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November 25, 1992, Vol 268, No. 20 >
ARTICLE | November 25, 1992

Immunologic Aspects of Endocrine Diseases FREE

James R. Baker, Jr, MD
JAMA. 1992;268(20):2899-2903. doi:10.1001/jama.1992.03490200151017
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References

OVER THE past several years, autoimmunity has been identified as the cause of most common endocrine disorders. These disorders are clinically important diseases that affect many individuals. In addition, the pathogenesis of these diseases offers unique opportunities for investigations into immune regulation and autoimmunity. While rapid progress has been made in the identification of the autoantigens, autoantibodies, and cellular immune elements involved in the immune destruction or stimulation of endocrine glands, the specific mechanisms and susceptibility factors leading to the development of these diseases are not clear. Research into these unresolved questions will likely provide many insights into autoimmune disease and lead to prevention of endocrine system dysfunction.

Proposed mechanisms for the development of autoimmune endocrine disease generally involve a multistep process. An initiating event likely entails nonspecific inflammation or trauma that results in a specific secondary immune response in a genetically susceptible individual. This specific immune response progressively destroys

REFERENCES

1 +
Weetman AP, McGregor AM.  Autoimmune thyroid disease. Endocr Rev . 1984;;5:309-337.
2 +
Aozasa M, Amino N, Iwatani Y, et al.  Intrathyroidal HLA-DR-positive lymphocytes in Hashimoto's disease: increases in CD8 and Leu-7 cells. Clin Immunol Immunopathol . 1989;;52:516-522.
3 +
Baker JR Jr, Saunders NB, Wartofsky L, Tseng YC, Burman KD.  Seronegative Hashimoto's thyroiditis with thyroid autoantibody production localized to the thyroid. Ann Intern Med . 1988;;108:26-30.
4 +
Libert F, Ludgate M, Vassart G.  Thyroperoxidase, but not the thyrotropin receptor, contains sequential epitopes recognized by autoantibodies in recombinant peptides expressed in the pUEX vector. J Clin Endocrinol Metab . 1991;;73:857-860.
5 +
MacKenzie WA, Schwartz AW, Friedman EW, Davies TF.  Intrathyroidal T cell clones from patients with autoimmune thyroid disease. J Clin Endocrinol Metab . 1987;;64:818-824.
6 +
Baker JR Jr.  Immunogenetics, the HLA system and endocrine disease.  In: Becker KL, ed. The Principles and Practice of Endocrinology and Metabolism . Philadelphia, Pa: JB Lippincott; 1990;:1401-1404.
7 +
Gerstein HC.  How common is postpartum thyroiditis? a methodologic overview of the literature. Arch Intern Med . 1990;;150:1397-1400.
8 +
Dussault JH, Rousseau F.  Immunologically mediated hypothyroidism. Endocrinol Metab Clin North Am . 1987;;16:417-429.
9 +
Burman KD, Baker JR Jr.  Immune mechanisms in Graves' disease. Endocrinol Rev . 1985;; 6:183-232.
10 +
McDougall IR.  Graves' disease: current concepts. Med Clin North Am . 1991;;75:79-95.
11 +
Parmentier M, Libert F, Maenhaut C, et al.  Molecular cloning of the thyrotropin receptor. Science . 1989;;246:1620-1622.
12 +
Bahn RS, Garrity JA, Gorman CA.  Clinical review 13: diagnosis and management of Graves' ophthalmopathy. J Clin Endocrinol Metab . 1990;;71:559-563.
13 +
Wilson K, Eisenbarth GS.  Immunopathogenesis and immunotherapy of type I diabetes. Annu Rev Med . 1990;;41:497-508.
14 +
Todd JA, BellJI, McDevitt HO.  HLA-DQb gene contributes to susceptibility and resistance to insulin-dependent diabetes mellitus. Nature . 1987;; 329:599-604.
15 +
Baisch JM, Weeks T, Giles R, Hoover M, Stastny P, Capra JD.  Analysis of HLA-DQ genotypes and susceptibility in insulin-dependent diabetes mellitus. N Engl J Med . 1990;;322:1836-1841.
16 +
Parham P.  A diversity of diabetes. Nature . 1990;; 345:662-664.
17 +
Lernmark A, Li S, Baekkeskov S, et al.  Isletspecific immune mechanisms. Diabetes Metab Rev . 1987;;3:959-980.
18 +
Haskins K, McDuffie M.  Acceleration of diabetes in young NOD mice with a CD4+ islet-specific T cell clone. Science . 1990;;249:1433-1436.
19 +
Riley WJ, Maclaren NK, Krischer J, et al.  A postoperative study of the development of diabetes in relatives of patients with insulin-dependent diabetes. N Engl J Med . 1990;;323:1167-1172.
20 +
Baekkeskov S, Aanstoot H-J, Christgau S, et al.  Identification of the 64K autoantigen in insulin-dependent diabetes as the GABA-synthesizing enzyme glutamic acid decarboxylase. Nature . 1990;; 347:151-156.
21 +
Burke CW.  Adrenocortical insufficiency. Clin Endocrinol Metab . 1985;;14:947-976.
22 +
Betterle C, Zanette F, Zanchetta R, et al.  Complement-fixing adrenal autoantibodies as a marker for predicting onset of idiopathic Addison's disease. Lancet . 1983;;1:1238-1241.
23 +
Latinne D, Vandeput Y, De-Bruyere M, Bottazzo F, Sokal G, Crabbe J.  Addison's disease: immunological aspects. Tissue Antigens . 1987;;30:23-24.
24 +
Neufeld M, MacLaren NK, Blizzard RM.  Autoimmune polygrandular syndromes. Pediatr Ann . 1980;;9:154-162.
25 +
Appleboom TM, Flowers FP.  Ketoconazole in the treatment of chronic mucocutaneous candidiasis secondary to autoimmune polyendocrinopathycandidiasis syndrome. Cutis . 1982;;30:71-72.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Weetman AP, McGregor AM.  Autoimmune thyroid disease. Endocr Rev . 1984;;5:309-337.
2 +
Aozasa M, Amino N, Iwatani Y, et al.  Intrathyroidal HLA-DR-positive lymphocytes in Hashimoto's disease: increases in CD8 and Leu-7 cells. Clin Immunol Immunopathol . 1989;;52:516-522.
3 +
Baker JR Jr, Saunders NB, Wartofsky L, Tseng YC, Burman KD.  Seronegative Hashimoto's thyroiditis with thyroid autoantibody production localized to the thyroid. Ann Intern Med . 1988;;108:26-30.
4 +
Libert F, Ludgate M, Vassart G.  Thyroperoxidase, but not the thyrotropin receptor, contains sequential epitopes recognized by autoantibodies in recombinant peptides expressed in the pUEX vector. J Clin Endocrinol Metab . 1991;;73:857-860.
5 +
MacKenzie WA, Schwartz AW, Friedman EW, Davies TF.  Intrathyroidal T cell clones from patients with autoimmune thyroid disease. J Clin Endocrinol Metab . 1987;;64:818-824.
6 +
Baker JR Jr.  Immunogenetics, the HLA system and endocrine disease.  In: Becker KL, ed. The Principles and Practice of Endocrinology and Metabolism . Philadelphia, Pa: JB Lippincott; 1990;:1401-1404.
7 +
Gerstein HC.  How common is postpartum thyroiditis? a methodologic overview of the literature. Arch Intern Med . 1990;;150:1397-1400.
8 +
Dussault JH, Rousseau F.  Immunologically mediated hypothyroidism. Endocrinol Metab Clin North Am . 1987;;16:417-429.
9 +
Burman KD, Baker JR Jr.  Immune mechanisms in Graves' disease. Endocrinol Rev . 1985;; 6:183-232.
10 +
McDougall IR.  Graves' disease: current concepts. Med Clin North Am . 1991;;75:79-95.
11 +
Parmentier M, Libert F, Maenhaut C, et al.  Molecular cloning of the thyrotropin receptor. Science . 1989;;246:1620-1622.
12 +
Bahn RS, Garrity JA, Gorman CA.  Clinical review 13: diagnosis and management of Graves' ophthalmopathy. J Clin Endocrinol Metab . 1990;;71:559-563.
13 +
Wilson K, Eisenbarth GS.  Immunopathogenesis and immunotherapy of type I diabetes. Annu Rev Med . 1990;;41:497-508.
14 +
Todd JA, BellJI, McDevitt HO.  HLA-DQb gene contributes to susceptibility and resistance to insulin-dependent diabetes mellitus. Nature . 1987;; 329:599-604.
15 +
Baisch JM, Weeks T, Giles R, Hoover M, Stastny P, Capra JD.  Analysis of HLA-DQ genotypes and susceptibility in insulin-dependent diabetes mellitus. N Engl J Med . 1990;;322:1836-1841.
16 +
Parham P.  A diversity of diabetes. Nature . 1990;; 345:662-664.
17 +
Lernmark A, Li S, Baekkeskov S, et al.  Isletspecific immune mechanisms. Diabetes Metab Rev . 1987;;3:959-980.
18 +
Haskins K, McDuffie M.  Acceleration of diabetes in young NOD mice with a CD4+ islet-specific T cell clone. Science . 1990;;249:1433-1436.
19 +
Riley WJ, Maclaren NK, Krischer J, et al.  A postoperative study of the development of diabetes in relatives of patients with insulin-dependent diabetes. N Engl J Med . 1990;;323:1167-1172.
20 +
Baekkeskov S, Aanstoot H-J, Christgau S, et al.  Identification of the 64K autoantigen in insulin-dependent diabetes as the GABA-synthesizing enzyme glutamic acid decarboxylase. Nature . 1990;; 347:151-156.
21 +
Burke CW.  Adrenocortical insufficiency. Clin Endocrinol Metab . 1985;;14:947-976.
22 +
Betterle C, Zanette F, Zanchetta R, et al.  Complement-fixing adrenal autoantibodies as a marker for predicting onset of idiopathic Addison's disease. Lancet . 1983;;1:1238-1241.
23 +
Latinne D, Vandeput Y, De-Bruyere M, Bottazzo F, Sokal G, Crabbe J.  Addison's disease: immunological aspects. Tissue Antigens . 1987;;30:23-24.
24 +
Neufeld M, MacLaren NK, Blizzard RM.  Autoimmune polygrandular syndromes. Pediatr Ann . 1980;;9:154-162.
25 +
Appleboom TM, Flowers FP.  Ketoconazole in the treatment of chronic mucocutaneous candidiasis secondary to autoimmune polyendocrinopathycandidiasis syndrome. Cutis . 1982;;30:71-72.

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