Division of Auxology, Istituto Auxologico Italiano, IRCCS, Piancavallo, Verbania, Italy.
Autoimmune Endocrine Diseases Unit, Bambino Gesù Children's Hospital, Research Institute, Rome, Italy.
Endocrine. 2018 Dec;62(3):733-736. doi: 10.1007/s12020-018-1666-5. Epub 2018 Jul 2.
The role of antipituitary antibodies in the pathophysiology of pituitary hormone deficiency has been increasingly elucidated over the last decade. Prader-Willi syndrome is a genetic disorder which includes hypothalamic/pituitary dysfunction as one of its main features. We looked for autoimmune pituitary involvement in 55 adults with Prader-Willi syndrome, discovering that about 30% of them have a positive titer of antipituitary antibodies. Although the presence of these autoantibodies could only be an "epiphenomenon", our results suggest that autoimmune mechanisms might contribute, at least in part, to the pituitary impairment of Prader-Willi syndrome, and in addition to genetically determined dysfunction of the central nervous system. This paper provides a new perspective on pituitary impairment in these patients, suggesting that the search for hypophisitis could be a reasonable and interesting field for further research.
在过去的十年中,抗垂体抗体在垂体激素缺乏症的病理生理学中的作用逐渐得到阐明。普拉德-威利综合征是一种遗传性疾病,其主要特征之一是下丘脑/垂体功能障碍。我们在 55 名普拉德-威利综合征成年患者中寻找自身免疫性垂体受累,发现约 30%的患者存在抗垂体抗体的阳性滴度。尽管这些自身抗体的存在可能只是一种“伴随现象”,但我们的研究结果表明,自身免疫机制可能至少部分地导致了普拉德-威利综合征的垂体损伤,而不仅仅是中枢神经系统的遗传功能障碍。本文为这些患者的垂体损伤提供了一个新的视角,提示寻找垂体炎可能是进一步研究的一个合理且有趣的领域。