title: Investigation of antihypothalamus and antipituitary antibodies in amateur boxers: is chronic repetitive head trauma-induced pituitary dysfunction associated with autoimmunity?
abstract: OBJECTIVE
  Current data clearly demonstrate that sports-related chronic repetitive head trauma due to boxing might result in hypopituitarism. However, the mechanism of sports-related traumatic brain injury-induced pituitary dysfunction is still unclear. In order to understand whether autoimmune mechanisms could play a role in the pituitary dysfunction due to sports-related head trauma, we investigated the presence of antipituitary antibodies (APAs) and antihypothalamus antibodies (AHAs) in amateur boxers.
  
  
  METHODS
  Sixty-one actively competing (n=44) or retired (n=17) male boxers (mean age, 26 years; range, 17-53) who had been evaluated regarding pituitary functions previously were included in the study. In all boxers and in 60 age/sex-similar normal controls, AHAs and APAs were investigated by an indirect immunofluorescence method.
  
  
  RESULTS
  AHAs were detected in 13 of 61 boxers (21.3%), and APAs were detected in 14 of 61 boxers (22.9%), but in none of the normal controls. Pituitary dysfunction was significantly higher in AHA-positive boxers (46.2%) than in AHA-negative boxers (10.4%) (P=0.003). There was a significant association between AHA positivity and hypopituitarism due to boxing (odds ratio: 7.37, 95% confidence interval 1.8-30.8). There was no significant association between APA positivity and hypopituitarism.
  
  
  CONCLUSIONS
  This study demonstrates for the first time the presence of AHAs and APAs in boxers who were exposed to sports-related head trauma. Moreover, the present investigation provides preliminary evidence that AHAs are associated with the development of pituitary dysfunction in boxers, thus suggesting that autoimmunity may have a role in the pathogenesis.
authors.affiliation: Department of Endocrinology, Erciyes University Medical School, Kayseri, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Tanriverdi
authors.forename: Annamaria
authors.initials: A
authors.lastname: De Bellis
authors.forename: Marina
authors.initials: M
authors.lastname: Battaglia
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Bellastella
authors.forename: Antonio
authors.initials: A
authors.lastname: Bizzarro
authors.forename: Antonio A
authors.initials: AA
authors.lastname: Sinisi
authors.forename: Antonio
authors.initials: A
authors.lastname: Bellastella
authors.forename: Kursad
authors.initials: K
authors.lastname: Unluhizarci
authors.forename: Ahmet
authors.initials: A
authors.lastname: Selcuklu
authors.forename: Felipe F
authors.initials: FF
authors.lastname: Casanueva
authors.forename: Fahrettin
authors.initials: F
authors.lastname: Kelestimur
mesh_terms: D000293:Adolescent; D000328:Adult; D001323:Autoantibodies / Q000032:analysis*; D015551:Autoimmunity / Q000276:immunology; D001914:Boxing / Q000293:injuries*; D001930:Brain Injuries / Q000150:complications* / Q000276:immunology; D006259:Craniocerebral Trauma / Q000150:complications*; D006801:Humans; D007018:Hypopituitarism / Q000209:etiology*; D007031:Hypothalamus / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D010902:Pituitary Gland / Q000276:immunology*
chemical_list: D001323:Autoantibodies