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A Simple Cell-based Immunofluorescence Assay to Detect Autoantibody Against the N-Methyl-D-Aspartate NMDA Receptor in Blood
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Detection Methods for Autoantibodies in Suspected Autoimmune Encephalitis.
Gerda Ricken1, Carmen Schwaiger1, Desiree De Simoni1
1Institute of Neurology, Medical University of Vienna, Vienna, Austria.
Frontiers in Neurology
|October 27, 2018
Summary
This review details antibody tests for paraneoplastic neurological syndromes (PNS) and autoimmune encephalitis (AIE). It highlights diagnostic value, limitations, and novel methods for detecting onconeuronal and anti-neuronal surface antibodies.
Area of Science:
- Neurology
- Immunology
- Diagnostic Medicine
Background:
- Paraneoplastic neurological syndromes (PNS) and anti-neuronal autoimmune encephalitis (AIE) are rare but serious conditions.
- Onconeuronal antibodies are established biomarkers for PNS, potentially indicating specific tumors.
- Anti-neuronal surface antibodies are key indicators for AIE.
Purpose of the Study:
- To review current and novel antibody test methods for PNS and AIE.
- To explain the diagnostic utility, limitations, and pitfalls of these assays.
- To explore new approaches for discovering additional autoantibodies in autoimmune neurological disorders.
Main Methods:
- Indirect immunohistochemistry on fixed rodent cerebellum combined with line assays for onconeuronal antibodies.
- Cell-based assays and tissue-based assays (TBA) with unfixed rodent brain tissue for anti-neuronal surface antibodies.
- Screening of teased nerve fibers for antibodies in peripheral neuropathy.
Main Results:
- Combining immunohistochemistry and line assays is recommended for onconeuronal antibodies; sole reliance on line assays risks false negatives.
- TBA are effective for screening neuronal surface antibodies and discovering new targets.
- Testing for antibodies against the node of Ranvier aids in identifying a subgroup of peripheral autoimmune neuropathies.
Conclusions:
- Accurate antibody testing is crucial for diagnosing PNS and AIE.
- Tissue-based assays offer broad screening capabilities and aid in discovering novel autoantibodies.
- Improved diagnostic assays enhance immunotherapy for autoimmune neurological conditions.
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