TY - JOUR
T1 - Peripherin-IgG association with neurologic and endocrine autoimmunity
AU - Chamberlain, Jayne L.
AU - Pittock, Sean J.
AU - Oprescu, Anna Maria
AU - Dege, Carissa
AU - Apiwattanakul, Metha
AU - Kryzer, Thomas J.
AU - Lennon, Vanda A.
N1 - Funding Information:
The authors thank Drs. Radhika Dhamija, Shannon Hinson, Christopher Klein and Daniel Lachance, and James Thoreson, James Fryer, Hui Tang and Mayo Core Facilities (Proteomics, Ben Madden, and Confocal Microscopy, Jim Tarara) for their contributions to this study, which was supported by NIH grants R01-DK71209 and P01-DK68055.
PY - 2010/6
Y1 - 2010/6
N2 - Peripherin-IgG has been reported a pertinent autoantibody in non-obese type 1 diabetic (NOD) mice. However, it has not previously been recognized in any human disease. In blinded evaluation of serum for markers of neurological autoimmunity in a high-volume diagnostic laboratory, we incidentally identified 26 patients (61% female) with an IgG that bound selectively to neural elements in enteric ganglia, sympathetic nerve trunks and discrete nerve tracts in mid-brain and hind-brain. The target antigen was identified as peripherin, a 55. kDa - type III intermediate filament protein. Review of clinical histories revealed that 54% of seropositive patients had dysautonomia (predominantly gastrointestinal dysmotility), 30% had neuropathies with varied sensory symptoms and 35% had clinical or serological evidence of endocrinopathy (type 1 diabetes, thyroiditis or premature ovarian failure). Collectively, 73% had autonomic dysfunction or endocrinopathy. None of 173 healthy subjects was seropositive. Subsequent western blot evaluation of archival sera from patients with small fiber/autonomic neuropathies (with or without endocrinopathy) revealed a 33% seropositivity rate for peripherin-IgG. Our further demonstration that peripherin-immunoreactive autonomic fibers in pancreas, thyroid and ovary are juxtaposed to endocrine epithelium, complement our clinical observations in suggesting that neuronal elements may be a pertinent initial target for immune attack in multiple forms of endocrine autoimmunity (intermolecular epitope spreading). It remains to be determined whether or not peripherin-IgG is predictive for development of small fiber neuropathy (autonomic or somatic).
AB - Peripherin-IgG has been reported a pertinent autoantibody in non-obese type 1 diabetic (NOD) mice. However, it has not previously been recognized in any human disease. In blinded evaluation of serum for markers of neurological autoimmunity in a high-volume diagnostic laboratory, we incidentally identified 26 patients (61% female) with an IgG that bound selectively to neural elements in enteric ganglia, sympathetic nerve trunks and discrete nerve tracts in mid-brain and hind-brain. The target antigen was identified as peripherin, a 55. kDa - type III intermediate filament protein. Review of clinical histories revealed that 54% of seropositive patients had dysautonomia (predominantly gastrointestinal dysmotility), 30% had neuropathies with varied sensory symptoms and 35% had clinical or serological evidence of endocrinopathy (type 1 diabetes, thyroiditis or premature ovarian failure). Collectively, 73% had autonomic dysfunction or endocrinopathy. None of 173 healthy subjects was seropositive. Subsequent western blot evaluation of archival sera from patients with small fiber/autonomic neuropathies (with or without endocrinopathy) revealed a 33% seropositivity rate for peripherin-IgG. Our further demonstration that peripherin-immunoreactive autonomic fibers in pancreas, thyroid and ovary are juxtaposed to endocrine epithelium, complement our clinical observations in suggesting that neuronal elements may be a pertinent initial target for immune attack in multiple forms of endocrine autoimmunity (intermolecular epitope spreading). It remains to be determined whether or not peripherin-IgG is predictive for development of small fiber neuropathy (autonomic or somatic).
KW - Autoimmune endocrinopathy
KW - Dysautonomia
KW - NOD mice
KW - Peripheral neuropathy
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U2 - 10.1016/j.jaut.2009.12.004
DO - 10.1016/j.jaut.2009.12.004
M3 - Article
C2 - 20061119
AN - SCOPUS:77952236568
SN - 0896-8411
VL - 34
SP - 469
EP - 477
JO - Journal of Autoimmunity
JF - Journal of Autoimmunity
IS - 4
ER -