Disease association, origin, and clinical relevance of autoantibodies to the glycolytic enzyme enolase

Serum autoantibodies to the glycolytic enzyme enolase have been reported in a diverse range of inflammatory, degenerative, and psychiatric disorders. Diseases in which these antibodies have been reported in high incidence inc lude autoimmune polyglandular syndrome type 1 (80%, 35 of 44), primary (69% , 60 of 87), and secondary (58%, 14 of 24) membranous nephropathy, cancer-a ssociated retinopathy (68.8%, 11 of 16), autoimmune hepatitis type 1 (60%, 12 of 20), mixed cryoglobulinemia with renal involvement (63.6%, seven of 1 1), cystoid macular edema (60%, six of 10), and endometriosis (50%, 21 of 4 1). In autoimmune polyglandular syndrome type 1 patients, all had chronic m ucocutaneous candidiasis with demonstrated antibody reactivity to candida e nolase, which is suggestive of cross reactivity or epitope mimicry. Formati on of autoantibodies to enolase may be a normal process, with reported inci dence in apparently healthy subjects ranging from 0% (zero of 91) to 11.7% (seven of 60). Nonetheless, we suggest that excessive production of these a utoantibodies, which are generated as a consequence of uptake of enolase by antigen-presenting cells and subsequent B cell activation, can potentially initiate tissue injury as a result of immune complex deposition.