Autoimmune polyglandular syndromes: interplay between the immune and the endocrine systems leading to a diverse set of clinical diseases and new insights into immune regulation

Diabetes Technol Ther. 2013 Jun:15 Suppl 2:S2-21-S2-28. doi: 10.1089/dia.2013.0130.

Abstract

During the last 50 years, three major classes of autoimmune polyglandular syndromes (APSs) have been defined, and their characteristics and heritability have been delineated. Simultaneously, studies of the immunologic bases of these syndromes provided fundamental information in understanding immune regulation. Genetic analyses of patients and their families with APS type 1 (autoimmune polyendocrinopathy candidiasis, ectodermal dystrophy) identified the autoimmune regulator (AIRE) gene, which drives the expression of peripheral tissue-specific antigens in thymic cells and is critical in the development of self-tolerance. Mutations in this gene cause APS type 1. In contrast, studies in APS type 2 have been instrumental in understanding the role of human leukocyte antigen type II and related molecules in the pathogenesis of polygenetic autoimmune diseases such as type 1A diabetes. Immune dysfunction polyendocrinopathy, enteropathy, X-linked syndrome, which is caused by mutations in the forkhead box P3 gene, has been a model for studying regulatory T cell biology. The APSs epitomize the synergies that the merger of clinical and basic science can achieve. This is the environment that George Eisenbarth was able to create at the Barbara Davis Center for Diabetes.

Publication types

  • Historical Article

MeSH terms

  • AIRE Protein
  • Autoantibodies / immunology
  • Candidiasis / diagnosis
  • Candidiasis / genetics
  • Candidiasis / immunology*
  • Endocrine System / immunology*
  • Endocrine System / pathology
  • Female
  • Forkhead Transcription Factors / immunology
  • Genetic Diseases, X-Linked / diagnosis
  • Genetic Diseases, X-Linked / genetics
  • Genetic Diseases, X-Linked / immunology*
  • Genetic Predisposition to Disease
  • Genetic Testing
  • HLA-B8 Antigen / immunology
  • History, 20th Century
  • History, 21st Century
  • Humans
  • Immunity, Innate*
  • Lymphocyte Subsets / immunology
  • Male
  • Mutation / genetics
  • Mutation / immunology
  • Polyendocrinopathies, Autoimmune / diagnosis
  • Polyendocrinopathies, Autoimmune / genetics
  • Polyendocrinopathies, Autoimmune / immunology*
  • Syndrome
  • Transcription Factors / genetics
  • Transcription Factors / immunology

Substances

  • Autoantibodies
  • FOXP3 protein, human
  • Forkhead Transcription Factors
  • HLA-B8 Antigen
  • Transcription Factors