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Journal Article 2012; 33(3): 301-303 PubMed PMID: 22635089 Citation  Keywords:  Adult, Age of Onset, Brain Injuries:complications, Disease Progression, Growth Disorders:etiology, Human Growth Hormone:deficiency, Humans, Male, Polyendocrinopathies, Autoimmune:complications,.   

: Both adult-onset growth hormone deficiency and autoimmune polyglandular syndrome are more frequent clinical entities than previously thought. In light of research carried out in recent years, it seems that growth hormone deficiency may be associated with proinflammatory state. This study describes a unique case of adult-onset growth hormone deficiency secondary to a traumatic brain injury in a young man, which was followed by the development of autoimmune polyglandular syndrome type 3. We discuss diagnostic and treatment dilemmas associated with discovering and management of both disorders in this patient. We conclude that in predisposed individuals growth hormone deficiency may lead to the development of autoimmune disorders of endocrine glands and/or exacerbate their clinical course....

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Case Reports 2012; 33(3): 298-300 PubMed PMID: 22635088 Citation  Keywords:  Aminoquinolines:administration & dosage, Disease Progression, Dopamine Agonists:administration & dosage, Female, Humans, Hyperprolactinemia:complications, Prolactin:blood, Thyroiditis, Autoimmune:complications, Young Adult, Zona Glomerulosa:immunology,.   

: Prolactin is a hormone with a multidirectional proinflammatory action. It has an anti-apoptotic effect, enhances proliferative response to antigens and mitogens, as well as enhances the production of immunoglobulins and autoantibodies. Increased prolactin levels are commonly observed in various organ and multi-organ specific autoimmune diseases. In our article, we report a case of a woman who developed progression of autoimmune thyroid disorder and developed insufficiency of the zona glomerulosa when her prolactin levels were increased. A normalization of plasma prolactin levels by quinagolide and replacement of risperidone with aripiprazole improved her clinical condition. Our study suggests that, in some patients, hyperprolactinemia may predispose to the development and progression of autoimmune disorders of endocrine glands....

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Journal Article 2011; 32(1): 25-33 PubMed PMID: 21407154 Citation  Keywords:  Animals, Astrocytes:immunology, Autoimmunity:immunology, Demyelinating Autoimmune Diseases, CNS:immunology, Dendritic Cells:immunology, Humans, Mesenchymal Stromal Cells:immunology, T-Lymphocytes, Regulatory:immunology,.   

: Much experimental and clinical evidence has been accumulated indicating the complexity of regulatory processes associated with autoimmune demyelination. Even slight disbalance of immunoregulatory circuits may result in the loss of proper control of self antigen specific immune reaction. Here, we discuss the immunoregulatory potential of several immune (dendritic cells and regulatory T cells), as well as non-immune cell populations (mesenchymal stem cells and astrocytes) with regard to their possible role in autoimmune demyelination....

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Journal Article 2010; 31(3): 283-289 PubMed PMID: 20588228 Citation  Keywords:  Dental Amalgam:adverse effects, Environmental Exposure:adverse effects, Helicobacter pylori:immunology, Humans, Inflammation:chemically induced, Lymphocyte Activation:drug effects, Metals, Heavy:adverse effects, Thyroiditis, Autoimmune:chemically induced,.   

: Environmental factors can play an important role in the development of autoimmune thyroiditis (AT) and other autoimmune diseases. This article reviews the role of heavy metals and infectious agents in AT. Currently, the genes responsible for a metal-induced pathology are known in experimental animals but similar knowledge is lacking in man. Metals such as nickel or mercury induce delayed type T cell hypersensitivity (allergy) which is relatively common, especially in women. T-cell allergy can be studied with the lymphocyte transformation test, LTT-MELISA. It has been found that patients with AT and other autoimmune diseases, such as multiple sclerosis, psoriasis, systemic lupus erythematosus and atopic eczema, show increased lymphocyte reactivity in vitro to inorganic mercury, nickel and other metals compared to healthy controls. The important source of mercury is dental amalgam. Replacement of amalgam in mercury-allergic subjects resulted in improvement of health in about 70% of patients. Several laboratory parameters such as mercury-specific lymphocyte responses in vitro and anti-thyroid autoantibodies were normalized as well. In contrast, no changes in health and laboratory results were observed in mercury-allergic patients who did not have their amalgams replaced. The same was true for non-allergic patients who underwent amalgam replacement. Infectious agents such as Helicobacter pylori (Hp) may cause chronic inflammation and autoimmune reactivity in susceptible subjects. The results of in vitro experiments performed with lymphocytes from Hp infected patients indicate that Hp can cause immunosuppression which might be eliminated by successful eradication therapy. In conclusion, heavy metals and Hp infection may play an important role in AT. Laboratory tests, such as LTT-MELISA, can help to determine the specific etiological agents causing inflammation in individual patients. The treatment of AT and other autoimmune diseases might be improved if such agents are eliminated and any future exposure restricted....

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Case Reports 2008; 29(6): 874-876 PubMed PMID: 19112420 Citation  Keywords:  Aged, Anti-Inflammatory Agents:therapeutic use, Autoimmune Diseases:complications, Azathioprine:therapeutic use, Diabetes Insipidus:etiology, Female, Humans, Hypothalamic Diseases:complications, Immunosuppressive Agents:therapeutic use, Methylprednisolone.   

: Autoimmune hypothalamitis is a rare autoimmune neuroendocirne disease. A case of a 70-year-old female with autoimmune hypothalamitis was reported. The chief clinical characteristics were diabetes insipidus and adenopituitary function deficiency. Cranial magnetic resonance imaging (MRI) scan indicated a mass in the hypothalamus. The diagnosis of autoimmune hypothalamitis was presumed. After treatment with prednisone, there was a marked reduction in the mass and the hypothalamus-adenopituitary function partially improved. However, after glucocorticoid therapy was withdrawn, the hypothalamic lesion relapsed progressively. High dose methylprednisolone pulse therapy (HDMPT) in combination with azathioprine was initiated thereafter. During follow-up, MRI scan indicated the lesion shrank strikingly, and the patient's clinical condition improved as well. In view of the good response of the hypothalamic lesion to glucocorticoid and immunodepressant, the putative diagnosis of autoimmune hypothalamitis was confirmed. This case report suggested that HDMPT in combination with azathioprine therapy might be an effective trial for autoimmune hypothalamitis treatment....

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Journal Article 2008; 29(3): 334-340 PubMed PMID: 18580850 Citation  Keywords:  Adolescent, Alleles, Antigens, CD:genetics, Autoimmune Diseases:epidemiology, CTLA-4 Antigen, Celiac Disease:epidemiology, Child, Cohort Studies, Diabetes Mellitus, Type 1:epidemiology, Endocrine System Diseases:epidemiology, Female, Genetic Markers, Geno.   

OBJECTIVES: The aim of the study was to determine the association of two CTLA-4 gene polymorphisms (CT60, +49 A/G) with Hashimoto thyroiditis (HT), type 1 diabetes mellitus (T1DM) and celiac disease (CD) as well as with the occurrence of multi-organ involvement by autoimmunity in children.

METHODS: Genotyping was done by RFLP analysis in Slovak children with HT (n=63) and CD (n=120) and both Slovak and Slovene children with T1DM (n=320) and healthy controls (n=231).

RESULTS: We found a significant association of the G allele of the CT60 polymorphism with HT (p<0,0005) in the Slovak population and T1DM in both Slovak (p<0.01) and Slovene populations (p<0.005). The G allele of the +49A/G polymorphism was significantly, though less strongly, associated with T1DM (p<0.05) and HT (p<0.05). Distribution of genotypes of CTLA-4 gene polymorphisms in CD patients did not differ significantly from controls. None of the polymorphisms was associated with multi-organ involvement by autoimmunity.

CONCLUSION: The G allele of both examined CTLA-4 gene polymorphisms predisposes to HT and T1DM, but not to CD. No association with multi-organ involvement was found. The GG genotype of the CT60 polymorphism may identify CD patients at an increased risk for concomitant T1DM and HT. Further studies to assess the predictive value of CTLA-4 polymorphisms for the co-occurrence of HT and T1DM in CD patients are needed....

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Journal Article 2007; 28(6): 861-867 PubMed PMID: 18063934 Citation  Keywords:  Adult, Analysis of Variance, Antibody Formation:immunology, Autoimmunity:immunology, Depression:blood, Depressive Disorder, Major:blood, Fatigue:blood, Fatigue Syndrome, Chronic:blood, Female, Humans, Immunoglobulin M:blood, Male, Middle Aged, Neuropsycho.   

: Major depression and chronic fatigue syndrome (CFS) are accompanied by signs of oxidative and nitrosative stress (O&NS) and an inflammatory response. Phosphatidyl inositol (Pi) is thought to play a role in depression. The aim of the present study is to examine whether depression and CFS are characterized by an IgM-mediated immune response directed against Pi. Toward this end, this study examines the serum IgM antibodies directed against Pi in 14 patients with major depression, 14 patients with CFS, 14 subjects with partial CFS, and in 11 normal controls. We found that the prevalence and mean value for the serum IgM levels directed against Pi were significantly greater in patients with major depression and CFS than in normal controls and patients with partial CFS. There were significant and positive correlations between serum IgM levels directed against Pi and two symptoms of the FibroFatigue Scale, i.e. fatigue and depression. The results show that an IgM-related immune response directed against Pi may occur in both depression and CFS and may play a role in the pathophysiology of the key symptom of CFS and major depression. It is suggested that the above disorders in Pi result from increased O&NS in both depression and CFS. Autoanti-Pi antibodies may have biological effects, for example, by changing inositol 1,4,5-triphosphate (IP3), phosphatidylinositol-4,5-bisphosphate (PIP2), diacylglycerol and phosphatidylinositol-3,4,5-triphosphate (PIP3) production, thus interfering with intracellular signalling processes. Future research in major depression and CFS should focus on the functional consequences of the immune responses directed against Pi....

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Journal Article 2007; 28(3): 259-266 PubMed PMID: 17627259 Citation  Keywords:  Adolescent, Adult, Aged, Autoantibodies:blood, Autoimmune Diseases:immunology, Female, Humans, Male, Middle Aged, Myoglobin:immunology, Myosins:immunology, Thyroid Diseases:immunology, Thyroxine:immunology, Triiodothyronine:immunology, Tropomyosin:immunol.   

OBJECTIVE: Anti-thyroglobulin, anti-thyroid-peroxidase and anti-TSH receptor antibodies have been observed with high frequency in autoimmune thyroid diseases. Thyroid hormone auto-antibodies (THAA): anti-thyroxine (T4) and anti-triiodothyronine (T3), conversely, have been reported rarely. In both hyperthyroidism and hypothyroidism, patients suffer from muscle weakness and function disorders. The aim of our study was the evaluation of the occurrence rate of autoantibodies targeting muscle proteins in a group of 24 patients with circulating anti-T3 and/or anti-T4 autoantibodies. The control group consisted of 41 healthy blood donors.

METHODS: In polyethylene tubes coated with muscle antigens: actin, myosin, myoglobin, troponin and tropomyosin solid-phase radioimmunoassay was performed to detect autoantibodies. A reaction with 125I-labelled staphylococcus protein A was used for the detection of antibodies bound to the antigens on the tubes.

RESULTS: We found a high occurrence of antibodies to muscle proteins in patients with THAA. Anti-myoglobin autoantibodies were most frequent (54.2% of subjects), the binding index values was very high and exceeded normal values two to four fold. Anti-myosin autoantibodies were detected in 50% of subjects; anti-troponin autoantibodies in 33.3%, and anti-tropomyosin autoantibody in 3 patients (12.5%). Differences between the patients and the controls were statistically significant. The antibody binding index to actin was low and statistically insignificant.

CONCLUSIONS: Our study indicates that muscle protein antibodies, especially to myoglobin, myosin and troponin, are very frequently present in patients with autoimmune thyroid disease and circulating anti-T3 and anti-T4 autoantibodies, as well as in most cases of chronic thyroiditis with clinical symptoms of hypothyroidisms....

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