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Berridge G, Menassa DA, Moloney T, Waters PJ, Welding I, Thomsen S, Zuberi S, Fischer R, Aricescu AR, Pike M, Dale RC, Kessler B, Vincent A, Lim M, Irani SR, Lang B. Glutamate receptor δ2 serum antibodies in pediatric opsoclonus myoclonus ataxia syndrome. Neurology 2018; 91:e714-e723. [PMID: 30045961 PMCID: PMC6107266 DOI: 10.1212/wnl.0000000000006035] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 05/18/2018] [Indexed: 12/03/2022] Open
Abstract
Objective To identify neuronal surface antibodies in opsoclonus myoclonus ataxia syndrome (OMAS) using contemporary antigen discovery methodology. Methods OMAS patient serum immunoglobulin G immunohistochemistry using age-equivalent rat cerebellar tissue was followed by immunoprecipitation, gel electrophoresis, and mass spectrometry. Data are available via ProteomeXchange (identifier PXD009578). This generated a list of potential neuronal surface cerebellar autoantigens. Live cell-based assays were used to confirm membrane-surface antigens and adsorb antigen-specific immunoglobulin Gs. The serologic results were compared to the clinical data. Results Four of the 6 OMAS sera tested bound rat cerebellar sections. Two of these sera with similar immunoreactivities were used in immunoprecipitation experiments using cerebellum from postnatal rat pups (P18). Mass spectrometry identified 12 cell-surface proteins, of which glutamate receptor δ2 (GluD2), a predominately cerebellar-expressed protein, was found at a 3-fold-higher concentration than the other 11 proteins. Antibodies to GluD2 were identified in 14/16 (87%) OMAS samples, compared with 5/139 (5%) pediatric and 1/38 (2.6%) adult serum controls (p < 0.0001), and in 2/4 sera from patients with neuroblastoma without neurologic features. Adsorption of positive OMAS sera against GluD2-transfected cells substantially reduced but did not eliminate reactivity toward cerebellar sections. Conclusion Autoantibodies to GluD2 are common in patients with OMAS, bind to surface determinants, and are potentially pathogenic.
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Affiliation(s)
- Georgina Berridge
- From the Oxford Autoimmune Neurology Group (G.B., D.A.M., T.M., P.J.W., I.W., S.T., M.P., A.V., S.R.I., B.L.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford; Target Discovery Institute (G.B., R.F., B.K.), NDM Research Building, University of Oxford, Old Road Campus, Oxford; Paediatric Neurosciences Research Group (S.Z.), School of Medicine, University of Glasgow; Division of Structural Biology (A.R.A.), Nuffield Department of Clinical Medicine, University of Oxford, UK; Clinical Neuroimmunology (R.C.D.), Institute for Neuroscience and Muscle Research, University of Sydney, Australia; Children's Neuroscience Centre (M.L.), Evelina London Children's Hospital at St Thomas' NHS Foundation Trust, King's Health Partners Academic Health Science Centre, London; and Faculty of Medicine and Life Sciences (M.L.), King's College London, UK
| | - David A Menassa
- From the Oxford Autoimmune Neurology Group (G.B., D.A.M., T.M., P.J.W., I.W., S.T., M.P., A.V., S.R.I., B.L.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford; Target Discovery Institute (G.B., R.F., B.K.), NDM Research Building, University of Oxford, Old Road Campus, Oxford; Paediatric Neurosciences Research Group (S.Z.), School of Medicine, University of Glasgow; Division of Structural Biology (A.R.A.), Nuffield Department of Clinical Medicine, University of Oxford, UK; Clinical Neuroimmunology (R.C.D.), Institute for Neuroscience and Muscle Research, University of Sydney, Australia; Children's Neuroscience Centre (M.L.), Evelina London Children's Hospital at St Thomas' NHS Foundation Trust, King's Health Partners Academic Health Science Centre, London; and Faculty of Medicine and Life Sciences (M.L.), King's College London, UK
| | - Teresa Moloney
- From the Oxford Autoimmune Neurology Group (G.B., D.A.M., T.M., P.J.W., I.W., S.T., M.P., A.V., S.R.I., B.L.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford; Target Discovery Institute (G.B., R.F., B.K.), NDM Research Building, University of Oxford, Old Road Campus, Oxford; Paediatric Neurosciences Research Group (S.Z.), School of Medicine, University of Glasgow; Division of Structural Biology (A.R.A.), Nuffield Department of Clinical Medicine, University of Oxford, UK; Clinical Neuroimmunology (R.C.D.), Institute for Neuroscience and Muscle Research, University of Sydney, Australia; Children's Neuroscience Centre (M.L.), Evelina London Children's Hospital at St Thomas' NHS Foundation Trust, King's Health Partners Academic Health Science Centre, London; and Faculty of Medicine and Life Sciences (M.L.), King's College London, UK
| | - Patrick J Waters
- From the Oxford Autoimmune Neurology Group (G.B., D.A.M., T.M., P.J.W., I.W., S.T., M.P., A.V., S.R.I., B.L.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford; Target Discovery Institute (G.B., R.F., B.K.), NDM Research Building, University of Oxford, Old Road Campus, Oxford; Paediatric Neurosciences Research Group (S.Z.), School of Medicine, University of Glasgow; Division of Structural Biology (A.R.A.), Nuffield Department of Clinical Medicine, University of Oxford, UK; Clinical Neuroimmunology (R.C.D.), Institute for Neuroscience and Muscle Research, University of Sydney, Australia; Children's Neuroscience Centre (M.L.), Evelina London Children's Hospital at St Thomas' NHS Foundation Trust, King's Health Partners Academic Health Science Centre, London; and Faculty of Medicine and Life Sciences (M.L.), King's College London, UK
| | - Imogen Welding
- From the Oxford Autoimmune Neurology Group (G.B., D.A.M., T.M., P.J.W., I.W., S.T., M.P., A.V., S.R.I., B.L.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford; Target Discovery Institute (G.B., R.F., B.K.), NDM Research Building, University of Oxford, Old Road Campus, Oxford; Paediatric Neurosciences Research Group (S.Z.), School of Medicine, University of Glasgow; Division of Structural Biology (A.R.A.), Nuffield Department of Clinical Medicine, University of Oxford, UK; Clinical Neuroimmunology (R.C.D.), Institute for Neuroscience and Muscle Research, University of Sydney, Australia; Children's Neuroscience Centre (M.L.), Evelina London Children's Hospital at St Thomas' NHS Foundation Trust, King's Health Partners Academic Health Science Centre, London; and Faculty of Medicine and Life Sciences (M.L.), King's College London, UK
| | - Selina Thomsen
- From the Oxford Autoimmune Neurology Group (G.B., D.A.M., T.M., P.J.W., I.W., S.T., M.P., A.V., S.R.I., B.L.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford; Target Discovery Institute (G.B., R.F., B.K.), NDM Research Building, University of Oxford, Old Road Campus, Oxford; Paediatric Neurosciences Research Group (S.Z.), School of Medicine, University of Glasgow; Division of Structural Biology (A.R.A.), Nuffield Department of Clinical Medicine, University of Oxford, UK; Clinical Neuroimmunology (R.C.D.), Institute for Neuroscience and Muscle Research, University of Sydney, Australia; Children's Neuroscience Centre (M.L.), Evelina London Children's Hospital at St Thomas' NHS Foundation Trust, King's Health Partners Academic Health Science Centre, London; and Faculty of Medicine and Life Sciences (M.L.), King's College London, UK
| | - Sameer Zuberi
- From the Oxford Autoimmune Neurology Group (G.B., D.A.M., T.M., P.J.W., I.W., S.T., M.P., A.V., S.R.I., B.L.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford; Target Discovery Institute (G.B., R.F., B.K.), NDM Research Building, University of Oxford, Old Road Campus, Oxford; Paediatric Neurosciences Research Group (S.Z.), School of Medicine, University of Glasgow; Division of Structural Biology (A.R.A.), Nuffield Department of Clinical Medicine, University of Oxford, UK; Clinical Neuroimmunology (R.C.D.), Institute for Neuroscience and Muscle Research, University of Sydney, Australia; Children's Neuroscience Centre (M.L.), Evelina London Children's Hospital at St Thomas' NHS Foundation Trust, King's Health Partners Academic Health Science Centre, London; and Faculty of Medicine and Life Sciences (M.L.), King's College London, UK
| | - Roman Fischer
- From the Oxford Autoimmune Neurology Group (G.B., D.A.M., T.M., P.J.W., I.W., S.T., M.P., A.V., S.R.I., B.L.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford; Target Discovery Institute (G.B., R.F., B.K.), NDM Research Building, University of Oxford, Old Road Campus, Oxford; Paediatric Neurosciences Research Group (S.Z.), School of Medicine, University of Glasgow; Division of Structural Biology (A.R.A.), Nuffield Department of Clinical Medicine, University of Oxford, UK; Clinical Neuroimmunology (R.C.D.), Institute for Neuroscience and Muscle Research, University of Sydney, Australia; Children's Neuroscience Centre (M.L.), Evelina London Children's Hospital at St Thomas' NHS Foundation Trust, King's Health Partners Academic Health Science Centre, London; and Faculty of Medicine and Life Sciences (M.L.), King's College London, UK
| | - A Radu Aricescu
- From the Oxford Autoimmune Neurology Group (G.B., D.A.M., T.M., P.J.W., I.W., S.T., M.P., A.V., S.R.I., B.L.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford; Target Discovery Institute (G.B., R.F., B.K.), NDM Research Building, University of Oxford, Old Road Campus, Oxford; Paediatric Neurosciences Research Group (S.Z.), School of Medicine, University of Glasgow; Division of Structural Biology (A.R.A.), Nuffield Department of Clinical Medicine, University of Oxford, UK; Clinical Neuroimmunology (R.C.D.), Institute for Neuroscience and Muscle Research, University of Sydney, Australia; Children's Neuroscience Centre (M.L.), Evelina London Children's Hospital at St Thomas' NHS Foundation Trust, King's Health Partners Academic Health Science Centre, London; and Faculty of Medicine and Life Sciences (M.L.), King's College London, UK
| | - Michael Pike
- From the Oxford Autoimmune Neurology Group (G.B., D.A.M., T.M., P.J.W., I.W., S.T., M.P., A.V., S.R.I., B.L.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford; Target Discovery Institute (G.B., R.F., B.K.), NDM Research Building, University of Oxford, Old Road Campus, Oxford; Paediatric Neurosciences Research Group (S.Z.), School of Medicine, University of Glasgow; Division of Structural Biology (A.R.A.), Nuffield Department of Clinical Medicine, University of Oxford, UK; Clinical Neuroimmunology (R.C.D.), Institute for Neuroscience and Muscle Research, University of Sydney, Australia; Children's Neuroscience Centre (M.L.), Evelina London Children's Hospital at St Thomas' NHS Foundation Trust, King's Health Partners Academic Health Science Centre, London; and Faculty of Medicine and Life Sciences (M.L.), King's College London, UK
| | - Russell C Dale
- From the Oxford Autoimmune Neurology Group (G.B., D.A.M., T.M., P.J.W., I.W., S.T., M.P., A.V., S.R.I., B.L.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford; Target Discovery Institute (G.B., R.F., B.K.), NDM Research Building, University of Oxford, Old Road Campus, Oxford; Paediatric Neurosciences Research Group (S.Z.), School of Medicine, University of Glasgow; Division of Structural Biology (A.R.A.), Nuffield Department of Clinical Medicine, University of Oxford, UK; Clinical Neuroimmunology (R.C.D.), Institute for Neuroscience and Muscle Research, University of Sydney, Australia; Children's Neuroscience Centre (M.L.), Evelina London Children's Hospital at St Thomas' NHS Foundation Trust, King's Health Partners Academic Health Science Centre, London; and Faculty of Medicine and Life Sciences (M.L.), King's College London, UK
| | - Benedikt Kessler
- From the Oxford Autoimmune Neurology Group (G.B., D.A.M., T.M., P.J.W., I.W., S.T., M.P., A.V., S.R.I., B.L.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford; Target Discovery Institute (G.B., R.F., B.K.), NDM Research Building, University of Oxford, Old Road Campus, Oxford; Paediatric Neurosciences Research Group (S.Z.), School of Medicine, University of Glasgow; Division of Structural Biology (A.R.A.), Nuffield Department of Clinical Medicine, University of Oxford, UK; Clinical Neuroimmunology (R.C.D.), Institute for Neuroscience and Muscle Research, University of Sydney, Australia; Children's Neuroscience Centre (M.L.), Evelina London Children's Hospital at St Thomas' NHS Foundation Trust, King's Health Partners Academic Health Science Centre, London; and Faculty of Medicine and Life Sciences (M.L.), King's College London, UK
| | - Angela Vincent
- From the Oxford Autoimmune Neurology Group (G.B., D.A.M., T.M., P.J.W., I.W., S.T., M.P., A.V., S.R.I., B.L.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford; Target Discovery Institute (G.B., R.F., B.K.), NDM Research Building, University of Oxford, Old Road Campus, Oxford; Paediatric Neurosciences Research Group (S.Z.), School of Medicine, University of Glasgow; Division of Structural Biology (A.R.A.), Nuffield Department of Clinical Medicine, University of Oxford, UK; Clinical Neuroimmunology (R.C.D.), Institute for Neuroscience and Muscle Research, University of Sydney, Australia; Children's Neuroscience Centre (M.L.), Evelina London Children's Hospital at St Thomas' NHS Foundation Trust, King's Health Partners Academic Health Science Centre, London; and Faculty of Medicine and Life Sciences (M.L.), King's College London, UK
| | - Ming Lim
- From the Oxford Autoimmune Neurology Group (G.B., D.A.M., T.M., P.J.W., I.W., S.T., M.P., A.V., S.R.I., B.L.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford; Target Discovery Institute (G.B., R.F., B.K.), NDM Research Building, University of Oxford, Old Road Campus, Oxford; Paediatric Neurosciences Research Group (S.Z.), School of Medicine, University of Glasgow; Division of Structural Biology (A.R.A.), Nuffield Department of Clinical Medicine, University of Oxford, UK; Clinical Neuroimmunology (R.C.D.), Institute for Neuroscience and Muscle Research, University of Sydney, Australia; Children's Neuroscience Centre (M.L.), Evelina London Children's Hospital at St Thomas' NHS Foundation Trust, King's Health Partners Academic Health Science Centre, London; and Faculty of Medicine and Life Sciences (M.L.), King's College London, UK
| | - Sarosh R Irani
- From the Oxford Autoimmune Neurology Group (G.B., D.A.M., T.M., P.J.W., I.W., S.T., M.P., A.V., S.R.I., B.L.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford; Target Discovery Institute (G.B., R.F., B.K.), NDM Research Building, University of Oxford, Old Road Campus, Oxford; Paediatric Neurosciences Research Group (S.Z.), School of Medicine, University of Glasgow; Division of Structural Biology (A.R.A.), Nuffield Department of Clinical Medicine, University of Oxford, UK; Clinical Neuroimmunology (R.C.D.), Institute for Neuroscience and Muscle Research, University of Sydney, Australia; Children's Neuroscience Centre (M.L.), Evelina London Children's Hospital at St Thomas' NHS Foundation Trust, King's Health Partners Academic Health Science Centre, London; and Faculty of Medicine and Life Sciences (M.L.), King's College London, UK
| | - Bethan Lang
- From the Oxford Autoimmune Neurology Group (G.B., D.A.M., T.M., P.J.W., I.W., S.T., M.P., A.V., S.R.I., B.L.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford; Target Discovery Institute (G.B., R.F., B.K.), NDM Research Building, University of Oxford, Old Road Campus, Oxford; Paediatric Neurosciences Research Group (S.Z.), School of Medicine, University of Glasgow; Division of Structural Biology (A.R.A.), Nuffield Department of Clinical Medicine, University of Oxford, UK; Clinical Neuroimmunology (R.C.D.), Institute for Neuroscience and Muscle Research, University of Sydney, Australia; Children's Neuroscience Centre (M.L.), Evelina London Children's Hospital at St Thomas' NHS Foundation Trust, King's Health Partners Academic Health Science Centre, London; and Faculty of Medicine and Life Sciences (M.L.), King's College London, UK.
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