MARKERS OF HUMORAL AUTOIMMUNITY IN AUTOIM MUNE ENDOCRINE DISEASES

To clarify the value of autoantibodies as risk factors of complication s in various endocrine abnormalities, the incidence bf autoantibodies to thyroid microsomal antigen (ATMA), thyroglobulin, and the surface a ntigens of the rat islet, adrenal cortex, adenohypophyseal cells and h uman skin fibroblasts was studied in patients with insulin-dependent m ellitus (IDDM), at the onset of the disease and during one-year insuli n therapy, non-insulin-dependent diabetes mellitus (NIDDM), Hashimoto thyroiditis, Graves' disease, diabetes associated with thyroidal dysfu nction, euthyroid polynodular goiter, Schmidt and polyglandular syndro mes and in the population. The antibodies were determined by ELISA. Po lyclonal activation of the immune system was found in all abnormalitie s, except in polyglandular in children. The proportion of patients wit h more than one type of antibodies was minimal (26.4%) in IDDM and max imal (62.0%) in Graves' disease. Among IDDM patients, polyclonal activ ation of the immune system was observed more often in women than in th en (48.5 vs 8.5%). The persistence of antibodies tb fibroblasts in IDD M patients was associated with the development of vascular complicatio ns. The latter were obserbed in 4 of 7 patients who had these antibodi es during a year and in none of negative patients. Thus, fibroblast an tibodies may have a predicative significance for the development of la te diabetic complications. The highest prevalence of these antibodies was discovered in Graves' disease (37.9%) wherein the antobodies may-b e involved in the development of exophthalmus and pretibial mixedema. Thyroidal dysfunction developed in all IDDM patients with ATMA preserv ed during a year and in none ATMA-negative patients. In the group of p atients with euthyroidal polynodular goiter, all ATMA-positive persons (n=22) and only 3 of 35 ATMA-negative patients had lymphocytic infilt ration or focal thyroiditis in the adjacent nodular thyroid tissue. In this patient group, an association between the presence of anti-hypos eal antibodies and the abnormal response of growth hormone to thyrotro pin-releasing factor was found. Thus, the investigation suggests that some autoantibodies to endocrine and extraendocrine tissue antigens ar e predicatively significant for the development of endocrine abnormali ties.