title: Diabetic peripheral neuropathy, is it an autoimmune disease?
abstract: BACKGROUND
  Autoimmunity has been identified in a significant number of neuropathies, such as, proximal neuropathies, and autonomic neuropathies associated with diabetes mellitus. However, possible correlations between diabetic peripheral neuropathy and autoimmunity have not yet been fully investigated.
  
  
  OBJECTIVE
  This study was conducted to investigate whether autoimmunity is associated with the pathogenesis of human diabetic peripheral neuropathy.
  
  
  METHODS
  A case-control analysis included three groups: 30 patients with diabetic peripheral neuropathy, 30 diabetic control patients without neuropathy, and 30 healthy controls. Blood analysis was conducted to compare the percentages of positive antinuclear antibodies (ANA) between the three groups. Secondary analysis investigated the correlations between the presence of autoimmune antibodies and sample demographics and neurological manifestations. This research was considered as a pilot study encouraging further investigations to take place in the near future.
  
  
  RESULTS
  Antinuclear antibodies were significantly present in the blood serum of patients with diabetic peripheral neuropathy in comparison to the control groups (p<0.001). The odds of positive values of ANA in the neuropathy group were 50 times higher when compared to control groups. Secondary analysis showed a significant correlation between the presence of ANA and the neurological manifestation of neuropathy (Neuropathy symptom score, Neuropathy disability score and Vibration Perception Threshold).
  
  
  CONCLUSIONS
  The study demonstrated for the first time that human peripheral diabetic neuropathy may have an autoimmune aetiology. The new pathogenic factors may lead to the consideration of new management plans involving new therapeutic approaches and disease markers.
authors.affiliation: Queen Margaret University, Musselburgh EH21 6UU, Edinburgh, Scotland, UK; Department of Podiatry, Orthopaedic Department, Royal Medical Services, Bahrain Defense Force Hospital, PO Box 28743, West Riffa, Bahrain. Electronic address: n.janahi1@hotmail.com.
authors.forename: Noor M
authors.initials: NM
authors.lastname: Janahi
authors.affiliation: Queen Margaret University, Musselburgh EH21 6UU, Edinburgh, Scotland, UK.
authors.forename: Derek
authors.initials: D
authors.lastname: Santos
authors.affiliation: Queen Margaret University, Musselburgh EH21 6UU, Edinburgh, Scotland, UK.
authors.forename: Christine
authors.initials: C
authors.lastname: Blyth
authors.affiliation: Department of Molecular Medicine, Princess Al-Jawhara Center for Genetics and Inherited Diseases, Arabian Gulf University, Manama 26671, Bahrain.
authors.forename: Moiz
authors.initials: M
authors.lastname: Bakhiet
authors.affiliation: Queen Margaret University, Musselburgh EH21 6UU, Edinburgh, Scotland, UK. Electronic address: moiz@agu.edu.bh.
authors.forename: Mairghread
authors.initials: M
authors.lastname: Ellis
mesh_terms: D000328:Adult; D000974:Antibodies, Antinuclear / Q000097:blood / Q000276:immunology*; D001327:Autoimmune Diseases / Q000097:blood / Q000276:immunology*; D015551:Autoimmunity / Q000276:immunology*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003929:Diabetic Neuropathies / Q000097:blood / Q000276:immunology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects
chemical_list: D000974:Antibodies, Antinuclear
keywords: Antinuclear antibody; Autoimmune disease; Autoimmunity; Diabetic peripheral neuropathy; Diabetic peripheral neuropathy pathogenesis