Journal
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY
Volume 125, Issue 2, Pages S226-S237Publisher
MOSBY-ELSEVIER
DOI: 10.1016/j.jaci.2009.09.053
Keywords
Type 1 diabetes; HLA; autoantibodies; immunotherapy; Addison disease; autoimmune polyendocrine syndrome type 1; autoimmune polyendocrine syndrome type 2; Graves disease; polyendocrine autoimmunity; iatrogenic autoimmunity
Categories
Funding
- National Institutes of Health [DK32083, DK32493, DK057538]
- Autoimmunity Prevention Center [AI50964]
- Diabetes Endocrine Research Center [P30 DK57516]
- Clinical Research Centers [MO1 RR00069, MO1 RR00051]
- Immune Tolerance Network [AI15416]
- American Diabetes Association
- Juvenile Diabetes Research Foundation
- Brehm Coalition
- Children's Diabetes Foundation
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Autoimmunity affects multiple glands in the endocrine system. Animal models and human studies highlight the importance of alleles in HLA-like molecules determining tissue-specific targeting that, with the loss of tolerance, leads to organ-specific autoimmunity. Disorders such as type 1A diabetes, Graves disease, Hashimoto thyroiditis, Addison disease, and many others result from autoimmune-mediated tissue destruction. Each of these disorders can be divided into stages beginning with genetic susceptibility, environmental triggers, active autoimmunity, and finally metabolic derangements with overt symptoms of disease. With an increased understanding of the immunogenetics and immunopathogenesis of endocrine autoimmune disorders, immunotherapies are becoming prevalent, especially in patients with type 1A diabetes. Immunotherapies are being used more in multiple subspecialty fields to halt disease progression. Although therapies for autoimmune disorders stop the progress of an immune response, immunomodulatory therapies for cancer and chronic infections can also provoke an unwanted immune response. As a result, there are now iatrogenic autoimmune disorders arising from the treatment of chronic viral infections and malignancies. (J Allergy Clin Immunol 2010;125:S226-37.)
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