Authors: Falorni, Alberto; Brozzetti, Annalisa; Torre, Daria La; Tortoioli, Cristina; Gambelunghe, Giovanni

Source: Expert Review of Clinical Immunology, Volume 4, Number 4, July 2008 , pp. 441-456(16)

Publisher: Expert Reviews

Abstract:

Autoimmune Addison's disease (AAD) is a complex genetic disease that results from the interaction of a predisposing genetic background with as yet unknown environmental factors. The disease is marked by the appearance of circulating autoantibodies against steroid 21-hydroxylase. Mutations of the autoimmune regulator gene are responsible for the so-called autoimmune polyendocrine syndrome type I (APS I), of which AAD is a major disease component. Among genetic factors for isolated AAD and APS II, a major role is played by HLA class II genes: HLA-DRB1^*0301-DQA1^*0501-DQB1^*0201 and DRB1^*04-DQA1^*0301-DQB1^*0302 are positively, and RB1^*0403 is negatively, associated with a genetic risk for AAD. The MHC class I chain-related gene A allele 5.1 is strongly and positively associated with AAD. Other gene polymorphisms contributing to genetic risk for AAD are MHC2TA, the gene coding for class II transactivator, the master regulator of class II expression, cytotoxic T lymphocyte antigen-4, PTPN22 and the vitamin D receptor.

Keywords: 21-hydroxylase autoantibody; CTLA-4; endogenous retrovirus; HLA; MHC; MHC2TA; MIC gene; prediction; primary adrenal insufficiency; vitamin D receptor

Document Type: Research article

DOI: http://dx.doi.org/10.1586/1744666X.4.4.441

Affiliations: 1: Department of Internal Medicine, Section of Internal Medicine and Endocrine and Metabolic Sciences, Via E. Dal Pozzo, 06126 Perugia, Italy., Email: falorni@dimisem.med.unipg.it

Publication date: 2008-07-01

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• Expert Review of Clinical Immunology provides expert analysis and commentary regarding the performance of new therapeutic and diagnostic modalities in disease states with a strong immunologic component, such as allergic asthma, rheumatoid arthritis, inflammatory bowel disease, psoriasis and multiple sclerosis
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