New approaches to immunological diagnostics of polyendocrinopathies

Cover Page

Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

In present work, we have analyzed clinical and prognostic significance of autoantibodies repertoire in patients with autoim­mune endocrine diseases, summarizing our five-year work experience in diagnostics of polyendocrinopathies. We have shown that serological markers of additional autoimmune diseases constituting the polyendocrinopathies are revealed in upto 11-15% of the patients with autoimmune endocrinopathies, such as diabetes mellitustype 1, thyroid diseases, polyendocrinopathies type 3a. These serological markers are associated with appropriate clinical presentations at a time-point of their detection, e.g. parietal-cell autoantibodies are associated with symptoms of gastrointestinal tract affections and with anemia.The observations of seropositive patients showed high manifestation risk for additional autoimmune diseases. Anti-thyroid peroxidase autoan­tibodies are associated with high risk of autoimmune thyroiditis development, whereas parietal-cell autoantibodies were con­nected with subsequent development of chronic autoimmune gastritis, gastroduodenitis and anaemia. We have determined high prognostic value of autoantibodies to islet cells in the children with disorders of carbohydrate metabolism and without clinical presentation of diabetes mellitus type 1 We have demonstrated that the incidence of islet-cell autoantibodies and adrenal-cortex autoantibodies preceded clinical manifestation of diabetes mellitus type 1 and Addison's disease for a period of up to one year. We have developed an algorithm for immunological screening of the patients with diabetes mellitus type 1, autoimmune thyroiditis, polyendocrinopathies of 3a type.

About the authors

I. S. Freidiin

Research Institute of Experimental Medicine, RAMS

Author for correspondence.
Email: shabanov@mail.rcom.ru

член-корреспондент РАМН

Russian Federation, St. Petersburg

Areg A. Totolian

Pavlov State Medical University

Email: shabanov@mail.rcom.ru
Russian Federation, St. Petersburg

T. A. Akimova

Pavlov State Medical University

Email: shabanov@mail.rcom.ru
Russian Federation, St. Petersburg

S. V. Lapin

Pavlov State Medical University

Email: shabanov@mail.rcom.ru
Russian Federation, St. Petersburg

References

  1. Вест С. Дж. Секреты ревматологии: Пер. с англ. М.-СПб.: Изд-во БИНОМ-Невский диалект, 1999. 768 с.
  2. Ройт А., Бростофф Дж., Мейл Д. Иммунология: Пер. с англ. М.: Мир, 2000. 592 с.
  3. Руководство по клинической эндокринологии / Под ред. проф. Н. Т. Старковой. СПб.: Питер, 1996. 540 с.
  4. Тихомирова (Акимова) ТА., Лапин С.В., Тотолян Арег А. Лабораторная диагностика полиэндокринопатий // Клин. лаб. диагн. 2007 (в печати)
  5. Anderson М. S., Venanzi Е. S., Klein L., Chen Z. et al. Projection of an immunological self shadow within the thymus by the aire protein // Science. 2002. Vol. 298. P. 1395-1401.
  6. Bach J. F. The effect of infections on susceptibility to autoimmune and allergic diseases // N. Engl. J. Med. 2002. Vol. 347. P. 911-920.
  7. Bach J. F. Insulm-dependent diabetes mellitus as an autoimmune disease П Endocr. Rev. 1994. Vol. 15. P. 516-542.
  8. Barker J. M., Eisenbarth G. S. Autoimmune polyendocrine syndromes. In: Eisenbarth G. S., ed. Type 1 diabetes: molecular, cellular, and clinical immunology. Denver: Barbara Davis Center for Childhood Diabetes. 2003 (Web only), at http://www.barbaradaviscenter. org.
  9. Betterle C., Dal Pra C., Mantero E, Zanchetta R. Autoimmune adrenal insufficiency and autoimmune polyendocrine syndromes: autoantibodies, autoantigens, and their applicability in diagnosis and disease prediction II Endocr. Rev. 2002. Vol. 23. P. 327-364,
  10. Betterle C., Vol pat о M., Rees-Smith B., Furmaniak J. et al. Adrenal cortex and steroid 21-hydroxylase autoantibodies in adult patients with organ-specific autoimmune diseases: markers of low progression to clinical Addison’s disease I/ J. Clin. Endocrinol. Metab. 1997. Vol. 82. P. 932-938.
  11. Betterle C., Volpato M., Rees Smith B., Furmaniak J. et al. II. Adrenal cortex and steroid 21-hydroxylase autoantibodies in children with organspecific autoimmune diseases: markers of high progression to clinical Addison’s disease /I J. Clin. Endocrinol. Metab. 1997. Vol. 82. P. 93 9-942.
  12. Bodansky H. J., Staines A., Stephenson C., Haigh D. et al. Evidence for an environmental effect in the aetiology of insulin-dependent diabetes in a tra.nsmigratory population // BMJ. 1992. Vol. 304. P. 1020-1022.
  13. Bonifacio E., Bingley P. J., Shattock M., Dean В. M. et al. Quantification of islet-cell antibodies and prediction of insulin-dependent diabetes I/ Lancet. 1990. Vol. 335. P. 147-149.
  14. Donner H., Braun J., Seidl C„ Rau H. et al. Codon 17 polymorphism of the cytotoxic T lymphocyte antigen 4 gene in Hashimoto’s thyroiditis and Addison’s disease H J. Clin. Endocrinol. Metab. 1997. Vol. 82. P. 4130-4132.
  15. Eisenbarth G. S., Gottlieb P. A. Autoimmune Polyen¬docrine Syndromes //N. Engl. J. Med. 2004. Vol. 350. P. 2068-2079.
  16. Ergun-Longmire B., KukrejaA., Maclaren N. Chapter 6 Autoimmune endocrine disorders. In: Pediatric endocrinology/ Editor by Maria New. (Web only) at http:// www.endotext.org/index.htm
  17. Kamradt T, Mitchinson N. A. Tolerance and autoimmunity // N. Engl. J. Med. 2001. Vol. 344. P. 655-664.
  18. Klein J., Sato A. The HLA system. Second of two parts // N. Engl. J. Med. 2000. Vol. 343. P. 782-786.
  19. Knip M., Karjalainen J, Ekerblom H. K. Islet cell antibodies are less predictive of IDDM among unaffected children in the general population than in sibs of chil¬dren with diabetes // Diabetes Care. 1998. Vol. 21. P. 1670-1673.
  20. Kriegel M. A., Lohmann T, Gabler C., Blank N, et al. Defect ive suppressor function of human CD4+ CD25+ regulatory T cells in autoimmune polyglandular syndrome type II H J. Exp. Med. 2004. Vol. 199 (9). P. 1285-1291.
  21. Leslie D., Lipsky P., Notkins A. L. Autoantibodies as predictors of disease // J. Clin. Invest. 2001. Vol. 108. P. 1417-1422.
  22. AfaclarenN. K, Riley W. J. Thyroid, gastric, and adrenal autoimmunities associated with insulin-dependent diabetes mellitus // Diabetes Care. 1985. Vol. 8 (1). P. 34-38.
  23. Moore K. W., de Waal Malejyt R., Coffman R. L., O’Garra A. Interleukin-10 and the interleukin-10 receptor 11 Ann. Rev. Immunol. 2001. Vol. 19. P. 683-765.
  24. Nistico L., Buzzetti R, Pritchard L. E., vander Auwera B. et al. The CTL.A-4 gene region of chromosome 2q33 is linked to, and associated with, type 1 diabetes. Belgian Diabetes Registry // Hum. Mol. Genet. 1996. Vol. 5. P. 1075-1080.
  25. Salerno M., Argenziano A., Di Maio S., Gasparini N. et al. Pubertal growth, sexual maturation, and final height in children with IDDM. Effects of age at onset and metabolic control П Diabetes Care. 1997. Vol. 20 (5). P. 721-724.
  26. Toh В. H., Van Driel I. R., Gleeson P. A. Pernicious anemia// N. Engl. J. Med. 1997. Vol. 337. P. 1441-1448.
  27. Ueda H., Howson J. M., Esposito L., HewardJ. et al. Association of the T-cell regulatory gene CTLA4 with susceptibility to autoimmune disease // Nature. 2003. Vol. 423. P. 506-511.
  28. Vaidya B., Imrie H., Geatch D. R., Perros P. et al. As¬sociation analysis of the cytotoxic T lymphocyte anti¬gen-4 (CTLA-4) and autoimmune regulator-1 (AIRE-1) genes in sporadic autoimmune Addison’s disease // J. Clin. Endoctinol. Metab. 2000. Vol. 85. P. 688-691.
  29. Vanderpump M. P, Tunbridge W. M., French J. M., Appleton D. et al. The incidence of thyroid disorders in the community: a twenty-year follow-up of the Whickham Survey П Clin. Endocrinol. (Oxf.). 1995. Vol. 43. P. 55-68.
  30. Velloso L. А., Winqvist О., Gustafsson J., Катре О. et al. AutoantiЬodies against а novel 51 kDa islet antigen and glutamate decarboxylase isoforms in autoimmune polyendocrine syndrome type 1// DiaЬetologia. 1994. Vol. 37. Р. 61-69.
  31. Viglietta V., Kent S. С., Orban Т., Hajler D. А. GAD65-reactive Т cells are activated in patients with autoimmune type 1а diabetes // J. Clin. Invest. 2002. Vol. 109. Р. 895-903
  32. Vitoria J. С., Castano L., ltxaso R., Bilbao J. Association oflnsulin-Dependent Diabetes Mellitus and Celiac Disease: А Study Based оп Serologic Markers // J. Pediatr. Gastroenterol. Nutr. 1998. Vol. 27 (1). Р. 47-52.
  33. Weetman А. Р., McGregor А. М Autoimmune thyroid disease: further developments in our understanding // Endocr. Rev. 1994. Vol. 15. Р. 788-830.
  34. Wi/ls-Karp М., SanJeliz J., Karp С. L. The germless theory of allergic disease: revisiting the hygiene hypothesis//Nat. Rev. Immunol. 2001. Vol. 1 (1). Р. 69-75.
  35. Wucherpfennig К. W. Structural basis of molecular mimicry// J.Autoimmun. 2001. Vol. 16 (3). Р. 293-302.
  36. Zanin-Zhorov А., Cahalon L., Та/ G., Margalit R. et al. Heat shock protein 60 activates cytokine-associated negative regulator SOCS3 in Т cells: effects оп signaling, chemotaxis, and inflammation// J. Irnmunol. 2005. Vol. 175.Р. 276-285.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2008 Eco-Vector


СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77 - 74760 от 29.12.2018 г.