Autonomic Abnormalities and Autoantibodies to Beta-Adrenergic Receptors

Abstract

We identified autoantibodies to β₂-adrenergic receptors in the plasma of three apparently normal subjects, four patients with allergic asthma, one subject who was "preallergic" (at risk of allergy), and one patient with cystic fibrosis. Although these antibodies appeared to be heterogeneous, they shared the ability to affect binding of [¹²⁵l]protein A to calf-lung membranes, to inhibit beta-adrenergic ligand binding to calf-lung beta-adrenergic receptors, and to precipitate solubilized calf-lung beta-adrenergic receptors in an indirect immunoprecipitation assay. The presence of autoantibodies to beta-adrenergic receptors in these subjects correlates with abnormal autonomic responsiveness characterized by alpha-adrenergic and cholinergic hypersensitivity and beta-adrenergic hyposensitivity. These findings suggest that autoantibodies to beta-adrenergic receptors may play a part in the development of autonomic abnormalities. (N Engl J Med. 1981; 305:1165–70.)