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Paraneoplastic cerebellar degeneration associated with an onconeural antibody against creatine kinase, brain-type

Syuichi Tetsuka1, Kaoru Tominaga, Eriko Ohta

  • 1Division of Neurology, Department of Internal Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498 Japan; Department of Biochemistry, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498 Japan.

Journal of the Neurological Sciences
|September 11, 2013
PubMed

Insights

Researchers identified a new onconeural antibody, anti-creatine kinase, brain-type (CKB), in a patient with paraneoplastic cerebellar degeneration (PCD) and bladder cancer. This discovery may aid in diagnosing PCD, a rare neurological complication of cancer.

Area of Science:

  • Neuroimmunology
  • Oncology
  • Proteomics

Background:

  • Paraneoplastic neurological syndromes (PNS), like paraneoplastic cerebellar degeneration (PCD), arise from onconeural immunity, where anti-cancer immune responses mistakenly target neural tissues.
  • Standard diagnostic markers for PNS, including specific onconeural antibodies, were absent in a patient with PCD and urothelial carcinoma (UC).

Observation:

  • A proteomic approach using mass spectrometry was employed to identify novel autoantibodies in the patient's serum and cerebrospinal fluid.
  • The study focused on identifying an antibody that cross-reacts with both cerebellar neurons and the patient's UC tissues.

Findings:

  • A novel autoantibody, anti-creatine kinase, brain-type (CKB), was identified in the patient's serum and cerebrospinal fluid.
  • Immunohistochemistry confirmed that anti-CKB antibody targets both cerebellar neurons and UC tissues.
  • Anti-CKB antibody was detected in three additional PCD patients but not in healthy donors or bladder cancer patients without PCD, suggesting its specificity for PCD.

Implications:

  • Anti-CKB antibody represents a new potential biomarker for diagnosing paraneoplastic cerebellar degeneration.
  • The findings expand the repertoire of known onconeural antibodies associated with PNS, improving diagnostic capabilities.
  • This research highlights the importance of exploring novel autoantibodies in challenging PNS cases, particularly those lacking established serological markers.
Keywords:
CancerCreatine kinase, brain-typeOnconeural antibodyParaneoplastic cerebellar degenerationParaneoplastic neurological syndromesProteomics

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