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[Autoimmunity and paraneoplastic neurologic syndromes]
J Y Delattre1, L Davila, F Vega
1Clinique Neurologique, Hôpital de la Salpêtrière, Paris.
Revue Neurologique
|January 1, 1991
Summary
High levels of antineuronal antibodies (AB) aid in diagnosing rare paraneoplastic syndromes when cancer is unknown. Identifying specific AB, like anti-Yo and anti-Hu, can pinpoint the primary tumor location.
Area of Science:
- Neurology
- Immunology
- Oncology
Context:
- Paraneoplastic syndromes affecting the nervous system are rare and challenging to diagnose, especially when the primary cancer is unknown.
- Elevated levels of specific antineuronal antibodies (AB) in serum and cerebrospinal fluid (CSF) have been observed in patients with these syndromes.
Purpose:
- To highlight the diagnostic and localizing value of detecting antineuronal antibodies in suspected paraneoplastic neurological syndromes.
- To discuss the known targets and associated cancers for specific antineuronal antibodies, such as anti-Yo and anti-Hu.
Summary:
- The anti-Yo antibody targets 34 and 62 kDa proteins in Purkinje cells and cancer cells, associated with paraneoplastic cerebellar degeneration in ovarian and breast cancer.
- The anti-Hu antibody targets a 37-40 kDa protein in neuronal nuclei and tumor cells, linked to subacute sensory neuronopathy and encephalomyelitis in small cell lung cancer.
- The presence of high titers of these antibodies confirms neurological diagnoses and suggests primary tumor locations, though their pathogenetic role and effective treatments remain under investigation.
Impact:
- Detection of antineuronal antibodies provides crucial diagnostic confirmation and aids in identifying the primary tumor site in unknown malignancies.
- Understanding the antigens targeted by these antibodies may elucidate the immune mechanisms underlying paraneoplastic neurological disorders.
- Further research is needed to explore the pathogenetic role of these antibodies and develop effective therapeutic strategies.