Pamela U. Freda
Dr. Freda's major research interests are clinical and translational investigations in patients with pituitary tumors. One series of studies focuses on patients with acromegaly, a rare disease characterized by excess GH and IGF-I and their multi-system adverse effects. For these studies she has established a very large cohort of newly diagnosed and postoperative patients with acromegaly. One series of studies examines a novel GH-IGF-I excess specific dysregulation of adipose tissue (AT) and lipodystrophy, which is hypothesized to contribute to insulin resistance, adipokine and appetite hormone dysregulation, endothelial cell dysfunction and ultimately increased CV risk in active acromegaly. The study examines muscle lipid by MRI and 1HMRS, hepatic lipid by 1HMRS, subcutaneous adipose tissue for macrophage infiltration and inflammation and the function of biopsied endothelial cells.
A second large study is a multi-disciplinary collaborative prospective study of clinically non-functioning pituitary adenomas (CNFA). This project prospectively studies two groups of such patients. A group of patients with asymptomatic pituitary lesions that do not require surgical intervention are followed in order to determine the appropriate initial evaluation and follow up as well as the safety of their conservative, non-surgical management. The outcome of patients with symptomatic CNFAs treated with surgery is also studied. The study examines the safety of conservative follow up for patients with small tumor remnants after surgery and determines in which of these patients radiotherapy is needed by examining the risks vs. benefits of post-operatively radiotherapy for residual/recurrent tumors. This project also studies for the first time, prospectively, the impact of the disease and our therapies on quality of life and neurocognitive function in patients with CNFAs and is establishing a novel bank of pituitary tumor specimens from our cohort that will be linked to the extensive clinical data collected in the prospective study.