Chapter 17 - Emerging drug delivery in the treatment of hyperpituitarism and hypopituitarism

Abstract

Hypopituitarism (failure to produce or underproduction of hormones released by the pituitary) and hyperpituitarism (excess production of hormones by the pituitary gland) are chronic endocrine disorders that arise as an outcome of diseases that affect brain tissue, namely metastatic deposits, primary tumors, trauma, surgery, radiotherapy, and vascular accidents. Hypopituitarism is correlated more with excessive incidences of mortality, as compared to hyperpituitarism. The common treatment for the management of hypopituitarism is hormone replacement therapy, but the continuous administration of certain hormones and their synthetic analogs may show substantially unexpected outcomes. Whereas in the case of tumor-associated compression and tissue damage leading to hypopituitarism the conventional approach of radiotherapy may be utilized to lower the tumor size and hence the revival of normal pituitary functions. On the other hand, the treatment of hyperpituitarism varies based upon the disease-causing factor and hormones impacted, which includes the use of competitive receptor antagonists for that specific hormone. For example, in patients with excessive secretion of growth hormone the analogs of somatostatin have been used effectively. Various literature revealed that the brain tissue differs from the other tissues of the body due to its restrictive blood-brain barrier which is the major limitation for designing alternative treatments for the diseased state associated with the pituitary. In such cases, nanotechnological approaches can be a promising alternative, especially during postsurgical treatment. This chapter seeks to provide an overview of research breakthroughs, drug therapy development trends, and delivery system applications in the treatment of hypopituitarism and hyperpituitarism.