A new serum test for the differential diagnosis of pituitary masses

鉴别诊断垂体肿块的新血清检测

• 批准号: 7629887
• 负责人: PATRIZIO CATUREGLI
• 金额: $ 20.5万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-05-10 至 2011-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7629887
• 关键词: Anterior Pituitary Hormones; Antibodies; Appearance; Autoantigens; Autoimmune Process; Autoimmunity; Biological Assay; Cell Line; Clinical; Collection; Development; Diagnosis; Differential Diagnosis; Disease; Enzyme-Linked Immunosorbent Assay; Experimental Models; Expression Library; Gel; Genetic Transcription; Grant; Histologic; Histopathology; Hormones; Human; Hypopituitarism; Immune; Immune system; Immunization; Immunoblotting; In Vitro; Knowledge; Lead; Lesion; Libraries; Lymphocyte; Mammalian Cell; Mass Spectrum Analysis; Molecular Biology; Mus; Operative Surgical Procedures; Pathogenesis; Pathogenicity; Patient Care; Patients; Pituitary Gland; Pituitary Gland Adenoma; Pituitary Hormones; Placental Lactogen; Procedures; Proteins; Proteomics; Protocols documentation; Recombinant Proteins; Reporting; SJL Mouse; Sampling; Sella Turcica Neoplasm; Serologic tests; Serum; Signs and Symptoms; Symptoms; Testing; Thyroid Gland; Translating; Two-Dimensional Gel Electrophoresis; adenoma; base; cDNA Expression; design; human disease; mouse model; public health relevance; tool; translation assay; two-dimensional

DESCRIPTION (provided by applicant): Masses of the pituitary gland (sellar masses) are common, representing approximately 15% of all intracranial masses. About half of the sellar masses are caused by a hormone-secreting adenoma and more easily diagnosed because of classical signs and symptoms. The remaining sellar masses, however, do not secrete any hormone (32% are non-functioning pituitary adenomas, and 10% are non-adenomatous lesions), and are therefore more difficult to differentiate. Often their diagnosis is established only after transsphenoidal surgery and pathological examination. Among the group of non-functioning pituitary masses, autoimmune (lymphocytic) hypophysitis is the only disease that has an immune pathogenesis. The pituitary autoantigens targeted in hypophysitis remain unknown. If discovered, they can lead to the development of a serum test useful to distinguish hypophysitis from the other non-functioning pituitary masses. This distinction is critical for patient care: in fact, hypophysitis can be usually managed medically, whereas the other conditions typically require surgery. The proposal reports our human and mouse studies aimed to discover the pituitary autoantigens and therefore develop an antibody-based serologic test for the differential diagnosis of non-functioning pituitary masses. PUBLIC HEALTH RELEVANCE: Pituitary masses are common. Because most of them do not secrete any pituitary hormone, they can often be diagnosed only after surgery and pathological examination. Autoimmune hypophysitis is the only disease entity among the non-functioning pituitary masses that has an immune pathogenesis. This grant is designed to develop an antibody- based serologic test to aid in the differential diagnosis of these common conditions. Such test could avoid unnecessary pituitary surgeries to patients with autoimmune hypophysitis.

描述（由申请人提供）：垂体肿块（鞍区肿块）很常见，约占所有颅内肿块的15%。大约有一半的鞍区肿块是由垂体分泌腺瘤引起的，由于典型的体征和症状，更容易诊断。然而，其余鞍区肿块不分泌任何激素（32%为无功能垂体腺瘤，10%为非腺瘤性病变），因此更难鉴别。通常只有在经蝶手术和病理检查后才能确诊。在无功能垂体肿块组中，自身免疫性（淋巴细胞性）垂体炎是唯一具有免疫发病机制的疾病。垂体炎中靶向的垂体自身抗原仍不清楚。如果被发现，它们可以导致血清试验的发展，用于区分垂体炎和其他无功能的垂体肿块。这种区别对于患者护理至关重要：事实上，垂体炎通常可以通过药物治疗，而其他疾病通常需要手术治疗。该提案报告了我们的人类和小鼠研究，旨在发现垂体自身抗原，从而开发一种基于抗体的血清学试验，用于无功能垂体肿块的鉴别诊断。公共卫生相关性：肺结核是常见的。由于大多数垂体瘤不分泌任何垂体激素，往往要经过手术和病理检查才能确诊。自身免疫性垂体炎是无功能垂体肿块中唯一具有免疫发病机制的疾病实体。这项拨款旨在开发一种基于抗体的血清学检测，以帮助这些常见疾病的鉴别诊断。对自身免疫性垂体炎患者可避免不必要的垂体手术。