Research Update - Professor Arlt's Perspective - 17/03/2020

In 2017, Professor Weibke Arlt, a member of our Clinical Advisory Panel, published research about Addison's and natural killer cells. In recent weeks, it's gone viral in light of the COVID-19 outbreak. We asked her to give her perspectives on what that means for us. She kindly tweeted her responses yesterday.

The publication 'Primary adrenal insufficiency is associated with impaired natural killer cell function: a potential link to increased mortality.' The study undertook a 'cross-sectional study of 42 patients with PAI due to autoimmune adrenalitis or bilateral adrenalectomy and 58 sex- and age-matched controls'.

So what is Professor Arlt's advice for people with Addison's in the current climate? We've collated her thoughts on this below for those without a Twitter account.

Every patient with Addison should continue to take their steroid replacement, not taking it, means risking life-threatening adrenal crisis! Patients with Addison have been shown by our group and an Italian group to have a reduced response of Natural killer cells fighting viruses.
— Wiebke Arlt (@WiebkeArlt) March 16, 2020

This might mean that patients with Addison's disease might be catching infections more easily than healthy people and in a recent paper we published we have shown that both patients with Addison's disease and congenital adrenal hyperplasia have an increased rate of infections
— Wiebke Arlt (@WiebkeArlt) March 16, 2020

However, the degree of immune-suppression we observed is much smaller than in patients who take very high doses of glucocorticoids to suppress chronic inflammatory disease such as rheumatoid arthritis or inflammatory bowel disease such as Crohn's
— Wiebke Arlt (@WiebkeArlt) March 16, 2020

Therefore, patients with Addison's disease should be at least as cautious as other people in following the government recommended social distancing measures, but they are at a much lower risk of infections than patients receiving high dose steroids or cancer treatment
— Wiebke Arlt (@WiebkeArlt) March 16, 2020

We are grateful to Professor Arlt for responding with her view on the research and its implications.

Read our Coronavirus advice for people with Addison's

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