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Evaluation of the Effect of IL-1 Antagonists on Pituitary Function
Fadime Aktas Koc1, Baris Sariakcali2, Ali Sahin3
1Department of Internal Medicine, Sivas Numune Hospital, Sivas, 58140, Türkiye, saglik.gov.tr.
Background:
Familial Mediterranean fever (FMF) is a hereditary autoinflammatory disease frequently observed in populations along the Eastern Mediterranean coast, characterized by recurrent fever, abdominal pain, and joint inflammation. The disease results from mutations in the MEFV gene, which plays a critical role in regulating IL-1β secretion. Mutations in pyrin lead to uncontrolled IL-1β release, driving FMF's inflammatory symptoms. IL-1 inhibitors, such as anakinra, rilonacept, and canakinumab, have been introduced as adjunctive treatments. This paper aims to investigate the effects of IL-1 inhibitors on pituitary functions in FMF patients.
Methods:
The study was conducted at Sivas Cumhuriyet University Hospital and included patients who had been using IL-1 inhibitors for at least 6 months. The control group consisted of patients receiving colchicine treatment only. Blood samples were collected to measure various pituitary and endocrine hormones. Patients with conditions like corticosteroid use, cancer, or hemodialysis were excluded. Hormonal levels were analyzed, and cortisol-deficient patients underwent a Synacthen test.
Results:
No significant differences were found in TSH, ACTH, cortisol, LH, estradiol, IGF-1, or PRL levels between the groups. However, differences were noted in FSH, total testosterone, and GH levels, with higher FSH and GH in the control group and higher testosterone in the experimental group.
Conclusions:
Although IL-1 plays a role in hormone secretion pathways, further studies are needed to better understand the effect of IL-1 antagonists on pituitary function, as no significant adrenal or pituitary insufficiencies were observed.
Insights
Interleukin-1 (IL-1) inhibitors did not cause significant pituitary or adrenal insufficiency in Familial Mediterranean Fever (FMF) patients. Further research is needed to fully understand IL-1 antagonist effects on pituitary function.
Area of Science:
- Endocrinology
- Rheumatology
- Genetics
Background:
- Familial Mediterranean Fever (FMF) is an autoinflammatory disease caused by MEFV gene mutations, leading to dysregulated IL-1β secretion and inflammation.
- IL-1 inhibitors are emerging as treatments for FMF, but their impact on endocrine function requires investigation.
Purpose of the Study:
- To evaluate the effects of IL-1 inhibitors on pituitary functions in FMF patients.
- To compare pituitary hormone levels in FMF patients on IL-1 inhibitors versus those on colchicine alone.
Main Methods:
- A comparative study was conducted at Sivas Cumhuriyet University Hospital.
- Pituitary and endocrine hormone levels were measured in FMF patients using IL-1 inhibitors for ≥6 months and a control group on colchicine.
- Exclusion criteria included corticosteroid use, cancer, and hemodialysis; Synacthen tests were performed for cortisol deficiency.
Main Results:
- No significant differences in TSH, ACTH, cortisol, LH, estradiol, IGF-1, or PRL levels were observed between the groups.
- FSH and GH levels were higher in the colchicine-only group.
- Total testosterone levels were higher in the IL-1 inhibitor group.
Conclusions:
- IL-1 inhibitors did not lead to significant adrenal or pituitary insufficiencies in FMF patients.
- While IL-1 influences hormone secretion, the clinical significance of observed hormonal differences requires further investigation.
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