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IgLON5-IgG: Innocent Bystander or Perpetrator?
Jane Andersen1,2, Bronte Jeffrey1,3, Winny Varikatt2,4
1Department of Immunology, NSW Health Pathology-ICPMR, Westmead Hospital, Sydney, NSW 2145, Australia.
Anti-IgLON5-associated disease pathogenesis is debated, with evidence supporting both neurodegenerative and autoimmune mechanisms. Multiple immune pathways likely contribute to this rare neurological condition.
Area of Science:
- Neurology
- Immunology
- Neuroimmunology
Background:
- Anti-IgLON5 (IgLON5-IgG)-associated disease is a recently identified clinical entity.
- Its underlying pathogenesis remains incompletely understood, necessitating further investigation.
Purpose of the Study:
- To review and evaluate the evidence for different pathogenetic mechanisms in Anti-IgLON5-associated disease.
- To explore the potential roles of neurodegeneration and autoimmunity in disease development.
Main Methods:
- Literature review of existing studies on Anti-IgLON5-associated disease.
- Analysis of neuropathological findings, genetic associations, and immunological markers.
Main Results:
- Evidence for neurodegeneration includes tauopathy and MAPT H1/H1 genotype.
- Evidence for autoimmunity includes IgLON5 cell-surface localization, antibody pathogenicity, HLA associations (DRB1*10:01, DQB1*05:01), and immunotherapy response.
Conclusions:
- The pathogenesis of Anti-IgLON5-associated disease is likely multifactorial, involving both neurodegenerative and autoimmune processes.
- Heterogeneity in disease presentation suggests diverse immune mechanisms may operate simultaneously.
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