Variability of antibody clones against alpha-synuclein and their use in the detection of Lewy pathology

According to the current recommended criteria for the diagnosis and staging of the Lewy body disease, it is necessary to evaluate the presence of Lewy bodies and Lewy neurites in specific areas of the brain. The most widely used staging systems assess the degree of neurodegeneration based on the distribution of Lewy pathology across specific anatomical regions of the brain, progressing in a caudo-rostral trajectory. Choosing the right antibody clone and using an optimized protocol including effective antigen retrieval is essential for the visualization of diagnostic deposits. The aim of our study was to evaluate the utility of some commercially available and widely used primary antibodies against alpha-synuclein in the context of post mortem diagnosis and staging of Lewy body disease. We focused on immunohistochemical and immunofluorescence analysis of Lewy pathology using antibodies with epitopes in all parts of the alphasynuclein polypeptide chain, including a conformation-specific clone and a clone for the detection of post-translationally modified protein.