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Mathias A, Perriot S, Jones S, Canales M, Bernard-Valnet R, Gimenez M, Torcida N, Oberholster L, Hottinger AF, Zekeridou A, Theaudin M, Pot C, Du Pasquier R. Human stem cell-derived neurons and astrocytes to detect novel auto-reactive IgG response in immune-mediated neurological diseases. Front Immunol 2024; 15:1419712. [PMID: 39114659 PMCID: PMC11303155 DOI: 10.3389/fimmu.2024.1419712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 07/11/2024] [Indexed: 08/10/2024] Open
Abstract
Background and objectives Up to 46% of patients with presumed autoimmune limbic encephalitis are seronegative for all currently known central nervous system (CNS) antigens. We developed a cell-based assay (CBA) to screen for novel neural antibodies in serum and cerebrospinal fluid (CSF) using neurons and astrocytes derived from human-induced pluripotent stem cells (hiPSCs). Methods Human iPSC-derived astrocytes or neurons were incubated with serum/CSF from 99 patients [42 with inflammatory neurological diseases (IND) and 57 with non-IND (NIND)]. The IND group included 11 patients with previously established neural antibodies, six with seronegative neuromyelitis optica spectrum disorder (NMOSD), 12 with suspected autoimmune encephalitis/paraneoplastic syndrome (AIE/PNS), and 13 with other IND (OIND). IgG binding to fixed CNS cells was detected using fluorescently-labeled antibodies and analyzed through automated fluorescence measures. IgG neuronal/astrocyte reactivity was further analyzed by flow cytometry. Peripheral blood mononuclear cells (PBMCs) were used as CNS-irrelevant control target cells. Reactivity profile was defined as positive using a Robust regression and Outlier removal test with a false discovery rate at 10% following each individual readout. Results Using our CBA, we detected antibodies recognizing hiPSC-derived neural cells in 19/99 subjects. Antibodies bound specifically to astrocytes in nine cases, to neurons in eight cases, and to both cell types in two cases, as confirmed by microscopy single-cell analyses. Highlighting the significance of our comprehensive 96-well CBA assay, neural-specific antibody binding was more frequent in IND (15 of 42) than in NIND patients (4 of 57) (Fisher's exact test, p = 0.0005). Two of four AQP4+ NMO and four of seven definite AIE/PNS with intracellular-reactive antibodies [1 GFAP astrocytopathy, 2 Hu+, 1 Ri+ AIE/PNS)], as identified in diagnostic laboratories, were also positive with our CBA. Most interestingly, we showed antibody-reactivity in two of six seronegative NMOSD, six of 12 probable AIE/PNS, and one of 13 OIND. Flow cytometry using hiPSC-derived CNS cells or PBMC-detected antibody binding in 13 versus zero patients, respectively, establishing the specificity of the detected antibodies for neural tissue. Conclusion Our unique hiPSC-based CBA allows for the testing of novel neuron-/astrocyte-reactive antibodies in patients with suspected immune-mediated neurological syndromes, and negative testing in established routine laboratories, opening new perspectives in establishing a diagnosis of such complex diseases.
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Affiliation(s)
- Amandine Mathias
- Laboratories of Neuroimmunology, Neuroscience Research Center and Division of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital and Lausanne University, Epalinges, Switzerland
| | - Sylvain Perriot
- Laboratories of Neuroimmunology, Neuroscience Research Center and Division of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital and Lausanne University, Epalinges, Switzerland
| | - Samuel Jones
- Laboratories of Neuroimmunology, Neuroscience Research Center and Division of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital and Lausanne University, Epalinges, Switzerland
| | - Mathieu Canales
- Laboratories of Neuroimmunology, Neuroscience Research Center and Division of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital and Lausanne University, Epalinges, Switzerland
| | - Raphaël Bernard-Valnet
- Service of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Marie Gimenez
- Laboratories of Neuroimmunology, Neuroscience Research Center and Division of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital and Lausanne University, Epalinges, Switzerland
| | - Nathan Torcida
- Laboratories of Neuroimmunology, Neuroscience Research Center and Division of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital and Lausanne University, Epalinges, Switzerland
| | - Larise Oberholster
- Laboratories of Neuroimmunology, Neuroscience Research Center and Division of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital and Lausanne University, Epalinges, Switzerland
| | - Andreas F. Hottinger
- Lundin Family Brain Tumor Research Centre, Department of Clinical Neurosciences and Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Anastasia Zekeridou
- Department of Laboratory Medicine and Pathology and Department of Neurology, Center for MS and Autoimmune Neurology, Mayo Clinic, Rochester, MN, United States
| | - Marie Theaudin
- Service of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Caroline Pot
- Laboratories of Neuroimmunology, Neuroscience Research Center and Division of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital and Lausanne University, Epalinges, Switzerland
- Service of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Renaud Du Pasquier
- Laboratories of Neuroimmunology, Neuroscience Research Center and Division of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital and Lausanne University, Epalinges, Switzerland
- Service of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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Liu P, Lin X, Wu S. Case report: Overlap syndrome of neuromyelitis optica spectrum disorder with anti-Argonaute antibodies. Front Immunol 2024; 15:1366531. [PMID: 38887290 PMCID: PMC11180789 DOI: 10.3389/fimmu.2024.1366531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 05/10/2024] [Indexed: 06/20/2024] Open
Abstract
Aquaporin-4 antibodies (AQP4-Abs) are a diagnostic marker for patients with a demyelinating disease called neuromyelitis optica spectrum disorder (NMOSD). Anti-Argonaute antibodies (AGO-Abs) present as potential biomarkers of the overlap syndrome between NMOSD and other autoimmune diseases. In this paper, we present the case of an adult woman with numbness, tingling, and burning sensations in her arms and subsequent bilateral internuclear ophthalmoplegia. Brain-cervical-thoracic magnetic resonance imaging (MRI) showed T2 hyperintensities in the dorsal brainstem and around the midbrain aqueduct and longitudinally transverse myelitis with homogeneous enhancement on gadolinium-enhanced MRI. The contemporaneous detection of AQP4- and AGO-Abs led to a definite diagnosis of overlap syndrome of NMOSD with AGO-Abs. The patient was treated with immunosuppressive agents, including corticosteroids and immunoglobulins, and achieved remission. This case highlights a novel phenotype of NMOSD with AGO-Abs overlap syndrome, which presents with relapsing brainstem syndrome and longitudinally extensive myelitis with acute severe neurological involvement. The promising prognosis of the disease could serve as a distinct clinical profile. Broad screening for antibodies against central nervous system autoimmune antigens is recommended in suspected patients with limited or atypical clinical manifestations.
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Affiliation(s)
- Pei Liu
- Department of Neurology, The First Affiliated Hospital of Northwest University, Xi’an, Shaanxi, China
- Xi’an Key Laboratory for Innovation and Translation of Neuroimmunological Diseases, Xi’an, China
| | - Xuemei Lin
- Department of Neurology, The First Affiliated Hospital of Northwest University, Xi’an, Shaanxi, China
- Xi’an Key Laboratory for Innovation and Translation of Neuroimmunological Diseases, Xi’an, China
| | - Songdi Wu
- Department of Neurology, The First Affiliated Hospital of Northwest University, Xi’an, Shaanxi, China
- Xi’an Key Laboratory for Innovation and Translation of Neuroimmunological Diseases, Xi’an, China
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Du BQ, Lai QL, Li EC, Cai MT, Fang GL, Shen CH, Zhang YX, Ding MP. Myelin oligodendrocyte glycoprotein antibody and N-methyl-d-aspartate receptor antibody overlapping syndrome: insights from the recent case reports. Clin Exp Immunol 2024; 215:27-36. [PMID: 37724585 PMCID: PMC10776248 DOI: 10.1093/cei/uxad109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 08/23/2023] [Accepted: 09/15/2023] [Indexed: 09/21/2023] Open
Abstract
The overlapping of two or more types of neural autoantibodies in one patient has increasingly been documented in recent years. The coexistence of myelin oligodendrocyte glycoprotein (MOG) and N-methyl-d-aspartate receptor (NMDAR) antibodies is most common, which leads to a unique condition known as the MOG antibody and NMDAR antibody overlapping syndrome (MNOS). Here, we have reviewed the pathogenesis, clinical manifestations, paraclinical features, and treatment of MNOS. Forty-nine patients with MNOS were included in this study. They were young males with a median onset age of 23 years. No tumors were observed in the patients, and 24 of them reported prodromal symptoms. The most common clinical presentations were psychiatric symptoms (35/49) and seizures (25/49). Abnormalities on magnetic resonance imaging involved the brainstem (11/49), cerebellum (9/49), and parietal lobe (9/49). Most patients mostly responded to immunotherapy and had a good long-term prognosis. However, the overall recurrence rate of MNOS was higher than that of mono antibody-positive diseases. The existence of concurrent NMDAR antibodies should be suspected in patients with MOG antibody-associated disease having psychiatric symptoms, seizures, movement disorders, or autonomic dysfunction. Similarly, serum MOG antibody testing should be performed when patients with anti-NMDAR encephalitis present with atypical clinical manifestations, such as visual impairment and limb weakness, and neuroradiological findings, such as optic nerve, spinal cord, or infratentorial involvement or meningeal enhancement. Early detection of the syndrome and prompt treatment can be beneficial for these patients, and maintenance immunosuppressive therapy is recommended due to the high overall recurrence rate of the syndrome.
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Affiliation(s)
- Bing-Qing Du
- Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Qi-Lun Lai
- Department of Neurology, Zhejiang Hospital, Hangzhou, China
| | - Er-Chuang Li
- Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Meng-Ting Cai
- Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Gao-Li Fang
- Department of Neurology, Zhejiang Chinese Medicine and Western Medicine Integrated Hospital, Hangzhou, China
| | - Chun-Hong Shen
- Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yin-Xi Zhang
- Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Mei-Ping Ding
- Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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Seok JM, Jeon MY, Chung YH, Ju H, Lee HL, Kwon S, Min JH, Kang ES, Kim BJ. Clinical characteristics of myelin oligodendrocyte glycoprotein antibody-associated disease according to their epitopes. Front Neurol 2023; 14:1200961. [PMID: 37435160 PMCID: PMC10331291 DOI: 10.3389/fneur.2023.1200961] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 06/12/2023] [Indexed: 07/13/2023] Open
Abstract
Background The detection of myelin oligodendrocyte glycoprotein autoantibodies (MOG-Ab) is essential for the diagnosis of MOG-Ab-associated disease (MOGAD). The clinical implications of different epitopes recognized by MOG-Ab are largely unknown. In this study, we established an in-house cell-based immunoassay for detecting MOG-Ab epitopes and examined the clinical characteristics of patients with MOG-Ab according to their epitopes. Methods We conducted a retrospective review of patients with MOG-Ab-associated disease (MOGAD) in our single center registry, and collected serum samples from enrolled patients. Human MOG variants were generated to detect epitopes recognized by MOG-Ab. The differences in clinical characteristics according to the presence of reactivity to MOG Proline42 (P42) were evaluated. Results Fifty five patients with MOGAD were enrolled. Optic neuritis was the most common presenting syndrome. The P42 position of MOG was a major epitope of MOG-Ab. The patients with a monophasic clinical course and childhood-onset patients were only observed in the group that showed reactivity to the P42 epitope. Conclusion We developed an in-house cell-based immunoassay to analyze the epitopes of MOG-Ab. The P42 position of MOG is the primary target of MOG-Ab in Korean patients with MOGAD. Further studies are needed to determine the predictive value of MOG-Ab and its epitopes.
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Affiliation(s)
- Jin Myoung Seok
- Department of Neurology, Soonchunhyang University Hospital Cheonan, Soonchunhyang University College of Medicine, Cheonan, Republic of Korea
| | - Mi Young Jeon
- Department of Neurology, Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Yeon Hak Chung
- Department of Neurology, Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hyunjin Ju
- Department of Neurology, Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hye Lim Lee
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Soonwook Kwon
- Department of Neurology, Inha University Hospital, Incheon, Republic of Korea
| | - Ju-Hong Min
- Department of Neurology, Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea
| | - Eun-Suk Kang
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Byoung Joon Kim
- Department of Neurology, Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Zhang LM, Zhang HB, Zou YF, Liu MW. Contactin-associated protein-2 and anti-aquaporin-4 antibody positive autoimmune encephalitis secondary to herpes simplex encephalitis: A case report. Medicine (Baltimore) 2023; 102:e33767. [PMID: 37335713 DOI: 10.1097/md.0000000000033767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2023] Open
Abstract
RATIONALE Recurrent herpes simplex encephalitis (HSE) can easily induce autoimmune encephalitis (AE). However, there are few reports of anti-contactin-associated protein-2 (CASPR2)-related encephalitis, especially with positive anti-aquaporin 4 (AQP4) antibodies. PATIENT CONCERNS A 14-year-old boy was admitted to the Department of Neurology of the First Affiliated Hospital of Kunming Medical University for "headache, dizziness, and fever for four days" with positive anti-CASPR2 and anti-AQP4 antibodies in the cerebrospinal fluid. DIAGNOSES Cranial MRI showed lesions in the right hippocampus, amygdala, and insular lobe, with local sulcus enhancement in the right insular, temporal, and frontal lobes. The fluid-attenuated inversion recovery was significantly enhanced. Human herpes virus type I was detected by cerebrospinal fluid metagenomic testing. The patient was diagnosed with AE secondary to HSE, with positive anti-CASPR2 and anti-AQP4 antibodies. INTERVENTIONS After 2 weeks of immunoglobulin and methylprednisolone immunomodulatory therapy, acyclovir antivirus, mannitol dehydration, reducing intracranial pressure, and other symptomatic support therapy. OUTCOMES The patient's symptoms significantly improved, with no complaints of discomfort, and he was discharged for observation. The patient was followed up a month after discharge and had no complaints of discomfort. LESSONS CASPR2 and anti-aquaporin-4 antibody-positive AE have not been reported to be positive. This case will raise awareness of CASPR2 and anti-aquaporin-4 antibody-positive AE secondary to HSE, strengthen diagnostic capacities, and provide advice to treat it.
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Affiliation(s)
- Lin-Ming Zhang
- Department of Neurology, the First Affiliated Hospital of Kunming Medical University, Wuhua District, Kunming, China
| | - Huan-Bo Zhang
- Trauma Center, the First Affiliated Hospital of Kunming Medical University, Wuhua District, Kunming, China
| | - Yong-Fang Zou
- Department of Emergency Medicine, the First Affiliated Hospital of Kunming Medical University, Wuhua District, Kunming, China
| | - Ming-Wei Liu
- Department of Emergency Medicine, the First Affiliated Hospital of Kunming Medical University, Wuhua District, Kunming, China
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Bartley CM, Ngo TT, Cadwell CR, Harroud A, Schubert RD, Alvarenga BD, Hawes IA, Zorn KC, Hunyh T, Teliska LH, Kung AF, Shah S, Gelfand JM, Chow FC, Rasband MN, Dubey D, Pittock SJ, DeRisi JL, Wilson MR, Pleasure SJ. Dual ankyrinG and subpial autoantibodies in a man with well-controlled HIV infection with steroid-responsive meningoencephalitis: A case report. Front Neurol 2023; 13:1102484. [PMID: 36756346 PMCID: PMC9900111 DOI: 10.3389/fneur.2022.1102484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 12/16/2022] [Indexed: 01/24/2023] Open
Abstract
Neuroinvasive infection is the most common cause of meningoencephalitis in people living with human immunodeficiency virus (HIV), but autoimmune etiologies have been reported. We present the case of a 51-year-old man living with HIV infection with steroid-responsive meningoencephalitis whose comprehensive pathogen testing was non-diagnostic. Subsequent tissue-based immunofluorescence with acute-phase cerebrospinal fluid revealed anti-neural antibodies localizing to the axon initial segment (AIS), the node of Ranvier (NoR), and the subpial space. Phage display immunoprecipitation sequencing identified ankyrinG (AnkG) as the leading candidate autoantigen. A synthetic blocking peptide encoding the PhIP-Seq-identified AnkG epitope neutralized CSF IgG binding to the AIS and NoR, thereby confirming a monoepitopic AnkG antibody response. However, subpial immunostaining persisted, indicating the presence of additional autoantibodies. Review of archival tissue-based staining identified candidate AnkG autoantibodies in a 60-year-old woman with metastatic ovarian cancer and seizures that were subsequently validated by cell-based assay. AnkG antibodies were not detected by tissue-based assay and/or PhIP-Seq in control CSF (N = 39), HIV CSF (N = 79), or other suspected and confirmed neuroinflammatory CSF cases (N = 1,236). Therefore, AnkG autoantibodies in CSF are rare but extend the catalog of AIS and NoR autoantibodies associated with neurological autoimmunity.
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Affiliation(s)
- Christopher M. Bartley
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Thomas T. Ngo
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Cathryn R. Cadwell
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
- Department of Pathology, University of California, San Francisco, San Francisco, CA, United States
| | - Adil Harroud
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Ryan D. Schubert
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Bonny D. Alvarenga
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Isobel A. Hawes
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
- Biomedical Sciences Graduate Program, University of California, San Francisco, San Francisco, CA, United States
| | - Kelsey C. Zorn
- Department of Biochemistry and Biophysics, University of California, San Francisco, San Francisco, CA, United States
| | - Trung Hunyh
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Lindsay H. Teliska
- Department of Neuroscience, Baylor College of Medicine, Houston, TX, United States
| | - Andrew F. Kung
- School of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Shailee Shah
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, United States
- Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, Rochester, MN, United States
| | - Jeffrey M. Gelfand
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Felicia C. Chow
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Matthew N. Rasband
- Department of Neuroscience, Baylor College of Medicine, Houston, TX, United States
| | - Divyanshu Dubey
- Department of Neurology, Mayo Clinic Foundation, Rochester, MN, United States
- Department of Laboratory Medicine and Pathology, Mayo Clinic Foundation, Rochester, MN, United States
| | - Sean J. Pittock
- Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, Rochester, MN, United States
- Department of Neurology, Mayo Clinic Foundation, Rochester, MN, United States
- Department of Laboratory Medicine and Pathology, Mayo Clinic Foundation, Rochester, MN, United States
| | - Joseph L. DeRisi
- Department of Biochemistry and Biophysics, University of California, San Francisco, San Francisco, CA, United States
- Chan Zuckerberg Biohub, San Francisco, CA, United States
| | - Michael R. Wilson
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Samuel J. Pleasure
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
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Harsini S, Rezaei N. Autoimmune diseases. Clin Immunol 2023. [DOI: 10.1016/b978-0-12-818006-8.00001-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Zhang S, Mao C, Li X, Miao W, Teng J. Advances in Potential Cerebrospinal Fluid Biomarkers for Autoimmune Encephalitis: A Review. Front Neurol 2022; 13:746653. [PMID: 35937071 PMCID: PMC9355282 DOI: 10.3389/fneur.2022.746653] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 06/20/2022] [Indexed: 12/24/2022] Open
Abstract
Autoimmune encephalitis (AE) is a severe inflammatory disease of the brain. Patients with AE demonstrate amnesia, seizures, and psychosis. Recent studies have identified numerous associated autoantibodies (e.g., against NMDA receptors (NMDARs), LGI1, etc.) involved in the pathogenesis of AE, and the levels of diagnosis and treatment are thus improved dramatically. However, there are drawbacks of clinical diagnosis and treatment based solely on antibody levels, and thus the application of additional biomarkers is urgently needed. Considering the important role of immune mechanisms in AE development, we summarize the relevant research progress in identifying cerebrospinal fluid (CSF) biomarkers with a focus on cytokines/chemokines, demyelination, and nerve damage.
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Towards a Better Understanding of the Atypical Features of Chronic Graft-Versus-Host Disease: A Report from the 2020 National Institutes of Health Consensus Project Task Force. Transplant Cell Ther 2022; 28:426-445. [PMID: 35662591 PMCID: PMC9557927 DOI: 10.1016/j.jtct.2022.05.038] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 05/16/2022] [Accepted: 05/24/2022] [Indexed: 12/31/2022]
Abstract
Alloreactive and autoimmune responses after allogeneic hematopoietic cell transplantation can occur in non-classical chronic graft-versus-host disease (chronic GVHD) tissues and organ systems or manifest in atypical ways in classical organs commonly affected by chronic GVHD. The National Institutes of Health (NIH) consensus projects were developed to improve understanding and classification of the clinical features and diagnostic criteria for chronic GVHD. While still speculative whether atypical manifestations are entirely due to chronic GVHD, these manifestations remain poorly captured by the current NIH consensus project criteria. Examples include chronic GVHD impacting the hematopoietic system as immune mediated cytopenias, endothelial dysfunction, or as atypical features in the musculoskeletal system, central and peripheral nervous system, kidneys, and serous membranes. These purported chronic GVHD features may contribute significantly to patient morbidity and mortality. Most of the atypical chronic GVHD features have received little study, particularly within multi-institutional and prospective studies, limiting our understanding of their frequency, pathogenesis, and relation to chronic GVHD. This NIH consensus project task force report provides an update on what is known and not known about the atypical manifestations of chronic GVHD, while outlining a research framework for future studies to be undertaken within the next three to seven years. We also provide provisional diagnostic criteria for each atypical manifestation, along with practical investigation strategies for clinicians managing patients with atypical chronic GVHD features.
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Jiang X, Yi S, Liu Q, Su D, Li L, Xiao C, Zhang J. Asperosaponin VI ameliorates the CMS-induced depressive-like behaviors by inducing a neuroprotective microglial phenotype in hippocampus via PPAR-γ pathway. J Neuroinflammation 2022; 19:115. [PMID: 35610721 PMCID: PMC9131532 DOI: 10.1186/s12974-022-02478-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 05/15/2022] [Indexed: 02/04/2023] Open
Abstract
Background The natural compound asperosaponin VI has shown potential as an antidepressant, but how it works is unclear. Here, we explored its effects on mice exposed to chronic mild stress (CMS) and the underlying molecular pathways. Methods Mice were exposed to CMS for 3 weeks followed by asperosaponin VI (40 mg/kg) or imipramine (20 mg/kg) for another 3 weeks. Depression-like behaviors were assessed in the forced swimming test (FST), sucrose preference test (SPT), tail suspension test (TST). Microglial phenotypes were evaluated using immunofluorescence staining, real-time quantitative PCR and enzyme-linked immunosorbent assays in hippocampus of mice. In some experiments, stressed animals were treated with the PPAR-γ antagonist GW9662 to examine its involvement in the effects of asperosaponin VI. Blockade of PPAR-γ in asperosaponin VI-treated primary microglia in the presence of lipopolysaccharide (LPS) was executed synchronously. The nuclear transfer of PPAR-γ in microglia was detected by immunofluorescence staining in vitro and in vivo. A co-cultured model of neuron and microglia was used for evaluating the regulation of ASA VI on the microglia–neuron crosstalk molecules. Results Asperosaponin VI ameliorated depression-like behaviors of CMS mice based on SPT, TST and FST, and this was associated with a switch of hippocampal microglia from a pro-inflammatory (iNOS+-Iba1+) to neuroprotective (Arg-1+-Iba1+) phenotype. CMS reduced the expression levels of PPAR-γ and phosphorylated PPAR-γ in hippocampus, which asperosaponin VI partially reversed. GW9662 treatment prevented the nuclear transfer of PPAR-γ in asperosaponin VI-treated microglia and inhibited the induction of Arg-1+ microglia. Blockade of PPAR-γ signaling also abolished the ability of asperosaponin VI to suppress pro-inflammatory cytokines while elevating anti-inflammatory cytokines in the hippocampus of CMS mice. The asperosaponin VI also promoted interactions between hippocampal microglia and neurons by enhancing CX3CL1/CX3CR1 and CD200/CD200R, and preserved synaptic function based on PSD95, CamKII β and GluA levels, but not in the presence of GW9662. Blockade of PPAR-γ signaling also abolished the antidepressant effects of asperosaponin VI in the SPT, TST and FST. Conclusion CMS in mice induces a pro-inflammatory microglial phenotype that causes reduced crosstalk between microglia and neuron, inflammation and synaptic dysfunction in the hippocampus, ultimately leading to depression-like behaviors. Asperosaponin VI may ameliorate the effects of CMS by inducing microglia to adopt a PPAR-γ-dependent neuroprotective phenotype. Supplementary Information The online version contains supplementary material available at 10.1186/s12974-022-02478-y.
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Affiliation(s)
- Xue Jiang
- Laboratory of Neuropharmacology, Resource Institute for Chinese and Ethnic Materia Medica, Guizhou University of Traditional Chinese Medicine, Guiyang, 550025, China.,State Key Laboratory of Quality Research in Chinese Medicine and Institute of Chinese Medical Sciences, University of Macau, Avenida da Universidade, Taipa, Macau, 999078, China
| | - Saini Yi
- Laboratory of Neuropharmacology, Resource Institute for Chinese and Ethnic Materia Medica, Guizhou University of Traditional Chinese Medicine, Guiyang, 550025, China
| | - Qin Liu
- Laboratory of Neuropharmacology, Resource Institute for Chinese and Ethnic Materia Medica, Guizhou University of Traditional Chinese Medicine, Guiyang, 550025, China
| | - Dapeng Su
- Laboratory of Neuropharmacology, Resource Institute for Chinese and Ethnic Materia Medica, Guizhou University of Traditional Chinese Medicine, Guiyang, 550025, China
| | - Liangyuan Li
- Laboratory of Neuropharmacology, Resource Institute for Chinese and Ethnic Materia Medica, Guizhou University of Traditional Chinese Medicine, Guiyang, 550025, China
| | - Chenghong Xiao
- Laboratory of Neuropharmacology, Resource Institute for Chinese and Ethnic Materia Medica, Guizhou University of Traditional Chinese Medicine, Guiyang, 550025, China
| | - Jinqiang Zhang
- Laboratory of Neuropharmacology, Resource Institute for Chinese and Ethnic Materia Medica, Guizhou University of Traditional Chinese Medicine, Guiyang, 550025, China.
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11
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Tanimura Y, Hiroaki Y, Mori M, Fujiyoshi Y. Cell-based flow cytometry assay for simultaneous detection of multiple autoantibodies in a single serum sample. Anal Biochem 2022; 650:114721. [DOI: 10.1016/j.ab.2022.114721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 04/06/2022] [Accepted: 05/04/2022] [Indexed: 11/17/2022]
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12
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Harschnitz O, Studer L. Human stem cell models to study host-virus interactions in the central nervous system. Nat Rev Immunol 2021; 21:441-453. [PMID: 33398129 PMCID: PMC9653304 DOI: 10.1038/s41577-020-00474-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2020] [Indexed: 01/30/2023]
Abstract
Advancements in human pluripotent stem cell technology offer a unique opportunity for the neuroimmunology field to study host-virus interactions directly in disease-relevant cells of the human central nervous system (CNS). Viral encephalitis is most commonly caused by herpesviruses, arboviruses and enteroviruses targeting distinct CNS cell types and often leading to severe neurological damage with poor clinical outcomes. Furthermore, different neurotropic viruses will affect the CNS at distinct developmental stages, from early prenatal brain development to the aged brain. With the unique flexibility and scalability of human pluripotent stem cell technology, it is now possible to examine the molecular mechanisms underlying acute infection and latency, determine which CNS subpopulations are specifically infected, study temporal aspects of viral susceptibility, perform high-throughput chemical or genetic screens for viral restriction factors and explore complex cell-non-autonomous disease mechanisms. Therefore, human pluripotent stem cell technology has the potential to address key unanswered questions about antiviral immunity in the CNS, including emerging questions on the potential CNS tropism of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
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Affiliation(s)
- Oliver Harschnitz
- Developmental Biology Program, Sloan Kettering Institute for Cancer Research, New York (NY), USA,The Center for Stem Cell Biology, Sloan Kettering Institute for Cancer Research, New York (NY), USA,
| | - Lorenz Studer
- Developmental Biology Program, Sloan Kettering Institute for Cancer Research, New York (NY), USA,The Center for Stem Cell Biology, Sloan Kettering Institute for Cancer Research, New York (NY), USA
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13
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Macrini C, Gerhards R, Winklmeier S, Bergmann L, Mader S, Spadaro M, Vural A, Smolle M, Hohlfeld R, Kümpfel T, Lichtenthaler SF, Franquelim HG, Jenne D, Meinl E. Features of MOG required for recognition by patients with MOG antibody-associated disorders. Brain 2021; 144:2375-2389. [PMID: 33704436 DOI: 10.1093/brain/awab105] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 12/21/2020] [Accepted: 01/08/2021] [Indexed: 01/03/2023] Open
Abstract
Antibodies (Abs) to myelin oligodendrocyte glycoprotein (MOG) define a distinct disease entity. Here we aimed to understand essential structural features of MOG required for recognition by autoantibodies from patients. We produced the N-terminal part of MOG in a conformationally correct form; this domain was insufficient to identify patients with MOG-Abs by ELISA even after site-directed binding. This was neither due to a lack of lipid embedding nor to a missing putative epitope at the C-terminus, which we confirmed to be an intracellular domain. When MOG was displayed on transfected cells, patients with MOG-Abs recognized full-length MOG much better than its N-terminal part with the first hydrophobic domain (p < 0.0001). Even antibodies affinity-purified with the extracellular part of MOG recognized full-length MOG better than the extracellular part of MOG after transfection. The second hydrophobic domain of MOG enhanced the recognition of the extracellular part of MOG by antibodies from patients as seen with truncated variants of MOG. We confirmed the pivotal role of the second hydrophobic domain by fusing the intracellular part of MOG from the evolutionary distant opossum to the human extracellular part; the chimeric construct restored the antibody-binding completely. Further, we found that in contrast to 8-18C5, MOG-Abs from patients bound preferentially as F(ab')2 rather than Fab. It was previously found that bivalent binding of human IgG1, the prominent isotype of MOG-Abs, requires that its target antigen is displayed at a distance of 13-16 nm. We found that, upon transfection, molecules of MOG did not interact so closely to induce a Förster resonance energy transfer (FRET) signal, indicating that they are more than 6 nm apart. We propose that the intracellular part of MOG holds the monomers apart at a suitable distance for bivalent binding; this could explain why a cell-based assay is needed to identify MOG-Abs. Our finding that MOG-Abs from most patients require bivalent binding has implications for understanding the pathogenesis of MOG-antibody-associated-disorders. Since bivalently bound antibodies have been reported to only poorly bind C1q, we speculate that the pathogenicity of MOG-Abs is mostly mediated by other mechanisms than complement activation. Therefore, therapeutic inhibition of complement activation should be less efficient in MOG-Ab associated disorders than in patients with Abs to aquaporin-4.
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Affiliation(s)
- Caterina Macrini
- Institute of Clinical Neuroimmunology, Biomedical Center and University Hospitals, Ludwig-Maximilians-Universität München, 82152 Munich, Germany
| | - Ramona Gerhards
- Institute of Clinical Neuroimmunology, Biomedical Center and University Hospitals, Ludwig-Maximilians-Universität München, 82152 Munich, Germany
| | - Stephan Winklmeier
- Institute of Clinical Neuroimmunology, Biomedical Center and University Hospitals, Ludwig-Maximilians-Universität München, 82152 Munich, Germany
| | - Lena Bergmann
- Physiological Chemistry, Biomedical Center, Ludwig-Maximilians-Universität, 82152 Munich, Germany
| | - Simone Mader
- Institute of Clinical Neuroimmunology, Biomedical Center and University Hospitals, Ludwig-Maximilians-Universität München, 82152 Munich, Germany
| | - Melania Spadaro
- Institute of Clinical Neuroimmunology, Biomedical Center and University Hospitals, Ludwig-Maximilians-Universität München, 82152 Munich, Germany
| | - Atay Vural
- Department of Neurology, Koc University School of Medicine, 34450 Istanbul, Turkey
| | - Michaela Smolle
- Physiological Chemistry, Biomedical Center, Ludwig-Maximilians-Universität, 82152 Munich, Germany
- BioPhysics Core Facility, Biomedical Center, Ludwig-Maximilians-Universität, 82152 Munich, Germany
| | - Reinhard Hohlfeld
- Institute of Clinical Neuroimmunology, Biomedical Center and University Hospitals, Ludwig-Maximilians-Universität München, 82152 Munich, Germany
| | - Tania Kümpfel
- Institute of Clinical Neuroimmunology, Biomedical Center and University Hospitals, Ludwig-Maximilians-Universität München, 82152 Munich, Germany
| | - Stefan F Lichtenthaler
- German Center for Neurodegenerative Diseases (DZNE) Munich and Neuroproteomics, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, 81675 Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), 81377 Munich, Germany
| | - Henri G Franquelim
- Cellular and Molecular Biophysics, Max Planck Institute of Biochemistry, 82152 Munich, Germany
| | - Dieter Jenne
- Institute of Lung Biology and Disease (ILBD), Comprehensive Pneumology Center (CPC), 81377 Munich, Germany
| | - Edgar Meinl
- Institute of Clinical Neuroimmunology, Biomedical Center and University Hospitals, Ludwig-Maximilians-Universität München, 82152 Munich, Germany
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14
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Anti-MOG antibodies associated demyelination following encephalomeningitis: Case report. J Neuroimmunol 2021; 353:577519. [PMID: 33631487 DOI: 10.1016/j.jneuroim.2021.577519] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 02/02/2021] [Accepted: 02/02/2021] [Indexed: 11/21/2022]
Abstract
Myelin oligodendrocyte glycoprotein (MOG) antibodies have been found in a broad range of demyelination diseases. In the present study, we reported three cases of patients with anti-MOG antibodies associated disorders (MOG-ADs) who initially presented as intracranial infection like encephalomeningitis with no evidence of demyelination injury, but were subsequently found the expression of MOG antibodies and other demyelination presentations. Our findings suggested that MOG-ADs can start as an intracranial infection like prodromal symptoms prior to the lesions of optic nerve, spinal cord, and white matter. Therefore, clinicians should be cautious of MOG-ADs in cases of encephalomeningitis even without demyelination injury.
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15
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Liu P, Bai M, Yan X, Ren K, Ding J, Zhao D, Li H, Yan Y, Guo J. Possible coexistence of MOG-IgG-associated disease and anti-Caspr2 antibody-associated autoimmune encephalitis: a first case report. Ther Adv Neurol Disord 2020; 13:1756286420969462. [PMID: 33193815 PMCID: PMC7605028 DOI: 10.1177/1756286420969462] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 10/01/2020] [Indexed: 01/05/2023] Open
Abstract
Myelin oligodendrocyte glycoprotein antibody-associated disease has been proposed as a separate inflammatory demyelinating disease of the central nervous system (CNS) since the discovery of pathogenic antibodies against myelin oligodendrocyte glycoprotein (MOG-IgG). Antibodies targeting contactin-associated protein-like 2 (Caspr2), a component of voltage-gated potassium channel (VGKC) complex, have been documented to be associated with a novel autoimmune synaptic encephalitis with a low incidence. Herein, we reported an adult female with initial presentation of decreased vision in the right eye and subsequent episodes of neuropsychiatric disturbance including hypersomnia, agitation, apatheia, and memory impairment. Magnetic resonance imaging (MRI) revealed multiple lesions scattered in brain, brainstem, and cervical and thoracic spinal cord, showing hypointensity on T1-weighted images, hyperintensity on T2-weighted and fluid attenuated inversion recovery (FLAIR) images. Heterogenous patchy or ring-like enhancement was observed in the majority of lesions. The detection of low-titer MOG-IgG exclusively in cerebrospinal fluid (CSF; titer, 1:1) and Caspr2-IgG in both serum and CSF (titers, 1:100 and 1:1) led to a possible diagnosis of coexisting MOG-IgG-associated disease (MOGAD) and anti-Caspr2 antibody-associated autoimmune encephalitis. The patient was treated with immunosuppressive agents including corticosteroids and immunoglobulin, and achieved a sustained remission. To the best of our knowledge, this is the first report on the possible coexistence of MOGAD and anti-Caspr2 antibody-associated autoimmune encephalitis, which advocates for the recommendation of a broad spectrum screening for antibodies against well-defined CNS antigens in suspected patients with autoimmune-mediated diseases of the CNS.
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Affiliation(s)
- Pei Liu
- Department of Neurology, Tangdu Hospital, Air Force Military Medical University, Xi'an, Shaanxi Province, China
| | - Miao Bai
- Department of Neurology, Tangdu Hospital, Air Force Military Medical University, Xi'an, Shaanxi Province, China
| | - Xu Yan
- Department of Neurology, Tangdu Hospital, Air Force Military Medical University, Xi'an, Shaanxi Province, China
| | - Kaixi Ren
- Department of Neurology, Tangdu Hospital, Air Force Military Medical University, Xi'an, Shaanxi Province, China
| | - Jiaqi Ding
- Department of Neurology, Tangdu Hospital, Air Force Military Medical University, Xi'an, Shaanxi Province, China
| | - Daidi Zhao
- Department of Neurology, Tangdu Hospital, Air Force Military Medical University, Xi'an, Shaanxi Province, China
| | - Hongzeng Li
- Department of Neurology, Tangdu Hospital, Air Force Military Medical University, Xi'an, Shaanxi Province, China
| | - Yaping Yan
- College of Life Sciences, Shaanxi Normal University, Xi'an, Shaanxi Province, China
| | - Jun Guo
- Department of Neurology, Tangdu Hospital, Air Force Military Medical University, No. 569 Xinsi Road, Xi'an, Shaanxi Province 710038, China
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16
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Zeneyedpour L, Sten-van `t Hoff J, Luider T. Using phosphoproteomics and next generation sequencing to discover novel therapeutic targets in patient antibodies. Expert Rev Proteomics 2020; 17:675-684. [DOI: 10.1080/14789450.2020.1845147] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Lona Zeneyedpour
- Department of Neurology, Erasmus MC, Laboratory of Neuro-Oncology/Clinical & Cancer Proteomics, Rotterdam, The Netherlands
| | - Jenny Sten-van `t Hoff
- Department of Neurology, Erasmus MC, Laboratory of Neuro-Oncology/Clinical & Cancer Proteomics, Rotterdam, The Netherlands
| | - Theo Luider
- Department of Neurology, Erasmus MC, Laboratory of Neuro-Oncology/Clinical & Cancer Proteomics, Rotterdam, The Netherlands
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17
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Bello-Morales R, Andreu S, López-Guerrero JA. The Role of Herpes Simplex Virus Type 1 Infection in Demyelination of the Central Nervous System. Int J Mol Sci 2020; 21:ijms21145026. [PMID: 32708697 PMCID: PMC7404202 DOI: 10.3390/ijms21145026] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 07/14/2020] [Accepted: 07/15/2020] [Indexed: 12/13/2022] Open
Abstract
Herpes simplex type 1 (HSV-1) is a neurotropic virus that infects the peripheral and central nervous systems. After primary infection in epithelial cells, HSV-1 spreads retrogradely to the peripheral nervous system (PNS), where it establishes a latent infection in the trigeminal ganglia (TG). The virus can reactivate from the latent state, traveling anterogradely along the axon and replicating in the local surrounding tissue. Occasionally, HSV-1 may spread trans-synaptically from the TG to the brainstem, from where it may disseminate to higher areas of the central nervous system (CNS). It is not completely understood how HSV-1 reaches the CNS, although the most accepted idea is retrograde transport through the trigeminal or olfactory tracts. Once in the CNS, HSV-1 may induce demyelination, either as a direct trigger or as a risk factor, modulating processes such as remyelination, regulation of endogenous retroviruses, or molecular mimicry. In this review, we describe the current knowledge about the involvement of HSV-1 in demyelination, describing the pathways used by this herpesvirus to spread throughout the CNS and discussing the data that suggest its implication in demyelinating processes.
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Affiliation(s)
- Raquel Bello-Morales
- Departamento de Biología Molecular, Universidad Autónoma de Madrid, Cantoblanco, 28049 Madrid, Spain; (S.A.); (J.A.L.-G.)
- Centro de Biología Molecular Severo Ochoa, CSIC-UAM, Cantoblanco, 28049 Madrid, Spain
- Correspondence:
| | - Sabina Andreu
- Departamento de Biología Molecular, Universidad Autónoma de Madrid, Cantoblanco, 28049 Madrid, Spain; (S.A.); (J.A.L.-G.)
- Centro de Biología Molecular Severo Ochoa, CSIC-UAM, Cantoblanco, 28049 Madrid, Spain
| | - José Antonio López-Guerrero
- Departamento de Biología Molecular, Universidad Autónoma de Madrid, Cantoblanco, 28049 Madrid, Spain; (S.A.); (J.A.L.-G.)
- Centro de Biología Molecular Severo Ochoa, CSIC-UAM, Cantoblanco, 28049 Madrid, Spain
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18
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Tanaka S, Hashimoto B, Izaki S, Oji S, Fukaura H, Nomura K. Clinical and immunological differences between MOG associated disease and anti AQP4 antibody-positive neuromyelitis optica spectrum disorders: Blood-brain barrier breakdown and peripheral plasmablasts. Mult Scler Relat Disord 2020; 41:102005. [PMID: 32114369 DOI: 10.1016/j.msard.2020.102005] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 02/07/2020] [Accepted: 02/08/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Patients with anti-aquaporin-4 (AQP4) water channel antibody-positive neuromyelitis optica spectrum disorders (AQP4-NMOSD) and myelin oligodendrocyte glycoprotein (MOG) associated disease (MOGAD) often present with similar clinical symptoms, and some cases are hard to differentiate at the time of onset. In this study, we compared the clinical characteristics, cerebrospinal fluid (CSF) analysis parameters, and peripheral T/B lymphocyte subsets during the active and chronic phases in AQP4-NMOSD and MOGAD. METHODS A total of 17 MOGAD cases and 24 AQP4-NMOSD cases were studied. The clinical characteristics in both groups were summarized, including disease duration, total number of attacks, lesions, prevention of relapse during remission, and CSF analysis results during the active phase. T/B lymphocyte subsets were further investigated in the active and chronic phases. RESULTS In the comparative study on clinical symptoms, a large proportion of optic neuritis was unilateral in MOGAD. In the comparative study on CSF analysis, protein level was significantly lower in MOGAD compared with AQP4-NMOSD (p = 0.006); myelin basic protein was significantly lower in MOGAD compared with AQP4-NMOSD (p = 0.04); albumin quotient was significantly lower in MOGAD compared with AQP4-NMOSD (p = 0.02); and IgG Quotient was significantly lower in MOGAD compared with AQP4-NMOSD (p = 0.05). In the analysis of T/B lymphocyte subsets, plasmablasts of the B cell subset in the active phase were significantly lower in MOGAD (2.1 ± 2.4) compared to AQP4-NMOSD (7.8 ± 7.2) (p < 0.05). In the chronic phase, transitional B cells were significantly higher in MOGAD (2.1 ± 1.8) compared to AQP4-NMOSD (0.6 ± 0.4) (p < 0.01). CONCLUSION Clinical characteristics of MOGAD were similar to those of AQP4-NMOSD, but increased blood brain barrier permeability was suggested to be less severe in MOGAD compared to AQP4-NMOSD from CSF analysis. Furthermore, the pathogenesis of the two diseases was clearly distinct as plasmablasts in the active phase were not elevated in MOGAD, but were increased in AQP4-NMOSD.
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Affiliation(s)
- Satoru Tanaka
- Department of Neurology, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan.
| | - Baku Hashimoto
- Department of Neurology, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
| | - Shoko Izaki
- Department of Neurology, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
| | - Satoru Oji
- Department of Neurology, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
| | - Hikoaki Fukaura
- Department of Neurology, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
| | - Kyoichi Nomura
- Department of Neurology, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
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Tea F, Lopez JA, Ramanathan S, Merheb V, Lee FXZ, Zou A, Pilli D, Patrick E, van der Walt A, Monif M, Tantsis EM, Yiu EM, Vucic S, Henderson APD, Fok A, Fraser CL, Lechner-Scott J, Reddel SW, Broadley S, Barnett MH, Brown DA, Lunemann JD, Dale RC, Brilot F. Characterization of the human myelin oligodendrocyte glycoprotein antibody response in demyelination. Acta Neuropathol Commun 2019; 7:145. [PMID: 31481127 PMCID: PMC6724269 DOI: 10.1186/s40478-019-0786-3] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 08/09/2019] [Indexed: 12/14/2022] Open
Abstract
Over recent years, human autoantibodies targeting myelin oligodendrocyte glycoprotein (MOG Ab) have been associated with monophasic and relapsing central nervous system demyelination involving the optic nerves, spinal cord, and brain. While the clinical relevance of MOG Ab detection is becoming increasingly clear as therapeutic and prognostic differences from multiple sclerosis are acknowledged, an in-depth characterization of human MOG Ab is required to answer key challenges in patient diagnosis, treatment, and prognosis. Herein, we investigated the epitope, binding sensitivity, and affinity of MOG Ab in a cohort of 139 and 148 MOG antibody-seropositive children and adults (n = 287 patients at baseline, 130 longitudinal samples, and 22 cerebrospinal fluid samples). MOG extracellular domain was also immobilized to determine the affinity of MOG Ab. MOG Ab response was of immunoglobulin G1 isotype, and was of peripheral rather than intrathecal origin. High affinity MOG Ab were detected in 15% paediatric and 18% adult sera. More than 75% of paediatric and adult MOG Ab targeted a dominant extracellular antigenic region around Proline42. MOG Ab titers fluctuated over the progression of disease, but affinity and reactivity to Proline42 remained stable. Adults with a relapsing course intrinsically presented with a reduced immunoreactivity to Proline42 and had a more diverse MOG Ab response, a feature that may be harnessed for predicting relapse. Higher titers of MOG Ab were observed in more severe phenotypes and during active disease, supporting the pathogenic role of MOG Ab. Loss of MOG Ab seropositivity was observed upon conformational changes to MOG, and this greatly impacted the sensitivity of the detection of relapsing disorders, largely considered as more severe. Careful consideration of the binding characteristics of autoantigens should be taken into account when detecting disease-relevant autoantibodies.
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20
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Stengel H, Vural A, Brunder AM, Heinius A, Appeltshauser L, Fiebig B, Giese F, Dresel C, Papagianni A, Birklein F, Weis J, Huchtemann T, Schmidt C, Körtvelyessy P, Villmann C, Meinl E, Sommer C, Leypoldt F, Doppler K. Anti-pan-neurofascin IgG3 as a marker of fulminant autoimmune neuropathy. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION 2019; 6:6/5/e603. [PMID: 31454780 PMCID: PMC6705632 DOI: 10.1212/nxi.0000000000000603] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 06/25/2019] [Indexed: 12/31/2022]
Abstract
Objective To identify and characterize patients with autoantibodies against different neurofascin (NF) isoforms. Methods Screening of a large cohort of patient sera for anti-NF autoantibodies by ELISA and further characterization by cell-based assays, epitope mapping, and complement binding assays. Results Two different clinical phenotypes became apparent in this study: The well-known clinical picture of subacute-onset severe sensorimotor neuropathy with tremor that is known to be associated with IgG4 autoantibodies against the paranodal isoform NF-155 was found in 2 patients. The second phenotype with a dramatic course of disease with tetraplegia and almost locked-in syndrome was associated with IgG3 autoantibodies against nodal and paranodal isoforms of NF in 3 patients. The epitope against which these autoantibodies were directed in this second phenotype was the common Ig domain found in all 3 NF isoforms. In contrast, anti–NF-155 IgG4 were directed against the NF-155–specific Fn3Fn4 domain. The description of a second phenotype of anti–NF-associated neuropathy is in line with some case reports of similar patients that were published in the last year. Conclusions Our results indicate that anti–pan-NF-associated neuropathy differs from anti–NF-155-associated neuropathy, and epitope and subclass play a major role in the pathogenesis and severity of anti–NF-associated neuropathy and should be determined to correctly classify patients, also in respect to possible differences in therapeutic response.
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Affiliation(s)
- Helena Stengel
- From the Department of Neurology (H.S., A.M.B., L.A., B.F., A.P., C.S., K.D.), University Hospital Würzburg; Institute of Clinical Neuroimmunology (A.V., E.M.), Biomedical Center, University Hospitals, Ludwig-Maximilians-Universität München, Planegg-Martinsried; Universitätsklinikum Schleswig-Holstein Campus Kiel (A.H., F.L.), Neuroimmunology Section, Institute of Clinical Chemistry, Kiel/Lübeck; Department of Neurology (F.G.), University Hospital Halle; Department of Neurology (C.D., F.B.), University Hospital Mainz, Mainz; University Hospital Aachen (J.W.), Institute of Neuropathology, Aachen; Department of Neurology (T.H., P.K.), University Hospital Magdeburg; Institute for Pharmacology and Toxicology (C.S.), Otto-von-Guericke University; German Center for Neurodegenerative Diseases (P.K.), Magdeburg; Institute for Clinical Neurobiology (C.V.), University Hospital Würzburg; Department of Neurology (F.L.), Universitätsklinikum Schleswig-Holstein, Kiel, Germany; and Research Center for Translational Medicine (A.V), Koç University, Istanbul, Turkey
| | - Atay Vural
- From the Department of Neurology (H.S., A.M.B., L.A., B.F., A.P., C.S., K.D.), University Hospital Würzburg; Institute of Clinical Neuroimmunology (A.V., E.M.), Biomedical Center, University Hospitals, Ludwig-Maximilians-Universität München, Planegg-Martinsried; Universitätsklinikum Schleswig-Holstein Campus Kiel (A.H., F.L.), Neuroimmunology Section, Institute of Clinical Chemistry, Kiel/Lübeck; Department of Neurology (F.G.), University Hospital Halle; Department of Neurology (C.D., F.B.), University Hospital Mainz, Mainz; University Hospital Aachen (J.W.), Institute of Neuropathology, Aachen; Department of Neurology (T.H., P.K.), University Hospital Magdeburg; Institute for Pharmacology and Toxicology (C.S.), Otto-von-Guericke University; German Center for Neurodegenerative Diseases (P.K.), Magdeburg; Institute for Clinical Neurobiology (C.V.), University Hospital Würzburg; Department of Neurology (F.L.), Universitätsklinikum Schleswig-Holstein, Kiel, Germany; and Research Center for Translational Medicine (A.V), Koç University, Istanbul, Turkey
| | - Anna-Michelle Brunder
- From the Department of Neurology (H.S., A.M.B., L.A., B.F., A.P., C.S., K.D.), University Hospital Würzburg; Institute of Clinical Neuroimmunology (A.V., E.M.), Biomedical Center, University Hospitals, Ludwig-Maximilians-Universität München, Planegg-Martinsried; Universitätsklinikum Schleswig-Holstein Campus Kiel (A.H., F.L.), Neuroimmunology Section, Institute of Clinical Chemistry, Kiel/Lübeck; Department of Neurology (F.G.), University Hospital Halle; Department of Neurology (C.D., F.B.), University Hospital Mainz, Mainz; University Hospital Aachen (J.W.), Institute of Neuropathology, Aachen; Department of Neurology (T.H., P.K.), University Hospital Magdeburg; Institute for Pharmacology and Toxicology (C.S.), Otto-von-Guericke University; German Center for Neurodegenerative Diseases (P.K.), Magdeburg; Institute for Clinical Neurobiology (C.V.), University Hospital Würzburg; Department of Neurology (F.L.), Universitätsklinikum Schleswig-Holstein, Kiel, Germany; and Research Center for Translational Medicine (A.V), Koç University, Istanbul, Turkey
| | - Annika Heinius
- From the Department of Neurology (H.S., A.M.B., L.A., B.F., A.P., C.S., K.D.), University Hospital Würzburg; Institute of Clinical Neuroimmunology (A.V., E.M.), Biomedical Center, University Hospitals, Ludwig-Maximilians-Universität München, Planegg-Martinsried; Universitätsklinikum Schleswig-Holstein Campus Kiel (A.H., F.L.), Neuroimmunology Section, Institute of Clinical Chemistry, Kiel/Lübeck; Department of Neurology (F.G.), University Hospital Halle; Department of Neurology (C.D., F.B.), University Hospital Mainz, Mainz; University Hospital Aachen (J.W.), Institute of Neuropathology, Aachen; Department of Neurology (T.H., P.K.), University Hospital Magdeburg; Institute for Pharmacology and Toxicology (C.S.), Otto-von-Guericke University; German Center for Neurodegenerative Diseases (P.K.), Magdeburg; Institute for Clinical Neurobiology (C.V.), University Hospital Würzburg; Department of Neurology (F.L.), Universitätsklinikum Schleswig-Holstein, Kiel, Germany; and Research Center for Translational Medicine (A.V), Koç University, Istanbul, Turkey
| | - Luise Appeltshauser
- From the Department of Neurology (H.S., A.M.B., L.A., B.F., A.P., C.S., K.D.), University Hospital Würzburg; Institute of Clinical Neuroimmunology (A.V., E.M.), Biomedical Center, University Hospitals, Ludwig-Maximilians-Universität München, Planegg-Martinsried; Universitätsklinikum Schleswig-Holstein Campus Kiel (A.H., F.L.), Neuroimmunology Section, Institute of Clinical Chemistry, Kiel/Lübeck; Department of Neurology (F.G.), University Hospital Halle; Department of Neurology (C.D., F.B.), University Hospital Mainz, Mainz; University Hospital Aachen (J.W.), Institute of Neuropathology, Aachen; Department of Neurology (T.H., P.K.), University Hospital Magdeburg; Institute for Pharmacology and Toxicology (C.S.), Otto-von-Guericke University; German Center for Neurodegenerative Diseases (P.K.), Magdeburg; Institute for Clinical Neurobiology (C.V.), University Hospital Würzburg; Department of Neurology (F.L.), Universitätsklinikum Schleswig-Holstein, Kiel, Germany; and Research Center for Translational Medicine (A.V), Koç University, Istanbul, Turkey
| | - Bianca Fiebig
- From the Department of Neurology (H.S., A.M.B., L.A., B.F., A.P., C.S., K.D.), University Hospital Würzburg; Institute of Clinical Neuroimmunology (A.V., E.M.), Biomedical Center, University Hospitals, Ludwig-Maximilians-Universität München, Planegg-Martinsried; Universitätsklinikum Schleswig-Holstein Campus Kiel (A.H., F.L.), Neuroimmunology Section, Institute of Clinical Chemistry, Kiel/Lübeck; Department of Neurology (F.G.), University Hospital Halle; Department of Neurology (C.D., F.B.), University Hospital Mainz, Mainz; University Hospital Aachen (J.W.), Institute of Neuropathology, Aachen; Department of Neurology (T.H., P.K.), University Hospital Magdeburg; Institute for Pharmacology and Toxicology (C.S.), Otto-von-Guericke University; German Center for Neurodegenerative Diseases (P.K.), Magdeburg; Institute for Clinical Neurobiology (C.V.), University Hospital Würzburg; Department of Neurology (F.L.), Universitätsklinikum Schleswig-Holstein, Kiel, Germany; and Research Center for Translational Medicine (A.V), Koç University, Istanbul, Turkey
| | - Florian Giese
- From the Department of Neurology (H.S., A.M.B., L.A., B.F., A.P., C.S., K.D.), University Hospital Würzburg; Institute of Clinical Neuroimmunology (A.V., E.M.), Biomedical Center, University Hospitals, Ludwig-Maximilians-Universität München, Planegg-Martinsried; Universitätsklinikum Schleswig-Holstein Campus Kiel (A.H., F.L.), Neuroimmunology Section, Institute of Clinical Chemistry, Kiel/Lübeck; Department of Neurology (F.G.), University Hospital Halle; Department of Neurology (C.D., F.B.), University Hospital Mainz, Mainz; University Hospital Aachen (J.W.), Institute of Neuropathology, Aachen; Department of Neurology (T.H., P.K.), University Hospital Magdeburg; Institute for Pharmacology and Toxicology (C.S.), Otto-von-Guericke University; German Center for Neurodegenerative Diseases (P.K.), Magdeburg; Institute for Clinical Neurobiology (C.V.), University Hospital Würzburg; Department of Neurology (F.L.), Universitätsklinikum Schleswig-Holstein, Kiel, Germany; and Research Center for Translational Medicine (A.V), Koç University, Istanbul, Turkey
| | - Christian Dresel
- From the Department of Neurology (H.S., A.M.B., L.A., B.F., A.P., C.S., K.D.), University Hospital Würzburg; Institute of Clinical Neuroimmunology (A.V., E.M.), Biomedical Center, University Hospitals, Ludwig-Maximilians-Universität München, Planegg-Martinsried; Universitätsklinikum Schleswig-Holstein Campus Kiel (A.H., F.L.), Neuroimmunology Section, Institute of Clinical Chemistry, Kiel/Lübeck; Department of Neurology (F.G.), University Hospital Halle; Department of Neurology (C.D., F.B.), University Hospital Mainz, Mainz; University Hospital Aachen (J.W.), Institute of Neuropathology, Aachen; Department of Neurology (T.H., P.K.), University Hospital Magdeburg; Institute for Pharmacology and Toxicology (C.S.), Otto-von-Guericke University; German Center for Neurodegenerative Diseases (P.K.), Magdeburg; Institute for Clinical Neurobiology (C.V.), University Hospital Würzburg; Department of Neurology (F.L.), Universitätsklinikum Schleswig-Holstein, Kiel, Germany; and Research Center for Translational Medicine (A.V), Koç University, Istanbul, Turkey
| | - Aikaterini Papagianni
- From the Department of Neurology (H.S., A.M.B., L.A., B.F., A.P., C.S., K.D.), University Hospital Würzburg; Institute of Clinical Neuroimmunology (A.V., E.M.), Biomedical Center, University Hospitals, Ludwig-Maximilians-Universität München, Planegg-Martinsried; Universitätsklinikum Schleswig-Holstein Campus Kiel (A.H., F.L.), Neuroimmunology Section, Institute of Clinical Chemistry, Kiel/Lübeck; Department of Neurology (F.G.), University Hospital Halle; Department of Neurology (C.D., F.B.), University Hospital Mainz, Mainz; University Hospital Aachen (J.W.), Institute of Neuropathology, Aachen; Department of Neurology (T.H., P.K.), University Hospital Magdeburg; Institute for Pharmacology and Toxicology (C.S.), Otto-von-Guericke University; German Center for Neurodegenerative Diseases (P.K.), Magdeburg; Institute for Clinical Neurobiology (C.V.), University Hospital Würzburg; Department of Neurology (F.L.), Universitätsklinikum Schleswig-Holstein, Kiel, Germany; and Research Center for Translational Medicine (A.V), Koç University, Istanbul, Turkey
| | - Frank Birklein
- From the Department of Neurology (H.S., A.M.B., L.A., B.F., A.P., C.S., K.D.), University Hospital Würzburg; Institute of Clinical Neuroimmunology (A.V., E.M.), Biomedical Center, University Hospitals, Ludwig-Maximilians-Universität München, Planegg-Martinsried; Universitätsklinikum Schleswig-Holstein Campus Kiel (A.H., F.L.), Neuroimmunology Section, Institute of Clinical Chemistry, Kiel/Lübeck; Department of Neurology (F.G.), University Hospital Halle; Department of Neurology (C.D., F.B.), University Hospital Mainz, Mainz; University Hospital Aachen (J.W.), Institute of Neuropathology, Aachen; Department of Neurology (T.H., P.K.), University Hospital Magdeburg; Institute for Pharmacology and Toxicology (C.S.), Otto-von-Guericke University; German Center for Neurodegenerative Diseases (P.K.), Magdeburg; Institute for Clinical Neurobiology (C.V.), University Hospital Würzburg; Department of Neurology (F.L.), Universitätsklinikum Schleswig-Holstein, Kiel, Germany; and Research Center for Translational Medicine (A.V), Koç University, Istanbul, Turkey
| | - Joachim Weis
- From the Department of Neurology (H.S., A.M.B., L.A., B.F., A.P., C.S., K.D.), University Hospital Würzburg; Institute of Clinical Neuroimmunology (A.V., E.M.), Biomedical Center, University Hospitals, Ludwig-Maximilians-Universität München, Planegg-Martinsried; Universitätsklinikum Schleswig-Holstein Campus Kiel (A.H., F.L.), Neuroimmunology Section, Institute of Clinical Chemistry, Kiel/Lübeck; Department of Neurology (F.G.), University Hospital Halle; Department of Neurology (C.D., F.B.), University Hospital Mainz, Mainz; University Hospital Aachen (J.W.), Institute of Neuropathology, Aachen; Department of Neurology (T.H., P.K.), University Hospital Magdeburg; Institute for Pharmacology and Toxicology (C.S.), Otto-von-Guericke University; German Center for Neurodegenerative Diseases (P.K.), Magdeburg; Institute for Clinical Neurobiology (C.V.), University Hospital Würzburg; Department of Neurology (F.L.), Universitätsklinikum Schleswig-Holstein, Kiel, Germany; and Research Center for Translational Medicine (A.V), Koç University, Istanbul, Turkey
| | - Tessa Huchtemann
- From the Department of Neurology (H.S., A.M.B., L.A., B.F., A.P., C.S., K.D.), University Hospital Würzburg; Institute of Clinical Neuroimmunology (A.V., E.M.), Biomedical Center, University Hospitals, Ludwig-Maximilians-Universität München, Planegg-Martinsried; Universitätsklinikum Schleswig-Holstein Campus Kiel (A.H., F.L.), Neuroimmunology Section, Institute of Clinical Chemistry, Kiel/Lübeck; Department of Neurology (F.G.), University Hospital Halle; Department of Neurology (C.D., F.B.), University Hospital Mainz, Mainz; University Hospital Aachen (J.W.), Institute of Neuropathology, Aachen; Department of Neurology (T.H., P.K.), University Hospital Magdeburg; Institute for Pharmacology and Toxicology (C.S.), Otto-von-Guericke University; German Center for Neurodegenerative Diseases (P.K.), Magdeburg; Institute for Clinical Neurobiology (C.V.), University Hospital Würzburg; Department of Neurology (F.L.), Universitätsklinikum Schleswig-Holstein, Kiel, Germany; and Research Center for Translational Medicine (A.V), Koç University, Istanbul, Turkey
| | - Christian Schmidt
- From the Department of Neurology (H.S., A.M.B., L.A., B.F., A.P., C.S., K.D.), University Hospital Würzburg; Institute of Clinical Neuroimmunology (A.V., E.M.), Biomedical Center, University Hospitals, Ludwig-Maximilians-Universität München, Planegg-Martinsried; Universitätsklinikum Schleswig-Holstein Campus Kiel (A.H., F.L.), Neuroimmunology Section, Institute of Clinical Chemistry, Kiel/Lübeck; Department of Neurology (F.G.), University Hospital Halle; Department of Neurology (C.D., F.B.), University Hospital Mainz, Mainz; University Hospital Aachen (J.W.), Institute of Neuropathology, Aachen; Department of Neurology (T.H., P.K.), University Hospital Magdeburg; Institute for Pharmacology and Toxicology (C.S.), Otto-von-Guericke University; German Center for Neurodegenerative Diseases (P.K.), Magdeburg; Institute for Clinical Neurobiology (C.V.), University Hospital Würzburg; Department of Neurology (F.L.), Universitätsklinikum Schleswig-Holstein, Kiel, Germany; and Research Center for Translational Medicine (A.V), Koç University, Istanbul, Turkey
| | - Peter Körtvelyessy
- From the Department of Neurology (H.S., A.M.B., L.A., B.F., A.P., C.S., K.D.), University Hospital Würzburg; Institute of Clinical Neuroimmunology (A.V., E.M.), Biomedical Center, University Hospitals, Ludwig-Maximilians-Universität München, Planegg-Martinsried; Universitätsklinikum Schleswig-Holstein Campus Kiel (A.H., F.L.), Neuroimmunology Section, Institute of Clinical Chemistry, Kiel/Lübeck; Department of Neurology (F.G.), University Hospital Halle; Department of Neurology (C.D., F.B.), University Hospital Mainz, Mainz; University Hospital Aachen (J.W.), Institute of Neuropathology, Aachen; Department of Neurology (T.H., P.K.), University Hospital Magdeburg; Institute for Pharmacology and Toxicology (C.S.), Otto-von-Guericke University; German Center for Neurodegenerative Diseases (P.K.), Magdeburg; Institute for Clinical Neurobiology (C.V.), University Hospital Würzburg; Department of Neurology (F.L.), Universitätsklinikum Schleswig-Holstein, Kiel, Germany; and Research Center for Translational Medicine (A.V), Koç University, Istanbul, Turkey
| | - Carmen Villmann
- From the Department of Neurology (H.S., A.M.B., L.A., B.F., A.P., C.S., K.D.), University Hospital Würzburg; Institute of Clinical Neuroimmunology (A.V., E.M.), Biomedical Center, University Hospitals, Ludwig-Maximilians-Universität München, Planegg-Martinsried; Universitätsklinikum Schleswig-Holstein Campus Kiel (A.H., F.L.), Neuroimmunology Section, Institute of Clinical Chemistry, Kiel/Lübeck; Department of Neurology (F.G.), University Hospital Halle; Department of Neurology (C.D., F.B.), University Hospital Mainz, Mainz; University Hospital Aachen (J.W.), Institute of Neuropathology, Aachen; Department of Neurology (T.H., P.K.), University Hospital Magdeburg; Institute for Pharmacology and Toxicology (C.S.), Otto-von-Guericke University; German Center for Neurodegenerative Diseases (P.K.), Magdeburg; Institute for Clinical Neurobiology (C.V.), University Hospital Würzburg; Department of Neurology (F.L.), Universitätsklinikum Schleswig-Holstein, Kiel, Germany; and Research Center for Translational Medicine (A.V), Koç University, Istanbul, Turkey
| | - Edgar Meinl
- From the Department of Neurology (H.S., A.M.B., L.A., B.F., A.P., C.S., K.D.), University Hospital Würzburg; Institute of Clinical Neuroimmunology (A.V., E.M.), Biomedical Center, University Hospitals, Ludwig-Maximilians-Universität München, Planegg-Martinsried; Universitätsklinikum Schleswig-Holstein Campus Kiel (A.H., F.L.), Neuroimmunology Section, Institute of Clinical Chemistry, Kiel/Lübeck; Department of Neurology (F.G.), University Hospital Halle; Department of Neurology (C.D., F.B.), University Hospital Mainz, Mainz; University Hospital Aachen (J.W.), Institute of Neuropathology, Aachen; Department of Neurology (T.H., P.K.), University Hospital Magdeburg; Institute for Pharmacology and Toxicology (C.S.), Otto-von-Guericke University; German Center for Neurodegenerative Diseases (P.K.), Magdeburg; Institute for Clinical Neurobiology (C.V.), University Hospital Würzburg; Department of Neurology (F.L.), Universitätsklinikum Schleswig-Holstein, Kiel, Germany; and Research Center for Translational Medicine (A.V), Koç University, Istanbul, Turkey
| | - Claudia Sommer
- From the Department of Neurology (H.S., A.M.B., L.A., B.F., A.P., C.S., K.D.), University Hospital Würzburg; Institute of Clinical Neuroimmunology (A.V., E.M.), Biomedical Center, University Hospitals, Ludwig-Maximilians-Universität München, Planegg-Martinsried; Universitätsklinikum Schleswig-Holstein Campus Kiel (A.H., F.L.), Neuroimmunology Section, Institute of Clinical Chemistry, Kiel/Lübeck; Department of Neurology (F.G.), University Hospital Halle; Department of Neurology (C.D., F.B.), University Hospital Mainz, Mainz; University Hospital Aachen (J.W.), Institute of Neuropathology, Aachen; Department of Neurology (T.H., P.K.), University Hospital Magdeburg; Institute for Pharmacology and Toxicology (C.S.), Otto-von-Guericke University; German Center for Neurodegenerative Diseases (P.K.), Magdeburg; Institute for Clinical Neurobiology (C.V.), University Hospital Würzburg; Department of Neurology (F.L.), Universitätsklinikum Schleswig-Holstein, Kiel, Germany; and Research Center for Translational Medicine (A.V), Koç University, Istanbul, Turkey
| | - Frank Leypoldt
- From the Department of Neurology (H.S., A.M.B., L.A., B.F., A.P., C.S., K.D.), University Hospital Würzburg; Institute of Clinical Neuroimmunology (A.V., E.M.), Biomedical Center, University Hospitals, Ludwig-Maximilians-Universität München, Planegg-Martinsried; Universitätsklinikum Schleswig-Holstein Campus Kiel (A.H., F.L.), Neuroimmunology Section, Institute of Clinical Chemistry, Kiel/Lübeck; Department of Neurology (F.G.), University Hospital Halle; Department of Neurology (C.D., F.B.), University Hospital Mainz, Mainz; University Hospital Aachen (J.W.), Institute of Neuropathology, Aachen; Department of Neurology (T.H., P.K.), University Hospital Magdeburg; Institute for Pharmacology and Toxicology (C.S.), Otto-von-Guericke University; German Center for Neurodegenerative Diseases (P.K.), Magdeburg; Institute for Clinical Neurobiology (C.V.), University Hospital Würzburg; Department of Neurology (F.L.), Universitätsklinikum Schleswig-Holstein, Kiel, Germany; and Research Center for Translational Medicine (A.V), Koç University, Istanbul, Turkey
| | - Kathrin Doppler
- From the Department of Neurology (H.S., A.M.B., L.A., B.F., A.P., C.S., K.D.), University Hospital Würzburg; Institute of Clinical Neuroimmunology (A.V., E.M.), Biomedical Center, University Hospitals, Ludwig-Maximilians-Universität München, Planegg-Martinsried; Universitätsklinikum Schleswig-Holstein Campus Kiel (A.H., F.L.), Neuroimmunology Section, Institute of Clinical Chemistry, Kiel/Lübeck; Department of Neurology (F.G.), University Hospital Halle; Department of Neurology (C.D., F.B.), University Hospital Mainz, Mainz; University Hospital Aachen (J.W.), Institute of Neuropathology, Aachen; Department of Neurology (T.H., P.K.), University Hospital Magdeburg; Institute for Pharmacology and Toxicology (C.S.), Otto-von-Guericke University; German Center for Neurodegenerative Diseases (P.K.), Magdeburg; Institute for Clinical Neurobiology (C.V.), University Hospital Würzburg; Department of Neurology (F.L.), Universitätsklinikum Schleswig-Holstein, Kiel, Germany; and Research Center for Translational Medicine (A.V), Koç University, Istanbul, Turkey.
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21
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Bien CG. Diagnosing autoimmune encephalitis based on clinical features and autoantibody findings. Expert Rev Clin Immunol 2019; 15:511-527. [PMID: 30676128 DOI: 10.1080/1744666x.2019.1573676] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
INTRODUCTION Autoimmune encephalitides have been accepted as a reproducible and treatable new group of diseases. At present, there is concern that such diagnoses might be made too liberally. Areas covered: This article suggests how to make valid diagnoses. They should consist of three elements: the clinical syndrome, the associated antibody and the presumed cause or predisposition. Recently, an international consortium published formal clinical criteria for autoimmune encephalitides to enable diagnoses even if antibody testing is not (immediately) available and to prevent overinterpretation of questionable antibody results. Antibody testing has greatly benefitted from the introduction of cell-based assays for the demonstration of antibodies against surface antigens. Paraneoplastic or post-infectious situations, side effects of tumor therapies or genetic predispositions help to explain why a patient develops autoimmune encephalitis. Expert opinion: With the application of this three-fold diagnostic system, clinicians can counsel patients regarding therapy and prognosis, while researchers can form meaningful patient cohorts. An operationalization of criteria would be advantageous.
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Affiliation(s)
- Christian G Bien
- a Epilepsy Center Bethel, Krankenhaus Mara , Bielefeld , Germany.,b Laboratory Krone , Bad Salzuflen , Germany
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22
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Liang W, Zhang J, Saint-Martin M, Xu F, Noraz N, Liu J, Honnorat J, Liu H. Structural mapping of hot spots within human CASPR2 discoidin domain for autoantibody recognition. J Autoimmun 2018; 96:168-177. [PMID: 30337146 DOI: 10.1016/j.jaut.2018.09.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 09/23/2018] [Accepted: 09/30/2018] [Indexed: 01/17/2023]
Abstract
Accumulating evidence has showed that anti-CASPR2 autoantibodies occur in a long list of neurological immune disorders including limbic encephalitis (LE). Belonging to the well-known neurexin superfamily, CASPR2 has been suggested to be a central node in the molecular networks controlling neurodevelopment. Distinct from other subfamilies in the neurexin superfamily, the CASPR subfamily features a unique discoidin (Disc) domain. As revealed by our and others' recent studies, CASPR2 Disc domain bears a major epitope for autoantibodies. However, structural information on CASPR2 recognition by autoantibodies has been lacking. Here, we report the crystal structure of human CASPR2 Disc domain at a high resolution of 1.31 Å, which is the first atomic-resolution structure of the CASPR subfamily members. The Disc domain adopts a total β structure and folds into a distorted jellyroll-like barrel with a conserved disulfide-bond interlocking its N- and C-termini. Defined by four loops and located in one end of the barrel, the "loop-tip surface" is totally polar and easily available for protein docking. Based on structure-guided epitope prediction, we generated nine mutants and evaluated their binding to autoantibodies of cerebrospinal fluid from twelve patients with limbic encephalitis. The quadruple mutant G69N/A71S/S77N/D78R impaired CASPR2 binding to autoantibodies from eleven LE patients, which indicates that the loop L1 in the Disc domain bears hot spots for autoantibody interaction. Structural mapping of autoepitopes within human CASPR2 Disc domain sheds light on how autoantibodies could sequester CASPR2 ectodomain and antagonize its functionalities in the pathogenic processes.
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Affiliation(s)
- Wenjun Liang
- State Key Laboratory of Natural and Biomimetic Drugs & School of Pharmaceutical Sciences, Peking University Health Science Center, 38 Xueyuan Road, Haidian District, Beijing 100191, China; Department of Molecular and Cellular Pharmacology, School of Pharmaceutical Sciences, Peking University Health Science Center, 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Junying Zhang
- State Key Laboratory of Natural and Biomimetic Drugs & School of Pharmaceutical Sciences, Peking University Health Science Center, 38 Xueyuan Road, Haidian District, Beijing 100191, China; Department of Molecular and Cellular Pharmacology, School of Pharmaceutical Sciences, Peking University Health Science Center, 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Margaux Saint-Martin
- French Reference Center on Paraneoplastic Neurological Syndrome, Hospices Civils de Lyon, Hôpital Neurologique, Bron, France; INSERM U1217-CNRS UMR5310, NeuroMyoGene Institute, Lyon, France; Université Claude Bernard Lyon 1, Université de Lyon, France
| | - Fei Xu
- State Key Laboratory of Natural and Biomimetic Drugs & School of Pharmaceutical Sciences, Peking University Health Science Center, 38 Xueyuan Road, Haidian District, Beijing 100191, China; Department of Molecular and Cellular Pharmacology, School of Pharmaceutical Sciences, Peking University Health Science Center, 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Nelly Noraz
- French Reference Center on Paraneoplastic Neurological Syndrome, Hospices Civils de Lyon, Hôpital Neurologique, Bron, France; INSERM U1217-CNRS UMR5310, NeuroMyoGene Institute, Lyon, France; Université Claude Bernard Lyon 1, Université de Lyon, France
| | - Jianmei Liu
- State Key Laboratory of Natural and Biomimetic Drugs & School of Pharmaceutical Sciences, Peking University Health Science Center, 38 Xueyuan Road, Haidian District, Beijing 100191, China; Department of Molecular and Cellular Pharmacology, School of Pharmaceutical Sciences, Peking University Health Science Center, 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Jérôme Honnorat
- French Reference Center on Paraneoplastic Neurological Syndrome, Hospices Civils de Lyon, Hôpital Neurologique, Bron, France; INSERM U1217-CNRS UMR5310, NeuroMyoGene Institute, Lyon, France; Université Claude Bernard Lyon 1, Université de Lyon, France.
| | - Heli Liu
- State Key Laboratory of Natural and Biomimetic Drugs & School of Pharmaceutical Sciences, Peking University Health Science Center, 38 Xueyuan Road, Haidian District, Beijing 100191, China; Department of Molecular and Cellular Pharmacology, School of Pharmaceutical Sciences, Peking University Health Science Center, 38 Xueyuan Road, Haidian District, Beijing 100191, China.
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23
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Spadaro M, Winklmeier S, Beltrán E, Macrini C, Höftberger R, Schuh E, Thaler FS, Gerdes LA, Laurent S, Gerhards R, Brändle S, Dornmair K, Breithaupt C, Krumbholz M, Moser M, Krishnamoorthy G, Kamp F, Jenne D, Hohlfeld R, Kümpfel T, Lassmann H, Kawakami N, Meinl E. Pathogenicity of human antibodies against myelin oligodendrocyte glycoprotein. Ann Neurol 2018; 84:315-328. [PMID: 30014603 DOI: 10.1002/ana.25291] [Citation(s) in RCA: 120] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 05/15/2018] [Accepted: 07/01/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Autoantibodies against myelin oligodendrocyte glycoprotein (MOG) occur in a proportion of patients with inflammatory demyelinating diseases of the central nervous system (CNS). We analyzed their pathogenic activity by affinity-purifying these antibodies (Abs) from patients and transferring them to experimental animals. METHODS Patients with Abs to MOG were identified by cell-based assay. We determined the cross-reactivity to rodent MOG and the recognized MOG epitopes. We produced the correctly folded extracellular domain of MOG and affinity-purified MOG-specific Abs from the blood of patients. These purified Abs were used to stain CNS tissue and transferred in 2 models of experimental autoimmune encephalomyelitis. Animals were analyzed histopathologically. RESULTS We identified 17 patients with MOG Abs from our outpatient clinic and selected 2 with a cross-reactivity to rodent MOG; both had recurrent optic neuritis. Affinity-purified Abs recognized MOG on transfected cells and stained myelin in tissue sections. The Abs from the 2 patients recognized different epitopes on MOG, the CC' and the FG loop. In both patients, these Abs persisted during our observation period of 2 to 3 years. The anti-MOG Abs from both patients were pathogenic upon intrathecal injection in 2 different rat models. Together with cognate MOG-specific T cells, these Abs enhanced T-cell infiltration; together with myelin basic protein-specific T cells, they induced demyelination associated with deposition of C9neo, resembling a multiple sclerosis type II pathology. INTERPRETATION MOG-specific Abs affinity purified from patients with inflammatory demyelinating disease induce pathological changes in vivo upon cotransfer with myelin-reactive T cells, suggesting that these Abs are similarly pathogenic in patients. Ann Neurol 2018;84:315-328.
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Affiliation(s)
- Melania Spadaro
- Institute of Clinical Neuroimmunology, Biomedical Center and University Hospitals, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Stephan Winklmeier
- Institute of Clinical Neuroimmunology, Biomedical Center and University Hospitals, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Eduardo Beltrán
- Institute of Clinical Neuroimmunology, Biomedical Center and University Hospitals, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Caterina Macrini
- Institute of Clinical Neuroimmunology, Biomedical Center and University Hospitals, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Romana Höftberger
- Institute of Neurology, Medical University of Vienna, Vienna, Austria
| | - Elisabeth Schuh
- Institute of Clinical Neuroimmunology, Biomedical Center and University Hospitals, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Franziska S Thaler
- Institute of Clinical Neuroimmunology, Biomedical Center and University Hospitals, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Lisa Ann Gerdes
- Institute of Clinical Neuroimmunology, Biomedical Center and University Hospitals, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Sarah Laurent
- Institute of Clinical Neuroimmunology, Biomedical Center and University Hospitals, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Ramona Gerhards
- Institute of Clinical Neuroimmunology, Biomedical Center and University Hospitals, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Simone Brändle
- Institute of Clinical Neuroimmunology, Biomedical Center and University Hospitals, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Klaus Dornmair
- Institute of Clinical Neuroimmunology, Biomedical Center and University Hospitals, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Constanze Breithaupt
- Department of Physical Biotechnology, Martin Luther University of Halle-Wittenberg, Halle, Germany
| | - Markus Krumbholz
- Department of Neurology and Hertie Institute for Clinical Brain Research, Eberhard Karl University, Tübingen, Germany
| | - Markus Moser
- Max Planck Institute of Biochemistry, Martinsried, Germany
| | | | - Frits Kamp
- Department of Biophysics, Biomedical Center, Ludwig Maximilian University of Munich, Munich, Germany
| | - Dieter Jenne
- Comprehensive Pneumology Center (CPC), Institute of Lung Biology and Disease, Helmholtz Zentrum München, Munich, and Max Planck Institute of Neurobiology, Planegg-Martinsried, Germany
| | - Reinhard Hohlfeld
- Institute of Clinical Neuroimmunology, Biomedical Center and University Hospitals, Ludwig-Maximilians-Universität München, Munich, Germany.,Munich Cluster for Systems Neurology, Munich, Germany
| | - Tania Kümpfel
- Institute of Clinical Neuroimmunology, Biomedical Center and University Hospitals, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Hans Lassmann
- Center for Brain Research, Medical University of Vienna, Austria
| | - Naoto Kawakami
- Institute of Clinical Neuroimmunology, Biomedical Center and University Hospitals, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Edgar Meinl
- Institute of Clinical Neuroimmunology, Biomedical Center and University Hospitals, Ludwig-Maximilians-Universität München, Munich, Germany
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24
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Fagone P, Mazzon E, Chikovani T, Saraceno A, Mammana S, Colletti G, Mangano K, Bramanti P, Nicoletti F. Decitabine induces regulatory T cells, inhibits the production of IFN-gamma and IL-17 and exerts preventive and therapeutic efficacy in rodent experimental autoimmune neuritis. J Neuroimmunol 2018; 321:41-48. [PMID: 29957387 DOI: 10.1016/j.jneuroim.2018.05.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 05/24/2018] [Accepted: 05/26/2018] [Indexed: 02/01/2023]
Abstract
Guillain-Barré syndrome (GBS) is an immune-mediated acute disorder of the peripheral nervous system. Despite treatment, there is an associated mortality and severe disability in 9 to 17% of the cases. Decitabine (DAC) is a hypomethylating drug used in myelodisplastic syndrome, that has been shown to exert immunomodulatory effects. We have evaluated the effects of DAC in two rodent models of GBS, the Experimental Allergic Neuritis (EAN). Both prophylactic and therapeutic treatment with DAC ameliorated the clinical course of EAN, increasing the numbers of thymic regulatory T cells and reducing the production of proinflammmatory cytokines. Our data suggest the possible use of decitabine for the treatment of GBS.
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Affiliation(s)
- Paolo Fagone
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Emanuela Mazzon
- IRCCS Centro Neurolesi Bonino Pulejo, Stada Statale 113, C.da Casazza, 98124 Messina, Italy
| | - Tinatin Chikovani
- Department of Immunology, Tbilisi State Medical University, 0186 Tbilisi, Georgia
| | - Andrea Saraceno
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Santa Mammana
- IRCCS Centro Neurolesi Bonino Pulejo, Stada Statale 113, C.da Casazza, 98124 Messina, Italy
| | - Giuseppe Colletti
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Katia Mangano
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Placido Bramanti
- IRCCS Centro Neurolesi Bonino Pulejo, Stada Statale 113, C.da Casazza, 98124 Messina, Italy
| | - Ferdinando Nicoletti
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy.
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25
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Harschnitz O. Human Stem Cell-Derived Models: Lessons for Autoimmune Diseases of the Nervous System. Neuroscientist 2018; 25:199-207. [PMID: 29781367 DOI: 10.1177/1073858418777999] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Autoimmunity of the peripheral and central nervous system is an important cause of disease and long-term neurological disability. Autoantibodies can target both intracellular and extracellular neuronal epitopes. Autoantibodies that target cell-surface epitopes infer pathogenicity through several distinct mechanisms, while patients often respond to immunotherapy. However, the underlying pathogenesis of these autoantibodies is yet to be fully understood. Human stem cell-based disease modeling, and the rise of induced pluripotent stem cell technology in particular, has revolutionized the fields of disease modeling and therapeutic screening for neurological disorders. These human disease models offer a unique platform in which to study autoimmunity of the nervous system. Here, we take an in-depth look at the possibilities that these models provide to study neuronal autoantibodies and their underlying pathogenesis.
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Affiliation(s)
- Oliver Harschnitz
- 1 The Center for Stem Cell Biology, Developmental Biology Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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26
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Silva RBM, Greggio S, Venturin GT, da Costa JC, Gomez MV, Campos MM. Beneficial Effects of the Calcium Channel Blocker CTK 01512-2 in a Mouse Model of Multiple Sclerosis. Mol Neurobiol 2018; 55:9307-9327. [PMID: 29667130 DOI: 10.1007/s12035-018-1049-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 03/27/2018] [Indexed: 12/30/2022]
Abstract
Voltage-gated calcium channels (VGCCs) play a critical role in neuroinflammatory diseases, such as multiple sclerosis (MS). CTK 01512-2 is a recombinant version of the peptide Phα1β derived from the spider Phoneutria nigriventer, which inhibits N-type VGCC/TRPA1-mediated calcium influx. We investigated the effects of this molecule in the mouse model of experimental autoimmune encephalomyelitis (EAE). The effects of CTK 01512-2 were compared to those displayed by ziconotide-a selective N-type VGCC blocker clinically used for chronic pain-and fingolimod-a drug employed for MS treatment. The intrathecal (i.t.) treatment with CTK 01512-2 displayed beneficial effects, by preventing nociception, body weight loss, splenomegaly, MS-like clinical and neurological scores, impaired motor coordination, and memory deficits, with an efficacy comparable to that observed for ziconotide and fingolimod. This molecule displayed a favorable profile on EAE-induced neuroinflammatory changes, including inflammatory infiltrate, demyelination, pro-inflammatory cytokine production, glial activation, and glucose metabolism in the brain and spinal cord. The recovery of spatial memory, besides a reduction of serum leptin levels, allied to central and peripheral elevation of the anti-inflammatory cytokine IL-10, was solely modulated by CTK 01512-2, dosed intrathecally. The intravenous (i.v.) administration of CTK 01512-2 also reduced the EAE-elicited MS-like symptoms, similarly to that seen in animals that received fingolimod orally. Ziconotide lacked any significant effect when dosed by i.v. route. Our results indicate that CTK 01512-2 greatly improved the neuroinflammatory responses in a mouse model of MS, with a higher efficacy when compared to ziconotide, pointing out this molecule as a promising adjuvant for MS management.
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Affiliation(s)
- Rodrigo B M Silva
- Escola de Medicina, Programa de Pós-Graduação em Medicina e Ciências da Saúde, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, 90619-900, Brazil.,Escola de Ciências da Saúde, Centro de Toxicologia e Farmacologia, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Avenida Ipiranga, 6681, Porto Alegre, RS, 90619-900, Brazil
| | - Samuel Greggio
- Centro de Pesquisa Pré-Clínica, Instituto do Cérebro do Rio Grande do Sul - Brain Institute (BraIns), Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, 90610-000, Brazil.,Escola de Ciências da Saúde, Curso de Graduação em Biomedicina, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, 90619-900, Brazil
| | - Gianina T Venturin
- Centro de Pesquisa Pré-Clínica, Instituto do Cérebro do Rio Grande do Sul - Brain Institute (BraIns), Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, 90610-000, Brazil
| | - Jaderson C da Costa
- Centro de Pesquisa Pré-Clínica, Instituto do Cérebro do Rio Grande do Sul - Brain Institute (BraIns), Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, 90610-000, Brazil
| | - Marcus V Gomez
- Núcleo de Pós-Graduação, Instituto de Ensino e Pesquisa da Santa Casa de Belo Horizonte, Belo Horizonte, 30150-240, Brazil
| | - Maria M Campos
- Escola de Medicina, Programa de Pós-Graduação em Medicina e Ciências da Saúde, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, 90619-900, Brazil. .,Escola de Ciências da Saúde, Centro de Toxicologia e Farmacologia, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Avenida Ipiranga, 6681, Porto Alegre, RS, 90619-900, Brazil. .,Escola de Ciências da Saúde, Curso de Graduação em Odontologia, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, 90619-900, Brazil. .,Escola de Ciências da Saúde, Programa de Pós-Graduação em Odontologia, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, 90619-900, Brazil.
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27
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Wu F, Kong L, Zhu Y, Zhou Q, Jiang X, Chang M, Zhou Y, Cao Y, Xu K, Wang F, Tang Y. The Influence of Myelin Oligodendrocyte Glycoprotein on White Matter Abnormalities in Different Onset Age of Drug-Naïve Depression. Front Psychiatry 2018; 9:186. [PMID: 29867609 PMCID: PMC5962804 DOI: 10.3389/fpsyt.2018.00186] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 04/23/2018] [Indexed: 01/11/2023] Open
Abstract
Neurophysiological mechanisms of white matter abnormalities in the earlier onset major depressive disorder (eoMDD, onset age ≤25 years old) differ from that in the later onset MDD (loMDD, onset age >25 years old). Myelin oligodendrocyte glycoprotein (MOG) is an important factor influencing white matter development. The influence of MOG on white matter in MDD of different age onset need to be explored. We compared MOG plasma concentrations and diffusion tensor imaging (DTI) data in 35 first-episode medication-naïve MDD patients (23 eoMDD, 12 loMDD), and 32 healthy controls (HC, 17 younger, 15 older). MOG was significantly higher in eoMDD and lower in loMDD compared with HC. Mean diffusivity (MD) values were significantly increased in inferior fronto-occipital fasciculus (IFOF) in eoMDD, and decreased in loMDD. In both younger and older groups, MOG correlated positively with IFOF MD values. Abnormal MOG has different influence in MDD of different age onset, which is linked to MOG's overly active effect on abnormal white matter in eoMDD and markedly weak effect in loMDD cases. Abnormal MOG would be an important factor in white matter damage in MDD; the influence of MOG differs with onset age.
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Affiliation(s)
- Feng Wu
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Lingtao Kong
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Yue Zhu
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Qian Zhou
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China.,Shanghai Mental Health Center, Shanghai, China
| | - Xiaowei Jiang
- Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, China.,Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Miao Chang
- Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Yifang Zhou
- Department of Gerontology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Yang Cao
- Shenyang Mental Health Center, Shenyang, China
| | - Ke Xu
- Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Fei Wang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China.,Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Yanqing Tang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China.,Department of Gerontology, The First Affiliated Hospital of China Medical University, Shenyang, China
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28
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Sharma S, Malmeström C, Lindberg C, Meisel S, Schön K, Verolin M, Lycke NY. A Sensitive Method for Detecting Peptide-specific CD4 + T Cell Responses in Peripheral Blood from Patients with Myasthenia Gravis. Front Immunol 2017; 8:1370. [PMID: 29114250 PMCID: PMC5660702 DOI: 10.3389/fimmu.2017.01370] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 10/05/2017] [Indexed: 01/04/2023] Open
Abstract
Myasthenia gravis (MG) is an autoimmune neurological disorder typified by skeletal muscle fatigue and most often production of autoantibodies against the nicotinic acetylcholine receptor (AChR). The present study was undertaken to assess the extent of AChR-peptide recognition in MG patients using co-culturing (DC:TC) of autologous monocyte-derived dendritic cells (moDCs) and highly enriched CD4+ T cells from the blood as compared to the traditional whole peripheral blood mononuclear cell (PBMC) cultures. We found that the DC:TC cultures were highly superior to the PBMC cultures for detection of reactivity toward HLA-DQ/DR-restricted AChR-peptides. In fact, whereas DC:TC cultures identified recognition in all MG patients the PBMC cultures failed to detect responsiveness in around 40% of the patients. Furthermore, reactivity to multiple peptides was evident in DC:TC cultures, while PBMC cultures mostly exhibited reactivity to a single peptide. No healthy control (HC) CD4+ T cells responded to the peptides in either culture system. Interestingly, whereas spontaneous production of IFNγ and IL-17 was observed in the DC:TC cultures from MG patients, recall responses to peptides enhanced IL-10 production in 9/13 MG patients, while little increase in IFNγ and IL-17 was seen. HCs did not produce cytokines to peptide stimulations. We conclude that the DC: TC culture system is significantly more sensitive and better identifies the extent of responsiveness in MG patients to AChR-peptides than traditional PBMC cultures.
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Affiliation(s)
- Sapna Sharma
- Department of Microbiology and Immunology, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden
| | - Clas Malmeström
- Laboratory for Clinical Immunology, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | | | - Sarah Meisel
- Department of Microbiology and Immunology, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden
| | - Karin Schön
- Department of Microbiology and Immunology, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden
| | | | - Nils Yngve Lycke
- Department of Microbiology and Immunology, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden
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29
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Dragin N, Nancy P, Villegas J, Roussin R, Le Panse R, Berrih-Aknin S. Balance between Estrogens and Proinflammatory Cytokines Regulates Chemokine Production Involved in Thymic Germinal Center Formation. Sci Rep 2017; 7:7970. [PMID: 28801669 PMCID: PMC5554297 DOI: 10.1038/s41598-017-08631-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 07/12/2017] [Indexed: 12/11/2022] Open
Abstract
The early-onset form of Myasthenia Gravis (MG) is prevalent in women and associates with ectopic germinal centers (GCs) development and inflammation in the thymus. we aimed to investigate the contribution of estrogens in the molecular processes involved in thymic GCs formation. We examined expression of genes involved in anti-acetylcholine receptor (AChR) response in MG, MHC class II and α-AChR subunit as well as chemokines involved in GC development (CXCL13, CCL21and CXCL12). In resting conditions, estrogens have strong regulatory effects on thymic epithelial cells (TECs), inducing a decreased protein expression of the above molecules. In knockout mouse models for estrogen receptor or aromatase, we observed that perturbation in estrogen transduction pathway altered MHC Class II, α-AChR, and CXCL13 expression. However, in inflammatory conditions, estrogen effects were partially overwhelmed by pro-inflammatory cytokines. Interestingly, estrogens were able to control production of type I interferon and therefore play dual roles during inflammatory events. In conclusion, we showed that estrogens inhibited expression of α-AChR and HLA-DR in TECs, suggesting that estrogens may alter the tolerization process and favor environment for an autoimmune response. By contrast, under inflammatory conditions, estrogen effects depend upon strength of the partner molecules with which it is confronted to.
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Affiliation(s)
- Nadine Dragin
- Inovarion, Paris, France. .,Sorbonne Universités, UPMC Univ Paris 06, Paris, France. .,INSERM U974, Paris, France.
| | - Patrice Nancy
- Department of Pathology, New York University, School of Medicine, New York, USA
| | - José Villegas
- Sorbonne Universités, UPMC Univ Paris 06, Paris, France.,INSERM U974, Paris, France.,AIM, institute of myology, Paris, France
| | | | - Rozen Le Panse
- Sorbonne Universités, UPMC Univ Paris 06, Paris, France.,INSERM U974, Paris, France.,AIM, institute of myology, Paris, France
| | - Sonia Berrih-Aknin
- Sorbonne Universités, UPMC Univ Paris 06, Paris, France.,INSERM U974, Paris, France.,AIM, institute of myology, Paris, France
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30
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Pilli D, Zou A, Tea F, Dale RC, Brilot F. Expanding Role of T Cells in Human Autoimmune Diseases of the Central Nervous System. Front Immunol 2017. [PMID: 28638382 PMCID: PMC5461350 DOI: 10.3389/fimmu.2017.00652] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
It is being increasingly recognized that a dysregulation of the immune system plays a vital role in neurological disorders and shapes the treatment of the disease. Aberrant T cell responses, in particular, are key in driving autoimmunity and have been traditionally associated with multiple sclerosis. Yet, it is evident that there are other neurological diseases in which autoreactive T cells have an active role in pathogenesis. In this review, we report on the recent progress in profiling and assessing the functionality of autoreactive T cells in central nervous system (CNS) autoimmune disorders that are currently postulated to be primarily T cell driven. We also explore the autoreactive T cell response in a recently emerging group of syndromes characterized by autoantibodies against neuronal cell-surface proteins. Common methodology implemented in T cell biology is further considered as it is an important determinant in their detection and characterization. An improved understanding of the contribution of autoreactive T cells expands our knowledge of the autoimmune response in CNS disorders and can offer novel methods of therapeutic intervention.
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Affiliation(s)
- Deepti Pilli
- Brain Autoimmunity Group, Institute for Neuroscience and Muscle Research, The Kids Research Institute at The Children's Hospital at Westmead, University of Sydney, Sydney, NSW, Australia
| | - Alicia Zou
- Brain Autoimmunity Group, Institute for Neuroscience and Muscle Research, The Kids Research Institute at The Children's Hospital at Westmead, University of Sydney, Sydney, NSW, Australia
| | - Fiona Tea
- Brain Autoimmunity Group, Institute for Neuroscience and Muscle Research, The Kids Research Institute at The Children's Hospital at Westmead, University of Sydney, Sydney, NSW, Australia
| | - Russell C Dale
- Brain Autoimmunity Group, Institute for Neuroscience and Muscle Research, The Kids Research Institute at The Children's Hospital at Westmead, University of Sydney, Sydney, NSW, Australia.,Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Fabienne Brilot
- Brain Autoimmunity Group, Institute for Neuroscience and Muscle Research, The Kids Research Institute at The Children's Hospital at Westmead, University of Sydney, Sydney, NSW, Australia.,Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
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31
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Detecting synaptic autoantibodies in psychoses: need for more sensitive methods. Curr Opin Neurol 2017; 30:317-326. [DOI: 10.1097/wco.0000000000000447] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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32
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Sinmaz N, Tea F, Pilli D, Zou A, Amatoury M, Nguyen T, Merheb V, Ramanathan S, Cooper ST, Dale RC, Brilot F. Dopamine-2 receptor extracellular N-terminus regulates receptor surface availability and is the target of human pathogenic antibodies from children with movement and psychiatric disorders. Acta Neuropathol Commun 2016; 4:126. [PMID: 27908295 PMCID: PMC5134269 DOI: 10.1186/s40478-016-0397-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 11/23/2016] [Indexed: 12/17/2022] Open
Abstract
Anti-Dopamine-2 receptor (D2R) antibodies have been recently identified in a subgroup of children with autoimmune movement and psychiatric disorders, however the epitope(s) and mechanism of pathogenicity remain unknown. Here we report a major biological role for D2R extracellular N-terminus as a regulator of receptor surface availability, and as a major epitope targeted and impaired in brain autoimmunity. In transfected human cells, purified anti-D2R antibody from patients specifically and significantly reduced human D2R surface levels. Next, human D2R mutants modified in their extracellular domains were subcloned, and we analyzed the region bound by 35 anti-D2R antibody-positive patient sera using quantitative flow cytometry on live transfected cells. We found that N-glycosylation at amino acids N5 and/or N17 was critical for high surface expression in interaction with the last 15 residues of extracellular D2R N-terminus. No anti-D2R antibody-positive patient sera bound to the three extracellular loops, but all patient sera (35/35) targeted the extracellular N-terminus. Overall, patient antibody binding was dependent on two main regions encompassing amino acids 20 to 29, and 23 to 37. Residues 20 to 29 contributed to the majority of binding (77%, 27/35), among which 26% (7/27) sera bound to amino acids R20, P21, and F22, 37% (10/27) patients were dependent on residues at positions 26 and 29, that are different between humans and mice, and 30% (8/27) sera required R20, P21, F22, N23, D26, and A29. Seven patient sera bound to the region 23 to 37 independently of D26 and A29, but most sera exhibited N-glycosylation-independent epitope recognition at N23. Interestingly, no evident segregation of binding pattern according to patient clinical phenotype was observed. D2R N-terminus is a central epitope in autoimmune movement and psychiatric disorders and this knowledge could help the design of novel specific immune therapies tailored to improve patient outcome.
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