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Chuquisana O, Stascheit F, Keller CW, Pučić-Baković M, Patenaude AM, Lauc G, Tzartos S, Wiendl H, Willcox N, Meisel A, Lünemann JD. Functional Signature of LRP4 Antibodies in Myasthenia Gravis. NEUROLOGY(R) NEUROIMMUNOLOGY & NEUROINFLAMMATION 2024; 11:e200220. [PMID: 38507656 PMCID: PMC10959168 DOI: 10.1212/nxi.0000000000200220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 01/26/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND AND OBJECTIVES Antibodies (Abs) specific for the low-density lipoprotein receptor-related protein 4 (LRP4) occur in up to 5% of patients with myasthenia gravis (MG). The objective of this study was to profile LRP4-Ab effector actions. METHODS We evaluated the efficacy of LRP4-specific compared with AChR-specific IgG to induce Ab-dependent cellular phagocytosis (ADCP), Ab-dependent cellular cytotoxicity (ADCC), and Ab-dependent complement deposition (ADCD). Functional features were additionally assessed in an independent AChR-Ab+ MG cohort. Levels of circulating activated complement proteins and frequency of Fc glycovariants were quantified and compared with demographically matched 19 healthy controls. RESULTS Effector actions that required binding of Fc domains to cellular FcRs such as ADCC and ADCP were detectable for both LRP4-specific and AChR-specific Abs. In contrast to AChR-Abs, LRP4-binding Abs showed poor efficacy in inducing complement deposition. Levels of circulating activated complement proteins were not substantially increased in LRP4-Ab-positive MG. Frequency of IgG glycovariants carrying 2 sialic acid residues, indicative for anti-inflammatory IgG activity, was decreased in patients with LRP4-Ab-positive MG. DISCUSSION LRP4-Abs are more effective in inducing cellular FcR-mediated effector mechanisms than Ab-dependent complement activation. Their functional signature is different from AChR-specific Abs.
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Affiliation(s)
- Omar Chuquisana
- From the Department of Neurology with Institute of Translational Neurology (O.C., C.W.K., H.W., J.D.L.), University Hospital Münster; Department of Neurology with Experimental Neurology (F.S., A.M.); Neuroscience Clinical Research Center (F.S., A.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Germany; Genos Glycoscience Research Laboratory (M.P.-B., A.-M.P., G.L.), Zagreb; Faculty of Pharmacy and Biochemistry (G.L.), University of Zagreb, Croatia; Tzartos NeuroDiagnostics (S.T.); Department of Neurobiology (S.T.), Hellenic Pasteur Institute, Athens, Greece; Nuffield Department of Clinical Neurosciences (N.W.), Weatherall Institute of Molecular Medicine, University of Oxford, United Kingdom; and Center for Stroke Research Berlin (A.G.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Germany
| | - Frauke Stascheit
- From the Department of Neurology with Institute of Translational Neurology (O.C., C.W.K., H.W., J.D.L.), University Hospital Münster; Department of Neurology with Experimental Neurology (F.S., A.M.); Neuroscience Clinical Research Center (F.S., A.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Germany; Genos Glycoscience Research Laboratory (M.P.-B., A.-M.P., G.L.), Zagreb; Faculty of Pharmacy and Biochemistry (G.L.), University of Zagreb, Croatia; Tzartos NeuroDiagnostics (S.T.); Department of Neurobiology (S.T.), Hellenic Pasteur Institute, Athens, Greece; Nuffield Department of Clinical Neurosciences (N.W.), Weatherall Institute of Molecular Medicine, University of Oxford, United Kingdom; and Center for Stroke Research Berlin (A.G.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Germany
| | - Christian W Keller
- From the Department of Neurology with Institute of Translational Neurology (O.C., C.W.K., H.W., J.D.L.), University Hospital Münster; Department of Neurology with Experimental Neurology (F.S., A.M.); Neuroscience Clinical Research Center (F.S., A.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Germany; Genos Glycoscience Research Laboratory (M.P.-B., A.-M.P., G.L.), Zagreb; Faculty of Pharmacy and Biochemistry (G.L.), University of Zagreb, Croatia; Tzartos NeuroDiagnostics (S.T.); Department of Neurobiology (S.T.), Hellenic Pasteur Institute, Athens, Greece; Nuffield Department of Clinical Neurosciences (N.W.), Weatherall Institute of Molecular Medicine, University of Oxford, United Kingdom; and Center for Stroke Research Berlin (A.G.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Germany
| | - Maja Pučić-Baković
- From the Department of Neurology with Institute of Translational Neurology (O.C., C.W.K., H.W., J.D.L.), University Hospital Münster; Department of Neurology with Experimental Neurology (F.S., A.M.); Neuroscience Clinical Research Center (F.S., A.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Germany; Genos Glycoscience Research Laboratory (M.P.-B., A.-M.P., G.L.), Zagreb; Faculty of Pharmacy and Biochemistry (G.L.), University of Zagreb, Croatia; Tzartos NeuroDiagnostics (S.T.); Department of Neurobiology (S.T.), Hellenic Pasteur Institute, Athens, Greece; Nuffield Department of Clinical Neurosciences (N.W.), Weatherall Institute of Molecular Medicine, University of Oxford, United Kingdom; and Center for Stroke Research Berlin (A.G.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Germany
| | - Anne-Marie Patenaude
- From the Department of Neurology with Institute of Translational Neurology (O.C., C.W.K., H.W., J.D.L.), University Hospital Münster; Department of Neurology with Experimental Neurology (F.S., A.M.); Neuroscience Clinical Research Center (F.S., A.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Germany; Genos Glycoscience Research Laboratory (M.P.-B., A.-M.P., G.L.), Zagreb; Faculty of Pharmacy and Biochemistry (G.L.), University of Zagreb, Croatia; Tzartos NeuroDiagnostics (S.T.); Department of Neurobiology (S.T.), Hellenic Pasteur Institute, Athens, Greece; Nuffield Department of Clinical Neurosciences (N.W.), Weatherall Institute of Molecular Medicine, University of Oxford, United Kingdom; and Center for Stroke Research Berlin (A.G.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Germany
| | - Gordan Lauc
- From the Department of Neurology with Institute of Translational Neurology (O.C., C.W.K., H.W., J.D.L.), University Hospital Münster; Department of Neurology with Experimental Neurology (F.S., A.M.); Neuroscience Clinical Research Center (F.S., A.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Germany; Genos Glycoscience Research Laboratory (M.P.-B., A.-M.P., G.L.), Zagreb; Faculty of Pharmacy and Biochemistry (G.L.), University of Zagreb, Croatia; Tzartos NeuroDiagnostics (S.T.); Department of Neurobiology (S.T.), Hellenic Pasteur Institute, Athens, Greece; Nuffield Department of Clinical Neurosciences (N.W.), Weatherall Institute of Molecular Medicine, University of Oxford, United Kingdom; and Center for Stroke Research Berlin (A.G.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Germany
| | - Socrates Tzartos
- From the Department of Neurology with Institute of Translational Neurology (O.C., C.W.K., H.W., J.D.L.), University Hospital Münster; Department of Neurology with Experimental Neurology (F.S., A.M.); Neuroscience Clinical Research Center (F.S., A.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Germany; Genos Glycoscience Research Laboratory (M.P.-B., A.-M.P., G.L.), Zagreb; Faculty of Pharmacy and Biochemistry (G.L.), University of Zagreb, Croatia; Tzartos NeuroDiagnostics (S.T.); Department of Neurobiology (S.T.), Hellenic Pasteur Institute, Athens, Greece; Nuffield Department of Clinical Neurosciences (N.W.), Weatherall Institute of Molecular Medicine, University of Oxford, United Kingdom; and Center for Stroke Research Berlin (A.G.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Germany
| | - Heinz Wiendl
- From the Department of Neurology with Institute of Translational Neurology (O.C., C.W.K., H.W., J.D.L.), University Hospital Münster; Department of Neurology with Experimental Neurology (F.S., A.M.); Neuroscience Clinical Research Center (F.S., A.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Germany; Genos Glycoscience Research Laboratory (M.P.-B., A.-M.P., G.L.), Zagreb; Faculty of Pharmacy and Biochemistry (G.L.), University of Zagreb, Croatia; Tzartos NeuroDiagnostics (S.T.); Department of Neurobiology (S.T.), Hellenic Pasteur Institute, Athens, Greece; Nuffield Department of Clinical Neurosciences (N.W.), Weatherall Institute of Molecular Medicine, University of Oxford, United Kingdom; and Center for Stroke Research Berlin (A.G.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Germany
| | - Nick Willcox
- From the Department of Neurology with Institute of Translational Neurology (O.C., C.W.K., H.W., J.D.L.), University Hospital Münster; Department of Neurology with Experimental Neurology (F.S., A.M.); Neuroscience Clinical Research Center (F.S., A.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Germany; Genos Glycoscience Research Laboratory (M.P.-B., A.-M.P., G.L.), Zagreb; Faculty of Pharmacy and Biochemistry (G.L.), University of Zagreb, Croatia; Tzartos NeuroDiagnostics (S.T.); Department of Neurobiology (S.T.), Hellenic Pasteur Institute, Athens, Greece; Nuffield Department of Clinical Neurosciences (N.W.), Weatherall Institute of Molecular Medicine, University of Oxford, United Kingdom; and Center for Stroke Research Berlin (A.G.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Germany
| | - Andreas Meisel
- From the Department of Neurology with Institute of Translational Neurology (O.C., C.W.K., H.W., J.D.L.), University Hospital Münster; Department of Neurology with Experimental Neurology (F.S., A.M.); Neuroscience Clinical Research Center (F.S., A.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Germany; Genos Glycoscience Research Laboratory (M.P.-B., A.-M.P., G.L.), Zagreb; Faculty of Pharmacy and Biochemistry (G.L.), University of Zagreb, Croatia; Tzartos NeuroDiagnostics (S.T.); Department of Neurobiology (S.T.), Hellenic Pasteur Institute, Athens, Greece; Nuffield Department of Clinical Neurosciences (N.W.), Weatherall Institute of Molecular Medicine, University of Oxford, United Kingdom; and Center for Stroke Research Berlin (A.G.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Germany
| | - Jan D Lünemann
- From the Department of Neurology with Institute of Translational Neurology (O.C., C.W.K., H.W., J.D.L.), University Hospital Münster; Department of Neurology with Experimental Neurology (F.S., A.M.); Neuroscience Clinical Research Center (F.S., A.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Germany; Genos Glycoscience Research Laboratory (M.P.-B., A.-M.P., G.L.), Zagreb; Faculty of Pharmacy and Biochemistry (G.L.), University of Zagreb, Croatia; Tzartos NeuroDiagnostics (S.T.); Department of Neurobiology (S.T.), Hellenic Pasteur Institute, Athens, Greece; Nuffield Department of Clinical Neurosciences (N.W.), Weatherall Institute of Molecular Medicine, University of Oxford, United Kingdom; and Center for Stroke Research Berlin (A.G.M.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Germany
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