From pituitary expansion to empty sella: Disease progression in a mouse model of autoimmune hypophysitis

Isabella Lupi, Jiangyang Zhang, Angelika Gutenberg, Melissa Landek-Salgado, Shey Cherng Tzou, Susumu Mori, Patrizio P Caturegli

Research output: Contribution to journalArticle

Abstract

Lymphocytic hypophysitis has a variable clinical course, where a swelling of the pituitary gland at presentation is thought to be followed by pituitary atrophy and empty sella. Data in patients, however, are scanty and contradictory. To better define the course of hypophysitis, we used an experimental model based on the injection of pituitary proteins into SJL mice. A cohort of 33 mice was divided into three groups: 18 cases were immunized with pituitary proteins emulsified in complete Freund's adjuvant; six controls were injected with adjuvant only; and nine controls were left untreated. Mice were followed by cranial magnetic resonance imaging (MRI) for up to 300 d, for a total of 106 MRI scans, and killed at different time points to correlate radiological and pathological findings. Empty sella was defined as a reduction in pituitary volume greater than 2 SD below the mean volume. All immunized mice showed by MRI a significant expansion of pituitary volume during the early phases of the disease. The volume then decreased gradually in the majority of cases (14 of 18, 78%), reaching empty sella values by d 300 after immunization. In a minority of cases (four of 18, 22%), the decrease was so rapid and marked to induce a central area of necrosis accompanied by hemorrhages, mimicking the condition known in patients as pituitary apoplexy. No radiological or pathological changes were observed in controls. Overall, these findings indicate that the evolution of hypophysitis is complex but can lead, through different routes, to the development of empty sella.

Original languageEnglish (US)
Pages (from-to)4190-4198
Number of pages9
JournalEndocrinology
Volume152
Issue number11
DOIs
StatePublished - Nov 2011

Fingerprint

Disease Progression
Magnetic Resonance Imaging
Pituitary Apoplexy
Freund's Adjuvant
Pituitary Gland
Atrophy
Immunization
Proteins
Theoretical Models
Necrosis
Hemorrhage
Injections
Autoimmune Hypophysitis
Hypophysitis

ASJC Scopus subject areas

  • Endocrinology

Cite this

From pituitary expansion to empty sella : Disease progression in a mouse model of autoimmune hypophysitis. / Lupi, Isabella; Zhang, Jiangyang; Gutenberg, Angelika; Landek-Salgado, Melissa; Tzou, Shey Cherng; Mori, Susumu; Caturegli, Patrizio P.

In: Endocrinology, Vol. 152, No. 11, 11.2011, p. 4190-4198.

Research output: Contribution to journalArticle

Lupi, Isabella ; Zhang, Jiangyang ; Gutenberg, Angelika ; Landek-Salgado, Melissa ; Tzou, Shey Cherng ; Mori, Susumu ; Caturegli, Patrizio P. / From pituitary expansion to empty sella : Disease progression in a mouse model of autoimmune hypophysitis. In: Endocrinology. 2011 ; Vol. 152, No. 11. pp. 4190-4198.
@article{96749a8591794f3f8a69da93f8cbef33,
title = "From pituitary expansion to empty sella: Disease progression in a mouse model of autoimmune hypophysitis",
abstract = "Lymphocytic hypophysitis has a variable clinical course, where a swelling of the pituitary gland at presentation is thought to be followed by pituitary atrophy and empty sella. Data in patients, however, are scanty and contradictory. To better define the course of hypophysitis, we used an experimental model based on the injection of pituitary proteins into SJL mice. A cohort of 33 mice was divided into three groups: 18 cases were immunized with pituitary proteins emulsified in complete Freund's adjuvant; six controls were injected with adjuvant only; and nine controls were left untreated. Mice were followed by cranial magnetic resonance imaging (MRI) for up to 300 d, for a total of 106 MRI scans, and killed at different time points to correlate radiological and pathological findings. Empty sella was defined as a reduction in pituitary volume greater than 2 SD below the mean volume. All immunized mice showed by MRI a significant expansion of pituitary volume during the early phases of the disease. The volume then decreased gradually in the majority of cases (14 of 18, 78{\%}), reaching empty sella values by d 300 after immunization. In a minority of cases (four of 18, 22{\%}), the decrease was so rapid and marked to induce a central area of necrosis accompanied by hemorrhages, mimicking the condition known in patients as pituitary apoplexy. No radiological or pathological changes were observed in controls. Overall, these findings indicate that the evolution of hypophysitis is complex but can lead, through different routes, to the development of empty sella.",
author = "Isabella Lupi and Jiangyang Zhang and Angelika Gutenberg and Melissa Landek-Salgado and Tzou, {Shey Cherng} and Susumu Mori and Caturegli, {Patrizio P}",
year = "2011",
month = "11",
doi = "10.1210/en.2011-1004",
language = "English (US)",
volume = "152",
pages = "4190--4198",
journal = "Endocrinology",
issn = "0013-7227",
publisher = "The Endocrine Society",
number = "11",

}

TY - JOUR

T1 - From pituitary expansion to empty sella

T2 - Disease progression in a mouse model of autoimmune hypophysitis

AU - Lupi, Isabella

AU - Zhang, Jiangyang

AU - Gutenberg, Angelika

AU - Landek-Salgado, Melissa

AU - Tzou, Shey Cherng

AU - Mori, Susumu

AU - Caturegli, Patrizio P

PY - 2011/11

Y1 - 2011/11

N2 - Lymphocytic hypophysitis has a variable clinical course, where a swelling of the pituitary gland at presentation is thought to be followed by pituitary atrophy and empty sella. Data in patients, however, are scanty and contradictory. To better define the course of hypophysitis, we used an experimental model based on the injection of pituitary proteins into SJL mice. A cohort of 33 mice was divided into three groups: 18 cases were immunized with pituitary proteins emulsified in complete Freund's adjuvant; six controls were injected with adjuvant only; and nine controls were left untreated. Mice were followed by cranial magnetic resonance imaging (MRI) for up to 300 d, for a total of 106 MRI scans, and killed at different time points to correlate radiological and pathological findings. Empty sella was defined as a reduction in pituitary volume greater than 2 SD below the mean volume. All immunized mice showed by MRI a significant expansion of pituitary volume during the early phases of the disease. The volume then decreased gradually in the majority of cases (14 of 18, 78%), reaching empty sella values by d 300 after immunization. In a minority of cases (four of 18, 22%), the decrease was so rapid and marked to induce a central area of necrosis accompanied by hemorrhages, mimicking the condition known in patients as pituitary apoplexy. No radiological or pathological changes were observed in controls. Overall, these findings indicate that the evolution of hypophysitis is complex but can lead, through different routes, to the development of empty sella.

AB - Lymphocytic hypophysitis has a variable clinical course, where a swelling of the pituitary gland at presentation is thought to be followed by pituitary atrophy and empty sella. Data in patients, however, are scanty and contradictory. To better define the course of hypophysitis, we used an experimental model based on the injection of pituitary proteins into SJL mice. A cohort of 33 mice was divided into three groups: 18 cases were immunized with pituitary proteins emulsified in complete Freund's adjuvant; six controls were injected with adjuvant only; and nine controls were left untreated. Mice were followed by cranial magnetic resonance imaging (MRI) for up to 300 d, for a total of 106 MRI scans, and killed at different time points to correlate radiological and pathological findings. Empty sella was defined as a reduction in pituitary volume greater than 2 SD below the mean volume. All immunized mice showed by MRI a significant expansion of pituitary volume during the early phases of the disease. The volume then decreased gradually in the majority of cases (14 of 18, 78%), reaching empty sella values by d 300 after immunization. In a minority of cases (four of 18, 22%), the decrease was so rapid and marked to induce a central area of necrosis accompanied by hemorrhages, mimicking the condition known in patients as pituitary apoplexy. No radiological or pathological changes were observed in controls. Overall, these findings indicate that the evolution of hypophysitis is complex but can lead, through different routes, to the development of empty sella.

UR - http://www.scopus.com/inward/record.url?scp=80054892089&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80054892089&partnerID=8YFLogxK

U2 - 10.1210/en.2011-1004

DO - 10.1210/en.2011-1004

M3 - Article

C2 - 21862619

AN - SCOPUS:80054892089

VL - 152

SP - 4190

EP - 4198

JO - Endocrinology

JF - Endocrinology

SN - 0013-7227

IS - 11

ER -