Aggregation of subclinical autonomic nervous system dysfunction and autoantibodies in families with type I diabetes.
The purpose of our study was to evaluate the occurrence of autonomic nervous system autoantibodies (ANS) in the nondiabetic family members of insulin-dependent (type I) diabetic subjects. We studied 24 families, including 45 nondiabetic parents and 53 nondiabetic siblings of a type I diabetic proband. One hundred one nondiabetic population control subjects were also studied. Stored sera from nondiabetic family members and control subjects were evaluated for the presence of complement-fixing (CF) adrenal medullary antibodies (CF-ADM), sympathetic ganglia antibodies (CF-SG), and vagus nerve antibodies (CF-V) by indirect immunofluorescence. HLA-DR3 and -DR4 typing was performed on 42 nondiabetic family members and 104 diabetic subjects. One or more CF-ANS were in 45 of 93 (40%) nondiabetic family members compared to 2 of 70 (2.8%) control subjects. CF-SG were in 28 of 92 (30%) family members compared to 0 of 101 control subjects (P = 0.0001). CF-V were in 25 of 95 (26%) family members compared to 0 of 76 control subjects (P = 0.0001). CF-ADM were in 10 of 83 (12%) family members compared to 2 of 70 (2.8%) control subjects (P = 0.056). There was no HLA-DR3 or HLA-DR4 association with ANS. Subclinical autonomic dysfunction was demonstrated in 3 of 4 family members with autoantibodies compared to 0 of 4 family members without autoantibodies.
Brown
F M
FM
Neuroendocrine Immunology Laboratory, Joslin Diabetes Center, Boston, MA 02215.
Watts
M
M
Rabinowe
S L
SL
D000293:Adolescent; D000328:Adult; D001323:Autoantibodies / Q000032:analysis*; D001341:Autonomic Nervous System / Q000276:immunology / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000235:genetics* / Q000276:immunology / Q000503:physiopathology; D005190:Family; D005725:Ganglia, Autonomic / Q000276:immunology; D015803:HLA-DR3 Antigen / Q000032:analysis; D015804:HLA-DR4 Antigen / Q000032:analysis; D006339:Heart Rate; D006650:Histocompatibility Testing; D006801:Humans; D007223:Infant; D008875:Middle Aged; D012016:Reference Values; D012119:Respiration; D014636:Valsalva Maneuver
D001323:Autoantibodies; D015803:HLA-DR3 Antigen; D015804:HLA-DR4 Antigen