Steroidogenic antibodies predict premature ovarian failure in Addison’s
MedWire News: Findings indicate that women with autoimmune Addison's disease are at increased risk for developing autoimmune premature ovarian failure (POF).
Such patients with Addison's disease who are at high risk for POF can be identified through detection of steroidogenic antibodies, say the authors.
Addison's disease occurs both in isolation and as part of autoimmune polyendocrine syndromes (APS), of which there are three main types: APS-1, APS-2, APS-4. In the current study of 258 women aged less than 40 years, 14 women had APS-1, 165 had APS-2, 18 had APS-4, and 28 had isolated Addison's disease.
Of these women, 20.2% (n=52) also had autoimmune POF, with the highest prevalence of POF among women with APS-1 (>40%) and the lowest prevalence in patients with APS-2 (16%).
When the presence of steroid-producing cell antibodies (St-CA) and the steroidogenic enzyme autoantibodies 17α-hydroxylase (17α-OHAb) and P450 side-chain cleavage (P450sccAb) was assessed among the study group, St-CA positivity was observed in 72% of women with any type of Addison's disease plus POF, and in 25% of those with Addison's disease but no POF.
In addition, 90% of patients with both conditions were positive for at least one of the autoantibodies, whereas this figure was only 39% among POF-free Addison's disease patients.
Corrado Betterle (University of Padova, Italy) and team also investigated the ability of steroidogenic antibodies to predict future onset of POF in young women with Addison's disease.
They followed-up 41 women from the original cohort who had no signs of POF, over a mean period of 9 years, and found that 38% of those positive or seroconverted for 17α-OHAb or P450sccAb (n=21) developed POF. None of the 20 women who were negative for the antibodies developed POF over the follow-up period.
Betterle et al highlight that patients who developed Addison's disease and POF did so at a mean age of 27.0 years for Addison's disease and 28.5 years for POF.
"Overall, these observations indicate that ST-CA are very good markers of POF in patients with Addison's disease," say the authors.
They conclude: "Monitoring serum St-CA, 17α-OHAb, and P450sccAb positivity in female patients with [Addison's disease] should be helpful in the clinical management, particularly in ovarian function assessment."
The study is published in the Journal of Clinical Endocrinology and Metabolism.
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By Lauretta Ihonor