T and B cell reactivity to adrenal antigens in autoimmune Addison's disease

Autoimmune Addison's disease is a rare condition of uncertain pathogenesis. To delineate potential autoantigens, an adrenal homogenate was fractioned by SDS-gel electrophoresis and used in immunoblotting and T cell proliferation assays. Antibodies specific for adrenal proteins with approximate molecular weights of 70, 55 and 45 were found in five out of 20 consecutive Addison's disease patients at routine follow-up. Five sera also reacted with a 52-kD protein shared with liver. T cells from six out of 10 Addison's disease patients proliferated in response to a range of adrenal-specific antigens including one, in particular, with a molecular weight of 18-24 kD. T and B cell reactivity to adrenal antigens did not appear to correlate and there was no relationship with time since diagnosis, associated autoimmunity or HLA-DR type. These results show that the autoimmune response to adrenal antigens in Addison's disease is heterogeneous and that such autoreactivity can only be inconsistently documented using these techniques and circulating antibodies or T cells.