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Segal Y, Nisnboym M, Regev K, Arnon K, Kolb H, Fahoum F, Aizenstein O, Paran Y, Louzoun Y, Israeli S, Loewenthal R, Svetlitzky N, Alcalay Y, Raphael I, Gadoth A. New Insights on DR and DQ Human Leukocyte Antigens in Anti-LGI1 Encephalitis. NEUROLOGY(R) NEUROIMMUNOLOGY & NEUROINFLAMMATION 2023; 10:10/3/e200103. [PMID: 36973076 PMCID: PMC10042442 DOI: 10.1212/nxi.0000000000200103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 01/26/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND AND OBJECTIVES To explore the clinical characteristics and HLA associations of patients with anti-leucine-rich glioma-inactivated 1 encephalitis (LGI1E) from a large single center in Israel. Anti-LGI1E is the most commonly diagnosed antibody-associated encephalitic syndrome in adults. Recent studies of various populations reveal significant associations with specific HLA genes. We examined the clinical characteristics and HLA associations of a cohort of Israeli patients. METHODS Seventeen consecutive patients with anti-LGI1E diagnosed at Tel Aviv Medical Center between the years 2011 and 2018 were included. HLA typing was performed using next-generation sequencing at the tissue typing laboratory of Sheba Medical Center and compared with data from the Ezer Mizion Bone Marrow Donor Registry, containing over 1,000,000 samples. RESULTS Our cohort displayed a male predominance and median age at onset in the 7th decade, as previously reported. The most common presenting symptom was seizures. Notably, paroxysmal dizziness spells were significantly more common than previously reported (35%), whereas faciobrachial dystonic seizures were found only in 23%. HLA analysis revealed overrepresentation of DRB1*07:01 (OR: 3.18, CI: 20.9 p < 1.e-5) and DRB1*04:02 (OR: 3.8, CI: 20.1 p < 1.e-5), as well as of the DQ allele DQB1*02:02 (OR: 2.8, CI: 14.2 p < 0.0001) as previously reported. A novel overrepresentation observed among our patients was of the DQB1*03:02 allele (OR: 2.3, CI: 6.9 p < 0.008). In addition, we found DR-DQ associations, among patients with anti-LGI1E, that showed complete or near-complete linkage disequilibrium (LD). By applying LD analysis to an unprecedentedly large control cohort, we were able to show that although in the general population, DQB*03:02 is not fully associated with DRB1*04:02, in the patient population, both alleles are always coupled, suggesting the DRB1*04:02 association to be primary to disease predisposition. In silico predictions performed for the overrepresented DQ alleles reveal them to be strong binders of LGI1-derived peptides, similarly to overrepresented DR alleles. These predictions suggest a possible correlation between peptide binding sites of paired DR-DQ alleles. DISCUSSION Our cohort presents distinct immune characteristics with substantially higher overrepresentation of DRB1*04:02 and slightly lower overrepresentation of DQB1*07:01 compared with previous reports implying differences between different populations. DQ-DR interactions found in our cohort may shed additional light on the complex role of immunogenetics in the pathogenesis of anti-LGI1E, implying a possible relevance of certain DQ alleles and DR-DQ interactions.
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Affiliation(s)
- Yahel Segal
- From the Department of Neurology (Y.S.Y.S.N., K.R., K.A., H.K., F.F., A.G.), Tel-Aviv Medical Center; Neuroimmunology Unit (K.R., K.A., H.K.), Tel-Aviv Medical Center; Sackler Faculty of Medicine (K.A., O.A.), Tel-Aviv University; Sagol School of Neuroscience (K.A.), Tel-Aviv University; Epilepsy and EEG Unit (F.F.), Tel Aviv Medical Center; Encephalitis Center (O.A., Y.P., Y.A., A.G.), Tel-Aviv Medical Center; Department of Radiology (O.A.), Tel-Aviv Medical Center; Infectious Diseases Department (Y.P.), Tel-Aviv Medical Center; Department of Mathematics (Y.L., S.I.), Bar Ilan University, Ramat Gan; Tissue Typing Laboratory (R.L., N.S.), Sheba Medical Center, Ramat Gan; Immunology Laboratory (Y.A.), Tel Aviv Medical Center, Israel; and Department of Neurological Surgery (I.R.), University of Pittsburgh School of Medicine, PA
| | - Michal Nisnboym
- From the Department of Neurology (Y.S.Y.S.N., K.R., K.A., H.K., F.F., A.G.), Tel-Aviv Medical Center; Neuroimmunology Unit (K.R., K.A., H.K.), Tel-Aviv Medical Center; Sackler Faculty of Medicine (K.A., O.A.), Tel-Aviv University; Sagol School of Neuroscience (K.A.), Tel-Aviv University; Epilepsy and EEG Unit (F.F.), Tel Aviv Medical Center; Encephalitis Center (O.A., Y.P., Y.A., A.G.), Tel-Aviv Medical Center; Department of Radiology (O.A.), Tel-Aviv Medical Center; Infectious Diseases Department (Y.P.), Tel-Aviv Medical Center; Department of Mathematics (Y.L., S.I.), Bar Ilan University, Ramat Gan; Tissue Typing Laboratory (R.L., N.S.), Sheba Medical Center, Ramat Gan; Immunology Laboratory (Y.A.), Tel Aviv Medical Center, Israel; and Department of Neurological Surgery (I.R.), University of Pittsburgh School of Medicine, PA
| | - Keren Regev
- From the Department of Neurology (Y.S.Y.S.N., K.R., K.A., H.K., F.F., A.G.), Tel-Aviv Medical Center; Neuroimmunology Unit (K.R., K.A., H.K.), Tel-Aviv Medical Center; Sackler Faculty of Medicine (K.A., O.A.), Tel-Aviv University; Sagol School of Neuroscience (K.A.), Tel-Aviv University; Epilepsy and EEG Unit (F.F.), Tel Aviv Medical Center; Encephalitis Center (O.A., Y.P., Y.A., A.G.), Tel-Aviv Medical Center; Department of Radiology (O.A.), Tel-Aviv Medical Center; Infectious Diseases Department (Y.P.), Tel-Aviv Medical Center; Department of Mathematics (Y.L., S.I.), Bar Ilan University, Ramat Gan; Tissue Typing Laboratory (R.L., N.S.), Sheba Medical Center, Ramat Gan; Immunology Laboratory (Y.A.), Tel Aviv Medical Center, Israel; and Department of Neurological Surgery (I.R.), University of Pittsburgh School of Medicine, PA
| | - Karni Arnon
- From the Department of Neurology (Y.S.Y.S.N., K.R., K.A., H.K., F.F., A.G.), Tel-Aviv Medical Center; Neuroimmunology Unit (K.R., K.A., H.K.), Tel-Aviv Medical Center; Sackler Faculty of Medicine (K.A., O.A.), Tel-Aviv University; Sagol School of Neuroscience (K.A.), Tel-Aviv University; Epilepsy and EEG Unit (F.F.), Tel Aviv Medical Center; Encephalitis Center (O.A., Y.P., Y.A., A.G.), Tel-Aviv Medical Center; Department of Radiology (O.A.), Tel-Aviv Medical Center; Infectious Diseases Department (Y.P.), Tel-Aviv Medical Center; Department of Mathematics (Y.L., S.I.), Bar Ilan University, Ramat Gan; Tissue Typing Laboratory (R.L., N.S.), Sheba Medical Center, Ramat Gan; Immunology Laboratory (Y.A.), Tel Aviv Medical Center, Israel; and Department of Neurological Surgery (I.R.), University of Pittsburgh School of Medicine, PA
| | - Hadar Kolb
- From the Department of Neurology (Y.S.Y.S.N., K.R., K.A., H.K., F.F., A.G.), Tel-Aviv Medical Center; Neuroimmunology Unit (K.R., K.A., H.K.), Tel-Aviv Medical Center; Sackler Faculty of Medicine (K.A., O.A.), Tel-Aviv University; Sagol School of Neuroscience (K.A.), Tel-Aviv University; Epilepsy and EEG Unit (F.F.), Tel Aviv Medical Center; Encephalitis Center (O.A., Y.P., Y.A., A.G.), Tel-Aviv Medical Center; Department of Radiology (O.A.), Tel-Aviv Medical Center; Infectious Diseases Department (Y.P.), Tel-Aviv Medical Center; Department of Mathematics (Y.L., S.I.), Bar Ilan University, Ramat Gan; Tissue Typing Laboratory (R.L., N.S.), Sheba Medical Center, Ramat Gan; Immunology Laboratory (Y.A.), Tel Aviv Medical Center, Israel; and Department of Neurological Surgery (I.R.), University of Pittsburgh School of Medicine, PA
| | - Firas Fahoum
- From the Department of Neurology (Y.S.Y.S.N., K.R., K.A., H.K., F.F., A.G.), Tel-Aviv Medical Center; Neuroimmunology Unit (K.R., K.A., H.K.), Tel-Aviv Medical Center; Sackler Faculty of Medicine (K.A., O.A.), Tel-Aviv University; Sagol School of Neuroscience (K.A.), Tel-Aviv University; Epilepsy and EEG Unit (F.F.), Tel Aviv Medical Center; Encephalitis Center (O.A., Y.P., Y.A., A.G.), Tel-Aviv Medical Center; Department of Radiology (O.A.), Tel-Aviv Medical Center; Infectious Diseases Department (Y.P.), Tel-Aviv Medical Center; Department of Mathematics (Y.L., S.I.), Bar Ilan University, Ramat Gan; Tissue Typing Laboratory (R.L., N.S.), Sheba Medical Center, Ramat Gan; Immunology Laboratory (Y.A.), Tel Aviv Medical Center, Israel; and Department of Neurological Surgery (I.R.), University of Pittsburgh School of Medicine, PA
| | - Orna Aizenstein
- From the Department of Neurology (Y.S.Y.S.N., K.R., K.A., H.K., F.F., A.G.), Tel-Aviv Medical Center; Neuroimmunology Unit (K.R., K.A., H.K.), Tel-Aviv Medical Center; Sackler Faculty of Medicine (K.A., O.A.), Tel-Aviv University; Sagol School of Neuroscience (K.A.), Tel-Aviv University; Epilepsy and EEG Unit (F.F.), Tel Aviv Medical Center; Encephalitis Center (O.A., Y.P., Y.A., A.G.), Tel-Aviv Medical Center; Department of Radiology (O.A.), Tel-Aviv Medical Center; Infectious Diseases Department (Y.P.), Tel-Aviv Medical Center; Department of Mathematics (Y.L., S.I.), Bar Ilan University, Ramat Gan; Tissue Typing Laboratory (R.L., N.S.), Sheba Medical Center, Ramat Gan; Immunology Laboratory (Y.A.), Tel Aviv Medical Center, Israel; and Department of Neurological Surgery (I.R.), University of Pittsburgh School of Medicine, PA
| | - Yael Paran
- From the Department of Neurology (Y.S.Y.S.N., K.R., K.A., H.K., F.F., A.G.), Tel-Aviv Medical Center; Neuroimmunology Unit (K.R., K.A., H.K.), Tel-Aviv Medical Center; Sackler Faculty of Medicine (K.A., O.A.), Tel-Aviv University; Sagol School of Neuroscience (K.A.), Tel-Aviv University; Epilepsy and EEG Unit (F.F.), Tel Aviv Medical Center; Encephalitis Center (O.A., Y.P., Y.A., A.G.), Tel-Aviv Medical Center; Department of Radiology (O.A.), Tel-Aviv Medical Center; Infectious Diseases Department (Y.P.), Tel-Aviv Medical Center; Department of Mathematics (Y.L., S.I.), Bar Ilan University, Ramat Gan; Tissue Typing Laboratory (R.L., N.S.), Sheba Medical Center, Ramat Gan; Immunology Laboratory (Y.A.), Tel Aviv Medical Center, Israel; and Department of Neurological Surgery (I.R.), University of Pittsburgh School of Medicine, PA
| | - Yoram Louzoun
- From the Department of Neurology (Y.S.Y.S.N., K.R., K.A., H.K., F.F., A.G.), Tel-Aviv Medical Center; Neuroimmunology Unit (K.R., K.A., H.K.), Tel-Aviv Medical Center; Sackler Faculty of Medicine (K.A., O.A.), Tel-Aviv University; Sagol School of Neuroscience (K.A.), Tel-Aviv University; Epilepsy and EEG Unit (F.F.), Tel Aviv Medical Center; Encephalitis Center (O.A., Y.P., Y.A., A.G.), Tel-Aviv Medical Center; Department of Radiology (O.A.), Tel-Aviv Medical Center; Infectious Diseases Department (Y.P.), Tel-Aviv Medical Center; Department of Mathematics (Y.L., S.I.), Bar Ilan University, Ramat Gan; Tissue Typing Laboratory (R.L., N.S.), Sheba Medical Center, Ramat Gan; Immunology Laboratory (Y.A.), Tel Aviv Medical Center, Israel; and Department of Neurological Surgery (I.R.), University of Pittsburgh School of Medicine, PA
| | - Sapir Israeli
- From the Department of Neurology (Y.S.Y.S.N., K.R., K.A., H.K., F.F., A.G.), Tel-Aviv Medical Center; Neuroimmunology Unit (K.R., K.A., H.K.), Tel-Aviv Medical Center; Sackler Faculty of Medicine (K.A., O.A.), Tel-Aviv University; Sagol School of Neuroscience (K.A.), Tel-Aviv University; Epilepsy and EEG Unit (F.F.), Tel Aviv Medical Center; Encephalitis Center (O.A., Y.P., Y.A., A.G.), Tel-Aviv Medical Center; Department of Radiology (O.A.), Tel-Aviv Medical Center; Infectious Diseases Department (Y.P.), Tel-Aviv Medical Center; Department of Mathematics (Y.L., S.I.), Bar Ilan University, Ramat Gan; Tissue Typing Laboratory (R.L., N.S.), Sheba Medical Center, Ramat Gan; Immunology Laboratory (Y.A.), Tel Aviv Medical Center, Israel; and Department of Neurological Surgery (I.R.), University of Pittsburgh School of Medicine, PA
| | - Ron Loewenthal
- From the Department of Neurology (Y.S.Y.S.N., K.R., K.A., H.K., F.F., A.G.), Tel-Aviv Medical Center; Neuroimmunology Unit (K.R., K.A., H.K.), Tel-Aviv Medical Center; Sackler Faculty of Medicine (K.A., O.A.), Tel-Aviv University; Sagol School of Neuroscience (K.A.), Tel-Aviv University; Epilepsy and EEG Unit (F.F.), Tel Aviv Medical Center; Encephalitis Center (O.A., Y.P., Y.A., A.G.), Tel-Aviv Medical Center; Department of Radiology (O.A.), Tel-Aviv Medical Center; Infectious Diseases Department (Y.P.), Tel-Aviv Medical Center; Department of Mathematics (Y.L., S.I.), Bar Ilan University, Ramat Gan; Tissue Typing Laboratory (R.L., N.S.), Sheba Medical Center, Ramat Gan; Immunology Laboratory (Y.A.), Tel Aviv Medical Center, Israel; and Department of Neurological Surgery (I.R.), University of Pittsburgh School of Medicine, PA
| | - Nina Svetlitzky
- From the Department of Neurology (Y.S.Y.S.N., K.R., K.A., H.K., F.F., A.G.), Tel-Aviv Medical Center; Neuroimmunology Unit (K.R., K.A., H.K.), Tel-Aviv Medical Center; Sackler Faculty of Medicine (K.A., O.A.), Tel-Aviv University; Sagol School of Neuroscience (K.A.), Tel-Aviv University; Epilepsy and EEG Unit (F.F.), Tel Aviv Medical Center; Encephalitis Center (O.A., Y.P., Y.A., A.G.), Tel-Aviv Medical Center; Department of Radiology (O.A.), Tel-Aviv Medical Center; Infectious Diseases Department (Y.P.), Tel-Aviv Medical Center; Department of Mathematics (Y.L., S.I.), Bar Ilan University, Ramat Gan; Tissue Typing Laboratory (R.L., N.S.), Sheba Medical Center, Ramat Gan; Immunology Laboratory (Y.A.), Tel Aviv Medical Center, Israel; and Department of Neurological Surgery (I.R.), University of Pittsburgh School of Medicine, PA
| | - Yifat Alcalay
- From the Department of Neurology (Y.S.Y.S.N., K.R., K.A., H.K., F.F., A.G.), Tel-Aviv Medical Center; Neuroimmunology Unit (K.R., K.A., H.K.), Tel-Aviv Medical Center; Sackler Faculty of Medicine (K.A., O.A.), Tel-Aviv University; Sagol School of Neuroscience (K.A.), Tel-Aviv University; Epilepsy and EEG Unit (F.F.), Tel Aviv Medical Center; Encephalitis Center (O.A., Y.P., Y.A., A.G.), Tel-Aviv Medical Center; Department of Radiology (O.A.), Tel-Aviv Medical Center; Infectious Diseases Department (Y.P.), Tel-Aviv Medical Center; Department of Mathematics (Y.L., S.I.), Bar Ilan University, Ramat Gan; Tissue Typing Laboratory (R.L., N.S.), Sheba Medical Center, Ramat Gan; Immunology Laboratory (Y.A.), Tel Aviv Medical Center, Israel; and Department of Neurological Surgery (I.R.), University of Pittsburgh School of Medicine, PA
| | - Itay Raphael
- From the Department of Neurology (Y.S.Y.S.N., K.R., K.A., H.K., F.F., A.G.), Tel-Aviv Medical Center; Neuroimmunology Unit (K.R., K.A., H.K.), Tel-Aviv Medical Center; Sackler Faculty of Medicine (K.A., O.A.), Tel-Aviv University; Sagol School of Neuroscience (K.A.), Tel-Aviv University; Epilepsy and EEG Unit (F.F.), Tel Aviv Medical Center; Encephalitis Center (O.A., Y.P., Y.A., A.G.), Tel-Aviv Medical Center; Department of Radiology (O.A.), Tel-Aviv Medical Center; Infectious Diseases Department (Y.P.), Tel-Aviv Medical Center; Department of Mathematics (Y.L., S.I.), Bar Ilan University, Ramat Gan; Tissue Typing Laboratory (R.L., N.S.), Sheba Medical Center, Ramat Gan; Immunology Laboratory (Y.A.), Tel Aviv Medical Center, Israel; and Department of Neurological Surgery (I.R.), University of Pittsburgh School of Medicine, PA
| | - Avi Gadoth
- From the Department of Neurology (Y.S.Y.S.N., K.R., K.A., H.K., F.F., A.G.), Tel-Aviv Medical Center; Neuroimmunology Unit (K.R., K.A., H.K.), Tel-Aviv Medical Center; Sackler Faculty of Medicine (K.A., O.A.), Tel-Aviv University; Sagol School of Neuroscience (K.A.), Tel-Aviv University; Epilepsy and EEG Unit (F.F.), Tel Aviv Medical Center; Encephalitis Center (O.A., Y.P., Y.A., A.G.), Tel-Aviv Medical Center; Department of Radiology (O.A.), Tel-Aviv Medical Center; Infectious Diseases Department (Y.P.), Tel-Aviv Medical Center; Department of Mathematics (Y.L., S.I.), Bar Ilan University, Ramat Gan; Tissue Typing Laboratory (R.L., N.S.), Sheba Medical Center, Ramat Gan; Immunology Laboratory (Y.A.), Tel Aviv Medical Center, Israel; and Department of Neurological Surgery (I.R.), University of Pittsburgh School of Medicine, PA.
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Anagnostouli M, Vakrakou AG, Zambelis T, Boufidou F, Nikolaou C, Karandreas N, Kilidireas C. Myasthenia gravis, atypical polyneuropathy and multiple autoimmune phenomena in the same patient, with HLA-immunogenetic profile expectable for Greek chronic inflammatory demyelinating polyneuropathy: a case report. Int J Neurosci 2020; 132:593-600. [PMID: 32988257 DOI: 10.1080/00207454.2020.1829616] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE The comorbidity of myasthenia gravis (MG), with other autoimmune disorders like systemic lupus erythematosus (SLE), is relatively frequent but the co-occurrence with chronic inflammatory demyelinating polyneuropathy (CIDP) along with various autoimmune manifestations in the absence of thymoma is of extreme rarity. Our aim is to report a case of a woman who presented the concomitant appearance of MG, axonal sensory-motor polyneuropathy and hepatitis that may indicate an underlying pathogenetic link among the different autoimmune disorders. MATERIALS AND METHODS/RESULTS We present a case of a 54-year-old woman, with a generalized MG and a chronic sensory-motor polyneuropathy, hypothyroidism, anaemia, hepatitis, livedo reticularis and facial flush, of assumed autoimmune background, like SLE, although with persistent negative ANA antibodies, from the beginning and through the whole following years. The Human Leukocyte Antigen (HLA)-DRB1 genotyping showed a profile of alleles (DRB1*11:01/11:04) compatible with CIDP of mainly female gender in Greece and frequencies close to those of Sjogren's syndrome and scleroderma's in the Greek population. The diagnostic problems, the atypical clinical, electrophysiological and immunological features are discussed, along with the rarity of the case, with this exceptional combination of autoimmune manifestations, which could be truly associated under the clinical umbrella of a systemic disease, like SLE. However, our patient did not ever fulfil the SLE criteria. CONCLUSIONS To raise awareness among clinicians about the exceptional combination of autoimmune manifestations driven by a specific HLA background.
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Affiliation(s)
- Maria Anagnostouli
- 1st Department of Neurology, Medical School of Athens National and Kapodistrian University, NKUA, Aeginition Hospital, Athens, Greece.,Immunogenetics Laboratory, 1st Department of Neurology, Medical School of Athens National and Kapodistrian University, NKUA, Aeginition Hospital, Athens, Greece
| | - Aigli G Vakrakou
- 1st Department of Neurology, Medical School of Athens National and Kapodistrian University, NKUA, Aeginition Hospital, Athens, Greece
| | - Thomas Zambelis
- 1st Department of Neurology, Medical School of Athens National and Kapodistrian University, NKUA, Aeginition Hospital, Athens, Greece.,Laboratory of Electrophysiology, 1st Department of Neurology, Medical School of Athens National and Kapodistrian University, NKUA, Aeginition Hospital, Athens, Greece
| | - Fotini Boufidou
- Department of Biopathology and Immunology, Medical School of Athens National and Kapodistrian University, NKUA, Aeginition Hospital, Athens, Greece
| | - Chrysoula Nikolaou
- Department of Biopathology and Immunology, Medical School of Athens National and Kapodistrian University, NKUA, Aeginition Hospital, Athens, Greece
| | - Nikolaos Karandreas
- 1st Department of Neurology, Medical School of Athens National and Kapodistrian University, NKUA, Aeginition Hospital, Athens, Greece.,Laboratory of Electrophysiology, 1st Department of Neurology, Medical School of Athens National and Kapodistrian University, NKUA, Aeginition Hospital, Athens, Greece
| | - Constantinos Kilidireas
- 1st Department of Neurology, Medical School of Athens National and Kapodistrian University, NKUA, Aeginition Hospital, Athens, Greece.,Neuroimmunology Laboratory, 1st Department of Neurology of Medical School of Athens National and Kapodistrian University, NKUA, Aeginition Hospital, Athens, Greece
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Nogales-Gadea G, Ramos-Fransi A, Suárez-Calvet X, Navas M, Rojas-García R, Mosquera JL, Díaz-Manera J, Querol L, Gallardo E, Illa I. Analysis of serum miRNA profiles of myasthenia gravis patients. PLoS One 2014; 9:e91927. [PMID: 24637658 PMCID: PMC3956820 DOI: 10.1371/journal.pone.0091927] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Accepted: 02/17/2014] [Indexed: 12/14/2022] Open
Abstract
Myasthenia gravis (MG) is an autoimmune disease characterized by the presence of autoantibodies, mainly against the acetylcholine receptor (AChR). The mechanisms triggering and maintaining this chronic disease are unknown. MiRNAs are regulatory molecules that play a key role in the immune system and are altered in many autoimmune diseases. The aim of this study was to evaluate miRNA profiles in serum of 61 AChR MG patients. We studied serum from patients with early onset MG (n = 22), late onset MG (n = 27) and thymoma (n = 12), to identify alterations in the specific subgroups. In a discovery cohort, we analysed 381 miRNA arrays from 5 patients from each subgroup, and 5 healthy controls. The 15 patients had not received any treatment. We found 32 miRNAs in different levels in MG and analysed 8 of these in a validation cohort that included 46 of the MG patients. MiR15b, miR122, miR-140-3p, miR185, miR192, miR20b and miR-885-5p were in lower levels in MG patients than in controls. Our study suggests that different clinical phenotypes in MG share common altered mechanisms in circulating miRNAs, with no additional contribution of the thymoma. MG treatment intervention does not modify the profile of these miRNAs. Novel insights into the pathogenesis of MG can be reached by the analysis of circulating miRNAs since some of these miRNAs have also been found low in MG peripheral mononuclear cells, and have targets with important roles in B cell survival and antibody production.
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Affiliation(s)
- Gisela Nogales-Gadea
- Neuromuscular Diseases Unit, Hospital de la Santa Creu i Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain
- CIBER de enfermedades neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Alba Ramos-Fransi
- Neuromuscular Diseases Unit, Hospital de la Santa Creu i Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain
- CIBER de enfermedades neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Xavier Suárez-Calvet
- Neuromuscular Diseases Unit, Hospital de la Santa Creu i Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain
- CIBER de enfermedades neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Miquel Navas
- Neuromuscular Diseases Unit, Hospital de la Santa Creu i Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain
- CIBER de enfermedades neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Ricard Rojas-García
- Neuromuscular Diseases Unit, Hospital de la Santa Creu i Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain
- CIBER de enfermedades neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Jordi Díaz-Manera
- Neuromuscular Diseases Unit, Hospital de la Santa Creu i Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain
- CIBER de enfermedades neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Luis Querol
- Neuromuscular Diseases Unit, Hospital de la Santa Creu i Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain
- CIBER de enfermedades neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Eduard Gallardo
- Neuromuscular Diseases Unit, Hospital de la Santa Creu i Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain
- CIBER de enfermedades neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Isabel Illa
- Neuromuscular Diseases Unit, Hospital de la Santa Creu i Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain
- CIBER de enfermedades neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
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