title: Autoantibodies to nervous tissue structures are associated with autonomic neuropathy in type 1 (insulin-dependent) diabetes mellitus.
abstract: There is evidence that the immune system may play a role in the pathogenesis of autonomic neuropathy in Type 1 (insulin-dependent) diabetes mellitus. In the present study, we investigated the presence of autoantibodies to sympathetic and parasympathetic nervous structures and their correlation with other conventional autoantibodies in well-characterised diabetic populations, with or without diabetic neuropathy, and normal subjects. An indirect immunofluorescent complement-fixation technique was used, with monkey adrenal gland, rabbit cervical ganglia and vagus nerve as substrates. Of the patients with symptomatic autonomic neuropathy 33% were positive for at least one autoantibody (20% anti-sympathetic ganglia, 10% anti-vagus nerve and 13% anti-adrenal medulla). The frequency of having one or more antibodies to nervous tissues and the prevalence of anti-cervical ganglia antibodies were significantly higher in the neuropathic patients than in the diabetic control subjects with disease of similar duration and in the normal subjects (p < 0.05). Of the patients without complications with diabetes of shorter duration 33% were also positive for at least one autoantibody (13% anti-ganglia, 13% anti-vagus nerve and 13% anti-adrenal medulla). No correlation was found with other tissue autoantibodies, including islet cell antibodies. Our data indicate that nervous tissue autoantibodies are associated with symptomatic autonomic neuropathy. Anti-sympathetic ganglia and anti-vagus nerve antibodies seem to be more disease-specific. Patients with diabetes of shorter duration who were positive for these autoantibodies may represent pre-neuropathic patients.
authors.affiliation: Diabetic Department, King's College Hospital, London, UK.
authors.forename: M M
authors.initials: MM
authors.lastname: Zanone
authors.forename: M
authors.initials: M
authors.lastname: Peakman
authors.forename: T
authors.initials: T
authors.lastname: Purewal
authors.forename: P J
authors.initials: PJ
authors.lastname: Watkins
authors.forename: D
authors.initials: D
authors.lastname: Vergani
mesh_terms: D000293:Adolescent; D000311:Adrenal Glands / Q000294:innervation; D000328:Adult; D000818:Animals; D001323:Autoantibodies / Q000097:blood*; D001341:Autonomic Nervous System / Q000503:physiopathology*; D001794:Blood Pressure; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000276:immunology* / Q000503:physiopathology; D003929:Diabetic Neuropathies / Q000097:blood / Q000276:immunology* / Q000503:physiopathology; D005260:Female; D005455:Fluorescent Antibody Technique; D005728:Ganglia, Sympathetic / Q000166:cytology / Q000276:immunology*; D000882:Haplorhini; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000276:immunology; D011817:Rabbits; D012016:Reference Values; D013997:Time Factors; D014630:Vagus Nerve / Q000166:cytology / Q000276:immunology*; D014636:Valsalva Maneuver
chemical_list: D001323:Autoantibodies