Research Interests
Although typically benign, tumours of the pituitary and adrenal glands are often associated with significantly increased morbidity and mortality – reflecting the primary disorder (e.g. cardiometabolic dysfunction in acromegaly and Cushing’s; hypertension in primary aldosteronism), or its treatment (e.g. hypopituitarism after pituitary surgery or radiotherapy). Our research is focussed on optimising the diagnosis and treatment of these conditions, to allow more patients to access specific, and potentially definitive interventions in a timely manner. For example, we have developed, and introduced into clinical practice, novel PET imaging techniques, which are transforming the care of a subgroup of patients with pituitary and adrenal tumours – individuals previously deemed unsuitable for surgery, and consigned to a lifetime of expensive/poorly tolerated medical treatment, are, in many instances, undergoing curative surgery. In parallel studies, we perform detailed phenotyping of patients with (i) acromegaly, (ii) TSH-secreting pituitary adenomas and (iii) primary aldosteronism.
Together with Professor Chatterjee and Drs Moran, Oddy and Halsall, we also provide a UK national thyroid function test referral service, offering specialised clinical, biochemical, molecular and radiological phenotyping.
In cross-disciplinary work (with Judge Business School), we are studying the endocrine and neural basis of financial decision-making. We have shown that human physiology is a powerful influence on the behaviour of those working on the world’s trading floors.
Selected Publications
Ouyang J, Hardy R, Brown M, Helliwell T, Gurnell M, Cuthbertson DJ. 11C-metomidate PET-CT scanning can identify aldosterone-producing adenomas after unsuccessful lateralization with CT/MRI and adrenal venous sampling. Journal of Human Hypertension, 2017 Mar 9. Epub ahead of print. PMID: 28276424.
Coates J & Gurnell M. Combining field work and laboratory work in the study of financial risk-taking. Hormones and Behavior, 2017 Feb 4. Epub ahead of print. PMID:28174099.
Mendichovszky IA, Powlson AS, Manavaki R, Aigbirhio FI, Cheow H, Buscombe JR, Gurnell M*, Gilbert FJ. Targeted molecular imaging in adrenal disease – an emerging role for metomidate PET-CT. Diagnostics, 2016 Nov 18:6(4). pii: E42. PMID: 27869719. PMCID:PMC5192517.
Koulouri O, Hoole AC, English P, Allinson K, Antoun N, Cheow HK, Burnet NG, Donnelly N, Mannion RJ, Gurnell M. Localisation of an occult thyrotropinoma with 11C-Methionine PET-CT before and after somatostatin analogue therapy. Lancet Diabetes Endocrinol, 2016, 4(12):1050. PMID: 27777050.PMID: 7777050.
Dennedy MC, Annamalai AK, Prankerd Smith O, Freeman N, Vengopal K, Graggaber J, Koulouri O, Powlson AS, Shaw A, Halsall DJ, Gurnell M. Low DHEAS: a sensitive and specific test for detection of subclinical hypercortisolism in adrenal incidentalomas. J Clin Endocrinol Metab, 2016 Oct 31 (Epub ahead of print]. PMID: 27797672.
Taku N, Gurnell M, Burnet N, Jena R. Time Dependence of Radiation-induced Hypothalamic-Pituitary Axis Dysfunction in Adults Treated for Non-pituitary, Intracranial Neoplasms. Clin Oncol (R Coll Radiol), 2017, 29(1):34-41. PMID: 27697410.
Challis BG, Casey RT, Simpson HL, Gurnell M. Is there an optimal preoperative management strategy for phaeochromocytoma/paragangliomas? Clin Endocrinol, 2017, 86(2):163-67. PMID: 27696513.
Kandasamy N, Garfinkel SN, Page L, Hardy B, Critchley H, Gurnell M*, Coates JM. Interoceptive ability predicts survival on a London trading floor. Scientific Reports, 2016 Sep 19;6:32986. doi: 10.1038/srep32986. . PMID: 27641692. PMCID:PMC5027524.
Koulouri O, Kandasamy N, Hoole AC, Gillett D, Heard S, Powlson AS, O’Donovan DG, Annamalai AK, Simpson H, Akker SA, Aylwin S, Brooke A, Buch H, Levy M, Martin NM, Morris D, Parkinson C, Tysome JR, Santarius T, Donnelly NA, Buscombe J, Boros I, Smith R, Aigbirhio F, Antoun NM, Burnet NG, Cheow H, Mannion RJ, Pickard JD, Gurnell M. Successful treatment of residual pituitary adenoma in persistent acromegaly following localisation by 11C-methionine PET-CT co-registered with MRI. Eur J Endocrinol, 2016, 175(5):485-498. PMID: 27562400.
Thomas JD, Dattani A, Zemrak F, Burchell T, Akker SA, Gurnell M, Grossman AB, Davies LC, Korbonits M. Characterisation of myocardial structure and function in adult-onset growth hormone deficiency using cardiac magnetic resonance. Endocrine, 2016 Aug 17 (Epub ahead of print). PMID: 27535681.
Robba C, Bacigaluppi S, Bragazzi N, Lavinio A, Gurnell M, Bilotta F, Menon DK. Clinical prevalence and outcome impact of pituitary dysfunction after aneurysmal subarachnoid hemorrhage: a systematic review with meta-analysis. Pituitary, 2016, 19(5):522-35. PMID: 27287036.
Challis BC, Kandasamy N, Powlson AS, Koulouri O, Annamalai AK, Happerfield L, Marker A, Arends M, Nik-Zainal S, Gurnell M. Familial adrenocortical carcinoma in association with Lynch syndrome. J Clin Endocrinol Metab, 2016, 101(6):2269-72. PMID: 27144940. PMCID:PMC4891804.
Koulouri O, Nicholas AK, Schoenmakers E, Mokrosinski J, Lane F, Cole T, Kirk J, Farooqi IS, Chatterjee VK, Gurnell M, Schoenmakers N. A novel thyrotropin-releasing hormone receptor missense mutation (P81R) in central congenital hypothyroidism. J Clin Endocrinol Metab, 2016, 101(3):847-51. PMID: 26735259. PMCID:PMC4803180.
Powlson AS, Challis BG, Halsall DJ, Schoenmakers E, Gurnell M. Nephrogenic syndrome of inappropriate antidiuresis secondary to an activating mutation in the arginine vasopressin receptor AVPR2. Clin Endocrinol, 2016, 85(2):306-12 PMID: 26715131.
Annamalai AK, Sampathkumar K, Kane S, Shetty NS, Kulkarni S, Rangarajan V, Purandare N, Pai PS, Mahuvakar AD, Shanthi R, Suriyakumar G, Puri V, Subramaniam A, Gopalakrishnan C, Chelian M, Srinivasan KG, Gill AJ, Gurnell M*, Clifton-Bligh R. Needle(s) in the haystack – synchronous multifocal tumor induced osteomalacia. J Clin Endocrinol Metab, 2016, 101(2):390-93. PMID: 26691889.
Powlson AS & Gurnell M. Cardiovascular disease and sleep disordered breathing in acromegaly. Neuroendocrinology, 2016, 103(1):75-85. PMID: 26227953.
Teo AED, Garg S, Shaikh LH, Zhou J, Karet Frankl FE, Gurnell M, Happerfield L, Marker A, Bienz M, Azizan EAB, Brown MJ. Pregnancy, primary aldosteronism and somatic CTNNB1 mutations in the adrenal. N Engl J Med, 2015, 373(15):1429-36. PMID: 26397949. PMCID:PMC4612399.
Koulouri O, Steuwe A, Gillett D, Hoole AC, Powlson AS, Burnet NG, Cheow H, Mannion RJ, Pickard JD, Gurnell M. A role for 11C-methionine PET imaging in ACTH-dependent Cushing’s syndrome. Eur J Endocrinol, 2015, 173(4):M107-20. PMID: 26245763.
Powlson AS, Gurnell M*, Brown MJ. Nuclear imaging in the diagnosis of primary aldosteronism. Curr Opin Endocrinol Diabetes Obes, 2015, 22(3):150-6. PMID: 25871964. PMCID:PMC4405075.
Moran C, Agostini M, Visser WE, Schoenmakers E, Schoenmakers N, Offiah AC, Poole K, Rajanyagam O, Lyons G, Halsall D, Gurnell M, Chrysis D, Efthymiadou A, Buchanan C, Aylwin S & Chatterjee KK. Resistance to thyroid hormone caused by a mutation in thyroid hormone receptor (TR)1 and TR2: clinical, biochemical and genetic analyses of three related patients. Lancet Diabetes Endocrinol, 2014, 2(8):619-26. PMID: 24969835.
Schoenmakers N, Moran C, Campi I, Agostini M, Bacon O, Rajanayagan O, Schwabe J, Bradbury S, Barrett T, Geoghegan F, Druce M, Beck-Peccoz P, O’Toole A, Clark P, Bignell M, Lyons G, Halsall D, Gurnell M & Chatterjee VK. A novel albumin gene mutation (R222I) in familial dysalbuminaemic hyperthyroxinaemia. J Clin Endocrinol Metab, 2014, 99(7):E1381-6. PMID: 24646103 .PMCID:PMC4191552.
Kandasamy N, Hardy B, Page L, Schaffner M, Graggaber J, Powlson AS, Fletcher PC, Gurnell M*, Coates J. Cortisol shifts financial risk preferences. Proc Natl Acad Sci USA 2014, 111(9):3608-13. PMID: 24550472. PMCID:PMC3948282.
Koulouri O, Moran C, Halsall DJ, Chatterjee VK, Gurnell M. Pitfalls in the measurement and interpretation of thyroid function tests. Best Pract Res Clin Endocrinol Metab, 2013, 27(6):745-62. PMID: 24275187. PMCID:PMC3857600.
Moran C, Schoenmakers N, Agostini M, Schoenmakers E, Offiah A, Kydd A, Kahaly G, Mohr-Kahaly S, Rajanayagam O, Lyons G, Wareham N, Halsall D, Dattani M, Hughes S, Gurnell M, Park S, Chatterjee VK. An adult female with Resistance to Thyroid Hormone mediated by defective thyroid hormone receptor alpha. J Clin Endocrinol Metab, 2013, 98(11):4254-61. PMID: 23940126.
Annamalai AK, Webb A, Kandasamy N, Elkhawad M, Moir S, Khan F, Maki-Petaja K, Gayton EL, Strey CH, O’Toole S, Ariyaratnam S, Halsall DJ, Chaudhry AN, Berman L, Scoffings DJ, Antoun NM, Dutka DP, Wilkinson IB, Shneerson JM, Pickard JD, Simpson HL, Gurnell M. A Comprehensive Study of Clinical, Biochemical, Radiological, Vascular, Cardiac, and Sleep Parameters in an Unselected Cohort of Patients With Acromegaly Undergoing Presurgical Somatostatin Receptor Ligand Therapy. J Clin Endocrinol Metab, 2013, 98(3):1040-1050. PMID: 23393175.
Kay R, Halsall D, Annamalai A, Kandasamy N, Taylor K, Fenwick S, Webb A, Wark G, Pleasance S, Gurnell M. A novel mass spectrometry based method for determining insulin-like growth factor 1: assessment in a cohort of subjects with newly diagnosed acromegaly. Clin Endocrinol, 2013, 78(3):424-30. PMID: 23121616.
Bochukova E, Schoenmakers N, Agostini M, Schoenmakers E, Rajanayagam O, Keogh JM, Henning E, Reinemund J, Gevers E, Sarri M, Downes K, Offiah A, Albanese A, Halsall D, Schwabe JW, Bain M, Lindley K, Muntoni F, Khadem FV, Dattani M, Farooqi IS, Gurnell M, Chatterjee K 2012. A mutation in the thyroid hormone receptor alpha gene. N Engl J Med, 366(3); 243-9. PMID: 22168587.
Burton TJ, Mackenzie IS, Balan K, Koo B, Bird N, Soloviev DV, Azizan EA, Aigbirhio F, Gurnell M, Brown MJ 2012. Evaluation of the sensitivity and specificity of 11C-Metomidate Positron Emission Tomography (PET)-CT for lateralising aldosterone secretion by Conn’s adenomas. J Clin Endocrinol Metab, 97(1):100-9. PMID: 22112805.
* denotes joint senior author