Boag Alisdair M, Catchpole Brian
Hospital for Small Animals, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Midlothian, Scotland.
Department of Pathology and Pathogen Biology, Royal Veterinary College, University of London, Hatfield, UK.
Top Companion Anim Med. 2014 Dec;29(4):96-101. doi: 10.1053/j.tcam.2015.01.001. Epub 2015 Jan 5.
Hypoadrenocorticism is an uncommon disease in dogs and rare in humans, where it is known as Addison disease (ADD). The disease is characterized by a deficiency in corticosteroid production from the adrenal cortex, requiring lifelong hormone replacement therapy. When compared with humans, the pathogenesis of hypoadrenocorticism in dogs is not well established, although the evidence supports a similar autoimmune etiology of adrenocortical pathology. Several immune response genes have been implicated in determining susceptibility to Addison disease in humans, some of which are shared with other autoimmune syndromes. Indeed, other types of autoimmune disease are common (approximately 50%) in patients affected with ADD. Several lines of evidence suggest a genetic component to the etiology of canine hypoadrenocorticism. Certain dog breeds are overrepresented in epidemiologic studies, reflecting a likely genetic influence, supported by data from pedigree analysis. Molecular genetic studies have identified similar genes and signaling pathways, involved in ADD in humans, to be also associated with susceptibility to canine hypoadrenocorticism. Immune response genes such as the dog leukocyte antigen (DLA) and cytotoxic T-lymphocyte-associated protein 4 (CTLA4) genes seem to be particularly important. It is clear that there are genetic factors involved in determining susceptibility to canine hypoadrenocorticism, although similar to the situation in humans, this is likely to represent a complex genetic disorder.
肾上腺皮质功能减退症在犬类中是一种罕见疾病，在人类中更为罕见，在人类中被称为艾迪生病（ADD）。该疾病的特征是肾上腺皮质产生的皮质类固醇缺乏，需要终身激素替代疗法。与人类相比，犬类肾上腺皮质功能减退症的发病机制尚未完全明确，尽管有证据支持肾上腺皮质病理存在类似的自身免疫病因。一些免疫反应基因与人类艾迪生病的易感性有关，其中一些与其他自身免疫综合征共有。事实上，其他类型的自身免疫性疾病在患有ADD的患者中很常见（约50%）。有几条证据表明犬类肾上腺皮质功能减退症的病因存在遗传因素。某些犬种在流行病学研究中占比过高，反映出可能存在遗传影响，系谱分析数据也支持这一点。分子遗传学研究已确定，在人类ADD中涉及的类似基因和信号通路也与犬类肾上腺皮质功能减退症的易感性有关。免疫反应基因如犬白细胞抗原（DLA）和细胞毒性T淋巴细胞相关蛋白4（CTLA4）基因似乎尤为重要。很明显，在决定犬类肾上腺皮质功能减退症易感性方面存在遗传因素，尽管与人类情况类似，这可能是一种复杂的遗传疾病。
