title: Cell-mediated immunity and symptomatic diabetic autonomic neuropathy.
abstract: T lymphocytes have been implicated in the nerve damage observed in allergic experimental neuritis and in idiopathic polyneuritis. Symptomatic autonomic neuropathy in long-standing Type 1 diabetes is a rare and unexplained complication, and some preliminary evidence has suggested a pathogenetic role for the immune system. We have measured levels of activated T lymphocytes in 18 Type 1 diabetic patients with symptomatic autonomic neuropathy and in 16 matched patients with uncomplicated Type 1 diabetes. Purified T lymphocytes from peripheral blood were stained with a fluorescein-labelled monoclonal antibody directed to the activation marker HLA-DR and counted under UV microscopy. Percent DR positive T lymphocytes were significantly raised in the patients with autonomic neuropathy when compared with long-standing uncomplicated diabetic patients (8.2 +/- 4.2 vs 4.9 +/- 3.3%, p less than 0.01). This finding lends support for a role of the immune system in the development of autonomic neuropathy.
authors.affiliation: Diabetic Department, King's College Hospital, London, UK.
authors.forename: S G
authors.initials: SG
authors.lastname: Gilbey
authors.forename: M J
authors.initials: MJ
authors.lastname: Hussain
authors.forename: P J
authors.initials: PJ
authors.lastname: Watkins
authors.forename: D
authors.initials: D
authors.lastname: Vergani
mesh_terms: D000328:Adult; D001342:Autonomic Nervous System Diseases / Q000276:immunology* / Q000503:physiopathology; D003922:Diabetes Mellitus, Type 1 / Q000276:immunology*; D003925:Diabetic Angiopathies / Q000276:immunology; D003929:Diabetic Neuropathies / Q000276:immunology* / Q000503:physiopathology; D003930:Diabetic Retinopathy / Q000276:immunology; D006801:Humans; D007111:Immunity, Cellular; D008213:Lymphocyte Activation; D013601:T-Lymphocytes / Q000276:immunology