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Åke Lernmark

Principal investigator

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High diagnostic accuracy for idiopathic Addison’s disease with a sensitive radiobinding assay for autoantibodies against recombinant human 21-hydroxylase

Author

  • Alberto Falorni
  • Andrej Nikoshkov
  • Stefano Laureti
  • Eva Grenb�ck
  • Anna Lena Hulting
  • Giovanni Casucci
  • Fausto Santeusanio
  • Paolo Brunetti
  • Holger Luthman
  • Ǻke Lernmark

Summary, in English

Autoantibodies against 21-hydroxylase (P450c21) are common in idiopathic autoimmune Addison’s disease. In the present work, we have developed a sensitive radiobinding assay using in vitro translated recombinant human 35S-P450c21. Levels of P450c21 antibodies (P450c21-Ab) were expressed as a relative index (P450c21 index) using a P450c21-Ab positive Addisonian serum and two antibody-negative healthy sera as positive and negative standards in healthy individuals. The upper level of normal was the mean + 3 SD. Positivity for P450c21-Ab was confirmed by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) analysis of immunoprecipitated 35S-P450c21. In 38 Addisonian patients, P450c21-Ab were found in 24/28 (86%) idiopathic, 0/5 post-tuberculosis, 0/3 adrenoleukodystrophy, and 0/2 post-adrenalectomy sera. Among healthy individuals, 1/70 (1.4%) were positive. The P450c21 index, as an estimate of P450c21-Ab levels, correlated inversely with the duration of idiopathic Addison’s disease (r = -0.527; P = 0.007): 16/16 (100%) positive in patients with less than 20 yr and 8/12 (67%) positive in patients with more than 20 yr disease duration. The availability of this simple and sensitive radiobinding assay to evaluate levels of P450c21-Ab will permit large clinical studies as well as screening subjects at risk. In addition, the general population can now be screened to evaluate the predictive value of P450c21-Ab for Addison’s disease.

Publishing year

1995-01-01

Language

English

Pages

2752-2755

Publication/Series

Journal of Clinical Endocrinology and Metabolism

Volume

80

Issue

9

Document type

Journal article

Publisher

Oxford University Press

Topic

  • Rheumatology and Autoimmunity

Status

Published

ISBN/ISSN/Other

  • ISSN: 0021-972X