Serum antibodies to human pituitary membrane antigens in patients with autoimmune lymphocytic hypophysitis and infundibuloneurohypophysitis

Nishiki, Masateru; Murakami, Yoshio; Ozawa, Yasunori; Kato, Yuzuru

doi:10.1046/j.1365-2265.2001.01210.x

Cited by 56 publications

(32 citation statements)

References 18 publications

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“…Numerous studies have sought to identify antipituitary antibodies that could be used as noninvasive serological markers. Recently, an immunoblotting method was reported to diagnose lymphocytic hypophysitis efficiently (10,18,19). The method is capable of detecting multiple autoantigens at once.…”

Section: Discussionmentioning

confidence: 99%

Detection of autoantibodies against the pituitary-specific proteins in patients with lymphocytic hypophysitis

Tanaka

Tatsumi

Kimura³

et al. 2002

European Journal of Endocrinology

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Objective: Several reports have described antipituitary antibodies by immunofluorescent or immunoblotting methods in patients with lymphocytic hypophysitis. However, with the exception of the pituitary hormones, individual antigens specific for the pituitary gland have not been studied. To understand the pathogenesis of lymphocytic hypophysitis and to diagnose this disease efficiently, we studied the presence of autoantibodies against three pituitary-specific proteins, GH and two novel pituitary-specific proteins, namely, pituitary gland specific factor 1a (PGSF1a) and PGSF2. Design: Seventeen patients with lymphocytic hypophysitis, all of whom had pituitary enlargement (5 with lymphocytic adenohypophysitis and 12 with lymphocytic infundibuloneurohypophysitis, including 3 of the latter group proven by biopsy), and 14 patients with hypopituitarism without pituitary enlargement (10 with isolated ACTH deficiency and 4 with idiopathic TSH deficiency) were studied, and compared with 11 patients with non-functioning pituitary macroadenoma, 31 patients with other autoimmune diseases, and 36 healthy controls. Methods: The presence of each antibody was studied by radioligand assay using recombinant human 35 S-labeled protein.Results: Three (18%) patients with lymphocytic hypophysitis having pituitary enlargement, five (36%) patients with hypopituitarism without pituitary enlargement and three (9.7%) patients with other autoimmune diseases were positive for one or more of the antibodies studied. Conclusions: Anti-human GH, anti-PGSF1a, and anti-PGSF2 antibodies were detected in patients with lymphocytic hypophysitis and other hypopituitarism, but were not detected in patients with non-functioning pituitary macroadenoma. Detection of these antibodies may be useful for the diagnosis of lymphocytic hypophysitis.

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Section: Discussionmentioning

confidence: 99%

Detection of autoantibodies against the pituitary-specific proteins in patients with lymphocytic hypophysitis

Tanaka

Tatsumi

Kimura³

et al. 2002

European Journal of Endocrinology

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“…Thus, concerning the clinical significance, probably some APAs can be harmless, whereas others can activate intracellular signaling and exert a biological function (87,103).…”

Section: Etiopathogenesismentioning

confidence: 99%

Lymphocytic hypophysitis: a rare or underestimated disease?

Bellastella

Bizzarro²,

Coronella³

et al. 2003

Eur J Endocrinol

198

205

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Lymphocytic hypophysitis (LYH) is an uncommon autoimmune disease in which the pituitary gland is infiltrated by lymphocytes, plasma cells and macrophages and its function is usually impaired. It has to be suspected in pregnant women and in women with recent delivery presenting with hyperprolactinemia, headache, visual field alterations and changes of one or more pituitary hormone secretions with secondary impairment of related peripheral target glands, especially when associated with other autoimmune endocrine or non-endocrine disorders. It can also occur less frequently in prepubertal or post-menopausal women and in men. Headache, visual field impairment and more rarely diplopia are due to extrasellar pituitary enlargement with optic chiasma compression and/or to invasion of cavernous sinuses. Among the 'isolated' pituitary hormone deficiencies, ACTH deficit is usually the earliest and most frequent hormonal impairment and in rare cases can induce an acute secondary hyposurrenalism as the first sign of the disease, with high mortality in affected patients. Histopathological findings from pituitary biopsy show lymphoplasmacytic infiltrate with lymphoid aggregates surrounding atropic acini of pituitary cells; immunohistochemical analysis shows numerous mast cells randomly distributed and also localized in the vicinity of capillaries, suggesting a possible influence on capillary permeability and angiogenesis, thus favoring the inflammatory and immunological aggression against pituitary cells. Nuclear magnetic resonance imaging shows uniform sellar floor depression and an extrasellar symmetrical pituitary enlargement, usually displacing the optic chiasma, which shows a rapid homogeneous enhancement after gadolinium also involving the adjacent dura (dural tail). Antipituitary antibodies have been detected in several patients with LYH but their role needs to be clarified. Since a possible spontaneous remission can occur, a careful follow-up is required in subclinical patients without important hyposurrenalism or symptomatic extrasellar expansion. Medical (immunosuppressive, replacement and antiprolactinemic) and neurosurgical (decompression) treatments are needed in clinical symptomatic patients.

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“…Autoantibodies against tissue-specific proteins have proven to be useful markers for autoimmune diseases. Although pituitary-specific autoantibodies for lymphocytic hypophysitis have been reported, the corresponding autoantigens have not been identified (Crock 1998, Nishiki et al 2001.…”

Section: Introductionmentioning

confidence: 99%

Expression profile of active genes in the human pituitary gland

Tanaka

Tatsumi

Okubo³

et al. 2002

Journal of Molecular Endocrinology

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To characterize transcripts abundantly expressed in the human pituitary gland in general as well as to isolate novel transcripts expressed specifically in this gland, we generated an expression profile of the active genes transcribed in it. A total of 1015 randomly collected 3′ expressed sequence tags (ESTs) (gene signatures, GSs) were grouped into 527 GS species. The results showed the relative expression levels of genes in the pituitary gland. The genes comprising more than 1% of total mRNA were prolactin, growth hormone and chromogranin B genes. When known genes were categorized, the genes for pituitary hormones were the most actively transcribed, followed by the genes for ribosomal proteins, nuclear proteins and secretory granule proteins. Through comparison of this gene expression profile with the BodyMap database containing profiles generated from 63 other human tissues, we obtained 11 genes which appeared to be specifically expressed in the pituitary gland. In addition to the eight known genes, we identified three novel pituitary-specific transcripts which encode putative proteins: pituitary gland specific factor 1a (PGSF1a), PGSF1b and PGSF2. This expression profile method is a novel approach to the isolation of pituitary-specific genes that may have important functions.

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Serum antibodies to human pituitary membrane antigens in patients with autoimmune lymphocytic hypophysitis and infundibuloneurohypophysitis

Abstract: These findings suggest that serum antibodies to 68, 49, 43 kD human anterior pituitary antigen are specific but not so frequently detected in autoimmune lymphocytic hypophysitis.

Cited by 56 publications

References 18 publications

Detection of autoantibodies against the pituitary-specific proteins in patients with lymphocytic hypophysitis

Detection of autoantibodies against the pituitary-specific proteins in patients with lymphocytic hypophysitis

Lymphocytic hypophysitis: a rare or underestimated disease?

Expression profile of active genes in the human pituitary gland

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