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HLA analysis of immune checkpoint inhibitor-induced and idiopathic isolated ACTH deficiency

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Abstract

Purpose

Isolated adrenocorticotropic hormone deficiency is a rare disease; however, since immune check point inhibitors (ICIs) have become widely used, many more cases have been reported. In this study, we compared the human leukocyte antigen (HLA) signatures between ICI-induced isolated adrenocorticotropic hormone deficiency (IAD) and idiopathic IAD (IIAD).

Design and methods:

Clinical features and HLA frequencies were compared among 13 patients with ICI-induced IAD, 8 patients with IIAD, and healthy controls. HLA frequencies of healthy controls were adopted from a HLA database of Japanese population.

Results

Age and body mass index were higher, while the rate of weight loss was lower, in patients with ICI-induced IAD than in those with IIAD. No HLA alleles had a significantly higher frequency in patients with ICI-induced IAD than in healthy controls, whereas the frequencies of HLA-DRB1*09:01, HLA-DQA1*03:02, and DQB1*03:03 were significantly higher in patients with IIAD than in healthy controls.

Conclusions

ICI-induced IAD and IIAD were different in terms of HLA frequencies. There were no specific HLAs related to ICI-induced IAD, whereas several HLAs in strong linkage disequilibrium were associated with IIAD. This might suggest that the two diseases have different pathological mechanisms. HLAs unique to IIAD may be helpful in predicting its pathophysiology.

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Authors and Affiliations

  1. Department of Endocrinology, Diabetes and Metabolism, Graduate School of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, 113-8603, Tokyo, Japan

    Mayo Ono MD, Izumi Fukuda M.D., PhD, Mototsugu Nagao MD, PhD, Keiko Tomiyama MD, Mikiko Okazaki-Hada MD, Yuki Shuto MD, PhD, Shunsuke Kobayashi MD, PhD, Yuji Yamaguchi MD, Tomoko Nagamine MD, Yasushi Nakajima MD, Kyoko Inagaki-Tanimura MD, PhD & Hitoshi Sugihara MD, PhD

Authors
  1. Mayo Ono MD
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  2. Izumi Fukuda M.D., PhD
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  3. Mototsugu Nagao MD, PhD
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  4. Keiko Tomiyama MD
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  5. Mikiko Okazaki-Hada MD
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  6. Yuki Shuto MD, PhD
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  7. Shunsuke Kobayashi MD, PhD
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  8. Yuji Yamaguchi MD
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  9. Tomoko Nagamine MD
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  10. Yasushi Nakajima MD
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  11. Kyoko Inagaki-Tanimura MD, PhD
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  12. Hitoshi Sugihara MD, PhD
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Contributions

Ono M and Fukuda I designed the study. Ono M extracted the data and performed the statistical analysis. Ono M and Fukuda I wrote the manuscript. Nagao M, Tomiyama K, Okazaki-Hada M, Shuto Y, Kobayashi S, Yuji Y, Nagamine T, Nakajima Y, and Inagaki-Tanimura K contributed to the care of the patients and acquisition of the data. Sugihara H critically reviewed the article.

Corresponding author

Correspondence to Izumi Fukuda M.D., PhD.

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Ono, M., Fukuda, I., Nagao, M. et al. HLA analysis of immune checkpoint inhibitor-induced and idiopathic isolated ACTH deficiency. Pituitary 25, 615–621 (2022). https://doi.org/10.1007/s11102-022-01231-1

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  • DOI: https://doi.org/10.1007/s11102-022-01231-1

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