The incidence of endocrine autoimmunity is increasing worldwide. Complex molecular and cellular mechanisms underline the pathogenesis of autoimmune diseases with the contribution of putative environmental factors and the requisite allele(s) responsible for antigen presentation by antigen-presenting cells for T cell recognition. Although genetic factors have been well dissected, the environmental agents, including putative viruses, which may be causative of disease, are still under investigation. The long preclinical period of autoimmune disorders is characterised by an enhanced challenge over time of autoreactive T cells by an increased number of autoantigenic peptides and autoantibodies production. It is of considerable importance to establish predictive, preventive strategies of the disease onset. It is also relevant to project novel immunotherapeutic interventions aiming to halt the disease progression before and after the clinical manifestations become evident. In this article, we review the most recent and important patents related to autoimmune endocrine disorders with special reference to insulin-dependent diabetes mellitus, Addisons disease, Graves disease and Hashimotos thyroiditis. Engineered bioactive compounds aim to interfere with T cell activation and differentiation, to modulate other inflammatory effectors cells and cytokine production. We discuss the importance of the novel therapeutic targets in treating the immunopathological process in these categories of disorders.
Endocrinology, autoimmunity, type 1 diabetes, immunological mechanism, therapy, prevention, diagnosis
Ospedale Pediatrico Bambino Gesu', Research Institute, Piazza S. Onofrio 4, 00165 Rome, Italy.