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11:00
12:30
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Cushing’s Disease and Cushing’s Syndrome
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Masaaki YamamotoUnited States
Speaker
Beyond Cushing’s Syndrome: The Future of Research in Cortisol DysregulationThe hypothalamic–pituitary–adrenal (HPA) axis is one of the most essential systems for maintaining physiological homeostasis and plays a central role in the stress response. Autonomous or excessive cortisol secretion leads to Cushing’s syndrome, whereas insufficient cortisol secretion results in adrenal insufficiency. Despite their clinical importance, globally unified diagnostic criteria for disorders of cortisol excess or deficiency are still lacking, and definitive diagnosis often requires invasive procedures and a high level of clinical expertise.
From a therapeutic standpoint, precisely replicating physiological cortisol secretion remains a major challenge. Chronotherapy—an approach that incorporates diurnal cortisol rhythmicity into treatment—has gained increasing attention in recent years. However, physiological cortisol secretion fluctuates dynamically under the influence of numerous factors, making it inherently difficult to delineate the boundary between “normal” and “pathological” states. Moreover, commonly used cortisol assays have several pitfalls, underscoring the need for biomarkers that more accurately reflect glucocorticoid action in vivo.
Recent advances also include the development of non-invasive wearable devices capable of real-time monitoring of cortisol secretion. In this lecture, I will present emerging concepts, diagnostic approaches, and therapeutic innovations related to disorders of cortisol dysregulation, and discuss future directions in this evolving field.
201DE
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