EARLY MOLECULAR AND IMMUNE MARKERS AS A BASIS FOR DIFFERENTIATED THERAPY OF TYPE 2 AUTOIMMUNE POLYGLANDULAR SYNDROME (LITERATURE REVIEW)

Аннотация

Type 2 autoimmune polyglandular syndrome (APS-2) is a complex endocrine disorder characterized by a combination of autoimmune pathologies, such as Addison’s disease, autoimmune thyroiditis, and type 1 diabetes mellitus. Despite significant progress in the study of APS-2, its pathogenesis, diagnosis, and therapy remain relevant research areas. This literature review examines modern molecular and immune markers that play a key role in the early detection and prognosis of the disease. Genetic predispositions, including HLA-DR3 and HLA-DR4 alleles, as well as polymorphisms in the CTLA-4, PTPN22, FOXP3, and STAT4 genes, are analyzed. Special attention is paid to epigenetic factors such as DNA methylation and the influence of non-coding RNAs on immune mechanisms. Key immune markers, including autoantibodies to 21-hydroxylase, GAD65, and IA-2, as well as the role of pro-inflammatory cytokines and changes in the T-lymphocyte population, are considered. The review highlights prospects for differentiated therapy, including targeted monoclonal antibodies, antigen-specific immunotherapy, cellular technologies, and metabolic regulation. Further research into APS-2 mechanisms will contribute to the improvement of diagnostic and therapeutic approaches, enhancing the effectiveness of personalized medicine in endocrinology.