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Regenerative therapies in autoimmune Addison's disease

Lookup NU author(s): Dr Earn Gan, Professor Simon Pearce

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Abstract

© 2017 European Society of Endocrinology Printed in Great Britain. The treatment for autoimmune Addison's disease (AAD) has remained virtually unchanged in the last 60 years. Most patients have symptoms that are relatively well controlled with exogenous steroid replacement, but there may be persistent symptoms, recurrent adrenal crisis and poor quality of life, despite good compliance with optimal current treatments. Treatment with conventional exogenous steroid therapy is also associated with premature mortality, increased cardiovascular risk and complications related to excessive steroid replacement. Hence, novel therapeutic approaches have emerged in the last decade attempting to improve the long-term outcome and quality of life of patients with AAD. This review discusses the recent developments in treatment innovations for AAD, including the novel exogenous steroid formulations with the intention of mimicking the physiological biorhythm of cortisol secretion. Our group has also carried out a few studies attempting to restore endogenous glucocorticoid production via immunomodulatory and regenerative medicine approaches. The recent advances in the understanding of adrenocortical stem cell biology, and adrenal plasticity will also be discussed to help comprehend the science behind the therapeutic approaches adopted.


Publication metadata

Author(s): Gan EH, Pearce SH

Publication type: Review

Publication status: Published

Journal: European Journal of Endocrinology

Year: 2017

Volume: 176

Issue: 3

Pages: R123-R135

Print publication date: 01/03/2017

Online publication date: 03/11/2016

Acceptance date: 03/11/2016

ISSN (print): 0804-4643

ISSN (electronic): 1479-683X

Publisher: BioScientifica Ltd.

URL: https://doi.org/10.1530/EJE-16-0581

DOI: 10.1530/EJE-16-0581


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