Analysis of the pathophysiology of autoimmune endocrine disease

2018 Fiscal Year Final Research Report

• Project/Area Number: 17K16165
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Endocrinology
• Research Institution: Kobe University
• Principal Investigator: Bando Hironori 神戸大学, 医学研究科, 医学研究員 (80790708)
• Project Period (FY): 2017-04-01 – 2019-03-31
• Keywords: 自己免疫性下垂体炎 / 抗PIT-1抗体症候群 / ACTH単独欠損症 / IgG4関連下垂体炎 / 自己免疫性膵炎

Outline of Final Research Achievements

This study focuses on elucidation and clinical application of the onset mechanism of autoimmune hypopituitarism and aims at establishing a research base of clinical application to diagnosis and treatment from analysis of new autoimmune induced endocrine diseases cases.We analyzed the cases that caused hypopituitarism due to the tumor, and proposed a new cause of hypopituitarism "paraneoplastic syndrome". Also, PIT-1 positive cells were analyzed for syndrome (anti-PIT-1 antibody syndrome) having autoantibodies against the transcription factor "PIT-1" that specifically exist in the pituitary, and PIT-1 antigen was detected on the cell surface with MHC class I. We also conducted clinical studies on the frequency of hypophysitis in autoimmune pancreatitis, which is a representative of IgG4-related diseases.

Free Research Field

内分泌学

Academic Significance and Societal Importance of the Research Achievements

下垂体前葉機能低下症ならびに後葉が障害される下垂体性ADH分泌異常症はいずれも厚生労働省の難病に指定されており、これらの病態・病因の解明ならび診断・治療方法の確立は社会的なニーズも高い領域である。
今回の研究結果は新たな病態・病因の提唱に繋がる内容で有るものと考える。今後の下垂体機能低下症症例における診断時に潜在的な腫瘍の存在を疑う必要があることが明らかになった。加えて、近年報告が増加しているIgG4関連疾患症例内に下垂体機能低下症が潜在的に存在することを示唆する結果はIgG4関連疾患症例診療中に下垂体機能への配慮が必要なことを示すことに繋がった。