Autoantibodies to nervous tissue structures are associated with autonomic neuropathy in type 1 (insulin-dependent) diabetes mellitus

Diabetologia. 1993 Jun;36(6):564-9. doi: 10.1007/BF02743275.


There is evidence that the immune system may play a role in the pathogenesis of autonomic neuropathy in Type 1 (insulin-dependent) diabetes mellitus. In the present study, we investigated the presence of autoantibodies to sympathetic and parasympathetic nervous structures and their correlation with other conventional autoantibodies in well-characterised diabetic populations, with or without diabetic neuropathy, and normal subjects. An indirect immunofluorescent complement-fixation technique was used, with monkey adrenal gland, rabbit cervical ganglia and vagus nerve as substrates. Of the patients with symptomatic autonomic neuropathy 33% were positive for at least one autoantibody (20% anti-sympathetic ganglia, 10% anti-vagus nerve and 13% anti-adrenal medulla). The frequency of having one or more antibodies to nervous tissues and the prevalence of anti-cervical ganglia antibodies were significantly higher in the neuropathic patients than in the diabetic control subjects with disease of similar duration and in the normal subjects (p < 0.05). Of the patients without complications with diabetes of shorter duration 33% were also positive for at least one autoantibody (13% anti-ganglia, 13% anti-vagus nerve and 13% anti-adrenal medulla). No correlation was found with other tissue autoantibodies, including islet cell antibodies. Our data indicate that nervous tissue autoantibodies are associated with symptomatic autonomic neuropathy. Anti-sympathetic ganglia and anti-vagus nerve antibodies seem to be more disease-specific. Patients with diabetes of shorter duration who were positive for these autoantibodies may represent pre-neuropathic patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adrenal Glands / innervation
  • Adult
  • Animals
  • Autoantibodies / blood*
  • Autonomic Nervous System / physiopathology*
  • Blood Pressure
  • Child
  • Child, Preschool
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / immunology*
  • Diabetes Mellitus, Type 1 / physiopathology
  • Diabetic Neuropathies / blood
  • Diabetic Neuropathies / immunology*
  • Diabetic Neuropathies / physiopathology
  • Female
  • Fluorescent Antibody Technique
  • Ganglia, Sympathetic / cytology
  • Ganglia, Sympathetic / immunology*
  • Haplorhini
  • Heart Rate
  • Humans
  • Male
  • Middle Aged
  • Nerve Fibers / immunology
  • Rabbits
  • Reference Values
  • Time Factors
  • Vagus Nerve / cytology
  • Vagus Nerve / immunology*
  • Valsalva Maneuver


  • Autoantibodies