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DETECTION OF ANTI-PITUITARY AND ANTI-HYPOTHALAMUS ANTIBODIES TO INVESTIGATE THE ROLE OF PITUITARY OR HYPOTHALAMIC AUTOIMMUNITY IN PATIENTS WITH SELECTIVE IDIOPATHIC HYPOPITUITARISM.
MedLine Citation:
PMID:  21521324     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objective:  Anti-pituitary (APA) but not anti-hypothalamus antibodies (AHA) have been investigated in patients with idiopathic hypopituitarism. The present study searched for APA and AHA in some of these patients to investigate whether pituitary or hypothalamic autoimmunity could play a role in their pituitary dysfunction. Design:  Sixty-six patients with selective idiopathic hypopituitarism were studied: 27 with ACTH deficiency, 20 with GH deficiency and 19 with hypogonadotropic hypogonadism. Twenty patients with hypopituitarism secondary to hypophysectomy and 50 healthy subjects were enrolled as controls. Measurements:  APA and AHA were evaluated by indirect immunofluorescence in sera of patients and controls. Positive sera were retested by a four-layer double immunofluorescence to identify the cells targeted by these antibodies. Results:  APA were present at high titre in 4 out of 27 patients with ACTH deficiency (14.8%), 3 of 20 with GH deficiency (15%) and 4 of 19 with hypogonadotropic hypogonadism (21%) and targeted respectively corticotrophs, somatotrophs and gonadotrophs. AHA were found at high titre only in 5 patients with ACTH deficiency (18,5%), mostly targeting corticotropin releasing hormone-secreting cells; none of these 5 patients resulted positive for anti-pituitary antibodies. Among the controls only 1 hypophisectomized patient resulted APA positive at low titre. Conclusions:  Our results suggest that in patients with selective idiopathic hypopituitarism, detection of APA or AHA could better characterize an autoimmune process involving the pituitary or hypothalamus, respectively. In particular, detection of antibodies targeting selectively ACTH- or corticotropin releasing hormone-secreting cells may differentiate respectively secondary from tertiary variants of autoimmune hypoadrenalism.
Authors:
Annamaria De Bellis; Elena Pane; Giuseppe Bellastella; Antonio Agostino Sinisi; Caterina Colella; Roberta Giordano; Claudia Giavoli; Andrea Lania; Maria Rosaria Ambrosio; Carolina Di Somma; Maria Chiara Zatelli; Emanuela Arvat; Annamaria Colao; Antonio Bizzarro; Antonio Bellastella;
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-28
Journal Detail:
Title:  Clinical endocrinology     Volume:  -     ISSN:  1365-2265     ISO Abbreviation:  -     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-4-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0346653     Medline TA:  Clin Endocrinol (Oxf)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Blackwell Publishing Ltd.
Affiliation:
Department of Clinical and Experimental Medicine and Surgery, F. Magrassi, A. Lanzara, Second University of Naples, Naples, Italy. Department of Biological and Clinical Sciences; Division of Endocrinology; University of Turin, Turin; Italy. Department of Medical Sciences, University of Milan and Endocrine Unit, Istituto Clinico Humanitas IRCCS, Rozzano, Milano, Italy. Section of Endocrinology, Department of Biomedical Sciences and Advanced Therapies, University of Ferrara, Ferrara, Italy Department of Molecular and Clinical Endocrinology and Oncology, Section of Endocrinology, University "Federico II" of Naples, Naples, Italy. Diabetology and Metabolism, Department of Internal Medicine, University of Turin, Turin; Italy.
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