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A Simple Cell-based Immunofluorescence Assay to Detect Autoantibody Against the N-Methyl-D-Aspartate (NMDA) Receptor in Blood
Published on: January 9, 2018
Neuronal autoantigens--pathogenesis, associated disorders and antibody testing
1Department of Neurology, 3 W Gates, 3400 Spruce Street, University of Pennsylvania, Philadelphia, PA 19104, USA. eric.lancaster@uphs.upenn.edu
Nature Reviews. Neurology
|June 20, 2012
Summary
Antibodies targeting neuronal cell-surface proteins offer new insights into CNS autoimmunity, enabling recovery in many patients. Disorders targeting intracellular antigens show poorer treatment response due to irreversible neuronal damage.
Area of Science:
- Neuroimmunology
- Neurology
- Autoimmune Disorders
Background:
- Antibodies targeting neuronal cell-surface proteins have revolutionized understanding of CNS autoimmunity.
- These disorders, often affecting young individuals, present with diverse neurological and psychiatric symptoms previously considered idiopathic.
- Autoantigens involved play critical roles in synaptic function and nerve excitability.
Purpose of the Study:
- To review neuronal antibody targets, emphasizing cell-surface and synaptic antigens.
- To present an algorithm for identifying and assessing antibodies against these antigens.
- To differentiate prognosis based on antibody targets (cell-surface vs. intracellular).
Main Methods:
- Literature review of neuronal antibody targets.
- Focus on cell-surface and synaptic autoantigens: NMDA, AMPA, GABA receptors, LGI1, CASPR2, mGluRs.
- Development of a diagnostic and assessment algorithm for cell-surface/synaptic antibodies.
Main Results:
- Cell-surface/synaptic antibody disorders show potential for significant recovery with immunotherapy.
- Intracellular antibody disorders are associated with T-cell-mediated neuronal degeneration and poorer treatment outcomes.
- Identified key autoantigens include NMDA, AMPA, GABA receptors, LGI1, CASPR2, and mGluRs.
Conclusions:
- Antibodies to neuronal cell-surface proteins represent a treatable cause of CNS disorders.
- Distinguishing between cell-surface and intracellular targets is crucial for prognosis and treatment strategy.
- The proposed algorithm aids in the identification and management of these complex autoimmune neurological conditions.
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