Paraneoplastic autoimmune hypophysitis: An emerging concept.

Abstract

Pituitary autoimmunity is one of the principal causes of hypopituitarism. Additionally, hypophysitis is one of the immune-related adverse events associated with immunotherapy. Recent case-oriented research has revealed a novel type of autoimmune hypophysitis, anti-PIT-1 hypophysitis, related to isolated adrenocorticotropic hormone (ACTH) deficiency and immune checkpoint inhibitor-related hypophysitis, as a form of paraneoplastic syndrome. Under these conditions, the ectopic expression of pituitary antigens present in tumors evokes a breakdown of immune tolerance, resulting in the production of autoantibodies and autoreactive cytotoxic T cells that specifically harm pituitary cells. Consequently, an innovative clinical entity of paraneoplastic autoimmune hypophysitis has been purported. This novel concept and its underlying mechanisms provide clues for understanding the pathogenesis of autoimmune pituitary diseases and can be applied to other autoimmune diseases. This review discusses the etiology of paraneoplastic autoimmune hypophysitis and its future.

• Authors: Hironori Bando, Keitaro Kanie, Yutaka Takahashi
• Journal: Best practice & research. Clinical endocrinology & metabolism (Best Pract Res Clin Endocrinol Metab) Vol. 36 Issue 3 Pg. 101601 (05 2022) ISSN: 1878-1594 [Electronic] Netherlands
• PMID: 34876362 (Publication Type: Journal Article, Review, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2021 Elsevier Ltd. All rights reserved.

Chemical References

• Autoantibodies
• Adrenocorticotropic Hormone

Topics

• Adrenocorticotropic Hormone (deficiency)
• Autoantibodies
• Autoimmune Diseases
• Autoimmune Hypophysitis
• Endocrine System Diseases
• Genetic Diseases, Inborn
• Humans
• Hypoglycemia
• Hypophysitis (etiology)
• Pituitary Diseases (etiology)