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Evidence for specific autoimmunity against sympathetic and parasympathetic nervous tissues in Type 1 diabetes mellitus and the relation to cardiac autonomic dysfunction.
Diabet Med. 1998 Jun; 15(6):467-72.DM

Abstract

There is growing evidence for the involvement of immunological factors in the pathogenesis of cardiac autonomic dysfunction in Type 1 diabetes mellitus (DM). To evaluate the presence of autoantibodies against autonomic nervous tissues and their relationship with tests of autonomic function, 64 newly diagnosed and 142 long duration Type 1 DM patients were investigated for sympathetic and parasympathetic ganglia (CF-SG and CF-PSG) autoantibodies with a complement-fixing indirect immunofluorescence technique. Five cardiac reflex tests were performed to assess autonomic function. Fifty-seven patients with neurological diseases other than diabetic neuropathy and 131 healthy control subjects were also tested for CF-SG and CF-PSG autoantibodies. CF-SG autoantibodies were observed in 47 (23%) and CF-PSG autoantibodies in 21 (10%) of 206 Type 1 DM patients (p < 0.001). In contrast, these autoantibodies were detected in 3 (5%) and 1 (2%) of patients with non-diabetic neurological diseases and 3 (2%) and 4 (3%) of control subjects (p < 0.01, p < 0.05, p < 0.0001, p < 0.05 vs Type 1 DM patients). All except two Type 1 DM patients with CF-PSG autoantibodies also presented with CF-SG autoantibodies. In diabetic patients with long duration, CF-SG autoantibodies were more frequent in patients with ECG-based cardiac autonomic neuropathy (CAN; > or =2 of 5 cardiac reflex tests abnormal) compared to patients without CAN although this did not reach statistical significance (29% vs 17%, p = 0.06). However, 4 (80%) of 5 newly diagnosed and 23 (32%) of 73 established Type 1 DM patients with abnormalities in heart rate variation during deep breathing and/or standing from lying presented with CF-SG autoantibodies compared to 12 (25%) of 58 newly diagnosed (p < 0.05) and 7 (11%) of 63 established Type 1 DM patients (p < 0.01), in whom both tests were normal. The results suggest that autoimmune factors contribute to the pathogenesis of cardiac autonomic dysfunction in Type 1 DM and that autoantibodies against sympathetic and parasympathetic nervous tissues are relatively specific for Type 1 DM.

Authors+Show Affiliations

Muhr-Becker D
Institute of Nutrition Science, Technical University of Munich, Germany.
Ziegler AG
No affiliation info available
Druschky A
No affiliation info available
Wolfram G
No affiliation info available
Haslbeck M
No affiliation info available
Neundörfer B
No affiliation info available
Standl E
No affiliation info available
Schnell O
No affiliation info available

MeSH

AdultAgedAntibody SpecificityAutoimmunityAutonomic Nervous System DiseasesCase-Control StudiesDiabetes Mellitus, Type 1Diabetic NeuropathiesFemaleFluorescent Antibody Technique, IndirectGanglia, AutonomicGanglia, ParasympatheticHeartHumansMaleMiddle AgedSympathetic Nervous System

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

9632120

Citation

Muhr-Becker, D, et al. "Evidence for Specific Autoimmunity Against Sympathetic and Parasympathetic Nervous Tissues in Type 1 Diabetes Mellitus and the Relation to Cardiac Autonomic Dysfunction." Diabetic Medicine : a Journal of the British Diabetic Association, vol. 15, no. 6, 1998, pp. 467-72.
Muhr-Becker D, Ziegler AG, Druschky A, et al. Evidence for specific autoimmunity against sympathetic and parasympathetic nervous tissues in Type 1 diabetes mellitus and the relation to cardiac autonomic dysfunction. Diabet Med. 1998;15(6):467-72.
Muhr-Becker, D., Ziegler, A. G., Druschky, A., Wolfram, G., Haslbeck, M., Neundörfer, B., Standl, E., & Schnell, O. (1998). Evidence for specific autoimmunity against sympathetic and parasympathetic nervous tissues in Type 1 diabetes mellitus and the relation to cardiac autonomic dysfunction. Diabetic Medicine : a Journal of the British Diabetic Association, 15(6), 467-72.
Muhr-Becker D, et al. Evidence for Specific Autoimmunity Against Sympathetic and Parasympathetic Nervous Tissues in Type 1 Diabetes Mellitus and the Relation to Cardiac Autonomic Dysfunction. Diabet Med. 1998;15(6):467-72. PubMed PMID: 9632120.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evidence for specific autoimmunity against sympathetic and parasympathetic nervous tissues in Type 1 diabetes mellitus and the relation to cardiac autonomic dysfunction. AU - Muhr-Becker,D, AU - Ziegler,A G, AU - Druschky,A, AU - Wolfram,G, AU - Haslbeck,M, AU - Neundörfer,B, AU - Standl,E, AU - Schnell,O, PY - 1998/6/19/pubmed PY - 1998/6/19/medline PY - 1998/6/19/entrez SP - 467 EP - 72 JF - Diabetic medicine : a journal of the British Diabetic Association JO - Diabet Med VL - 15 IS - 6 N2 - There is growing evidence for the involvement of immunological factors in the pathogenesis of cardiac autonomic dysfunction in Type 1 diabetes mellitus (DM). To evaluate the presence of autoantibodies against autonomic nervous tissues and their relationship with tests of autonomic function, 64 newly diagnosed and 142 long duration Type 1 DM patients were investigated for sympathetic and parasympathetic ganglia (CF-SG and CF-PSG) autoantibodies with a complement-fixing indirect immunofluorescence technique. Five cardiac reflex tests were performed to assess autonomic function. Fifty-seven patients with neurological diseases other than diabetic neuropathy and 131 healthy control subjects were also tested for CF-SG and CF-PSG autoantibodies. CF-SG autoantibodies were observed in 47 (23%) and CF-PSG autoantibodies in 21 (10%) of 206 Type 1 DM patients (p < 0.001). In contrast, these autoantibodies were detected in 3 (5%) and 1 (2%) of patients with non-diabetic neurological diseases and 3 (2%) and 4 (3%) of control subjects (p < 0.01, p < 0.05, p < 0.0001, p < 0.05 vs Type 1 DM patients). All except two Type 1 DM patients with CF-PSG autoantibodies also presented with CF-SG autoantibodies. In diabetic patients with long duration, CF-SG autoantibodies were more frequent in patients with ECG-based cardiac autonomic neuropathy (CAN; > or =2 of 5 cardiac reflex tests abnormal) compared to patients without CAN although this did not reach statistical significance (29% vs 17%, p = 0.06). However, 4 (80%) of 5 newly diagnosed and 23 (32%) of 73 established Type 1 DM patients with abnormalities in heart rate variation during deep breathing and/or standing from lying presented with CF-SG autoantibodies compared to 12 (25%) of 58 newly diagnosed (p < 0.05) and 7 (11%) of 63 established Type 1 DM patients (p < 0.01), in whom both tests were normal. The results suggest that autoimmune factors contribute to the pathogenesis of cardiac autonomic dysfunction in Type 1 DM and that autoantibodies against sympathetic and parasympathetic nervous tissues are relatively specific for Type 1 DM. SN - 0742-3071 UR - https://www.unboundmedicine.com/medline/citation/9632120/Evidence_for_specific_autoimmunity_against_sympathetic_and_parasympathetic_nervous_tissues_in_Type_1_diabetes_mellitus_and_the_relation_to_cardiac_autonomic_dysfunction_ L2 - http://www.diseaseinfosearch.org/result/8214 DB - PRIME DP - Unbound Medicine ER -