title: Autoantibodies in patients with gut motility disorders and enteric neuropathy.
abstract: OBJECTIVE
  Enteric neuropathy with mild inflammation (ganglionitis) has been described in several motility disorders including irritable bowel syndrome (IBS), enteric dysmotility (ED), slow-transit constipation (STC) and chronic intestinal pseudo-obstruction (CIPO). The purpose of this study was to test the hypothesis that autoantibodies directed against specific neural antigens including ion channels may be associated with this finding.
  
  
  METHODS
  Comprehensive routine and immunohistochemical analyses of full-thickness jejunal laparoscopic biopsies were performed on patients fulfilling the international criteria for IBS, ED, STC and CIPO. Patients with ganglionitis had sera screened for specific antibodies to voltage-gated calcium channels (VGCCs) of P/Q- and N-type, voltage-gated potassium channels (VGKCs), glutamic acid decarboxylase (GAD) and neuronal alpha3-AChR by validated immunoprecipitation assays.
  
  
  RESULTS
  Thirty-three patients were included in the study. Two of them, both with IBS, were found to have positive antibody titres. One had anti-VGKC antibodies and one had anti-alpha3-AChR antibodies. No antibodies were detected in GAD or VGCCs (case reports presented).
  
  
  CONCLUSIONS
  A small proportion of patients with inflammatory enteric neuropathy have antibodies directed towards neuronal ion channels. The pathogenic role of such antibodies requires determination but may represent a possible aetiology of severe functional symptoms in these groups of patients.
authors.affiliation: Karolinska Institutet, Department of Medicine, Karolinska University Hospital, Huddinge, Stockholm, Sweden. hans.tornblom@karolinska.se
authors.forename: Hans
authors.initials: H
authors.lastname: Törnblom
authors.forename: Bethan
authors.initials: B
authors.lastname: Lang
authors.forename: Linda
authors.initials: L
authors.lastname: Clover
authors.forename: Charles H
authors.initials: CH
authors.lastname: Knowles
authors.forename: Angela
authors.initials: A
authors.lastname: Vincent
authors.forename: Greger
authors.initials: G
authors.lastname: Lindberg
mesh_terms: D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000097:blood*; D001327:Autoimmune Diseases / Q000276:immunology*; D001706:Biopsy; D015220:Calcium Channels / Q000276:immunology; D003248:Constipation / Q000276:immunology; D005260:Female; D005769:Gastrointestinal Motility / Q000276:immunology; D005968:Glutamate Decarboxylase / Q000276:immunology; D006801:Humans; D047468:Immunoprecipitation / Q000379:methods; D007410:Intestinal Diseases / Q000276:immunology*; D043183:Irritable Bowel Syndrome / Q000276:immunology; D007583:Jejunum / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000276:immunology*; D024642:Potassium Channels, Voltage-Gated / Q000276:immunology; D011950:Receptors, Cholinergic / Q000276:immunology
chemical_list: D001323:Autoantibodies; D015220:Calcium Channels; D024642:Potassium Channels, Voltage-Gated; D011950:Receptors, Cholinergic; D005968:Glutamate Decarboxylase