Acromegaly historical perspective

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:  Ahmed Elsaiey, MBBCH [2]

## Overview

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Acromegaly was first described by DR. Johannes Wier in 1567. Dr. Verga reported a case of acromegaly in 1864 that was a case of a patient with a disproportionate big face. Through 1877 to 1900s, many physicians reported cases of acromegaly. In 1970, Dr. Besser used bromocriptine in the treatment of acromegaly and it showed a remarkable improvement in the patients condition. In 1988, FDA approved octreotide as a treatment to acromegaly.

## Historical Perspective

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### Discovery

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* In 1567, Dr.  Johannes Wier was the first to describe a case of a giant female patient. Dr. Wier described the course of acromegaly in this patient in his article. He mentioned that she was of normal stature then she began to increase in height and size at age of fourteen. However, she had a normal good life. Dr. Wier was also the first who described link between the acromegaly and amenorrhea in this patient.[1]
* In 1772, Dr. Nicolas Saucerotte reported a case which has a clinical presentation linked with acromegaly.[2]
* In 1864, Dr. Andrea Verga reported a case of acromegaly. Dr. Verga reported a patient with disproportional big face.
* In 1877, Dr. Brigidi was the first who described pituitary adenoma. Dr. Brigidi reported a case of an actor who presented with chronic bone deformities. Dr. Bridgi then linked between the pituitary adenoma and the acromegaly.
* In 1884, Dr. Fritsche and Theodor Klebs also reported a case of acromegaly with pituitary adenoma.
* In 1886, Dr. Pierre Marie was the first who developed the name of acromegaly for the disease. Dr. Marie reported a patient presenting with hypertrophied extremities and he linked between this presentation and acromegaly.

### Landmark Events in the Development of Treatment Strategies

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* In the 1970s, bromocriptine, a dopamine agonist, was used by Dr. G. Michael Besser to treat acromegaly. Dr. Besser used bromocriptine on some patients and it showed a remarkable improvement in most of the patients. A reduction in the growth hormone was also observed.[3]
* In 1973, Dr. Roger Guillemin and Paul Brazeau discovered somatostatin which is a polypeptide inhibitor of the growth hormone.[4]
* In 1978, somatostatin analogs were developed by Dr. Wylie W. Vale. These somatostatin analogs provide the same inhibitory function and potency of somatostatin against acromegaly.[5]
* In 1982, another somatostatin analog called octreotide was developed by Dr. Wilfried Bauer and his team. Octreotide had a greater potency in inhibiting the growth hormone and it can resist degradation by the enzymes.[6]
* In 1988, FDA approved for the octreotide as a treatment to acromegaly.
* In 2001, growth hormone receptor antagonists drug, pegvisomant, was developed by Dr. John Kopchick. It has been successful in the treatment of acromegaly since 2001. Pegvisomant can be used with additional medications in the treatment of acromegaly.[7][8]

## References

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1. ↑ de Herder WW (2016). "The History of Acromegaly". Neuroendocrinology. 103 (1): 7–17. doi:10.1159/000371808. PMID 25572320.
2. ↑ Pearce JM (2006). "Nicolas Saucerotte: Acromegaly before Pierre Marie". J Hist Neurosci. 15 (3): 269–75. doi:10.1080/09647040500471764. PMID 16887764.
3. ↑ Besser GM, Wass JA, Thorner MO (1978). "Acromegaly--results of long term treatment with bromocriptine". Acta Endocrinol Suppl (Copenh). 216: 187–98. PMID 347861.CS1 maint: Multiple names: authors list (link)
4. ↑ Brazeau P, Vale W, Burgus R, Ling N, Butcher M, Rivier J; et al. (1973). "Hypothalamic polypeptide that inhibits the secretion of immunoreactive pituitary growth hormone". Science. 179 (4068): 77–9. PMID 4682131.CS1 maint: Explicit use of et al. (link) CS1 maint: Multiple names: authors list (link)
5. ↑ Vale W, Rivier J, Ling N, Brown M (1978). "Biologic and immunologic activities and applications of somatostatin analogs". Metabolism. 27 (9 Suppl 1): 1391–401. PMID 210361.CS1 maint: Multiple names: authors list (link)
6. ↑ Bauer W, Briner U, Doepfner W, Haller R, Huguenin R, Marbach P; et al. (1982). "SMS 201-995: a very potent and selective octapeptide analogue of somatostatin with prolonged action". Life Sci. 31 (11): 1133–40. PMID 6128648.CS1 maint: Explicit use of et al. (link) CS1 maint: Multiple names: authors list (link)
7. ↑ Kopchick JJ, Okada S (2001). "Growth hormone receptor antagonists: discovery and potential uses". Growth Horm IGF Res. 11 Suppl A: S103–9. PMID 11527080.
8. ↑ Trainer PJ, Drake WM, Katznelson L, Freda PU, Herman-Bonert V, van der Lely AJ; et al. (2000). "Treatment of acromegaly with the growth hormone-receptor antagonist pegvisomant". N Engl J Med. 342 (16): 1171–7. doi:10.1056/NEJM200004203421604. PMID 10770982.CS1 maint: Explicit use of et al. (link) CS1 maint: Multiple names: authors list (link)

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