摘要
自身免疫性垂体炎(AH)是一种累及下丘脑–垂体系统的器官特异性罕见疾病。其病理核心为免疫细胞在垂体内的多态性浸润,导致垂体结构与功能不同程度受损。最新研究表明,其发病机制涉及免疫耐受失衡、遗传易感性及肿瘤抗原异位表达等多重因素的共同作用。近年来,随着免疫检查点抑制剂(ICI)的广泛应用与诊断技术的发展,该病的分类体系不断扩展,目前已识别出抗PIT-1垂体炎、ICI相关性垂体炎等多种临床亚型。本综述概述了关于AH的研究背景、发病机制、诊断创新、治疗策略及预后影响因素,有助于了解目前垂体炎的最新进展和未来发展的领域,为临床医生对AH患者的早期识别和逐步治疗提供了相关依据。
Autoimmune hypophysitis (AH) is a rare organ-specific disease involving the hypothalamic-pituitary system. Its pathological hallmark is polymorphic infiltration of immune cells within the pituitary gland, leading to varying degrees of structural damage and functional impairment. The recent study shows that its pathogenesis involves a complex interplay of multiple factors, including dysregulated immune tolerance, genetic susceptibility, and ectopic expression of tumor-associated antigens. In recent years, with the widespread use of immune checkpoint inhibitors and advancements in diagnostic technologies, the classification of AH has continuously expanded. Recognized clinical subtypes now include anti-PIT-1 hypophysitis and immune checkpoint inhibitor-associated hypophysitis, among others. This review summarizes the current knowledge on the pathogenesis, diagnostic innovations, therapeutic strategies, and prognostic factors of AH and its emerging subtypes. It highlights the latest advances and outlines future directions in hypophysitis research, aiming to provide clinicians with evidence-based insights to facilitate early recognition and stepwise management of patients with AH.
出处
《临床医学进展》
2026年第2期295-304,共10页
Advances in Clinical Medicine
