Neurofascin Antibodies in a Large Cohort of Inflammatory Neuropathies from India

Inflammatory neuropathies are a heterogeneous group of disorders of the peripheral nerves. Pathogenic antibodies targeting various antigens at the node-paranode junctions, leading to its disorganization, are increasingly recognized as accounting for an important subset of inflammatory neuropathies. Among these, antibodies against neurofascin (NF)155 and NF186 are the most widely recognized. The current study aimed to determine the prevalence of NF155 and NF186 antibodies in an Indian cohort of patients with inflammatory neuropathies.

Seventy-six patients with inflammatory neuropathies, including 44 with Guillain-Barré syndrome (GBS) and 32 with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), and 32 healthy controls were recruited. NF155 and NF186 antibodies were tested in sera from all study participants.

In this study, 8/76 (10.53%) patients with inflammatory neuropathies tested positive for NF186 antibodies, including 5 (11.36%) with GBS and 3 (9.37%) with CIDP. Given the small sample size, definitive differences between the NF186 antibody-positive and antibody-negative groups could not be established. None of the patients with GBS and NF186 antibody positivity required mechanical ventilation. None of the patients with CIDP and NF186 antibody positivity had an acute GBS-like onset. One patient in the NF186 antibody-positive CIDP group had the phenotype of combined central and peripheral demyelination. None of the study participants tested positive for NF155 antibodies.

A higher proportion of GBS patients showed NF186 reactivity in the present study than in previous reports. The spectrum of other pathogenic antibodies remains to be tested, as the majority of patients with inflammatory neuropathies tested negative for the two NF antibodies.