{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T06:01:00Z","timestamp":1792735260993,"version":"4.5.0"},"reference-count":146,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2020,2,16]],"date-time":"2020-02-16T00:00:00Z","timestamp":1581811200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Autonomic neuropathy has been reported in autoimmune rheumatic diseases (ARD) including Sj\u00f6gren\u2019s syndrome, systemic sclerosis, rheumatoid arthritis, and systemic lupus erythematosus. However, the pathophysiological mechanism underlying autonomic dysfunction remains unknown to researchers. On the other hand, autoimmune autonomic ganglionopathy (AAG) is an acquired immune-mediated disorder, which causes dysautonomia that is mediated by autoantibodies against ganglionic acetylcholine receptors (gAChRs). The purpose of this review was to describe the characteristics of autonomic disturbance through previous case reports and the functional tests used in these studies and address the importance of anti-gAChR antibodies. We have established luciferase immunoprecipitation systems to detect antibodies against gAChR in the past and determined the prevalence of gAChR antibodies in various autoimmune diseases including AAG and rheumatic diseases. Autonomic dysfunction, which affects lower parasympathetic and higher sympathetic activity, is usually observed in ARD. The anti-gAChR antibodies may play a crucial role in autonomic dysfunction observed in ARD. Further studies are necessary to determine whether anti-gAChR antibody levels are correlated with the severity of autonomic dysfunction in ARD.<\/jats:p>","DOI":"10.3390\/ijms21041332","type":"journal-article","created":{"date-parts":[[2020,2,19]],"date-time":"2020-02-19T04:06:01Z","timestamp":1582085161000},"page":"1332","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Ganglionic Acetylcholine Receptor Antibodies and Autonomic Dysfunction in Autoimmune Rheumatic Diseases"],"prefix":"10.3390","volume":"21","author":[{"given":"Michie","family":"Imamura","sequence":"first","affiliation":[{"name":"Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto 860-8556, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7486-0597","authenticated-orcid":false,"given":"Akihiro","family":"Mukaino","sequence":"additional","affiliation":[{"name":"Department of Molecular Neurology and Therapeutics, Kumamoto University Hospital, Kumamoto 860-8556, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koutaro","family":"Takamatsu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto 860-8556, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroto","family":"Tsuboi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki 305-8576, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osamu","family":"Higuchi","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, National Hospital Organization Nagasaki Kawatana Medical Center, Nagasaki 859-3615, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideki","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki 852-8501, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saori","family":"Abe","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki 305-8576, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukio","family":"Ando","sequence":"additional","affiliation":[{"name":"Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto 860-8556, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidenori","family":"Matsuo","sequence":"additional","affiliation":[{"name":"Department of Neurology, National Hospital Organization Nagasaki Kawatana Medical Center, Nagasaki 859-3615, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tadashi","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Kumamoto Sakurajyuji Hospital, Kumamoto 861-4173, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takayuki","family":"Sumida","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki 305-8576, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Kawakami","sequence":"additional","affiliation":[{"name":"Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki 852-8501, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1958-095X","authenticated-orcid":false,"given":"Shunya","family":"Nakane","sequence":"additional","affiliation":[{"name":"Department of Molecular Neurology and Therapeutics, Kumamoto University Hospital, Kumamoto 860-8556, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,2,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1097\/NRL.0000000000000134","article-title":"Spectrum of Autonomic Nervous System Impairment in Sj\u00f6gren Syndrome","volume":"22","author":"Goodman","year":"2017","journal-title":"Neurologist"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"99","DOI":"10.5114\/reum.2018.75521","article-title":"Neurological manifestations of primary Sj\u00f6gren\u2019s syndrome","volume":"56","author":"Gasik","year":"2018","journal-title":"Reumatologia"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/j.semarthrit.2013.05.002","article-title":"Neurologic involvement in scleroderma: A systematic review","volume":"43","author":"Amaral","year":"2013","journal-title":"Semin. 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