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Abstract
This review summarized different studies reporting the presence of autoantibodies reacting against cells of the pituitary (APAs) and/or hypothalamus (AHAs). Both APAs and AHAs have been revealed through immunofluorescence using different kinds of substrates. Autoantibodies against gonadotropic cells were mainly found in patients affected by cryptorchidism and hypogonadotropic hypogonadism while those against prolactin cells were found in different kinds of patients, the majority without pituitary abnormalities. APAs to growth hormone (GH) cells have been associated with GH deficiency while those against the adrenocorticotropic cells have distinguished central Cushing’s disease patients at risk of incomplete cure after surgical adenoma removal. AHAs to vasopressin cells have identified patients at risk of developing diabetes insipidus. APAs have been also found together with AHAs in patients affected by idiopathic hypopituitarism, but both were also present in different kinds of patients without abnormalities of the hypothalamic–pituitary axis. Despite some data being promising, the clinical use of pituitary and hypothalamus autoantibodies is still limited by the low diagnostic sensitivity, irreproducibility of the results, and the absence of autoantigen/s able to discriminate the autoimmune reaction involving the pituitary or the hypothalamus from the other autoimmune states.
Highlights
ADH is released at the median eminence level, from which reaches the anterior pituitary where it stimulates adrenocorticotropic hormone (ACTH) cells, together with corticotrophin-releasing hormone (CRH) to produce ACTH [4]
The diabetes insipidus is a rare condition that leads to frequent urination and excessive thirst caused by problems at the pituitary gland and/or kidneys [11]
The aim of this review is to summarize the relevant studies reporting the auto-abs reacting to cells of the pituitary (APAs), hypothalamus (AHAs), or both, and reveal their possible relation with alterations of the hypothalamic–pituitary axis
Summary
Two endocrine organs that cooperate to control the endocrine system of the body constitute the hypothalamic–pituitary axis. ADH is released at the median eminence level, from which reaches the anterior pituitary where it stimulates ACTH cells, together with corticotrophin-releasing hormone (CRH) to produce ACTH [4]. The pars intermedia is located between the anterior and posterior lobes of the pituitary, and produces the melanocyte stimulating hormone (MSH) in human fetal life. In adulthood, it is usually very small or absent. The median eminence, a crucial area for the axis located on the infundibulum, represents a connection between the hypothalamus and the hypophysis and includes the internal and the external zone. The external zone instead contains numerous axons of the hypothalamic tuberoinfundibular system that releases various neurofactors. Axon terminals containing catecholamines (dopamine, noradrenaline, and adrenaline), modulate secretion of GH through GHRH [6]
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