Anti-adrenal, cellular hypersensitivity in Addison's disease

The occurrence in idiopathic Addison's disease of circulating antibodies with specific reactivity to adrenocortical components indicates a state of organ-specific hypersensitivity of the humoral type. The typical histopathological picture in idiopathic Addison's disease suggests a co-existing cellular (delayed type) hypersensitivity with similar specificity. To test this possibility, the leucocyte migration test was applied in a series of patients with Addison's disease, using pooled, foetal, adrenal extract as antigen. The results indicate the existence in nine out of fifteen patients with idiopathic Addison's disease of a state of organ-specific, anti-adrenal hypersensitivity of the cellular type. This reactivity was not seen in patients with Addison's disease of unquestionably tuberculous origin. A parallel study showed that adrenal extract did not induce blast transformation in lymphocyte cultures, as estimated by examination of cell morphology and [¹⁴C]thymidine incorporation.