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Onconeural antigen spreading in paraneoplastic neurological disease due to small cell lung cancer

Andre Dik1, Christine Strippel1, Constanze Mönig1

  • 1Department of Neurology, University of Münster, Albert-Schweitzer-Campus 1, Münster, Germany.

Oxford Medical Case Reports
|July 14, 2018
PubMed

Insights

Paraneoplastic neurological diseases (PNDs) involve immune responses to onconeural antigens. This study details antigen spreading in small cell lung cancer (SCLC), revealing potential dissociation between anti-tumor and anti-neural immunity.

Area of Science:

  • Neuroimmunology
  • Oncology

Background:

  • Paraneoplastic neurological diseases (PNDs) are characterized by immune responses targeting onconeural antigens.
  • While IgG antibodies to single antigens are common, multiple antigen specificities are rare, often associated with specific cancers like small cell lung cancer (SCLC).

Observation:

  • A case study of a 70-year-old male with PND and SCLC exhibiting onconeural antigen spreading.
  • The patient displayed a broadening immune response against multiple onconeural antigens over time.

Findings:

  • Onconeural antigen spreading in PND can be driven by tumor antigen expression changes due to mutagenic processes.
  • A self-propagating immune response causing neuronal destruction can also lead to antigen spreading.

Implications:

  • This phenomenon highlights potential mechanisms for the development of PNDs.
  • It suggests a possible dissociation between the immune system's response to the tumor and its response to neural tissue during PND progression.

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