Failure of antibody response to polysaccharide antigen in treated panhypopituitary adults

• Published in: Clinical and experimental immunology 2009-05, Vol.156 (2), p.271-277
• Main Authors: Mukherjee, A, Helbert, M, Ryder, W.D.J, Borrow, R, Davis, J.R.E, Shalet, S.M
• Format: Article
• Language: English
• Subjects: Adult; Aged; Analytical, structural and metabolic biochemistry; Antibodies, Bacterial - blood; Antibody Formation; autoimmunity; Biological and medical sciences; Case-Control Studies; Endocrinopathies; Female; Fundamental and applied biological sciences. Psychology; Human Growth Hormone - therapeutic use; Humans; hypopituitarism; Hypopituitarism - blood; Hypopituitarism - drug therapy; Hypopituitarism - immunology; Hypothalamus. Hypophysis. Epiphysis (diseases); immune function; Immunoglobulin G - blood; Insulin-Like Growth Factor I - analysis; Logistic Models; Male; Medical sciences; Middle Aged; Non tumoral diseases. Target tissue resistance. Benign neoplasms; Pneumococcal Vaccines - administration & dosage; Pneumococcal Vaccines - immunology; Prolactin - blood; prolactin deficiency; Streptococcus pneumoniae; T-Lymphocyte Subsets - immunology; Tetanus Toxoid - immunology; Translational Studies; Vaccination
• ISSN: 0009-9104; 1365-2249
• DOI: 10.1111/j.1365-2249.2009.03881.x

Although pituitary hormones are known to affect immune function, treated hypopituitarism is not a recognized cause of immune deficiency in humans. We set out to assess integrity of baseline and stimulated immune function in severely hypopituitary adults. Twenty-one panhypopituitary adults (group 1), on stable pituitary replacement including growth hormone, and 12 healthy volunteers (group 2) were studied. Lymphocyte subsets, pneumococcal antibody levels pre- and 1 month after polysaccharide vaccination, T cell numbers and in-vitro interferon (IFN)-γ response were studied. There were no significant differences in T cell numbers or IFN-γ secretion. B cell numbers were lower in group 1, especially those with low prolactin levels. Independent of this finding, nine of 21 patients in this group had low antibody response to polysaccharide antigen. This was most striking in those with low insulin-like growth factor 1 levels and appeared to be independent of the use of anti-convulsants or corticosteroid replacement. Significant humoral immune deficiency is seen in panhypopituitarism and may contribute to morbidity.