Abstract

Multiple endocrine neoplasia type 1 (MEN1) is an endocrine tumor syndrome caused by heterozygous mutations in the MEN1 tumor suppressor gene. The MEN1 pancreas of the adolescent gene carrier frequently contain diffusely spread pre-neoplasias and microadenomas, progressing to macroscopic and potentially malignant pancreatic neuroendocrine tumors (P-NET), which represents the major death cause in MEN1. The unveiling of the molecular mechanism of P-NET which is not currently understood fully to allow the optimization of diagnostics and treatment. Glucagon-like peptide 1 (GLP-1) pathway is essential in islet regeneration, i.e. inhibition of β-cell apoptosis and enhancement of β-cell proliferation, yet involvement of GLP-1 in MEN1 related P-NET has not yet been demonstrated. The objective of this work was to investigate if normal sized islets of Men1 heterozygous mice have increased Glucagon-like peptide-1 receptor (GLP-1R) expression compared to wild type islets, and if this increase is detectable in vivo with positron emission tomography (PET) using [68Ga]Ga-DO3A-VS-Cys40-Exendin-4 (68Ga-Exendin-4). 68Ga-Exendin-4 showed potential for early lesion detection in MEN1 pancreas due to increased GLP1R expression.

Highlights

  • One of the most common inherited genetic syndromes related to neuroendocrine tumors is multiple endocrine neoplasia type 1 (MEN 1)

  • To clarify if GLP1 pathway is involved in initiation of proliferation in Multiple endocrine neoplasia type 1 (MEN1) pancreatic neoplasm and if GLP-1 receptor (GLP-1R) expression could reflect this transformation[19], we performed quantitative PCR as well as 68Ga-Exendin-4/positron emission tomography (PET)-studies in Men[1] mice

  • The clinical recognition of MEN1 related pancreatic neuroendocrine tumors (P-NET) are generally correlated to their abnormal hormone secretion

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Summary

Introduction

One of the most common inherited genetic syndromes related to neuroendocrine tumors is multiple endocrine neoplasia type 1 (MEN 1). Pancreatic neuroendocrine tumors (P-NET) occur in more than 80% of MEN1 patients[1] and is the major reason for MEN1-related death[2,3,4]. Treatment of these patients demands multidisciplinary care including surgery, chemotherapy and targeted therapies[5]. The proliferating endocrine cells[11] in Men[1] mice serve as a valuable model for studies of the pathophysiology and molecular events of importance for initiation of tumorigenesis in MEN1 P-NETs using preclinical in vitro, ex vivo and in vivo methods. To clarify if GLP1 pathway is involved in initiation of proliferation in MEN1 pancreatic neoplasm and if GLP-1R expression could reflect this transformation[19], we performed quantitative PCR as well as 68Ga-Exendin-4/PET-studies in Men[1] mice

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