Investigation of Antimuscarinic Receptor Autoantibodies in Patients with Acquired Idiopathic Generalized Anhidrosis

Abstract

Objective The autoimmune mechanism is considered to play an important role in the development of acquired idiopathic generalized anhidrosis (AIGA), and muscarinic M3 receptors (M3Rs) on eccrine glands are possible autoimmune targets. We investigated the existence of autoantibodies against M3Rs in AIGA patients. Methods We immunostained M3R-expressing cultured cells with the serum of 12 AIGA patients (mean age: 35.0±11.7 years, mean disease duration: 26.6±25.8 months) and 10 healthy subjects (mean age: 32.4± 10.4 years). Results The surface of the M3R-expressing cells was stained by the serum obtained from one of the 12 AIGA patients but not by the serum obtained from the remaining 11 patients or healthy subjects. Conclusion The presence of M3R autoantibodies may therefore be related to the underlying mechanism of disease in a subset of AIGA patients.

Revised guideline for the diagnosis and treatment of acquired idiopathic generalized anhidrosis in Japan

“…This lends credence to the theory that an autoimmune mechanism is involved . The involvement of autoantibodies to the muscarinic acetylcholine M3 receptor in sweat glands has been proposed as the underlying mechanism …”

“…6 The involvement of autoantibodies to the muscarinic acetylcholine M3 receptor in sweat glands has been proposed as the underlying mechanism. 7 Sudomotor neuropathy is believed to affect only sudomotor function without causing any other types of neuropathy. In sudomotor neuropathy, the following have been proposed as possible sites of dysfunction: (i) the hypothalamus; 8 (ii) the medulla oblongata and spinal cord; and (iii) the preganglionic and postganglionic sympathetic efferent fibers.…”

Degranulation and shrinkage of dark cells in eccrine glands and elevated serum carcinoembryonic antigen in patients with acquired idiopathic generalized anhidrosis

“…The pathognomonic changes are still unknown, but good responses to steroid therapy suggest that an autoimmune mechanism underlies AIGA aetiology. Pathological roles of various cells and molecules have been implied so far, such as mast cells, T cells, acetylcholine esterase and acetylcholine receptor M3 . However, they have not been established as having definite pathological effects.…”

Evaluation of the correlation between severity of acquired idiopathic generalized anhidrosis and quality of life scores

“…Acquired idiopathic generalized anhidrosis (AIGA) manifests with symptoms of heat retention and/or heat stroke due to the effects of the disorder on the perspiration ability of the whole body under thermal environmental changes or during exercise. 1,2 Moreover, cholinergic urticaria causes tingling pain in the whole body. While it is suspected that AIGA has a major impact on everyday life and in work situations, the degree of the actual impact is not well understood.…”