I marcatori sierologici del morbo di Addison autoimmune

Autoimmune Addison’s disease is the leading cause of primary adrenal insufficiency and is characterized by the presence of circulating anti-adrenal cortex autoantibodies (ACA) and anti-21-hydroxylase autoantibodies (21-OHAb). Their frequency varies according to the disease: they are present at onset in about 90% of cases and their prevalence decreases slowly over time. Indirect immunofluorescence (IIF) on monkey adrenal glands has been for many years the only method available and is still widely used today. Immunoprecipitation using 21-OH is currently the reference method for diagnosing autoimmune forms of primary adrenal insufficiency (ISP), but the probability of an accurate diagnosis of AD is greater than 99% in the case of double ACA and 21-OHAb positivity. 21-OHAb can also be detected by enzyme immunoenzymatic (ELISA) methods, but currently there are no comparative studies of this technique with the IIF and IPA methods. Therefore, there is a need for further comparative and validation studies of the currently available automated ELISA methods in order to evaluate their possible implementation in autoimmunology laboratories.