High prevalence of autoantibodies against carbonic anhydrase II and lactoferrin in type 1 diabetes: concept of autoimmune exocrinopathy and endocrinopathy of the pancreas

Pancreas. 2003 Jul;27(1):26-30. doi: 10.1097/00006676-200307000-00004.

Abstract

Introduction: 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.

Aims: To investigate the involvement of autoimmunity against the exocrine pancreas in type 1 diabetes.

Methodology: 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Asian Continental Ancestry Group
  • Autoantibodies / blood
  • Autoantibodies / immunology*
  • Carbonic Anhydrase II / immunology*
  • Child
  • Diabetes Mellitus, Type 1 / immunology*
  • Diabetes Mellitus, Type 2 / immunology*
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Humans
  • Japan
  • Lactoferrin / immunology*
  • Male
  • Middle Aged
  • Pancreatic Ducts / immunology

Substances

  • Autoantibodies
  • Lactoferrin
  • Carbonic Anhydrase II