High prevalence of autoantibodies against carbonic anhydrase II and lactoferrin in type 1 diabetes: concept of autoimmune exocrinopathy and endocrinopathy of the pancreas.
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.
Taniguchi
Takao
T
Department of Internal Medicine, Ohtsu Red Cross Hospital, Shiga, Japan.
Okazaki
Kazuichi
K
Okamoto
Motozumi
M
Seko
Shuji
S
Tanaka
Junnya
J
Uchida
Kazushige
K
Nagashima
Kazuaki
K
Kurose
Takeshi
T
Yamada
Yuichiro
Y
Chiba
Tsutomu
T
Seino
Yutaka
Y
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
D001323:Autoantibodies; D007781:Lactoferrin; D024402:Carbonic Anhydrase II