Endocrine And Organ Specific Autoimmunity

A dozen studies report on recent research findings for clinicians and scientists working in immunology. They discuss such topics as the immunobiology of autoimmunity, autoimmune polyendocrine syndrome types I and II, insights into the molecular mechanisms of the autoimmune thyroid diseases, type I d

Organ specific autoimmune disorders as a group are responsible for a major portion of all debilitating and at times life threatening chronic diseases. Over the past decade more has been learned concerning the molecular pathogenesis of these disorders than during the past 100 years.

This book is a comprehensive, easy-to-read discussion of the organ-specific autoimmune endocrine diseases emphasizing new contributions and trends for research and management. It begins with a brief chapter introducing the general principles of immunology, followed by discussions covering topics such as immunogenetics and animal models and how they can be applied toward interpreting human autoimmune endocrine diseases, autoimmune thyroid diseases, insulin-dependent diabetes mellitus hypophysitis, and Addison's disease. The book also discusses future trends toward gaining an understanding of these disorders and possible therapeutic principles. It is well-illustrated and will prove to be a useful reference source for internists, endocrinologists, and postgraduate students interested in human autoimmune endocrine diseases.

Nineteen eighty-six is a most appropriate year in which to be writing about developments in the organ-specific, autoimmune endocrine diseases. It celebrates the publication 30 years ago in 1956 of the classic papers of Roitt and Doniach and their co-workers I , and of Rose and Witebsky2 and Adams 3 and Purves . These three sets of fundamental observations provided the initial building blocks upon which much of what has been established in the field in the last 30 years was built. No publication of this nature on endocrine autoimmune disease can cover every aspect of the subject. I have chosen to highlight the organs (thyroid and pancreeas) which have attracted the most attention, and the areas of work within these fields within which most research effort is currently focused. There are still some gaps; the insulin and TSH receptors are not considered, nor in any detail are the role of cytotoxic mechanisms in mediating gland destruction. Molecular biology will undoubtedly in the next few years clarify once and for all the controversy that surrounds the structure of the TSH receptor and T cell cloning, the role of cell-mediated cytotoxicity. The pathogenetic mechanisms underlying autoimmunity are increasingly well understood and the search for the aetiology has begun.

Autoimmunity is the most common cause of endocrine disorders. This volume provides an up-to-date summary of recent advances in this important field. In addition, it describes developments in our understanding of conditions such as vitiligo and pernicious anaemia which are frequently associated with autoimmune endocrinopathies. There is a detailed review of animal models of endocrine disease which have contributed greatly to current knowledge. Furthermore, the aetiology, pathogenesis and treatment of the clinical disorders are discussed in depth. The book will be of interest to anyone working in the areas of endocrinology and immunology.

An international group of scientists contribute 19 perspectives on the current state of organ-specific and tissue-specific autoimmunity, describing experimentally induced and spontaneously occurring animal models for autoimmune diseases as examples for the development and assessment of new therapeutic strategies, and detailing clinical studies on the autoimmune processes and responses in such disorders as rheumatoid arthritis, syphilis, schizophrenia, multiple sclerosis, thyroid disease and autoimmune thyroiditis, autoimmune myocarditis, diabetes mellitus and polyendocrine syndromes, and human male infertility. Annotation(c) 2003 Book News, Inc., Portland, OR (booknews.com)

The Janeway's Immunobiology CD-ROM, Immunobiology Interactive, is included with each book, and can be purchased separately. It contains animations and videos with voiceover narration, as well as the figures from the text for presentation purposes.

The present monograph will concern itself with those disorders of the endocrine system, either associated with destruction, interference with function or hyper function, which are considered to be due to auto-immune processes. Endocrinopathies Non-endocrine auto-immune disorders associated with the endocrinopathies Graves' (Basedow's, Parry's) disease Pernicious anaemia Hashimoto's thyroiditis Vitiligo Idiopathic Addison's disease Myaesthenia gravis Insulinopenic diabetes mellitus Sjogren's syndrome Auto-immune oophoritis and orchitis Rheumatoid arthritis Auto-immune hypoparathyroidism Idiopathic thrombocytopenic purpura Auto-immune hypophysitis Chronic active hepatitis Possibly some cases of infertility Primary biliary cirrhosis due to anti-sperm antibodies Reproduced with permission from Volpe (1977) The above table indicates those organ-specific endocrinopathies considered to be due to auto-immune factors, as well as those non-endocrine, organ-specific auto-immune disorders which may be associated with them (Volpe 1977). It is evident that such disorders, occurring without any obvious external cause, raise the very elementary question of how immune processes directed against self constituents could be initiated. Generally, of course, the immune system acts as a regulatory and defence mechanism, and disorders of auto-immunity represent breakdowns in this regulatory system. The following chapters will be concerned with the individual components ofthe endocrine system so affected by auto-immune processes; it will first be necessary to provide an initial chapter for the purpose of summarizing some general principles of immunology, in order to place the immune disorders of the endocrine system in context.

In 1956, three groups independently reported evidence that some thyroid disease appearing spontaneously in humans or experimentally induced in animals are related to autoimmune processes. The interval between these landmark discoveries and the present has witnessed a remarkable and continuing growth of both knowledge and concepts concerning the mechanisms of immune regulation, the pathogenesis of autoimmune thyroid diseases, and their clinical and laboratory manifestations. More importantly knowledge of thyroid autoimmunity has, in many respects, comprised the vanguard of an ever increasing appreciation and understanding of autoimmune diseases in general. On November 24-26 1986, an International Symposium on Thyroid Autoimmunity was held in Pisa. Its purpose was to commemorate the birth of thyroid autoimmunity as a scientific discipline, to summarize current knowledge and concepts in this area, and where possible, to anticipate areas of opportunity for the future - hence the theme of the Symposium, Memories and Perspectives. To open the meeting, the Magnifico Rettore (Chancellor) of the University of Pisa granted special Awards to Dr. Deborah Doniach, Dr. Ivan Roitt, and Dr. Noel R. Rose, who published the first fundamental studies in the field of thyroid autoimmunity, and to Dr. Duncan G. Adams, whose discovery of the long-acting thyroid stimulator (LATS) opened the door to our current understanding of the pathogenesis of Graves' disease. During the meeting thirty plenary lectures were presented.