Detection of antipituitary and antihypothalamus antibodies to investigate the role of pituitary or hypothalamic autoimmunity in patients with selective idiopathic hypopituitarism

Annamaria De Bellis, Elena Pane, Giuseppe Bellastella, Antonio A. Sinisi, Caterina Colella, Roberta Giordano, Claudia Giavoli, Andrea Lania, Maria R. Ambrosio, Carolina Di Somma, Maria C. Zatelli, Emanuela Arvat, Annamaria Colao, Antonio Bizzarro, Antonio Bellastella, P. Beck-Peccoz, C. Betterle, S. Cannavò, E. Degli Uberti, E. GhigoG. Lombardi, M. Maghnie, F. Mantero, A. Spada, A. Falorni, M. Delvecchio, L. De Marinis, E. Martino, M. Rotondi, L. Chiovato

Research output: Contribution to journalArticle

Abstract

Objective Antipituitary (APA) but not antihypothalamus antibodies (AHA) have been investigated in patients with idiopathic hypopituitarism. This 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 Antipituitary 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 Antipituitary were present at high titre in 4 of 27 patients with ACTH deficiency (14·8%), 4 of 20 with GH deficiency (26%) and 5 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 corticotrophin-releasing hormone-secreting cells; none of these 5 patients resulted positive for antipituitary antibodies. Among the controls, only 1 hypophysectomized 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-secreting or corticotrophin-releasing hormone-secreting cells may differentiate, respectively secondary from tertiary variants of autoimmune hypoadrenalism.

Original languageEnglish
Pages (from-to)361-366
Number of pages6
JournalClinical Endocrinology
Volume75
Issue number3
DOIs
Publication statusPublished - Sep 2011

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

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    De Bellis, A., Pane, E., Bellastella, G., Sinisi, A. A., Colella, C., Giordano, R., Giavoli, C., Lania, A., Ambrosio, M. R., Di Somma, C., Zatelli, M. C., Arvat, E., Colao, A., Bizzarro, A., Bellastella, A., Beck-Peccoz, P., Betterle, C., Cannavò, S., Degli Uberti, E., ... Chiovato, L. (2011). Detection of antipituitary and antihypothalamus antibodies to investigate the role of pituitary or hypothalamic autoimmunity in patients with selective idiopathic hypopituitarism. Clinical Endocrinology, 75(3), 361-366. https://doi.org/10.1111/j.1365-2265.2011.04056.x