title: Median eminence dopaminergic nerve terminals: a novel target in autoimmune polyendocrine syndrome?
abstract: BACKGROUND
  Autoantibodies to adenohypophyseal endocrine cells or to vasopressin neurohypophyseal neurons have long been known. Conversely, autoimmune targeting of further hypothalamic-hypophyseal structures, such as the blood-brain barrier-deprived median eminence, has been little studied.
  
  
  OBJECTIVE
  We studied a case of autoimmune polyendocrine syndrome type I with GH secretory deficiency, a distinctly rare event in autoimmune polyendocrine syndrome type I. We used rat and bovine tissue substrates to study autoantibodies against hypothalamic-hypophyseal nerve structures and endocrine cells.
  
  
  RESULTS
  In the study case, circulating autoantibodies selectively decorated median eminence dopaminergic nerve terminals, as well as pituitary gonadotropes, but not GHRH nerve terminals or pituitary somatotropes. Such autoantibodies appeared de novo in parallel with the onset of GH secretory deficiency, whereas no median eminence labeling was found in patients suffering of idiopathic GH deficiency (n = 7) or in healthy controls (n = 23).
  
  
  CONCLUSIONS
  The pathophysiological significance of our patient's autoantibodies remains to be confirmed. Nonetheless, the heterogeneous neuroendocrine structures of the median eminence are pointed out as potential immune targets, relevant to autoimmune polyendocrinopathy, as well as to a wide range of other conditions.
authors.affiliation: NEF-Laboratory, Department of Cytomorphology, University of Calgari at Monseratto, 09042 Monserrato (Cagliari), Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Cocco
authors.forename: Antonella
authors.initials: A
authors.lastname: Meloni
authors.forename: Francesco
authors.initials: F
authors.lastname: Boi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pinna
authors.forename: Roberta
authors.initials: R
authors.lastname: Possenti
authors.forename: Stefano
authors.initials: S
authors.lastname: Mariotti
authors.forename: Gian-Luca
authors.initials: GL
authors.lastname: Ferri
mesh_terms: D000293:Adolescent; D000818:Animals; D001142:Aromatic-L-Amino-Acid Decarboxylases / Q000276:immunology; D001323:Autoantibodies / Q000097:blood; D002417:Cattle; D002648:Child; D002675:Child, Preschool; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000276:immunology; D019382:Human Growth Hormone / Q000172:deficiency / Q000378:metabolism; D006801:Humans; D008297:Male; D008473:Median Eminence / Q000276:immunology*; D016884:Polyendocrinopathies, Autoimmune / Q000276:immunology*; D051381:Rats; D017207:Rats, Sprague-Dawley; D014446:Tyrosine 3-Monooxygenase / Q000276:immunology
chemical_list: D001323:Autoantibodies; D019382:Human Growth Hormone; D007987:Gonadotropin-Releasing Hormone; D014446:Tyrosine 3-Monooxygenase; D001142:Aromatic-L-Amino-Acid Decarboxylases