Department of Endocrinology, Christie Hospital, Manchester, UK.
Clin Endocrinol (Oxf). 2010 Oct;73(4):425-31. doi: 10.1111/j.1365-2265.2009.03751.x.
Hypopituitarism is not currently considered as a potential cause of immune disruption in humans. Accumulating data from in vitro and animal models support a role for the pituitary gland in immune regulation. Furthermore, the increased mortality risk noted in patients with adult hypopituitarism remains poorly explained and immune dysfunction could conceivably contribute to this observation. In a recent issue of Clinical & Experimental Immunology, we presented new data relating to immune status in adults with treated, severe hypopituitarism. We observed humoral immune deficiency in a significant proportion, despite stable pituitary replacement, including growth hormone (GH). This was especially evident in those with low pretreatment IGF-I levels and appeared independent of anticonvulsant use or corticosteroid replacement. These observations require substantiation with future studies. In this short review, we summarize existing data relating to the effects of pituitary hormones on immune function and discuss potential clinical implications surrounding the hypothesis of immune dysregulation in severe hypopituitarism.
垂体功能减退症目前不被认为是人类免疫紊乱的潜在原因。来自体外和动物模型的累积数据支持垂体在免疫调节中的作用。此外，在成年垂体功能减退症患者中观察到的死亡率增加风险仍未得到很好的解释，免疫功能障碍可能可以解释这一观察结果。在最近一期的《临床与实验免疫学》中，我们提出了与接受治疗的严重垂体功能减退症成年人的免疫状况相关的新数据。尽管进行了稳定的垂体替代治疗，包括生长激素（GH），但我们观察到相当一部分人存在体液免疫缺陷。在那些预处理 IGF-I 水平较低的患者中，这种情况尤为明显，而且似乎与抗惊厥药物的使用或皮质类固醇替代无关。这些观察结果需要未来的研究来证实。在这篇简短的综述中，我们总结了现有的关于垂体激素对免疫功能影响的数据，并讨论了严重垂体功能减退症免疫失调假说所涉及的潜在临床意义。
