endofocusFOCUS ЭндокринологияFOCUS. Endocrinology2713-01772713-0185ООО "Издательство "Перо"10.62751/2713-0177-2025-6-4-05endofocus-163Research ArticleОБЗОР ЛИТЕРАТУРЫLITERATURE REVIEWРоль β-аррестинов и E-кадгерина в патогенезе гормон роста- и пролактин-секретирующих аденом гипофиза: обзор литературыThe role of β-arrestins and E-cadherin in the pathogenesis of growth hormone- and prolactin-secreting pituitary adenomas: A literature reviewhttps://orcid.org/0000-0003-3342-9412АшимоваР. Р.AshimovaR. R.

Ашимова Регина Рафиковна – ассистент кафедры эндокринологии; врач-эндокринолог

г. Казань

Regina R. Ashimova – assistant at the Department of endocrinology; endocrinologist 

Kazan

regina_ashimova@mail.ruhttps://orcid.org/0000-0001-8493-7893ВагаповаГ. Р.VagapovaG. R.

Вагапова Гульнар Рифатовна – д.м.н., профессор, заведующая кафедрой эндокринологии; врач-эндокринолог 

г. Казань

Gulnar R. Vagapova – D. Sci (Med.), Professor, Head of the Department of endocrinology; endocrinologist 

Kazan

g.r.vagapova@gmail.comhttps://orcid.org/0000-0003-2180-4414НасыбуллинаФ. А.NasybullinaF. A.

Насыбуллина Фарида Алимбековна – врач-эндокринолог

г.Казань

Farida A. Nasybullina – endocrinologist 

Kazan

nasybullinaf@mail.ruhttps://orcid.org/0000-0003-3702-7488ПашаевБ. Ю.PashayevB. Yu.

Пашаев Бахтияр Юсуфович – врач-нейрохирург 

г. Казань 

 

Bakhtiyar Yu. Pashayev – neurosurgeon; assistant at the Department of neurosurgery 

Kazan

bpashaev@yandex.ruhttps://orcid.org/0000-0002-1448-4945ХафизовА. Р.KhafizovA. R.

Хафизов Артур Рафаэлевич – врач-эндокринолог, заместитель генерального директора по клинико-экспертной работе 

г. Казань

Artur R. Khafizov – endocrinologist, Deputy Director General for clinical expertise work

Kazan

Hafartur@gmail.comКазанская государственная медицинская академия – филиал ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России; ГАУЗ «Межрегиональный клинико-диагностический центр»Kazan State Medical Academy – branch of the Russian Medical Academy of Continuous Professional Education; Interregional Clinical Diagnostic CenterГАУЗ «Городская клиническая больница №7 им. М.Н. Садыкова»City Clinical Hospital No. 7 named after M.N. SadykovФГБОУ ВО «Казанский государственный медицинский университет» Минздрава России; ГАУЗ «Межрегиональный клинико-диагностический центр»Interregional Clinical Diagnostic Center; Kazan State Medical UniversityГАУЗ «Межрегиональный клинико-диагностический центр»Interregional Clinical Diagnostic Center20252712202564Нейроэндокринология3642Copyright © Ашимова Р.Р., Вагапова Г.Р., Насыбуллина Ф.А., Пашаев Б.Ю., Хафизов А.Р., 20252025Ашимова Р.Р., Вагапова Г.Р., Насыбуллина Ф.А., Пашаев Б.Ю., Хафизов А.Р.Ashimova R.R., Vagapova G.R., Nasybullina F.A., Pashayev B.Y., Khafizov A.R.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://endofocus.elpub.ru/jour/article/view/163

Гормон роста- и пролактин-секретирующие аденомы гипофиза отличаются высокой вариабельностью клинического течения и ответа на проводимую терапию. В последние годы активно изучаются молекулярные биомаркеры, ассоциированные с характером роста и гормональной секреции аденом гипофиза для их возможного применения в качестве прогностических факторов, определяющих тактику ведения пациентов. Одними из перспективных молекул в этом плане являются β-аррестины и E-кадгерин. β-Аррестины представляют собой многофункциональные адаптерные белки, модулирующие пролиферацию, миграцию ряда опухолевых клеток и их чувствительность к атипролиферативной терапии. E-кадгерин – ключевой трансмембранный белок клеточной адгезии, который, помимо структурной роли, также регулирует пролиферацию, дифференцировку и защиту клеток от апоптоза. В представленном обзоре приводятся результаты исследований из базы PubMed, касающихся роли β-аррестинов и E-кадгерина в патофизиологии гормон роста- или пролактин-секретирующих аденом гипофиза с акцентом на потенциальные возможности определения этих белков как биомаркеров прогноза эффективности медикаментозной терапии аналогами соматостатина при акромегалии и агонистами дофаминовых рецепторов при пролактиномах.                                                                                          

Growth hormone- and prolactin-secreting pituitary adenomas are characterized by high variability of clinical course and response to therapy. In recent years, molecular biomarkers associated with the growth pattern and hormonal secretion of pituitary adenomas have been actively studied for their possible use as prognostic factors determining patient management tactics. Some of the promising molecules are β-arrestins and E-cadherin. β-arrestins are multifunctional adapter proteins that modulate proliferation, migration of a number of tumor cells and their sensitivity to antiproliferative therapy. E-cadherin is a key transmembrane protein of cell adhesion, which in addition to its structural role, is also regulates proliferation, differentiation and protection of cells from apoptosis. This review presents the results of studies included in the PubMed database concerning the role of β-arrestins and E-cadherin in the pathophysiology of growth hormone- or prolactin-secreting pituitary adenomas, with an emphasis on the potential to identify these proteins as biomarkers for predicting the effectiveness of drug therapy with somatostatin analogues in acromegaly and dopamine receptor agonists in prolactinomas.

аденомы гипофизаакромегалияпролактиномаβ-аррестиныE-кадгеринбиомаркерыответ на лечениеpituitary adenomasacromegalyprolactinomaβ-arrestinsE-cadherinbiomarkersresponse to therapyReferencesDaly AF, Beckers A. The epidemiology of pituitary adenomas. Endocrinol Metab Clin North Am. 2020;49(3):347–55. doi: 10.1016/j.ecl.2020.04.002.СПИСОК ЛИТЕРАТУРЫMete O, Lopes MB. Overview of the 2017 WHO classification of pituitary tumors. Endocr Pathol. 2017;28(3):228–43. doi: 10.1007/s12022-017-9498-z.Daly AF, Beckers A. The Epidemiology of Pituitary Adenomas. Endocrinol Metab Clin North Am. 2020 Sep;49(3):347-355. doi: 10.1016/j.ecl.2020.04.002.Пржиялковская Е.Г., Мокрышева Н.Г., Трошина Е.А., Мельниченко Г.А., Дедов И.И., Анциферов М.Б.c соавт. Клинические рекомендации «Акромегалия» (проект). Ожирение и метаболизм. 2024;21(2):215–249.doi: 10.14341/omet13153.Mete O, Lopes MB. Overview of the 2017 WHO Classification of Pituitary Tumors. Endocr Pathol. 2017 Sep;28(3):228-243. doi: 10.1007/s12022-017-9498-z.Дедов И.И., Мельниченко Г.А., Дзеранова Л.К., Андреева Е.Н., Гринева Е.Н., Марова Е.И. c соавт. Клинические рекомендации «Гиперпролактинемия» (проект). Ожирение и метаболизм. 2023;20(2):170–188. doi: 10.14341/omet13002.Przhiyalkovskaya E.G., Mokrysheva N.G., Troshina E.A. et al. Guidelines on diagnostics and treatment of acromegaly (draft). Obesity and metabolism. 2024;21(2):215-249. (In Russ.) doi: 10.14341/omet13153.Melmed S, Casanueva FF, Hoffman AR, Kleinberg DL, Montori VM, Schlechte JA, Wass JA; Endocrine Society. Diagnosis and treatment of hyperprolactinemia: An Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011;96(2):273–88. doi:10.1210/jc.2010-1692.Dedov I.I., Melnichenko G.A., Dzeranova L.K. et al. Clinical guidelines ‘Hyperprolactinemia’ (draft). Obesity and metabolism. 2023;20(2):170-188. (In Russ.) doi: 10.14341/omet13002Fleseriu M, Biller BMK, Freda PU, Gadelha MR, Giustina A, Katznelson L et al. A Pituitary Society update to acromegaly management guidelines. Pituitary. 2021;24(1):1–13. doi: 10.1007/s11102-020-01091-7.Melmed S, Casanueva FF, Hoffman AR. et al. Diagnosis and treatment of hyperprolactinemia:an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011 Feb;96(2):273-88. doi:10.1210/jc.2010-1692.Asa SL, Mete O, Perry A, Osamura RY. Overview of the 2022 WHO classification of pituitary tumors. Endocr Pathol. 2022;33(1):6–26. doi: 10.1007/s12022-022-09703-7.Fleseriu M, Biller BMK, Freda PU et al. Pituitary Society update to acromegaly management guidelines. Pituitary. 2021 Feb;24(1):1-13. doi:10.1007/s11102-021-01148-7.Song Q, Ji Q, Li Q. The role and mechanism of β-arrestins in cancer invasion and metastasis (Review). Int J Mol Med. 2018;41(2):631–39.doi: 10.3892/ijmm.2017.3288.Asa SL, Mete O, Perry A et al. Overview of the 2022 WHO Classification of Pituitary Tumors. Endocr Pathol 33, 6–26 (2022). doi: 10.1007/s12022-022-09703-7Smith JS, Rajagopal S. The β-arrestins: Multifunctional regulators of G protein-coupled receptors. J Biol Chem. 2016;291(17):8969–77. doi: 10.1074/jbc.R115.713313.Song Q, Ji Q, Li Q. The role and mechanism of β-arrestins in cancer invasion and metastasis (Review). Int J Mol Med. 2018 Feb;41(2):631-9. doi:10.3892/ijmm.2017.3288.Aamna B, Kumar Dan A, Sahu R, Behera SK, Parida S. Deciphering the signaling mechanisms of β-arrestin1 and β-arrestin2 in regulation of cancer cell cycle and metastasis. J Cell Physiol. 2022;237(10):3717–33. doi: 10.1002/jcp.30849.Smith JS, Rajagopal S. The β-arrestins: multifunctional regulators of G protein-coupled receptors. J Biol Chem. 2016 Apr 22;291(17):8969-77. doi:10.1074/jbc.R115.713313.Mangili F, Giardino E, Treppiedi D, Barbieri AM, Catalano R, Locatelli M et al. Beta-arrestin 2 is required for dopamine receptor type 2 inhibitory effects on AKT phosphorylation and cell proliferation in pituitary tumors. Neuroendocrinology. 2021;111(6):568–79. doi: 10.1159/000509219.Aamna B, Kumar DA, Sahu R et al. Deciphering the signaling mechanisms of β-arrestin1 and β-arrestin2 in regulation of cancer cell cycle and metastasis. J Cell Physiol. 2022 Oct;237(10):3717-33. doi:10.1002/jcp.30849.Di Muro G, Mangili F, Esposito E, Barbieri AM, Catalano R, Treppiedi D et al. β-arrestin 2-biased dopamine receptor type 2 (DRD2) agonist is more efficacious than cabergoline in reducing cell proliferation in PRL-secreting but not in non-functioning pituitary tumor cells. Cancers (Basel). 2023;15(12):3218. doi: 10.3390/cancers15123218.Mangili F, Giardino E, Treppiedi D et al. Beta-Arrestin 2 Is Required for Dopamine Receptor Type 2 Inhibitory Effects on AKT Phosphorylation and Cell Proliferation in Pituitary Tumors. Neuroendocrinology. 2021;111(6):568-79. doi:10.1159/000509219.Beaulieu JM, Gainetdinov RR. The physiology, signaling, and pharmacology of dopamine receptors. Pharmacol Rev. 2011;63(1):182–217. doi: 10.1124/pr.110.002642.Genesio DM, Di Muro G, Barbieri AM et al. β-Arrestin 2-Biased Dopamine Receptor Type 2 (DRD2) Agonist Is More Efficacious Than Cabergoline in Reducing Cell Proliferation in PRL-Secreting but Not in Non-Functioning Pituitary Tumor Cells. Cancers (Basel). 2023 Jun 16;15(12):3218. doi:10.3390/cancers15123218.Spada A, Mantovani G, Lania AG, Treppiedi D, Mangili F, Catalano R et al. Pituitary tumors: Genetic and molecular factors underlying pathogenesis and clinical behavior. Neuroendocrinology. 2022;112(1):15–33. doi: 10.1159/000514862.Beaulieu JM, Gainetdinov RR. The physiology, signaling, and pharmacology of dopamine receptors. Pharmacol Rev. 2011 Mar;63(1):182-217. doi: 10.1124/pr.110.002642. Epub 2011 Feb 8. PMID: 21303898Treppiedi D, Mangili F, Giardino E, Catalano R, Locatelli M, Lania AG et al. Cytoskeleton protein filamin A is required for efficient somatostatin receptor type 2 internalization and recycling through Rab5 and Rab4 sorting endosomes in tumor somatotroph cells. Neuroendocrinology. 2020;110(7–8):642–52. doi: 10.1159/000503791.Spada A, Mantovani G, Lania AG et al. Pituitary Tumors: Genetic and Molecular Factors Underlying Pathogenesis and Clinical Behavior. Neuroendocrinology. 2022;112(1):15-33. doi: 10.1159/000514862.Gatto F, Feelders R, van der Pas R, Kros JM, Dogan F, van Koetsveld PM et al. β-Arrestin 1 and 2 and G protein-coupled receptor kinase 2 expression in pituitary adenomas: Role in the regulation of response to somatostatin analogue treatment in patients with acromegaly. Endocrinology. 2013;154(12):4715–25. doi: 10.1210/en.2013-1672.Treppiedi D, Mangili F, Giardino E et al. Cytoskeleton Protein Filamin A Is Required for Efficient Somatostatin Receptor Type 2 Internalization and Recycling through Rab5 and Rab4 Sorting Endosomes in Tumor Somatotroph Cells. Neuroendocrinology. 2020;110(7-8):642-652. doi: 10.1159/000503791.Gatto F, Biermasz NR, Feelders RA, Kros JM, Dogan F, van der Lely AJ et al. Low beta-arrestin expression correlates with the responsiveness to long-term somatostatin analog treatment in acromegaly. Eur J Endocrinol. 2016;174(5):651–62. doi: 10.1530/EJE-15-0391.Gatto F, Feelders R, van der Pas R et al. β-Arrestin 1 and 2 and G protein-coupled receptor kinase 2 expression in pituitary adenomas: role in the regulation of response to somatostatin analogue treatment in patients with acromegaly. Endocrinology. 2013 Dec;154(12):4715-25. doi: 10.1210/en.2013-1672. Epub 2013 Oct 29. PMID: 24169548.Coelho MCA, Vasquez ML, Wildemberg LE, Vazquez-Borrego MC, Bitana L, Camacho AHDS et al. Molecular evidence and clinical importance of β-arrestins expression in patients with acromegaly. J Cell Mol Med. 2018;22(4):2110–16. doi: 10.1111/jcmm.13427.Gatto F, Biermasz NR, Feelders RA et al. Low beta-arrestin expression correlates with the responsiveness to long-term somatostatin analog treatment in acromegaly. Eur J Endocrinol. 2016 May;174(5):651-62. doi: 10.1530/EJE-15-0391.Akdemir AS, Metin Armagan D, Polat Korkmaz O, Ozkaya HM, Kadioglu P, Gazioglu N et al. Association between β-arrestin-2 and filamin-A gene variations with medical treatment response in acromegaly patients. Minerva Endocrinol (Torino). 2025;50(1):32–41. doi: 10.23736/S2724-6507.21.03611-3.Coelho MCA, Vasquez ML, Wildemberg LE et al. Molecular evidence and clinical importance of β-arrestins expression in patients with acromegaly. J Cell Mol Med. 2018 Apr;22(4):2110-6. doi:10.1111/jcmm.13427.Засадкевич Ю.М., Бриллиант А.А., Сазонов С.В. Роль кадгеринов в норме и при развитии рака молочной железы. Архив патологии. 2015;77(3):57–64. doi: 10.17116/patol201577357-64.Akdemir AS, Metin Armagan D, Polat Korkmaz O et al. Association between β-arrestin-2 and filamin-A gene variations with medical treatment response in acromegaly patients. Minerva Endocrinol (Torino). 2025 Mar;50(1):32-41. doi: 10.23736/S2724-6507.21.03611-3.Niessen CM, Leckband D, Yap AS. Tissue organization by cadherin adhesion molecules: dynamic molecular and cellular mechanisms of morphogenetic regulation. Physiol Rev. 2011;91(2):691–731. doi: 10.1152/physrev.00004.2010.Zasadkevich YuM, Brilliant AA, Sazonov SV. Role of cadherins in health and in developing breast cancer. Russian Journal of Archive of Pathology. 2015;77(3):57‑64. (In Russ.) doi: 10.17116/patol201577357-64.Mendonsa AM, Na TY, Gumbiner BM. E-cadherin in contact inhibition and cancer. Oncogene. 2018;37(35):4769–80. doi: 10.1038/s41388-018-0304-2.Niessen CM, Leckband D, Yap AS. Tissue organization by cadherin adhesion molecules: dynamic molecular and cellular mechanisms of morphogenetic regulation. Physiol Rev. 2011 Apr;91(2):691-731. doi:10.1152/physrev.00004.2010.Burandt E, Lübbersmeyer F, Gorbokon N, Buscheck F, Luebke AM, Menz A et al. E-Cadherin expression in human tumors: a tissue microarray study on 10,851 tumors. Biomark Res. 9 2021;9(1):44. doi: 10.1186/s40364-021-00299-4.Mendonsa AM, Na TY, Gumbiner BM. E-cadherin in contact inhibition and cancer. Oncogene. 2018 Sep;37(35):4769-80. doi:10.1038/s41388-018-0304-2Kikuchi M, Yatabe M, Kouki T, Fujiwara K, Takigami S, Sakamoto A, Yashiro T. Changes in E- and N-cadherin expression in developing rat adenohypophysis. Anat Rec (Hoboken). 2007;290(5):486–90. doi: 10.1002/ar.20516.Burandt E, Lübbersmeyer F, Gorbokon N et al. E-Cadherin expression in human tumors: a tissue microarray study on 10,851 tumors. Biomark Res 9, 44 (2021). doi: 10.1186/s40364-021-00299-4.Qian ZR, Li CC, Yamasaki H, Mizusawa N, Yoshimoto K, Yamada S et al. Role of E-cadherin, alpha-, beta-, and gamma-catenins, and p120 (cell adhesion molecules) in prolactinoma behavior. Mod Pathol. 2002;15(12):1357–65. doi: 10.1097/01.MP.0000039572.75188.1A.Kikuchi M, Yatabe M, Kouki T et al. Changes in E- and N-cadherin expression in developing rat adenohypophysis. Anat Rec (Hoboken). 2007 May;290(5):486-90. doi: 10.1002/ar.20516. PMID: 17373711Qian ZR, Sano T, Yoshimoto K, Asa SL, Yamada S, Mizusawa N, Kudo E. Tumor-specific downregulation and methylation of the CDH13 (H-cadherin) and CDH1 (E-cadherin) genes correlate with aggressiveness of human pituitary adenomas. Mod Pathol. 2007;20(12):1269–77. doi: 10.1038/modpathol.3800965.Qian ZR, Li CC, Yamasaki H, Asa SL et al. Role of E-cadherin, alpha-, beta-, and gamma-catenins, and p120 (cell adhesion molecules) in prolactinoma behavior. Mod Pathol. 2002 Dec;15(12):1357-65. doi:10.1097/01.MP.0000039572.75188.1A.Chauvet N, Romanò N, Meunier AC, Galibert E, Fontanaud P, Mathieu MN et al. Combining cadherin expression with molecular markers discriminates invasiveness in growth hormone and prolactin pituitary adenomas. J Neuroendocrinol. 2016;28(2):12352. doi: 10.1111/jne.12352.Qian ZR, Asa SL, Siomi H et al. Tumor-specific downregulation and methylation of the CDH13 (H-cadherin) and CDH1 (E-cadherin) genes correlate with aggressiveness of human pituitary adenomas. Mod Pathol. 2007 Dec;20(12):1269-77. doi:10.1038/modpathol.3800965.Mendes GA, Haag T, Trott G, Rech CGSL, Ferreira NP, Oliveira MC et al. Expression of E-cadherin, Slug and NCAM and its relationship to tumor invasiveness in patients with acromegaly. Braz J Med Biol Res. 2017;51(2):e6808. doi: 10.1590/1414-431X20176808.Chauvet N, Romanò N, Meunier AC et al. Combining Cadherin Expression with Molecular Markers Discriminates Invasiveness in Growth Hormone and Prolactin Pituitary Adenomas. J Neuroendocrinol. 2016 Feb;28(2):12352. doi:10.1111/jne.12352.Fougner SL, Lekva T, Borota OC, Hald JK, Bollerslev J, Berg JP. The expression of E-cadherin in somatotroph pituitary adenomas is related to tumor size, invasiveness, and somatostatin analog response. J Clin Endocrinol Metab. 2010;95(5):2334–42. doi: 10.1210/jc.2009-2197.Mendes GA, Haag T, Trott G et al. Expression of E-cadherin, Slug and NCAM and its relationship to tumor invasiveness in patients with acromegaly. Braz J Med Biol Res. 2017 Dec 11;51(2): e6808. doi: 10.1590/1414-431X20176808.Venegas-Moreno E, Flores-Martinez A, Dios E, Vazquez-Borrego MC, Ibanez-Costa A, Madrazo-Atutxa A et al. E-cadherin expression is associated with somatostatin analogue response in acromegaly. J Cell Mol Med. 2019;23(5):3088–96. doi: 10.1111/jcmm.13851.Fougner SL, Lekva T, Borota OC et al. The expression of E-cadherin in somatotroph pituitary adenomas is related to tumor size, invasiveness, and somatostatin analog response. J Clin Endocrinol Metab. 2010 May;95(5):2334-42. doi:10.1210/jc.2009-2197.Puig-Domingo M, Gil J, Sampedro-Nunez M, Jorda M, Webb SM, Serra Get al. Molecular profiling for acromegaly treatment: A validation study. Endocr Relat Cancer 2020;27(6):375–89. doi: 10.1530/ERC-18-0565.Venegas-Moreno E, Flores-Martinez A, Dios E et al. E-cadherin expression is associated with somatostatin analogue response in acromegaly. J Cell Mol Med. 2019 Mar;23(5):3088-96. doi:10.1111/jcmm.13851.Soukup J, Hornychova H, Manethova M, Michalova K, Michnova L, Popovska L et al. Predictive and prognostic significance of tumour subtype, SSTR1-5 and e-cadherin expression in a well-defined cohort of patients with acromegaly. J Cell Mol Med. 2021;25(5):2484–92. doi: 10.1111/jcmm.16173.Puig-Domingo M, Gil J, Sampedro-Nuñez M et al. Molecular profiling for acromegaly treatment: A validation study. Endocr. Relat. Cancer 2020, 27, 375–389. doi:10.1530/ERC-18-0565.Gliga MC, Chinezu L, Pascanu IM. Predicting response to medical treatment in acromegaly via granulation pattern, expression of somatostatin receptors type 2 and 5 and E-cadherin. Int J Mol Sci. 2024;25(16):8663. doi: 10.3390/ijms25168663.Soukup J, Hornychova H, Manethova M et al. Predictive and prognostic significance of tumour subtype, SSTR1-5 and e-cadherin expression in a well-defined cohort of patients with acromegaly. J Cell Mol Med. 2021 Mar;25(5):2484-2492. doi: 10.1111/jcmm.16173.Marques-Pamies M, Gil J, Sampedro-Nunez M, Valassi E, Biagetti B, GimenezPalop O et al. Personalized medicine in acromegaly: The ACROFAST Study. J Clin Endocrinol Metab. 2024;110(1):30–40. doi: 10.1210/clinem/dgae444.Gliga MC, Chinezu L, Pascanu IM. Predicting Response to Medical Treatment in Acromegaly via Granulation Pattern, Expression of Somatostatin Receptors Type 2 and 5 and E-Cadherin. Int J Mol Sci. 2024 Aug 8;25(16):8663. doi: 10.3390/ijms25168663.Marques-Pamies M, Gil J, Sampedro-Nuñez M et al. Personalized Medicine in Acromegaly: The ACROFAST Study. J Clin Endocrinol Metab. 2024 Jan;110(1):30-40. doi:10.1210/clinem/dgae444.Marques-Pamies M, Gil J, Sampedro-Nuñez M et al. Personalized Medicine in Acromegaly: The ACROFAST Study. J Clin Endocrinol Metab. 2024 Jan;110(1):30-40. doi:10.1210/clinem/dgae444.

The authors declare that there are no conflicts of interest present.