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Mihajkoska E, Poceva Panovska A, Brezovska K, Pendovska M, Taravari A, Suturkova L. The role of antibodies to peripheral nerve antigens in pathogenesis and laboratory evaluation of immune-mediated neuropathies. MAKEDONSKO FARMACEVTSKI BILTEN 2021. [DOI: 10.33320/maced.pharm.bull.2021.67.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Detection of antiganglioside autoantibodies and their association with clinically defined subtypes implicate an autoimmune mechanism of peripheraland cranial nerve damage in peripheral neuropathies.
Increased titer of antibodies that react with human peripheral nerve antigens have been reported in patients with motor neuropathy including Guillain-Barré syndrome,chronic inflammatory demyelinating polyneuropathy, multifocal motor neuropathy and sensory motor neuropathy. This study represents review of the data related to increased titers of anti-glucoconjugate antibodies in different autoimmune neuropathies and their correlation with existence of structural homology between bacterial and glycoconjugated structures, as a basis for understanding the immune pathological response to glycoproteins and glycolipids present in the human peripheral nerve as target antigens in autoimmune neuropathies.
Evaluation of presence and increased level of autoantibodies against peripheral nerve antigens could be an important parameter in laboratory evaluation, diagnosis and prognosis of autoimmune neuropathies and contribute in more efficient therapeutic approaches in treatment of these pathological conditions.
Keywords: anti-glycoconjugate antibodies, anti-ganglioside antibodies, peripheral nerves, autoimmune neuropathies
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Affiliation(s)
- Evgenija Mihajkoska
- Faculty of Pharmacy, Ss. Cyril and Methodius University in Skopje, Mother Theresa 47, 1000 Skopje, Republic of North Macedonia
| | - Ana Poceva Panovska
- Faculty of Pharmacy, Ss. Cyril and Methodius University in Skopje, Mother Theresa 47, 1000 Skopje, Republic of North Macedonia
| | - Katerina Brezovska
- Faculty of Pharmacy, Ss. Cyril and Methodius University in Skopje, Mother Theresa 47, 1000 Skopje, Republic of North Macedonia
| | - Marija Pendovska
- University Clinic for Hematology, Ss. Cyril and Methodius University in Skopje, Mother Theresa 47, 1000 Skopje, Republic of North Macedonia
| | - Arben Taravari
- Universiy Clinic for Neurology, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 50 Divizija 6, 1000 Skopje, Republic of North Macedonia
| | - Ljubica Suturkova
- Faculty of Pharmacy, Ss. Cyril and Methodius University in Skopje, Mother Theresa 47, 1000 Skopje, Republic of North Macedonia
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Abstract
Anti-ganglioside antibodies are principally associated with autoimmune peripheral neuropathies. In these disorders, immune attack is inadvertently directed at peripheral nerve by autoantibodies that target glycan structures borne by glycolipids, particularly gangliosides concentrated in nerve myelin and axons. The most thoroughly studied disorder is the acute paralytic disease, Guillain-Barré syndrome (GBS) in which IgG autoantibodies against gangliosides arise following acute infections, notably Campylobacter jejuni enteritis. Additionally, chronic autoimmune neuropathies are associated with IgM antibodies directed against many glycolipids including gangliosides. This introductory chapter briefly summarizes the immunological and pathological features of these disorders, focusing on the methodological development of antibody measurement and of animal models.
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Affiliation(s)
- Hugh J Willison
- Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, Glasgow Biomedical Research Centre, University of Glasgow, Glasgow, UK.
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3
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Yu XB, Uhde M, Green PH, Alaedini A. Autoantibodies in the Extraintestinal Manifestations of Celiac Disease. Nutrients 2018; 10:E1123. [PMID: 30127251 PMCID: PMC6115844 DOI: 10.3390/nu10081123] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 08/15/2018] [Accepted: 08/17/2018] [Indexed: 02/07/2023] Open
Abstract
Increased antibody reactivity towards self-antigens is often indicative of a disruption of homeostatic immune pathways in the body. In celiac disease, an autoimmune enteropathy triggered by the ingestion of gluten from wheat and related cereals in genetically predisposed individuals, autoantibody reactivity to transglutaminase 2 is reflective of the pathogenic role of the enzyme in driving the associated inflammatory immune response. Autoantibody reactivity to transglutaminase 2 closely corresponds with the gluten intake and clinical presentation in affected patients, serving as a highly useful biomarker in the diagnosis of celiac disease. In addition to gastrointestinal symptoms, celiac disease is associated with a number of extraintestinal manifestations, including those affecting skin, bones, and the nervous system. Investigations of these manifestations in celiac disease have identified a number of associated immune abnormalities, including B cell reactivity towards various autoantigens, such as transglutaminase 3, transglutaminase 6, synapsin I, gangliosides, and collagen. Clinical relevance, pathogenic potential, mechanism of development, and diagnostic and prognostic value of the various identified autoantibody reactivities continue to be subjects of investigation and will be reviewed here.
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Affiliation(s)
- Xuechen B Yu
- Department of Medicine, Columbia University Medical Center, 1130 Saint Nicholas Ave., New York, NY 10032, USA.
- Celiac Disease Center, Columbia University, New York, NY 10032, USA.
- Institute of Human Nutrition, Columbia University, New York, NY 10032, USA.
| | - Melanie Uhde
- Department of Medicine, Columbia University Medical Center, 1130 Saint Nicholas Ave., New York, NY 10032, USA.
- Celiac Disease Center, Columbia University, New York, NY 10032, USA.
| | - Peter H Green
- Department of Medicine, Columbia University Medical Center, 1130 Saint Nicholas Ave., New York, NY 10032, USA.
- Celiac Disease Center, Columbia University, New York, NY 10032, USA.
| | - Armin Alaedini
- Department of Medicine, Columbia University Medical Center, 1130 Saint Nicholas Ave., New York, NY 10032, USA.
- Celiac Disease Center, Columbia University, New York, NY 10032, USA.
- Institute of Human Nutrition, Columbia University, New York, NY 10032, USA.
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4
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Determination of degree of RBC agglutination for blood typing using a small quantity of blood sample in a microfluidic system. Biosens Bioelectron 2018; 102:234-241. [DOI: 10.1016/j.bios.2017.11.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 10/15/2017] [Accepted: 11/01/2017] [Indexed: 12/11/2022]
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Leal de Araujo J, Tizard I, Guo J, Heatley JJ, Rodrigues Hoffmann A, Rech RR. Are anti-ganglioside antibodies associated with proventricular dilatation disease in birds? PeerJ 2017; 5:e3144. [PMID: 28413724 PMCID: PMC5390765 DOI: 10.7717/peerj.3144] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 03/04/2017] [Indexed: 11/20/2022] Open
Abstract
The identification of Parrot bornaviruses (PaBV) in psittacine birds with proventricular dilatation disease (PDD) has not been sufficient to explain the pathogenesis of this fatal disease, since not all infected birds develop clinical signs. Although the most accepted theory indicates that PaBV directly triggers an inflammatory response in this disease, another hypothesis suggests the disease is triggered by autoantibodies targeting neuronal gangliosides, and PDD might therefore resemble Guillain-Barré Syndrome (GBS) in its pathogenesis. Experimental inoculation of pure gangliosides and brain-derived ganglioside extracts were used in two different immunization studies. The first study was performed on 17 healthy chickens (Gallus gallus domesticus): 11 chickens were inoculated with a brain ganglioside extract in Freund’s complete adjuvant (FCA) and six chickens inoculated with phosphate-buffered saline. A second study was performed five healthy quaker parrots (Myiopsitta monachus) that were divided into three groups: Two quaker parrots received purified gangliosides in FCA, two received a crude brain extract in FCA, and one control quaker parrot received FCA alone. One chicken developed difficult in walking. Histologically, only a mild perivascular and perineural lymphocytic infiltrate in the proventriculus. Two quaker parrots (one from each treatment group) had mild lymphoplasmacytic encephalitis and myelitis. However, none of the quaker parrots developed myenteric ganglioneuritis, suggesting that autoantibodies against gangliosides in birds are not associated with a condition resembling PDD.
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Affiliation(s)
- Jeann Leal de Araujo
- Department of Veterinary Pathobiology, Texas A&M University, College Station, TX, United States
| | - Ian Tizard
- Department of Veterinary Pathobiology, Texas A&M University, College Station, TX, United States
| | - Jianhua Guo
- Department of Veterinary Pathobiology, Texas A&M University, College Station, TX, United States
| | - J Jill Heatley
- Department of Small Animal Clinical Sciences, Texas A&M University, College Station, TX, United States
| | | | - Raquel R Rech
- Department of Veterinary Pathobiology, Texas A&M University, College Station, TX, United States
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Shinchi H, Yuki N, Ishida H, Hirata K, Wakao M, Suda Y. Visual Detection of Human Antibodies Using Sugar Chain-Immobilized Fluorescent Nanoparticles: Application as a Point of Care Diagnostic Tool for Guillain-Barré Syndrome. PLoS One 2015; 10:e0137966. [PMID: 26378448 PMCID: PMC4574945 DOI: 10.1371/journal.pone.0137966] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 08/25/2015] [Indexed: 11/18/2022] Open
Abstract
Sugar chain binding antibodies have gained substantial attention as biomarkers due to their crucial roles in various disorders. In this study, we developed simple and quick detection method of anti-sugar chain antibodies in sera using our previously developed sugar chain-immobilized fluorescent nanoparticles (SFNPs) for the point-of-care diagnostics. Sugar chain structure on SFNPs was modified with the sugar moieties of the GM1 ganglioside via our original linker molecule to detect anti-GM1 antibodies. The structures and densities of the sugar moieties immobilized on the nanoparticles were evaluated in detail using lectins and sera containing anti-GM1 antibodies from patients with Guillain-Barré syndrome, a neurological disorder, as an example of disease involving anti-sugar chain antibodies. When optimized SFNPs were added to sera from patients with Guillain-Barré syndrome, fluorescent aggregates were able to visually detect under UV light in three hours. The sensitivity of the detection method was equivalent to that of the current ELISA method used for the diagnosis of Guillain-Barré syndrome. These results suggest that our method using SFNPs is suitable for the point-of-care diagnostics of diseases involving anti-sugar chain antibodies.
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Affiliation(s)
- Hiroyuki Shinchi
- Department of Chemistry, Biotechnology and Chemical Engineering, Kagoshima University, 1-21-40 Kohrimoto, Kagoshima 890–0065, Japan
| | - Nobuhiro Yuki
- Department of Neurology, Dokkyo Medical University, Tochigi 321–0293, Japan
- Brain & Mind Research Institute, University of Sydney, Level 7, Building F, 94 Mallett Street, Camperdown, NSW 2050, Australia
| | - Hideharu Ishida
- Department of Applied Bioorganic Chemistry, Gifu University, Gifu 501–1193, Japan
| | - Koichi Hirata
- Department of Neurology, Dokkyo Medical University, Tochigi 321–0293, Japan
| | - Masahiro Wakao
- Department of Chemistry, Biotechnology and Chemical Engineering, Kagoshima University, 1-21-40 Kohrimoto, Kagoshima 890–0065, Japan
| | - Yasuo Suda
- Department of Chemistry, Biotechnology and Chemical Engineering, Kagoshima University, 1-21-40 Kohrimoto, Kagoshima 890–0065, Japan
- SUDx-Biotec Corporation, 1-42-1 Shiroyama, Kagoshima 890–0013, Japan
- * E-mail:
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7
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Rupp A, Galban-Horcajo F, Bianchi E, Dondi M, Penderis J, Cappell J, Burgess K, Matiasek K, McGonigal R, Willison HJ. Anti-GM2 ganglioside antibodies are a biomarker for acute canine polyradiculoneuritis. J Peripher Nerv Syst 2013; 18:75-88. [PMID: 23521648 PMCID: PMC4854321 DOI: 10.1111/jns5.12011] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Acute canine polyradiculoneuritis (ACP) is considered to be the canine equivalent of the human peripheral nerve disorder Guillain-Barré syndrome (GBS); an aetiological relationship, however, remains to be demonstrated. In GBS, anti-glycolipid antibodies (Abs) are considered as important disease mediators. To address the possibility of common Ab biomarkers, the sera of 25 ACP dogs, 19 non-neurological, and 15 epileptic control dogs were screened for IgG Abs to 10 glycolipids and their 1 : 1 heteromeric complexes using combinatorial glycoarrays. Anti-GM2 ganglioside Abs were detected in 14/25 ACP dogs, and anti-GA1 Abs in one further dog. All controls except for one were negative for anti-glycolipid Abs. In this cohort of cases and controls, the glycoarray screen reached a diagnostic sensitivity of 60% and a specificity of 97%; a lower sensitivity (32%) was reported using a conventional glycolipid ELISA. To address the possible pathogenic role for anti-GM2 Abs in ACP, we identified GM2 in canine sciatic nerve by both mass spectrometry and thin layer chromatography overlay. In immunohistological studies, GM2 was localized predominantly to the abaxonal Schwann cell membrane. The presence of anti-GM2 Abs in ACP suggests that it may share a similar pathophysiology with GBS, for which it could thus be considered a naturally occurring animal model.
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Affiliation(s)
- Angie Rupp
- Neuroimmunology Group, Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Francesc Galban-Horcajo
- Neuroimmunology Group, Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Ezio Bianchi
- Veterinary Teaching Hospital, University of Parma, Parma, Italy
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Maurizio Dondi
- Veterinary Teaching Hospital, University of Parma, Parma, Italy
| | - Jacques Penderis
- School of Veterinary Medicine, Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Joanna Cappell
- Neuroimmunology Group, Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
- Glasgow Polyomics, Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Karl Burgess
- Glasgow Polyomics, Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Kaspar Matiasek
- Section of Clinical and Comparative Neuropathology, Department of Veterinary Clinical Sciences, Ludwig-Maximilians-University, Munich, Germany
| | - Rhona McGonigal
- Neuroimmunology Group, Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Hugh J. Willison
- Neuroimmunology Group, Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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8
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Asati A, Kachurina O, Kachurin A. Simultaneous measurements of auto-immune and infectious disease specific antibodies using a high throughput multiplexing tool. PLoS One 2012; 7:e42681. [PMID: 22952605 PMCID: PMC3431397 DOI: 10.1371/journal.pone.0042681] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2012] [Accepted: 07/11/2012] [Indexed: 11/18/2022] Open
Abstract
Considering importance of ganglioside antibodies as biomarkers in various immune-mediated neuropathies and neurological disorders, we developed a high throughput multiplexing tool for the assessment of gangliosides-specific antibodies based on Biolpex/Luminex platform. In this report, we demonstrate that the ganglioside high throughput multiplexing tool is robust, highly specific and demonstrating ∼100-fold higher concentration sensitivity for IgG detection than ELISA. In addition to the ganglioside-coated array, the high throughput multiplexing tool contains beads coated with influenza hemagglutinins derived from H1N1 A/Brisbane/59/07 and H1N1 A/California/07/09 strains. Influenza beads provided an added advantage of simultaneous detection of ganglioside- and influenza-specific antibodies, a capacity important for the assay of both infectious antigen-specific and autoimmune antibodies following vaccination or disease. Taken together, these results support the potential adoption of the ganglioside high throughput multiplexing tool for measuring ganglioside antibodies in various neuropathic and neurological disorders.
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Affiliation(s)
| | | | - Anatoly Kachurin
- Sanofi Pasteur, VaxDesign Campus, Orlando, Florida, United States of America
- * E-mail:
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9
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Caudie C, Quittard Pinon A, Taravel D, Sivadon-Tardy V, Orlikowski D, Rozenberg F, Sharshar T, Raphaël JC, Gaillard JL. Preceding infections and anti-ganglioside antibody profiles assessed by a dot immunoassay in 306 French Guillain-Barré syndrome patients. J Neurol 2011; 258:1958-64. [PMID: 21516465 DOI: 10.1007/s00415-011-6042-9] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2011] [Revised: 03/21/2011] [Accepted: 04/04/2011] [Indexed: 11/25/2022]
Abstract
We describe by an in-house dot immunoassay, specific anti-ganglioside and sulfatide antibodies, by comparing the results from a large group of 134 infected French GBS patients and those from 172 noninfected French GBS and 142 control groups. A recent infection was identified in 134/306 (43.8%) GBS patients: Campylobacter jejuni (24.6%) was the most common agent, followed by cytomegalovirus (12.4%), Mycoplasma pneumoniae (3.2%) and Epstein-Barr virus (1.3%). Anti-ganglioside antibodies were detected in 97/306 (31.7%) of total GBS patients, 82/134 (61.2%) of GBS patients with a recent identified infection and 15/172 (8.7%) of the patients without identified infection. According to the specificities and antibody classes, four specific IgG antibody profiles were individualised against the two major GM1 and GD1a gangliosides in motor axonal C. jejuni-associated GBS variants, against GQ1b and disialylated gangliosides in Miller Fisher syndrome and its variants. One specific IgM profile against GM2 was found in 16/38 (42%) of severe sensory demyelinating CMV-associated GBS and in 8/17 (47%) of subjects with recent CMV infection with no neurological disease. IgG or IgM antibodies to GM1 were found in 5/10 M. pneumoniae-infected patients. IgM antibodies to GM1 were observed in the control groups, 15% of the 74 patients with amyotrophic lateral sclerosis, 19% of the 51 patients with chronic inflammatory demyelinating polyneuropathy, and 9% of the 21 healthy control subjects. The fine specificity of the four IgG antibody profiles and the IgM anti-GM2 profile is closely related to the nature of the preceding infections and the pattern of clinical features.
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Affiliation(s)
- Christiane Caudie
- Service de Neurobiologie, Centre de Biologie et de Pathologie Est, Hôpitaux de Lyon, Groupement Hospitalier Est, Bron, 69677 Lyon, France.
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10
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Lees JR, Golumbek PT, Sim J, Dorsey D, Russell JH. Regional CNS responses to IFN-gamma determine lesion localization patterns during EAE pathogenesis. J Exp Med 2008; 205:2633-42. [PMID: 18852291 PMCID: PMC2571937 DOI: 10.1084/jem.20080155] [Citation(s) in RCA: 134] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2008] [Accepted: 09/16/2008] [Indexed: 11/30/2022] Open
Abstract
The localization of inflammatory foci within the cerebellum is correlated to severe clinical outcomes in multiple sclerosis (MS). Previous studies of experimental autoimmune encephalomyelitis (EAE), a model of MS, revealed distinct clinical outcomes correlated with the capacity of the animal to produce IFN-gamma. Outcomes were linked to localization of inflammatory cells in either the spinal cord (wild type [WT]) or the cerebellum and brain stem (IFN-gamma deficient). We demonstrate, using an adoptive transfer system, that the ability of the central nervous system (CNS) to sense pathogenic T cell-produced IFN-gamma during EAE initiation determines the sites of CNS pathogenesis. Transfer of WT Th1 cells into IFN-gamma receptor-deficient mice results in pathogenic invasion of the brain stem and cerebellum with attendant clinical symptoms, which are identical to the disease observed after transfer of IFN-gamma-deficient T cells to WT hosts. Inflammation of the spinal cord associated with classical EAE is abrogated in both IFN-gamma-deficient systems. Cotransfer of CNS antigen-specific WT Th1 cells with IFN-gamma-deficient T cells is sufficient to restore spinal cord invasion and block cerebellar and brain stem invasion. These data demonstrate that interaction between IFN-gamma and host CNS cells during the initiation of EAE can selectively promote or suppress neuroinflammation and pathogenesis.
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Affiliation(s)
- Jason R Lees
- Department of Surgery, University of Maryland School of Medicine, Baltimore, MD 21201, USA
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11
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Abstract
Autoantibody production is an important feature of many autoimmune disorders, signifying a breakdown of immune tolerance to self-antigens. In celiac disease, an autoimmune enteropathy with multiple extra-intestinal manifestations, autoantibody reactivity to transglutaminase 2 (TG2) has been shown to closely correlate with the acute phase of the disease. It serves as a specific and sensitive marker of celiac disease, and is highly useful in aiding diagnosis and follow-up. Immune reactivity to other autoantigens, including transglutaminase 3, actin, ganglioside, collagen, calreticulin and zonulin, among others, has also been reported in celiac disease. The clinical significance of these antibodies is not known, although some may be associated with specific clinical presentations or extra-intestinal manifestations of celiac disease. This review examines the presence of anti-TG2 and other autoantibodies in celiac disease, discussing their diagnostic value, their potential role in disease pathogenesis and current hypotheses that explain how their release may be triggered.
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Affiliation(s)
- Armin Alaedini
- Department of Neurology and Neuroscience, Cornell University, New York, NY 10021, USA.
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12
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Abstract
The Miller Fisher syndrome (MFS), characterized by ataxia, areflexia, and ophthalmoplegia, was first recognized as a distinct clinical entity in 1956. MFS is mostly an acute, self-limiting condition, but there is anecdotal evidence of benefit with immunotherapy. Pathological data remain scarce. MFS can be associated with infectious, autoimmune, and neoplastic disorders. Radiological findings have suggested both central and peripheral involvement. The anti-GQ1b IgG antibody titer is most commonly elevated in MFS, but may also be increased in Guillain-Barré syndrome (GBS) and Bickerstaff's brainstem encephalitis (BBE). Molecular mimicry, particularly in relation to antecedent Campylobacter jejuni and Hemophilus influenzae infections, is likely the predominant pathogenic mechanism, but the roles of other biological factors remain to be established. Recent studies have demonstrated the presence of neuromuscular transmission defects in association with anti-GQ1b IgG antibody, both in vitro and in vivo. Collective findings from clinical, radiological, immunological, and electrophysiological techniques have helped to define MFS, GBS, and BBE as major disorders within the proposed spectrum of anti-GQ1b IgG antibody syndrome.
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Affiliation(s)
- Y L Lo
- Department of Neurology, National Neuroscience Institute, Singapore General Hospital, Outram Road, 169608 Singapore.
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13
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Nores GA, Lardone RD, Comín R, Alaniz ME, Moyano AL, Irazoqui FJ. Anti-GM1 antibodies as a model of the immune response to self-glycans. Biochim Biophys Acta Gen Subj 2007; 1780:538-45. [PMID: 18029096 DOI: 10.1016/j.bbagen.2007.09.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2007] [Revised: 09/10/2007] [Accepted: 09/11/2007] [Indexed: 10/22/2022]
Abstract
Glycans are a class of molecules with high structural variability, frequently found in the plasma membrane facing the extracellular space. Because of these characteristics, glycans are often considered as recognition molecules involved in cell social functions, and as targets of pathogenic factors. Induction of anti-glycan antibodies is one of the early events in immunological defense against bacteria that colonize the body. Because of this natural infection, antibodies recognizing a variety of bacterial glycans are found in sera of adult humans and animals. The immune response to glycans is restricted by self-tolerance, and no antibodies to self-glycans should exist in normal subjects. However, antibodies recognizing structures closely related to self-glycans do exist, and can lead to production of harmful anti-self antibodies. Normal human sera contain low-affinity anti-GM1 IgM-antibodies. Similar antibodies with higher affinity or different isotype are found in some neuropathy patients. Two hypotheses have been developed to explain the origin of disease-associated anti-GM1 antibodies. According to the "molecular mimicry" hypothesis, similarity between GM1 and Campylobacter jejuni lipopolysaccharide carrying a GM1-like glycan is the cause of Guillain-Barré syndrome associated with anti-GM1 IgG-antibodies. According to the "binding site drift" hypothesis, IgM-antibodies associated with disease originate through changes in the binding site of normally occurring anti-GM1 antibodies. We now present an "integrated" hypothesis, combining the "mimicry" and "drift" concepts, which satisfactorily explains most of the published data on anti-GM1 antibodies.
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Affiliation(s)
- Gustavo A Nores
- Departamento de Química Biológica Dr. Ranwel Caputto, CIQUIBIC, CONICET, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina.
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14
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Alaedini A, Latov N. Transglutaminase-independent binding of gliadin to intestinal brush border membrane and GM1 ganglioside. J Neuroimmunol 2006; 177:167-72. [PMID: 16766047 DOI: 10.1016/j.jneuroim.2006.04.022] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2006] [Revised: 04/13/2006] [Accepted: 04/24/2006] [Indexed: 12/26/2022]
Abstract
Anti-ganglioside antibodies have been described in celiac disease or gluten sensitivity, in conjunction with the presence of central and peripheral nervous system deficits. The observed antibody reactivity to gangliosides is postulated to be related to the anti-gliadin immune response, either through antigenic mimicry, or by formation of gliadin-ganglioside complexes and haptenization. We examined the possibility of the presence of ganglioside-like epitopes in gliadin, as well as the potential for complex formation between gliadin and GM1 ganglioside. Low levels of glycosylation were present in gliadin, but ganglioside-like carbohydrate epitopes were not detected. However, gliadin was found to bind to GM1 ganglioside and to the GM1-rich intestinal brush border membrane. The described complex formation and possible haptenization of GM1 by gliadin may be responsible for driving the anti-ganglioside antibody response in some patients with gluten sensitivity. Furthermore, binding of gliadin to GM1 on the intestinal epithelium might have a role in the anti-gliadin immune response and contribute to the intestinal inflammatory reaction in celiac disease.
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Affiliation(s)
- Armin Alaedini
- Department of Neurology and Neuroscience, 1300 York Ave, Weill Medical College of Cornell University, New York, NY 10021, USA.
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15
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Csurhes PA, Sullivan AA, Green K, Greer JM, Pender MP, McCombe PA. Increased circulating T cell reactivity to GM1 ganglioside in patients with Guillain–Barré syndrome. J Clin Neurosci 2005; 12:409-15. [PMID: 15925771 DOI: 10.1016/j.jocn.2004.04.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2004] [Accepted: 04/22/2004] [Indexed: 10/25/2022]
Abstract
This study was performed to determine whether increased ganglioside-specific T cell reactivity can be detected in the peripheral blood of patients with Guillain-Barre syndrome (GBS) and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). T cell responsiveness to the gangliosides GM1, GM3, GD1a, GD1b, GD3, GT1b, GQ1b and sulphatide was assessed in peripheral blood mononuclear cells from untreated GBS patients (57), CIDP patients (43), patients with other peripheral neuropathies (55) and healthy control subjects (74) in a standard 6-day proliferation assay. Increased T cell reactivity to GM1 occurred in GBS patients compared to healthy controls and patients with other neuropathies. There was increased reactivity to GM3 in GBS patients compared to patients with other neuropathies but not compared to healthy controls. The frequencies of increased T cell reactivity to GM1 and GM3 in CIDP patients were intermediate between those of GBS patients and controls. We suggest that T cell reactivity to gangliosides might play a contributory role in the pathogenesis of GBS and perhaps CIDP.
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Affiliation(s)
- Peter A Csurhes
- Department of Medicine, The University of Queensland, Brisbane, Australia
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Goldfarb AR, Weimer LH, Brannagan TH. Rituximab treatment of an IgM monoclonal autonomic and sensory neuropathy. Muscle Nerve 2005; 31:510-5. [PMID: 15685616 DOI: 10.1002/mus.20244] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Rituximab, a monoclonal antibody against B-cell membrane marker CD-20, is an effective treatment for immunoglobulin M (IgM) monoclonal anti-myelin-associated glycoprotein (MAG) neuropathies. We report a patient with an autonomic and painful sensory neuropathy associated with an IgM lambda monoclonal gammopathy, responsive to rituximab. Treatment resulted in a decline in total IgM and improvement in the patient's painful neuropathy and dysautonomia. Rituximab may be an effective and tolerable treatment for autonomic and sensory neuropathy associated with IgM monoclonal gammopathy.
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Affiliation(s)
- Adina R Goldfarb
- Peripheral Neuropathy Center, Department of Neurology and Neuroscience, Weill Medical College of Cornell University, 635 Madison Avenue, Suite 400, New York, New York 10022, USA
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Rocha CT, Escolar DM. Update on diagnosis and treatment of hereditary and acquired polyneuropathies in childhood. SUPPLEMENTS TO CLINICAL NEUROPHYSIOLOGY 2004; 57:255-71. [PMID: 16106624 DOI: 10.1016/s1567-424x(09)70362-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Affiliation(s)
- Carolina Tesi Rocha
- Department of Neurology, Research Center for Genetic Medicine, MDA Clinic, Children's National Medical Center, George Washington University, Washington, DC 20010, USA
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18
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Alaedini A, Green PHR, Sander HW, Hays AP, Gamboa ET, Fasano A, Sonnenberg M, Lewis LD, Latov N. Ganglioside reactive antibodies in the neuropathy associated with celiac disease. J Neuroimmunol 2002; 127:145-8. [PMID: 12044986 DOI: 10.1016/s0165-5728(02)00102-9] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We tested patients with celiac disease (CD) for the presence of serum anti-ganglioside antibodies. Six of twenty-seven patient sera were reactive against brain gangliosides by an agglutination immunoassay. Neurological examination in all six revealed the presence of distal sensory loss, consistent with the diagnosis of peripheral neuropathy. When tested by ELISA for antibodies to isolated GM1, GM2, GD1a, GD1b, GT1b, and GQ1b gangliosides, all six were positive for IgG antibodies to at least one. The neuropathy of celiac disease may be autoimmune and associated with anti-ganglioside antibodies. The presence of IgG reactivity furthermore implicates a T cell-mediated response to ganglioside antigens.
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Affiliation(s)
- Armin Alaedini
- Department of Neurology and Neuroscience, Cornell University, 525 E. 68th St., LC-807, New York, NY 10021, USA.
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