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Corrigendum to "Effects of modified release hydrocortisone on restoration of early morning cortisol, quality of life, and fatigue in adrenal insufficiency (The CHAMPAIN study): a randomised, double-blind, double-dummy, cross-over study comparing Chronocort and Plenadren"[eClinical Medicine 91(2026); 103714].

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MANAGEMENT OF ENDOCRINE DISEASE: Residual adrenal function in Addison's disease.

Simon H S Pearce1,2, Earn H Gan1,2, Catherine Napier2

  • 1Translational and Clinical Research Institute, Newcastle University, Newcastle, UK.

European Journal of Endocrinology
|December 11, 2020
PubMed
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Autoimmune Addison's disease (AAD) is heterogeneous, with 30% of patients retaining some adrenal function. This residual function may indicate potential for adrenal regeneration and improved outcomes in some individuals.

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Area of Science:

  • Endocrinology
  • Autoimmune Diseases
  • Adrenal Gland Physiology

Background:

  • Autoimmune Addison's disease (AAD) is increasingly recognized as a heterogeneous condition.
  • Approximately 30% of patients with established AAD exhibit residual adrenal function, characterized by persistent cortisol and other steroid secretion.
  • This residual function is more prevalent in men and is observed across varying disease durations.

Purpose of the Study:

  • To explore the heterogeneity of autoimmune Addison's disease.
  • To investigate the characteristics and potential implications of residual adrenal function in AAD patients.
  • To assess the significance of preserved steroidogenesis in the context of adrenal stem cell populations.

Main Methods:

  • Review of accumulated evidence on autoimmune Addison's disease over the past decade.
  • Analysis of patient data characterizing residual adrenal function (cortisol, glucocorticoid, mineralocorticoid secretion).
  • Correlation of residual function with patient demographics (sex) and disease duration.

Main Results:

  • Evidence suggests AAD is a heterogeneous disease.
  • Persistent steroidogenesis is present in about 30% of AAD patients, more common in men.
  • Residual function can persist for over 20 years, though it is more common in shorter disease durations.

Conclusions:

  • Residual adrenal function in AAD signifies an intact adrenocortical stem cell population.
  • This finding opens possibilities for regeneration of adrenal steroidogenesis.
  • Potential for improvement in adrenal failure exists for some patients with AAD.