ArticleThe Journal of clinical endocrinology and metabolism2026
Long-term follow-up of autoimmune polyendocrine syndrome type 1 in Norway.
Article in The Journal of clinical endocrinology and metabolism, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Systematic and proactive evaluation of AIRE missense variant effects.American journal of human genetics · 2026Article
- Long-term follow-up of autoimmune polyendocrine syndrome type 1 in Norway.The Journal of clinical endocrinology and metabolism · 2026Article
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Authors and funding
22 authors.
Funding
Abstract
contextAutoimmune polyendocrine syndrome type 1 (APS-1) is a rare yet severe multiorgan autoimmune disease caused by mutations in the autoimmune regulator (AIRE) gene. Classical APS-1 arises from biallelic recessive AIRE mutations, whereas dominant negative mutations cause a milder, nonclassical phenotype with variable clinical presentation. Due to its rarity, long-term, population-based data are limited, underscoring the need for extended follow-up to guide lifelong care and research.
objectiveTo characterize the clinical profiles of APS-1 and explore associations between disease manifestations, autoantibody profiles, and AIRE mutations over an extended follow-up (1996-2025). PATIENTS: All known Norwegian patients with APS-1.
methodsWe analyzed longitudinal clinical and laboratory data of 71 APS-1 patients (49 classical, 22 nonclassical) from the Norwegian Registry of Organ-specific Autoimmune Diseases. Data included clinical progression, autoantibody and cytokine profiles, and AIRE genotypes. Additionally, we compared age at diagnosis of primary adrenal insufficiency (PAI) in patients with and without (n = 999) APS-1.
resultsIn classical APS-1, the most frequent clinical manifestations were chronic mucocutaneous candidiasis, enamel hypoplasia, and PAI, while for nonclassical APS-1 vitiligo, hypothyroidism, and PAI were most common. A broad proinflammatory cytokine signature was observed in classical APS-1, along with increased levels of the soluble form of the interferon (IFN)-α/β receptor.
conclusionAPS-1 should be considered in patients diagnosed with PAI before age 20, and AIRE sequencing is recommended for diagnostic confirmation. The presence of IFN-ω autoantibodies, a proinflammatory cytokine profile, and increased soluble IFN receptor levels further support the role of dysregulated interferon responses in APS-1 pathogenesis.
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