Tumor expression of dopamine receptor and prolactin is associated with acute dopamine agonist response in acromegaly
7 affiliations
- 1Section of Specialized Endocrinology, Oslo University Hospital
- 2University of Oslo, Faculty of Medicine
- 3Research Institute of Internal Medicine, Oslo University Hospital
- 4Department of Immunology, Genetics and Pathology, Uppsala University
- 5Department of Clinical Pathology, Uppsala University Hospital
- 6Department of Medicine, Haukeland University Hospital
- 7Department of Endocrinology, Akershus University Hospital
Abstract
Objectives: In acromegaly, primary treatment is usually pituitary surgery. Remission rates are approximately 50% with pituitary tumor size and invasiveness playing important roles. Medical therapy is the secondary treatment for many patients. Yet, dopamine agonist responsiveness is variable, and reliable prognostic markers are lacking. We aimed to identify markers of dopamine agonist responsiveness. We hypothesized that (i) dopamine agonist response correlates with high dopamine receptor D2 expression and prolactin expression and secretion and (ii) estrogen receptor α expression is associated with tumor properties.
Design: Single-center retrospective cohort analysis with treatment-naive patients who had undergone a bromocriptine test as a marker for dopamine agonist response.
Methods: Sixty-nine patients with newly diagnosed acromegaly between 2008 and 2017 were included. During this period, the bromocriptine test was performed routinely at our center. Baseline hormone concentrations and MR images were evaluated retrospectively. Immunohistochemical staining of hormones and receptors and gene expression of dopamine receptor D2 in tumor tissue were performed and assessed.
Results: Dopamine agonist test response and high dopamine receptor D2 gene expression were correlated ( r = 0.53; p ≤ 0.001), and both were associated with higher serum prolactin concentration and tumor prolactin expression, assessed by immunohistochemistry. Prolactin and estrogen receptor α expression were correlated, and strong expression was associated with smaller and less invasive tumors.
Conclusions: Dopamine receptor D2 and prolactin expression are markers for dopamine agonist test response, providing valuable insights for personalized management and optimization of medical therapy in patients with acromegaly. Although prolactin and estrogen receptor α expression may be associated with tumor growth, the clinical applicability remains unclear.
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BibTeX
@article{atai2026tumor,
title = {{Tumor expression of dopamine receptor and prolactin is associated with acute dopamine agonist response in acromegaly}},
author = {Shahriar Atai and Merisa Abusdal and Maren Ileby Wessel and Olivera Casar-Borota and Kristin Astrid Øystese and Jacob Winther and Jens Bollerslev and Ansgar Heck},
journal = {Frontiers in Endocrinology},
year = {2026},
month = oct,
doi = {10.3389/fendo.2026.1930467},
url = {https://www.frontiersin.org/articles/10.3389/fendo.2026.1930467/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Tumor expression of dopamine receptor and prolactin is associated with acute dopamine agonist response in acromegaly
AU - Shahriar Atai
AU - Merisa Abusdal
AU - Maren Ileby Wessel
AU - Olivera Casar-Borota
AU - Kristin Astrid Øystese
AU - Jacob Winther
AU - Jens Bollerslev
AU - Ansgar Heck
PY - 2026
DA - 2026/10/19
JO - Frontiers in Endocrinology
DO - 10.3389/fendo.2026.1930467
UR - https://www.frontiersin.org/articles/10.3389/fendo.2026.1930467/full
AB - Objectives: In acromegaly, primary treatment is usually pituitary surgery. Remission rates are approximately 50% with pituitary tumor size and invasiveness playing important roles. Medical therapy is the secondary treatment for many patients. Yet, dopamine agonist responsiveness is variable, and reliable prognostic markers are lacking. We aimed to identify markers of dopamine agonist responsiveness. We hypothesized that (i) dopamine agonist response correlates with high dopamine receptor D2 expression and prolactin expression and secretion and (ii) estrogen receptor α expression is associated with tumor properties. Design: Single-center retrospective cohort analysis with treatment-naive patients who had undergone a bromocriptine test as a marker for dopamine agonist response. Methods: Sixty-nine patients with newly diagnosed acromegaly between 2008 and 2017 were included. During this period, the bromocriptine test was performed routinely at our center. Baseline hormone concentrations and MR images were evaluated retrospectively. Immunohistochemical staining of hormones and receptors and gene expression of dopamine receptor D2 in tumor tissue were performed and assessed. Results: Dopamine agonist test response and high dopamine receptor D2 gene expression were correlated ( r = 0.53; p ≤ 0.001), and both were associated with higher serum prolactin concentration and tumor prolactin expression, assessed by immunohistochemistry. Prolactin and estrogen receptor α expression were correlated, and strong expression was associated with smaller and less invasive tumors. Conclusions: Dopamine receptor D2 and prolactin expression are markers for dopamine agonist test response, providing valuable insights for personalized management and optimization of medical therapy in patients with acromegaly. Although prolactin and estrogen receptor α expression may be associated with tumor growth, the clinical applicability remains unclear.
SN - 1664-2392
ER -