title: Failure of antibody response to polysaccharide antigen in treated panhypopituitary adults.
abstract: 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)-gamma response were studied. There were no significant differences in T cell numbers or IFN-gamma 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.
authors.affiliation: Department of Endocrinology, Christie Hospital, Manchester, UK. annice.mukherjee@srht.nhs.uk
authors.forename: A
authors.initials: A
authors.lastname: Mukherjee
authors.forename: M
authors.initials: M
authors.lastname: Helbert
authors.forename: W D J
authors.initials: WD
authors.lastname: Ryder
authors.forename: R
authors.initials: R
authors.lastname: Borrow
authors.forename: J R E
authors.initials: JR
authors.lastname: Davis
authors.forename: S M
authors.initials: SM
authors.lastname: Shalet
mesh_terms: D000328:Adult; D000368:Aged; D000907:Antibodies, Bacterial / Q000097:blood*; D000917:Antibody Formation; D016022:Case-Control Studies; D005260:Female; D019382:Human Growth Hormone / Q000627:therapeutic use; D006801:Humans; D007018:Hypopituitarism / Q000097:blood / Q000188:drug therapy / Q000276:immunology*; D007074:Immunoglobulin G / Q000097:blood*; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D022242:Pneumococcal Vaccines / Q000008:administration & dosage* / Q000276:immunology; D011388:Prolactin / Q000097:blood; D016176:T-Lymphocyte Subsets / Q000276:immunology; D013745:Tetanus Toxoid / Q000276:immunology; D014611:Vaccination
chemical_list: D000907:Antibodies, Bacterial; D007074:Immunoglobulin G; D022242:Pneumococcal Vaccines; D013745:Tetanus Toxoid; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I; D011388:Prolactin