Tuesday, 17 Sep 2019

You are here

Autoimmune Disease Clustering at ENDO 2019

A twin registry database study was presented at the Endocrine Society's annual meeting (ENDO 2019) in New Orleans, showed that that having autoimmune disease significantly increases the risk of other autoimmune disorders and that autoimmune clustering was highest in Addison's disease and vitiligo. 

Skov and his co-workers also looked at the likelihood of both twins in a pair having different autoimmune diseases -- which they named "pseudoconcordance" -- and compared these rates to measure autoimmune clustering.

Investigators from the Karolinska Institute set out to study heritability and overlap between seven autoimmune diseases known to cluster. Using twin studies they identified autoimmune diseases that tend to cluster, knowing that concordance rates would be higher in monozygotic than in dizygotic twins.

Their study of 116,320 twins from the Swedish Twin Registry found that Addison's disease, Celiac disease, and type 1 diabetes, are strongly influenced by genes with heritability greater than 85 percent. For example, the probandwise concordance rates ranged from 0.71 in monozygotic twins (MZ) with Addison’s disease to 0 in dizygotic twins (DZ) with Addison’s disease and vitiligo.  

They believe that environmental factors contribute to a lesser risk in Hashimoto's hypothyroidism, vitiligo, Graves' disease and atrophic gastritis

In the context of the seven autoimmune disorders studied, the authors fels that the probandwise concordance rates for individual diseases underestimate the burden of autoimmunity and that the genetic influence on disease occurrence for individual disorders is high.

Disclosures: 
The author has no conflicts of interest to disclose related to this subject

Add new comment

More Like This

Riociguat Fails in Systemic Sclerosis-Associated Digital Ulcers

Riociguat is an oral, selective soluble guanylate cyclase stimulator that has been studied in patients with digital ulcers (DU) due to systemic sclerosis (SSc) but study results show that short term (16 weeks) riociquat therapy does not sufficiently reduce the DU burden in SSc patients.

Nintedanib FDA Approved for Scleroderma Lung Disease

Last Friday, the US Food and Drug Administration approved Ofev (nintedanib) to slow the rate of decline in pulmonary function in adults with interstitial lung disease associated with systemic sclerosis or scleroderma, called SSc-ILD. ILD as a complication of SSc may lead to progressive loss of lung function and may be associated with a significant mortality risk. Prior to the approval of Olev, there were no FDA approved drugs for SSc-ILD.

With Autoimmunity, Checkpoint Inhibitors Can Be Used

Among patients with pre-existing autoimmune diseases who developed cancer and were treated with immune checkpoint inhibitors (ICI), flares of the underlying disease and other immune-related adverse events were common, a retrospective study conducted in France showed.

New EULAR/ACR Classification Criteria for SLE

The European League Against Rheumatism (EULAR) and the American College of Rheumatology (ACR) have jointly developed new classification criteria for systemic lupus erythematosus (SLE); prompted by the need for criteria that were both highly sensitive and specific. The net result is improved sensitivity and specificity, but the use of positive ANA requirement along with a longer list of weighted criteria ensures its utility in SLE research (including early or latent SLE), but not clinical practice.

Sjogren's Syndrome at Risk for Psychiatric Disorders

A population-based claims study from Taiwan shows significantly increased incidences of depressive disorder, anxiety disorder, and sleep disorder in patients with primary Sjögren’s syndrome (pSS).