About the research
Adrenal tumour research focusses on both common conditions (adrenal incidentaloma – 5% of the population with metabolic disease burden, Conn’s syndrome affecting 10% of hypertensives) and rare but devastating adrenocortical carcinoma (ACC; 5-year survival rate 30-40%). Through the European Network for the Study of Adrenal Tumours (ENSAT) we have access to a global network of other internationally leading teams. Combining mass spectrometry-based urine multi-steroid profiling and machine learning methods for data analysis, we have used this novel urine steroid metabolomics approach to uncover prevalent cortisol excess in mineralocorticoid hypertension and to develop a biomarker tool for the non-invasive diagnosis of ACC, recently validated in an ENSAT multi-centre trial led by Arlt with Chortis (EURINE-ACT), now in the process of roll-out to clinical practice.
Ronchi has developed novel applications of targeted molecular analyses including a liquid biopsy approach for rapid detection of ACC recurrence and also uses novel cell and tissue-based models for the identification of novel therapeutic targets for ACC treatment, and collaborating with Calebiro to investigate GPCR alterations in cortisol excess. Elhassan and Calebiro are collaborating in studying receptor signalling in adrenocortical tumours utilising state-of-the-art methodology, such as live-cell imaging, with the aim to understand tumour pathogenesis. Additional work targets the metabolic impact of mild autonomous cortisol excess (MACE) in adrenal incidentalomas (Prete, Arlt, Manolopoulos) and the significance of mineralocorticoid excess in hypertension (Lang, Prete, Arlt).
Urine steroid metabolomics as a novel tool for detection of recurrent adrenocortical carcinoma. Chortis V, Bancos I, Nijman T, Gilligan LC, Taylor AE, Ronchi CL, O'Reilly MW, Schreiner J, Asia M, Riester A, Perotti P, Libé R, Quinkler M, Canu L, Paiva I, Bugalho MJ, Kastelan D, Dennedy MC, Sherlock M, Ambroziak U, Vassiliadi D, Bertherat J, Beuschlein F, Fassnacht M, Deeks JJ, Biehl M, Arlt W. J Clin Endocrinol Metab. 2019 Oct 29. [Epub ahead of print]
Natural History of Adrenal Incidentalomas With and Without Mild Autonomous Cortisol Excess: A Systematic Review and Meta-analysis. Elhassan YS, Alahdab F, Prete A, Delivanis DA, Khanna A, Prokop L, Murad MH, O'Reilly MW, Arlt W, Bancos I. Ann Intern Med. 2019 Jun 25. [Epub ahead of print]