title: High prevalence of autoantibodies against carbonic anhydrase II and lactoferrin in type 1 diabetes: concept of autoimmune exocrinopathy and endocrinopathy of the pancreas.
abstract: BACKGROUND
  Dysfunction of the exocrine as well as the endocrine pancreas has been reported in type 1 diabetes. Lymphocytic infiltration of the exocrine pancreas is observed in approximately half of Japanese type 1 diabetic patients.
  
  
  OBJECTIVE
  To investigate the involvement of autoimmunity against the exocrine pancreas in type 1 diabetes.
  
  
  METHODS
  We examined autoantibodies against human carbonic anhydrase II (ACA) and lactoferrin (ALF), antigens in the pancreatic duct cells and the pancreatic acinus, respectively, in 43 type 1 diabetic patients and 20 type 2 diabetic patients using the enzyme-linked immunosorbent assay method.
  
  
  RESULTS
  Of 43 type 1 diabetic patients, ACA was detected in 28 patients (65%) and ALF was detected in 29 patients (67%). One or both of the antibodies were detected in 33 type 1 diabetic patients (77%). In contrast, neither ACA nor ALF were detected in type 2 diabetic patients.
  
  
  CONCLUSIONS
  The high prevalence of both ACA and ALF strongly suggests the involvement of autoimmunity against the exocrine pancreas as well as the endocrine pancreas in some type 1 diabetic patients. We propose that these conditions be referred to as autoimmune exocrinopathy and endocrinopathy of the pancreas.
authors.affiliation: Department of Internal Medicine, Ohtsu Red Cross Hospital, Shiga, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Taniguchi
authors.forename: Kazuichi
authors.initials: K
authors.lastname: Okazaki
authors.forename: Motozumi
authors.initials: M
authors.lastname: Okamoto
authors.forename: Shuji
authors.initials: S
authors.lastname: Seko
authors.forename: Junnya
authors.initials: J
authors.lastname: Tanaka
authors.forename: Kazushige
authors.initials: K
authors.lastname: Uchida
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Nagashima
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kurose
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Yamada
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Chiba
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Seino
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D044466:Asian People; D001323:Autoantibodies / Q000097:blood / Q000276:immunology*; D024402:Carbonic Anhydrase II / Q000276:immunology*; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000276:immunology*; D003924:Diabetes Mellitus, Type 2 / Q000276:immunology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007564:Japan; D007781:Lactoferrin / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts / Q000276:immunology
chemical_list: D001323:Autoantibodies; D007781:Lactoferrin; D024402:Carbonic Anhydrase II