Circulating immune profiles in ACTH-dependent Cushing's syndrome
Authors' conclusion
Immune profiling distinguishes CD/EAS and predicts infection risk in ACTH-dependent CS. Surgical remission facilitates immune reconstitution.
Study context
- Population
- Patients with ACTH-dependent Cushing's syndrome (CS) aged 11–75 years12 followed after remission
- Participants
- 211 patients
- Exposure
- Ectopic ACTH syndrome (EAS) vs Cushing's disease (CD)
- EASn = 38
- CDn = 173reference
- Outcome
- Lymphocyte subsets
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
| Group | Value | CD3+ T cells (cells/μL) | CD19+ B cell percentage |
|---|---|---|---|
| EAS | 224 (range 158.0–390.0) cells/μL | 505 [342.0-815.0] | 18.2% [13.3%-25.5%] |
| CD | 442 (range 313.0–611.0) cells/μL | 930 [713.0-1246.0] | 9.6% [6.1%-14.4%] |
Value
EAS224 (range 158.0–390.0) cells/μL
CD442 (range 313.0–611.0) cells/μL
CD3+ T cells (cells/μL)
EAS505 [342.0-815.0]
CD930 [713.0-1246.0]
CD19+ B cell percentage
EAS18.2% [13.3%-25.5%]
CD9.6% [6.1%-14.4%]
- EAS vs CD: P < 0.001 — CD4+ T cells; also P < .001 for CD3+ T cells and CD19+ B cell %
Observational data: associations, not effects.
Further findings
ML model (immune + non-immune parameters) for CD/EAS differentiation
- Balanced accuracy
- 75.4%
- AUC
- .840 (95% CI 0.770-0.910)
Severe infections
- Incidence of severe infections
- 13.7%
Multivariate model (24 h UFC, serum potassium nadir, CD19+ B cell %, CD4+ T cell count) predicting severe infection
- AUC
- .851 (95% CI 0.774-0.927)
- Sensitivity
- 86.2%
- Specificity
- 68.7%
Immune recovery after surgical remission · 8 weeks
- CD4+ T cells increased 3-fold
- P < 0.001
Original publication
Circulating immune profiles in ACTH-dependent Cushing's syndrome. Eur J Endocrinol. Published 4 April 2026. doi:10.
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