Abstract
A number of investigators have reported the detection of circulating autoantibodies directed against serum and cerebrospinal fluid (CSF) neuronal antigens in certain neurological clinical conditions. Using an immunohistochemical technique, we examined the sera and (when available) the CSF from 120 patients with several neurological disorders and 40 controls in order to analyze the incidence and specificity of the detection of these autoantibodies.
Circulating autoantibodies were found in 3 patients with cerebellar degeneration and in 3 patients with stiff-man syndrome, and different staining patterns were revealed in the same disease. Our findings confirm the reported disease-specificity of the detection of these autoantibodies in biological fluids, suggesting that a standardized immunohistochemical technique could constitute an easy and reproducible diagnostic tool in selected neurological conditions. These procedures enable the identification of an immunological pathogenesis of the disease and, in some case, early cancer detection. When atypical staining patterns of staining are found at immunohistochemistry, Western blot characterization of the recognized neuronal antigens is recommended.
Sommario
Diversi autori hanno descritto la presenza di autoanticorpi diretti contro antigeni neuronali nel siero e nel liquor di pazienti con alcune malattie neurologiche. Nel nostro studio abbiamo analizzato con metodiche immunoistochimiche il siero e, quando disponibile, il liquor di 120 pazienti con diverse malattie neurologiche ed il siero di 40 soggetti di controllo.
Sono stati rinvenuti autoanticorpi reattivi con antigeni neuronali in 3 pazienti con disturbi cerebellari (in 2 di origine paraneoplastica) ed in 3 pazienti con stiff-man syndrome. Il pattern di reattività è risultato tuttavia differenziato anche all'interno delle stesse patologie. I nostri risultati confermano la specificità del riscontro di questi autoanticorpi nei liquidi biologici. L'utilizzo di una metodica immunoistochimica rigorosamente standardizzata quò costituire pertanto un semplice e riproducibile ausilio diagnostico in alcune malattie neurologiche. Infatti questa metodica può consentire l'identificazione della patogenesi immunologica di una malattia e, in qualche caso, una diagnosi precoce di tumore. Nei casi di riscontro all'immunoistochimica di patterns di colorazione atipici risulta tuttavia importante anche la identificazione del peso molecolare dell' antigene riconosciuto (mediante metodiche elettroforetiche-Western Blot).
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References
Baekkeskov S., Aanstoot H.J., Christgau S., et al.,Identification of the 64K autoantigen in insulin-dependent diabetes as the GABA-synthesizing enzyme glutamic acid decarboxylase. Nature, 347:151–156, 1990.
Brashaer H.R., Greenlee J.E., Jaeckle K.A., Rose J.W.:Anticerebellar antibodies in neurologically normal patients with ovarian neoplasm. Neurology, 39:1605–1609, 1989.
Fathallah-Shaykh H., Wolf S., Wong E., et al.:Cloning of a leucine-zipper protein recognized by the sera of patients with antibody-associated paraneoplastic cerebellar degeneration. Proc. Natl. Acad. Sci. USA, 88:3451–3454, 1991.
Folli F., Solimena M., Cofiell R., et al.:Autoantibodies to a 128-Kd synaptic protein in free women with stiff-man syndrome and breast cancer. N. Engl. J. Med., 328:546–551, 1993.
Furneaux H.M., Rosenblum M.K., Dalmau J., et al.:Selective expression of Purkinje cell antigens in tumor tissue from patients with paraneo-plastic cerebellar degeneration. N. Engl. J. Med., 322:1844–1851, 1990.
Grimaldi L.:Sindromi neurologiche paraneo-plastiche. In: Tavolato B. (ed.) Neuroimmunologia Clinica. Il Pensiero Scientifico Editore, Roma, pp. 169–188, 1993.
Jaeckle K.A., Graus F., Houghton A., et al.:Autoimmune response of patients with paraneo-plastic cerebellar degeneration to a Purkinje cell cytoplasmic protein antigen. Ann. Neurol., 18:592–600, 1985.
Peterson K., Rosenblum M.K., Kotanides H., et al.:Paraneoplastic cerebellar degeneration. I.A clinical analysis of 55 anti-Yo antibody-positive patients. Neurology, 42:1931–1937, 1992.
Solimena M., Folli F., Denis-Donini S., et al.:Auto-antibodies to glutamic acid decarboxylase in a patient with stiff-man syndrome, epilepsy, and type I diabetes mellitus. N. Engl. J. Med., 318:1012–1020, 1988.
Solimena M., Foili F., Aparisi R., et al.:Autoantibodies to GABA-ergic neurons and pancreatic beta cells in stiff-man syndrome. N. Engl. J. Med., 322:1555–1560, 1990.
Tsukamoto T., Yamamoto H., Iwasaki Y., et al.:Antineural autoantibodies in patients with paraneoplastic cerebellar degereration. Arch. Neurol., 46:1225–1229, 1989.
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Giometto, B., Bozza, F., Faresin, F. et al. Circulating autoantibodies against central nervous system (CNS) antigens in neurological diseases. Ital J Neuro Sci 15, 177–182 (1994). https://doi.org/10.1007/BF02339320
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DOI: https://doi.org/10.1007/BF02339320