Feyzullova Aylin, Kirilov Georgi, Elenkova Atanaska, Tanev Dobromir, Kalinov Krassimir, Zacharieva Sabina, Robeva Ralitsa
Department of Endocrinology, Faculty of Medicine, Medical University-Sofia, 1000 Sofia, Bulgaria.
USHATE "Acad. Iv. Penchev", 1000 Sofia, Bulgaria.
J Clin Med. 2025 Jun 3;14(11):3951. doi: 10.3390/jcm14113951.
Addison's disease (AD) is a rare disorder that often develops in the context of autoimmune polyglandular syndromes. However, the prevalence of rheumatological autoimmune diseases and corresponding autoimmune markers in AD is poorly investigated. Therefore, the present study aims to explore systemic and organ-specific immune markers in a cohort of AD patients from a single tertiary endocrine center. : In total, 43 adult AD patients and 31 controls were included in the study. 21-hydroxylase autoantibodies (21OHAb), glutamic acid decarboxylase autoantibodies (GADAbs), zinc transporter-8 autoantibodies (ZnT8Abs), antibodies against nuclear antigens (ANAs), autoantibodies against cyclic citrullinated peptides (CCPAbs), rheumatoid factors (RFs), IgG autoantibodies against cardiolipin (ACLAbs), and autoantibodies against beta-2-Glycoprotein I (β2-GPIAbs) were measured in all participants. : An increased prevalence of antibodies against RFs (27.91% vs. 0%, < 0.001) and ANAs (13.95% vs. 0%, = 0.037) was found in AD patients compared to controls. Moreover, the titers of 21-hydroxylase and RF antibodies correlated positively (r = +0.269, = 0.020). The AD patients tended to show an increased prevalence of subthreshold ACL antibody reactivity compared to controls. All patients diagnosed with type 1 diabetes mellitus were GADAb- but not ZnT8Ab-positive. : The results show an increased prevalence of ANA and RF positivity in AD patients compared to controls and a significant association between 21-OHAb and RF positivity. ZnT8Ab positivity was not typical for adult AD patients from our ethnic group, while GADAbs were an essential marker for autoimmune diabetes mellitus. Extensive studies in different ethnic groups are needed to establish the clinical significance of various immunological markers for AD comorbidity and the appropriate follow-up protocols for patients with different antibody positivity.
艾迪生病（AD）是一种罕见疾病，常于自身免疫性多腺体综合征背景下发病。然而，AD患者中风湿性自身免疫疾病及相应自身免疫标志物的患病率研究甚少。因此，本研究旨在探索来自单一三级内分泌中心的一组AD患者的全身及器官特异性免疫标志物。：本研究共纳入43例成年AD患者及31例对照。检测了所有参与者的21-羟化酶自身抗体（21OHAb）、谷氨酸脱羧酶自身抗体（GADAbs）、锌转运体8自身抗体（ZnT8Abs）、抗核抗原抗体（ANAs）、抗环瓜氨酸肽自身抗体（CCPAbs）、类风湿因子（RFs）、抗心磷脂IgG自身抗体（ACLAbs）及抗β2-糖蛋白I自身抗体（β2-GPIAbs）。：与对照相比，AD患者中RFs抗体（27.91% 对0%，<0.001）及ANAs抗体（13.95% 对0%，=0.037）的患病率升高。此外，21-羟化酶和RF抗体的滴度呈正相关（r = +0.269，=0.020）。与对照相比，AD患者亚阈值ACL抗体反应性的患病率有升高趋势。所有诊断为1型糖尿病的患者GADAb阳性但ZnT8Ab阴性。：结果显示，与对照相比，AD患者ANA和RF阳性的患病率升高，且21-OHAb与RF阳性之间存在显著关联。ZnT8Ab阳性并非我们种族成年AD患者的典型特征，而GADAbs是自身免疫性糖尿病的重要标志物。需要在不同种族中进行广泛研究，以确立各种免疫标志物对AD合并症的临床意义以及针对不同抗体阳性患者的适当随访方案。
