the classical one. However, there are still authors who continue to treat patients (except microcarcinoma) still with RIT. This therapy can be performed both in conditions of hypothyroidism, or more recently without therapy withdrawal, but in euthyroid status after stimulation with recombinant human TSH. Moreover, the high serum TSH it’s the condition necessary for the thyroid cells stimulation, both for the production of thyroglobulin (Tg), and for the ability to concentrate radioiodine. The percentages of ablation and therefore of remission of the disease vary between 90 and 98% depending on the series published. RIT is followed by total body post-therapy scintigraphy that allows the visualization of radioactive iodine concentration in the body. About 10-15% of patients need an additional dose of radioiodine to complete the ablation of thyroid residues, while, in a small percentage of patients, for local or distant metastases or for detectable serum Tg levels
University of Missouri, USA
Time : 10:30-11:15
Eduardo J Simoes is a Chair, Wesbury and HMI Alumni Distinguished Professor of the Department of Health Management and Informatics-University of Missouri School of Medicine. His Medical degree is from Faculdade de Medicina, Universidade de Pernambuco-Brazil (1981), Diploma and Master of Science degree from the University Of London School Of Hygiene Tropical Medicine (1987) and Master of Public Health degree from Emory University School of Public Health (1991). He is a Fellow of the American College of Epidemiology. He has published more than 135 papers and served as an Editorial Board Member of reputable journals
About more than 500 million adults worldwide now have diabetes mellitus, 90% of whom have type-2 diabetes (T2D). Successful glycemic control key to prevent and reduce complications of T2D and reduce death related to the disease. However, maintaining optimal glycemic control through ongoing monitoring and treatment can be costly and challenging. The development of innovative self-care strategies to improve diabetes management is necessary. Advances in health information technologies (HITs) aim to increase the support of effective and affordable health-care delivery and patient education. There is evidence that HIT approaches using mobile, computer, e-mail, and internet enhance chronic disease management. This research provides an overview of the HITs in use for T2D management. We synthesize the latest findings on HITs’ effect in reducing HbA1c and managing complications from cardiovascular diseases. We discuss the current research limitations and implications for future research. Finally, we present barriers to applications of HITs in T2D management and suggested steps to move forward