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Folke J, Skougaard M, Korsholm TL, Laursen ALS, Salvesen L, Hejl AM, Bech S, Løkkegaard A, Brudek T, Ditlev SB, Aznar S. Assessing serum anti-nuclear antibodies HEp-2 patterns in synucleinopathies. Immun Ageing 2024; 21:49. [PMID: 39026277 PMCID: PMC11256463 DOI: 10.1186/s12979-024-00453-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Accepted: 07/12/2024] [Indexed: 07/20/2024]
Abstract
This study investigates the presence of antinuclear antibodies (ANA) in three primary synucleinopathies - Parkinson's disease (PD), multiple system atrophy (MSA), and dementia with Lewy bodies (DLB), compared to healthy controls. Autoinflammatory disorders typically involve the immune system mistakenly attacking the body's own cells and start producing ANA. There is an increasing body of evidence that immune-mediated inflammation is a pathological feature linked to synucleinopathies. To investigate whether this could be autoimmune mediated we analyzed for ANA in the plasma of 25 MSA, 25 PD, and 17 DLB patients, along with 25 healthy controls, using the ANA HEp-2 indirect immunofluorescence antibody assay (ANA HEp-2 IFA). Contrary to initial expectations, results showed ANA HEp-2 positivity in 12% of PD, 8% of MSA patients, 18% of DLB patients, and 17% of healthy controls, indicating no increased prevalence of ANA in synucleinopathies compared to age-matched healthy individuals. Various ANA HEp-2 patterns were identified, but no specific pattern was associated with individual synucleinopathies. We conclude hereby that synucleinopathies are not associated with detectable presence of ANA in plasma.
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Affiliation(s)
- Jonas Folke
- Centre for Neuroscience & Stereology, Department of Neurology, Bispebjerg and Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark
- Copenhagen Center for Translational Research, Bispebjerg and Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Marie Skougaard
- Copenhagen Center for Translational Research, Bispebjerg and Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Trine-Line Korsholm
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Anne-Line Strange Laursen
- Centre for Neuroscience & Stereology, Department of Neurology, Bispebjerg and Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark
- Copenhagen Center for Translational Research, Bispebjerg and Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Lisette Salvesen
- Department of Neurology, Bispebjerg and Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen Ø, DK-2100, Denmark
| | - Anne-Mette Hejl
- Department of Neurology, Bispebjerg and Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen Ø, DK-2100, Denmark
| | - Sara Bech
- Department of Neurology, Bispebjerg and Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Annemette Løkkegaard
- Department of Neurology, Bispebjerg and Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen Ø, DK-2100, Denmark
| | - Tomasz Brudek
- Centre for Neuroscience & Stereology, Department of Neurology, Bispebjerg and Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark
- Copenhagen Center for Translational Research, Bispebjerg and Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Sisse Bolm Ditlev
- Copenhagen Center for Translational Research, Bispebjerg and Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Susana Aznar
- Centre for Neuroscience & Stereology, Department of Neurology, Bispebjerg and Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark.
- Copenhagen Center for Translational Research, Bispebjerg and Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark.
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Lin CYR, Kuo SH. Ataxias: Hereditary, Acquired, and Reversible Etiologies. Semin Neurol 2023; 43:48-64. [PMID: 36828010 DOI: 10.1055/s-0043-1763511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
A variety of etiologies can cause cerebellar dysfunction, leading to ataxia symptoms. Therefore, the accurate diagnosis of the cause for cerebellar ataxia can be challenging. A step-wise investigation will reveal underlying causes, including nutritional, toxin, immune-mediated, genetic, and degenerative disorders. Recent advances in genetics have identified new genes for both autosomal dominant and autosomal recessive ataxias, and new therapies are on the horizon for targeting specific biological pathways. New diagnostic criteria for degenerative ataxias have been proposed, specifically for multiple system atrophy, which will have a broad impact on the future clinical research in ataxia. In this article, we aim to provide a review focus on symptoms, laboratory testing, neuroimaging, and genetic testing for the diagnosis of cerebellar ataxia causes, with a special emphasis on recent advances. Strategies for the management of cerebellar ataxia is also discussed.
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Affiliation(s)
- Chi-Ying R Lin
- Department of Neurology, Parkinson's Disease Center and Movement Disorders Clinic, Baylor College of Medicine, Houston, Texas.,Department of Neurology, Alzheimer's Disease and Memory Disorders Center, Baylor College of Medicine, Houston, Texas
| | - Sheng-Han Kuo
- Department of Neurology, College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York.,Initiative for Columbia Ataxia and Tremor, Columbia University Irving Medical Center, New York, New York
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Lin CR, Viswanathan A, Chen TX, Mitsumoto H, Vonsattel JP, Faust PL, Kuo S. Clinicopathological correlates of pyramidal signs in multiple system atrophy. Ann Clin Transl Neurol 2022; 9:988-994. [PMID: 35593123 PMCID: PMC9268870 DOI: 10.1002/acn3.51576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 04/23/2022] [Accepted: 04/26/2022] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE Pyramidal signs are common but often under-recognized in multiple system atrophy (MSA). The clinicopathological correlates of pyramidal signs in MSA are not well characterized. The present study aims to understand the role of pyramidal signs in MSA. METHODS We examined 40 autopsy-confirmed MSA cases in New York Brain Bank. The pyramidal signs were quantified by an established rating scale, summarized as the pyramidal score. We assessed whether pyramidal scores are associated with autonomic, parkinsonism, and cerebellar features and survival. We also examined whether the density of glial cytoplasmic inclusions (GCIs) in the motor cortex and its underlying white matter is associated with the pyramidal score. RESULTS MSA parkinsonian type cases have higher pyramidal scores compared to cerebellar type cases (p = 0.017). MSA cases with high pyramidal scores are more likely to have laryngeal stridor (OR = 4.89, p = 0.022), but less likely to have orthostatic hypotension (OR = 0.11, p = 0.006) and erectile dysfunction (OR = 0.05, p = 0.018). MSA cases with high pyramidal scores do not differ from those with low pyramidal scores in terms of bowel dysfunction, dry eyes and mouth, and survival. Finally, MSA cases with more GCIs in the motor cortex have higher pyramidal scores compared to those with few GCIs (p = 0.017). INTERPRETATION Pyramidal signs in MSA are associated with the parkinsonian subtype, laryngeal stridor, and certain autonomic dysfunction.
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Affiliation(s)
- Chi‐Ying R. Lin
- Department of NeurologyParkinson's Disease Center and Movement Disorders Clinic, Baylor College of MedicineHoustonTexasUSA
| | - Anisha Viswanathan
- Department of NeurologyColumbia University Irving Medical Center and the New York Presbyterian HospitalNew YorkNew YorkUSA
- Initiative for Columbia Ataxia and TremorColumbia University Irving Medical CenterNew YorkNew YorkUSA
| | - Tiffany X. Chen
- Department of NeurologyColumbia University Irving Medical Center and the New York Presbyterian HospitalNew YorkNew YorkUSA
- Initiative for Columbia Ataxia and TremorColumbia University Irving Medical CenterNew YorkNew YorkUSA
- Department of Biomedical Engineering, Whiting School of EngineeringJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Hiroshi Mitsumoto
- Department of NeurologyColumbia University Irving Medical Center and the New York Presbyterian HospitalNew YorkNew YorkUSA
- Eleanor and Lou Gehrig ALS CenterColumbia University Irving Medical CenterNew YorkNew YorkUSA
| | - Jean P. Vonsattel
- Department of Pathology and Cell BiologyColumbia University Irving Medical Center and the New York Presbyterian HospitalNew YorkNew YorkUSA
| | - Phyllis L. Faust
- Department of Pathology and Cell BiologyColumbia University Irving Medical Center and the New York Presbyterian HospitalNew YorkNew YorkUSA
| | - Sheng‐Han Kuo
- Department of NeurologyColumbia University Irving Medical Center and the New York Presbyterian HospitalNew YorkNew YorkUSA
- Initiative for Columbia Ataxia and TremorColumbia University Irving Medical CenterNew YorkNew YorkUSA
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