Autoimmune Diseases Of The Endocrine System

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.

This is a comprehensive and novel text that examines key features that predispose individuals to autoimmune diseases. The first section details the basic mechanism of autoimmunity and examines immunogenetic and environmental factors in autoimmunity. The next section examines autoimmune thyroid disease. The third section takes a look at Type 1 diabetes mellitus. In the final section, authors explain other autoimmune endocrinopathies.

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 the last decades, several in vitro and in vivo studies have revealed the existence of a very complex network between the neuroendocrine and immune system. Important molecular mechanisms underlying these interactions, in both physiological and pathological conditions, have also been described. Indeed, hormones play a pivotal role in the development and functional regulation of the immune system – both innate and acquired responses. Immune system cells present specific hormone receptors and themselves produce some hormones, thus influencing hormone secretion. More recently, the modulation of hormone secretion has been attempted for treating associated autoimmune disorders, further supporting the strong interplay between the endocrine and immune system. Distinguished experts, who have published extensively in their fields, have contributed comprehensive chapters to this volume. The focus is on the various aspects of endocrine-neuro-immune connections, providing an updated panorama - from basics to clinical applications - of current knowledge and still debated issues.

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.

Basic immunological principles and methods as they relate to cellular and subcellular processes of the endocrine system are important in understanding the underlying causes of endocrine disorders. Part of the Modern Endocrinology Series, this text covers a wide array of topics including pancreas development, immunogenetics, hypoparathyroidism, Graves' disease and vitiligo. The book is an integrated resource with a bench-to-bedside breadth that is useful to both basic scientists and healthcare professionals interested in endocrine autoimmune diseases.

Dr. Robert Volpé and his distinguished contributors comprehensively review the latest thinking about the theoretical, experimental, and clinical aspects of autoimmune endocrine disorders. These world-renowned experts examine the pathogenesis and immunogenetics of these diseases, discuss the role of sex hormones in autoimmunity, and elucidate the nature of autoantigens. They also provide clinical detail on a wide variety of autoimmune endocrinopathies, including autoimmune thyroid disease, Graves' ophthalmopathy and dermopathy, human insulin-dependent diabetes mellitus, and autoimmune adrenocortical failure. Postpartum autoimmune endocrine syndromes, autoimmune hypophysitis, and the polyglandular autoimmune syndromes are also discussed in detail. Comprehensive and authoritative, Autoimmune Endocrinopathies provides today's most up-to-date understanding of the etiology and pathogenesis of 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.