Nelson Vergel
Founder, ExcelMale.com
Ricciuti A, Travison TG, Di Dalmazi G, et al.
A Subset of Men with Age-Related Decline in Testosterone have Gonadotroph Autoantibodies. The Journal of Clinical Endocrinology & Metabolism.
http://press.endocrine.org/doi/abs/10.1210/jc.2016-1016
Context: Age-related decline in serum testosterone is being increasingly diagnosed. In most men, it associates with low or inappropriately normal gonadotropin levels, which suggests a hypothalamic-pituitary etiology. Autoantibodies against adenohypophyseal cells have been associated with pituitary dysfunction, however; the prevalence of pituitary autoimmunity in this age-related testosterone decline has not been assessed.
Objectives: Proof-of-Concept study to determine the prevalence of antibodies to gonadotrophs in older men with age-related low testosterone and compare it with healthy young and older eugonadal men.
Study Design: Cross-sectional case-control study of 182 men. Cases included 100 older men (≥65 yrs) with age-related low testosterone levels; Control groups comprised 50 young and 32 older healthy eugonadal men.
Serum antibodies against the anterior pituitary gland were measured using a 2-step approach:
1) single indirect immunofluorescence (i.e. participant serum only) to determine the pattern of cytosolic staining; and
2) double indirect immunofluorescence (i.e. participant serum plus a commercial adenohypophyseal hormone antibody) to identify the anterior pituitary cell type recognized by the patient's antibodies).
Results: In participants with positive anti-pituitary antibodies, the granular cytosolic pattern (highly predictive of pituitary autoimmunity) was only seen in older men with age-related low testosterone (4%) and none in control groups (0%, p=0.001). Double indirect immunofluorescence confirmed that pituitary antibodies were exclusively directed against the gonadotrophs.
Conclusion: A subset of older men with age-related low testosterone levels have specific antibodies against the gonadotrophs. Whether these antibodies are pathogenic and contributory to the age-related decline in testosterone remains to be established.
A Subset of Men with Age-Related Decline in Testosterone have Gonadotroph Autoantibodies. The Journal of Clinical Endocrinology & Metabolism.
http://press.endocrine.org/doi/abs/10.1210/jc.2016-1016
Context: Age-related decline in serum testosterone is being increasingly diagnosed. In most men, it associates with low or inappropriately normal gonadotropin levels, which suggests a hypothalamic-pituitary etiology. Autoantibodies against adenohypophyseal cells have been associated with pituitary dysfunction, however; the prevalence of pituitary autoimmunity in this age-related testosterone decline has not been assessed.
Objectives: Proof-of-Concept study to determine the prevalence of antibodies to gonadotrophs in older men with age-related low testosterone and compare it with healthy young and older eugonadal men.
Study Design: Cross-sectional case-control study of 182 men. Cases included 100 older men (≥65 yrs) with age-related low testosterone levels; Control groups comprised 50 young and 32 older healthy eugonadal men.
Serum antibodies against the anterior pituitary gland were measured using a 2-step approach:
1) single indirect immunofluorescence (i.e. participant serum only) to determine the pattern of cytosolic staining; and
2) double indirect immunofluorescence (i.e. participant serum plus a commercial adenohypophyseal hormone antibody) to identify the anterior pituitary cell type recognized by the patient's antibodies).
Results: In participants with positive anti-pituitary antibodies, the granular cytosolic pattern (highly predictive of pituitary autoimmunity) was only seen in older men with age-related low testosterone (4%) and none in control groups (0%, p=0.001). Double indirect immunofluorescence confirmed that pituitary antibodies were exclusively directed against the gonadotrophs.
Conclusion: A subset of older men with age-related low testosterone levels have specific antibodies against the gonadotrophs. Whether these antibodies are pathogenic and contributory to the age-related decline in testosterone remains to be established.
