hrp0089p1-p001 | Adrenals and HPA Axis P1 | ESPE2018

Evaluation of Long Term Metabolic Effects After Prenatal Dexamethasone Treatment in the Context of CAH – the Swedish Cohort

Wallensteen Lena , Karlsson Leif , Messina Valeria , Nordenstrom Anna , Lajic Svetlana

Background: Prenatal dexamethasone (DEX) treatment is in many countries offered to the pregnant woman, at risk of having a child with classic congenital adrenal hyperplasia (CAH), to reduce virilization in an affected female fetus. The treatment is effective in reducing virilization but may give long lasting effects on somatic and cognitive health. Here, we explore the potential effect on metabolism in children and adults not having CAH and exposed to DEX during the first trim...

hrp0089p1-p003 | Adrenals and HPA Axis P1 | ESPE2018

Cognition in Children with Congenital Adrenal Hyperplasia

Messina Valeria , Karlsson Leif , Hirvikoski Tatja , Nordenstrom Anna , Lajic Svetlana

Background: Congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency is one of the most common autosomal recessive disorders, affecting around 1/10 000 newborns worldwide. Postnatally, patients with classic CAH are treated with life-long glucocorticoid (GC) replacement therapy, such as hydrocortisone or prednisolone, and in the more severe cases also with mineralocorticoids. A negative impact of GCs on human cognition such as memory deficits have been reported bot...

hrp0086p1-p37 | Adrenal P1 | ESPE2016

DNA Methylation Signatures Associated with Prenatal Dexamethasone Treatment

Karlsson Leif , Barbaro Michela , Gomez-Cabrero David , Lajic Svetlana

Background: Prenatal treatment with dexamethasone (DEX) has been used since the mid 80’s to minimize virilisation of girls with congenital adrenal hyperplasia. Long-term data on treatment safety and health outcome are still limited. It has been shown in animal models that prenatal dexamethasone treatment affects DNA methylation signatures as well as metabolism and behavior. We have previously shown that DEX affects working memory in children who were treated with DEX duri...

hrp0089fc1.2 | Adrenals & HPA Axis | ESPE2018

Long-term Effects of Prenatal Dexamethasone Treatment and Postnatal Glucocorticoid Treatment on Brain Structure in the Context of CAH

Westeinde Annelies van't , Karlsson Leif , Sandberg Malin , Nordenstrom Anna , Paddila Nelly , Lajic Svetlana

Objective: Congenital Adrenal Hyperplasia (CAH) requires life-long replacement of cortisol. Female fetuses with classical CAH are virilized, which can be prevented by prenatal dexamethasone (DEX) treatment from gestational week 7. However, 7 out of 8 fetuses are treated unnecessarily during fetal life and are thus exposed to high prenatal glucocorticoid (GC) levels. Both prenatal exposures to high GC levels, as well as long term postnatal GC-treatment in patients with CAH are ...

hrp0089p1-p006 | Adrenals and HPA Axis P1 | ESPE2018

Altered DNA Methylation in Peripheral T-cells from Patients with Congenital Adrenal Hyperplasia

Karlsson Leif , Barbaro Michela , Ewing Ewoud , Gomez-Cabrero David , Lajic Svetlana

Background: Patients with Congenital Adrenal Hyperplasia (CAH) are at risk of several co-morbidities, such as impaired cognitive functions, short stature and adverse effects on metabolism. The causes of these effects are suboptimal glucocorticoid replacement therapy, adrenal crises and prenatal glucocorticoid exposure. However, there are no data available to this day how these factors are affecting epigenomic programs.Objective and hypot...

hrp0086p1-p18 | Adrenal P1 | ESPE2016

Adult Individuals with Classic Congenital Adrenal Hyperplasia Exhibit Deficits in Executive Functions

Karlsson Leif , Zimmermann Marius , Wallensteen Lena , Barbaro Michela , Nordenstrom Anna , Hirvikoski Tatja , Lajic Svetlana

Background: Individuals with classic congenital adrenal hyperplasia (CAH) are treated postnatally with glucocorticoids. Earlier research with animals and other disorders with excess GC exposure implicate that GCs can influence memory. Deficits in working memory can be seen already during childhood in children with classic CAH.Objective: We tested the hypothesis that adult individuals with classic CAH show impaired cognitive functions.<p class="abstex...

hrp0094p1-7 | Adrenal A | ESPE2021

Brain activity during working memory in congenital adrenal hyperplasia

van’t Westeinde Annelies , Zimmermann Marius , Messina Valeria , Karlsson Leif , Padilla Nelly , Lajic Svetlana ,

Objective: Congenital Adrenal Hyperplasia (CAH) requires life-long replacement of cortisol. However, this long-term GC-treatment could change the developmental trajectory of the brain and predispose patients to problems with cognition and mood regulation. Previously, we have found impairments in working memory in patients with CAH, as well as alterations in brain structure in regions of the central executive network (CEN). These changes could be associated wit...