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Institute of Metabolic Science

Metabolic Research Laboratories
 

Research Interests

Although typically benign, tumours of the pituitary and adrenal glands are associated with increased morbidity and mortality (e.g. due to cardiometabolic dysfunction in acromegaly and Cushing’s syndrome; hypertension in primary aldosteronism). Quality of life is often significantly impaired (lower than for several common malignancies), and many patients require long-term (even life-long) medical therapy.

Our research is focussed on optimising the diagnosis and treatment of these conditions, to allow more patients to access specific, and potentially curative interventions (e.g. surgery, stereotactic radiosurgery, radiofrequency ablation) in a timely manner. For example, we have developed and introduced into routine clinical practice, novel PET imaging techniques, which are transforming the care of a subgroup of patients with pituitary and adrenal tumours – individuals previously deemed unsuitable for surgery and consigned to a lifetime of expensive/poorly tolerated medical treatment, are, in many instances, undergoing curative surgery.

In parallel studies, we perform detailed phenotyping of patients with (i) acromegaly, (ii) TSH-secreting pituitary adenomas and (iii) primary aldosteronism.

Together with Professor Chatterjee and Drs Moran, Oddy and Halsall, we also provide a UK national thyroid function test referral service, offering specialised clinical, biochemical, molecular and radiological phenotyping.

Our expertise is acknowledged through authorship of several recent international guidelines, including:

Acromegaly: Acromegaly Consensus Group. Pituitary, 2023 PMID: 37923946

AVP deficiency: Working Group for renaming Diabetes Insipidus. Eur J Endocrinol, 2022 PMID: 36239119

Cushing’s Disease: Pituitary Society. Lancet Diabetes Endocrinol, 2021 PMID: 34687601.

Prolactinoma: Pituitary Society. Nat Rev Endocrinol, 2023 PMID: 37670148

Resistance to Thyroid Hormone & related disorders: European Thyroid Association, 2024 – Eur Thyroid J – in preparation

Traumatic Brain Injury: 2nd Lancet Neurology Commission on traumatic brain injury. Lancet Neurol, 2022 PMID: 36183712.


Group Members

Dr James MacFarlane, Clinical Fellow

Dr Sophie Howarth, Clinical Fellow

Dr Linus Haberbosch, Visiting Clinical Fellow

Mr D Gillett, Assistant Professor

Dr W Bashari, Honorary Consultant

Mr August Palma, Research Nurse


Research funding

BHF

MRC

NIHR

Cambridge Biomedical Research Centre

Publications

Key publications: 

Refardt J, Atila C, Chifu I, Ferrante E, Erlic Z, Drummond JB, Indirli R, Drexhage R, Sailer CO, Widmer A, Felder S, Powlson AS, Hutter N, Vogt DR, Gurnell M, Soares Rocha BS, Hofland J, Beuschlein F, Fassnacht M, Winzeler B, Christ-Crain M. Arginine versus hypertonic saline stimulated copeptin to diagnose AVP deficiency. N Engl J Med. 2023, 389(20):1877-87. PMID: 37966286

Haberbosch L, Gillett D, MacFarlane J, Koulouri O, Mai K, Spranger J, Mannion R, Cheow H, Jones J, Gurnell M. Dual role for L-{Methyl-11C]-Methionine PET in Acromegaly: Confirming Remission and Detecting Recurrence. J Nucl Med. 2023 Sep 28:jnumed.123.266446. doi: 10.2967/jnumed.123.266446. Online ahead of print. PMID: 37770112 

Mullen N, Curneen J, Donlon PT, Prakash P, Bancos I, Gurnell M*, Dennedy MC. Treating primary aldosteronism-induced hypertension: novel approaches and future outlooks. Endocr Rev, 2023 Aug 9:bnad026. doi: 10.1210/endrev/bnad026. Online ahead of print. PMID: 37556722

Wu X, Azizan EAB, Goodchild E, Garg S, Hagiyama M, Cabrera CP, Fernandes-Rosa FL, Boulkroun S, Kuan JL, Tiang Z, David A, Murakami M, Mein CA, Wozniak E, Zhao W, Marker A, Buss F, Saleeb RS, Salsbury J, Tezuka Y, Satoh F, Oki K, Udager AM, Cohen DL, Wachtel H, King PJ, Drake WM, Gurnell M, Ceral J, Ryska A, Mustangin M, Wong YP, Tan GC, Solar M, Reincke M, Rainey WE, Foo RS, Takaoka Y, Murray SA, Zennaro MC, Beuschlein F, Ito A, Brown MJ. Somatic mutations of CADM1 in aldosterone-producing adenomas and gap junction-dependent regulation of aldosterone production. Nat Genet. 2023 Jun;55(6):1009-1021. doi: 10.1038/s41588-023-01403-0. Epub 2023 Jun 8. PMID: 37291193

Gillett D, Marsden D, Crawford R, Ballout S, MacFarlane J, van der Meulen M, Gillett B, Bird N, Heard S, Powlson AS, Santarius T, Mannion R, Kolias A, Harper I, Mendichovszky IA, Aloj L, Cheow H, Bashari W, Koulouri O, Gurnell M. Development of a bespoke phantom to optimize molecular PET imaging of pituitary tumors. EJNMMI Phys. 2023 Jun 1;10(1):34. doi: 10.1186/s40658-023-00552-9. PMID: 37261547.

Wu X, Senanayake R, Goodchild E, Bashari WA, Salsbury J, Cabrera CP, Argentesi G, O'Toole SM, Matson M, Koo B, Parvanta L, Hilliard N, Kosmoliaptsis V, Marker A, Berney DM, Tan W, Foo R, Mein CA, Wozniak E, Savage E, Sahdev A, Bird N, Laycock K, Boros I, Hader S, Warnes V, Gillett D, Dawnay A, Adeyeye E, Prete A, Taylor AE, Arlt W, Bhuva AN, Aigbirhio F, Manisty C, McIntosh A, McConnachie A, Cruickshank JK, Cheow H, Gurnell M*, Drake WM, Brown MJ. [11C]metomidate PET-CT versus adrenal vein sampling for diagnosing surgically curable primary aldosteronism: a prospective, within-patient trial. Nat Med, 2023, Jan;29(1):190-202. PMID: 36646800.

Silins I, Sundin A, Lubberink M, O'Sullivan L, Gurnell M, Aigbirhio F, Brown M, Wall A, Åkerström T, Roslin S, Hellman P, Antoni G. First-in-human evaluation of [18F]CETO: a novel tracer for adrenocortical tumours. Eur J Nucl Med Mol Imaging, 2023, Jan;50(2):398-409. PMID: 36074157

Menzies-Gow A, Gurnell M, Heaney LG, Corren J, Bel EH, Maspero J, Harrison T, Jackson DJ, Price D, Lugogo N, Kreindler J, Burden A, de Giorgio-Miller A, Faison S, Padilla K, Martin UJ, Garcia Gil E; PONENTE Study Group. Adrenal function recovery after durable OCS-sparing with benralizumab in the PONENTE study. Eur Respir J. 2022 Dec 22;60(6):2103226. doi: 10.1183/13993003.03226-2021. Print 2022 Dec.PMID: 35896216

Bashari WA, van der Meulen M, MacFarlane J, Gillett D, R Senanayake R, Serban L, Powlson AS, Brooke AM, Scoffings DJ, Jones J, O'Donovan DG, Tysome J, Santarius T, Donnelly N, Boros I, Aigbirhio F, Jefferies S, Cheow HK, Mendichovszky IA, Kolias AG, Mannion R, Koulouri O, Gurnell M. 11C-methionine PET aids localization of microprolactinomas in patients with intolerance or resistance to dopamine agonist therapy. Pituitary, 2022, 25(4):573-586. PMID: 35608811.

Gillett D, Senanayake R, MacFarlane J, van der Meulen M, Koulouri O, Powlson AS, Crawford R, Gillett B, Bird N, Heard S, Kolias A, Mannion R, Aloj L, Mendichovszky IA, Cheow HK, Bashari WA, Gurnell M. Localization of TSH-secreting pituitary adenoma using 11C-methionine image subtraction. EJNMMI Res, 2022 May 7;12(1):26.doi: 10.1186/s13550-022-00899-7. PMID: 35524902.

100,000 Genomes Project Pilot Investigators, Smedley D, Smith KR, Martin A, Thomas EA, McDonagh EM, Cipriani V, Ellingford JM, Arno G, Tucci A, Vandrovcova J, Chan G, Williams HJ, Ratnaike T, Wei W, Stirrups K, Ibanez K, Moutsianas L, Wielscher M, Need A, Barnes MR, Vestito L, Buchanan J, Wordsworth S, Ashford S, Rehmström K, Li E, Fuller G, Twiss P, Spasic-Boskovic O, Halsall S, Floto RA, Poole K, Wagner A, Mehta SG, Gurnell M, Burrows N, James R, Penkett C, Dewhurst E, Gräf S, Mapeta R, Kasanicki M, Haworth A, Savage H, Babcock M, Reese MG, Bale M, Baple E, Boustred C, Brittain H, de Burca A, Bleda M, Devereau A, Halai D, Haraldsdottir E, Hyder Z, Kasperaviciute D, Patch C, Polychronopoulos D, Matchan A, Sultana R, Ryten M, Tavares ALT, Tregidgo C, Turnbull C, Welland M, Wood S, Snow C, Williams E, Leigh S, Foulger RE, Daugherty LC, Niblock O, Leong IUS, Wright CF, Davies J, Crichton C, Welch J, Woods K, Abulhoul L, Aurora P, Bockenhauer D, Broomfield A, Cleary MA, Lam T, Dattani M, Footitt E, Ganesan V, Grunewald S, Compeyrot-Lacassagne S, Muntoni F, Pilkington C, Quinlivan R, Thapar N, Wallis C, Wedderburn LR, Worth A, Bueser T, Compton C, Deshpande C, Fassihi H, Haque E, Izatt L, Josifova D, Mohammed S, Robert L, Rose S, Ruddy D, Sarkany R, Say G, Shaw AC, Wolejko A, Habib B, Burns G, Hunter S, Grocock RJ, Humphray SJ, Robinson PN, Haendel M, Simpson MA, Banka S, Clayton-Smith J, Douzgou S, Hall G, Thomas HB, O'Keefe RT, Michaelides M, Moore AT, Malka S, Pontikos N, Browning AC, Straub V, Gorman GS, Horvath R, Quinton R, Schaefer AM, Yu-Wai-Man P, Turnbull DM, McFarland R, Taylor RW, O'Connor E, Yip J, Newland K, Morris HR, Polke J, Wood NW, Campbell C, Camps C, Gibson K, Koelling N, Lester T, Németh AH, Palles C, Patel S, Roy NBA, Sen A, Taylor J, Cacheiro P, Jacobsen JO, Seaby EG, Davison V, Chitty L, Douglas A, Naresh K, McMullan D, Ellard S, Temple IK, Mumford AD, Wilson G, Beales P, Bitner-Glindzicz M, Black G, Bradley JR, Brennan P, Burn J, Chinnery PF, Elliott P, Flinter F, Houlden H, Irving M, Newman W, Rahman S, Sayer JA, Taylor JC, Webster AR, Wilkie AOM, Ouwehand WH, Raymond FL, Chisholm J, Hill S, Bentley D, Scott RH, Fowler T, Rendon A, Caulfield M. 100,000 Genomes Pilot on Rare-Disease Diagnosis in Health Care – Preliminary Report. N Engl J Med, 2021 Nov 11;385(20):1868-1880. PMID: 34758253.

Menzies-Gow A, Gurnell M, Heaney LG, Corren J, Bel EH, Maspero J, Harrison T, Jackson DJ, Price D, Lugogo N, Kreindler J, Burden A, de Giorgio-Miller A, Padilla K, Martin UJ, Garcia Gil E. Oral corticosteroid elimination via a personalised reduction algorithm in adults with severe eosinophilic asthma treated with benralizumab (PONENTE): a multicenter open-label, single-arm study. Lancet Respir Med, 2021 Oct 4:S2213-2600(21)00352-0. doi: 10.1016/S2213-2600(21)00352-0. Online ahead of print. PMID: 34619104.

Zhou J, Azizan EAB, Cabrera CP, Fernandes-Rosa FL, Boulkroun S, Argentesi G, Cottrell E, Amar L, Wu X, O'Toole S, Goodchild E, Marker A, Senanayake R, Garg S, Åkerström T, Backman S, Jordan S, Polubothu S, Berney DM, Gluck A, Lines KE, Thakker RV, Tuthill A, Joyce C, Kaski JP, Karet Frankl FE, Metherell LA, Teo AED, Gurnell M, Parvanta L, Drake WM, Wozniak E, Klinzing D, Kuan JL, Tiang Z, Gomez Sanchez CE, Hellman P, Foo RSY, Mein CA, Kinsler VA, Björklund P, Storr HL, Zennaro MC, Brown MJ. Somatic mutations of GNA11 and GNAQ in CTNNB1-mutant aldosterone-producing adenomas presenting in puberty, pregnancy or menopause. Nat Genet, 2021 Sep;53(9):1360-1372. PMID: 34385710.

Gillett D, Marsden D, Ballout S, Attili B, Bird N, Heard S, Gurnell M, Mendichovszky IA, Aloj L. 3D printing of 18F radioactive phantoms for PET imaging. EJNMMI Phys, 2021 Apr 28;8(1):38. doi: 10.1186/s40658-021-00383-6. PMID: 33909154.

Suehs CM, Menzies-Gow A, Price D, Bleecker ER, Canonica GW, Gurnell M, Bourdin A: Oral Corticosteroids Tapering Delphi Expert Panel. Expert consensus on the tapering of oral corticosteroids for the treatment of asthma. A Delphi study. Am J Respir Crit Care Med, 2021 April 1;203(7):871-881. PMID: 33112646.

Professor of Clinical Endocrinology
Head of Section (Specialty Medicine and Research Training)
Department of Medicine
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