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Bartley CM, Ngo TT, Duy Do L, Zekeridou A, Dandekar R, Muñiz-Castrillo S, Alvarenga BD, Zorn KC, Tubati A, Pinto AL, Browne WD, Hullett PW, Terrelonge M, Schubert RD, Piquet AL, Yang B, Montalvo Perero MJ, Kung AF, Mann SA, Shah MP, Geschwind MD, Gelfand JM, DeRisi JL, Pittock SJ, Honnorat J, Pleasure SJ, Wilson MR. Detection of High-Risk Paraneoplastic Antibodies against TRIM9 and TRIM67 Proteins. Ann Neurol 2023; 94:1086-1101. [PMID: 37632288 PMCID: PMC10842626 DOI: 10.1002/ana.26776] [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: 03/28/2023] [Revised: 08/22/2023] [Accepted: 08/22/2023] [Indexed: 08/27/2023]
Abstract
OBJECTIVE Co-occurring anti-tripartite motif-containing protein 9 and 67 autoantibodies (TRIM9/67-IgG) have been reported in only a very few cases of paraneoplastic cerebellar syndrome. The value of these biomarkers and the most sensitive methods of TRIM9/67-IgG detection are not known. METHODS We performed a retrospective, multicenter study to evaluate the cerebrospinal fluid and serum of candidate TRIM9/67-IgG cases by tissue-based immunofluorescence, peptide phage display immunoprecipitation sequencing, overexpression cell-based assay (CBA), and immunoblot. Cases in which TRIM9/67-IgG was detected by at least 2 assays were considered TRIM9/67-IgG positive. RESULTS Among these cases (n = 13), CBA was the most sensitive (100%) and revealed that all cases had TRIM9 and TRIM67 autoantibodies. Of TRIM9/67-IgG cases with available clinical history, a subacute cerebellar syndrome was the most common presentation (n = 7/10), followed by encephalitis (n = 3/10). Of these 10 patients, 70% had comorbid cancer (7/10), 85% of whom (n = 6/7) had confirmed metastatic disease. All evaluable cancer biopsies expressed TRIM9 protein (n = 5/5), whose expression was elevated in the cancerous regions of the tissue in 4 of 5 cases. INTERPRETATION TRIM9/67-IgG is a rare but likely high-risk paraneoplastic biomarker for which CBA appears to be the most sensitive diagnostic assay. ANN NEUROL 2023;94:1086-1101.
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Affiliation(s)
- Christopher M. Bartley
- Weill Institute for Neurosciences, University of California, San Francisco, California
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, California
| | - Thomas T. Ngo
- Weill Institute for Neurosciences, University of California, San Francisco, California
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, California
- Department of Neurology, University of California, San Francisco, California
| | - Le Duy Do
- French Reference Center on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis, Hospices Civils de Lyon and SynatAc Team, Institut MELiS, INSERM U1314/CNRS UMR 5284, Universités de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Anastasia Zekeridou
- Department of Neurology, Center MS and Autoimmune Neurology, Mayo Clinic
- Department of Laboratory Medicine and Pathology, Mayo Clinic
| | - Ravi Dandekar
- Weill Institute for Neurosciences, University of California, San Francisco, California
- Department of Neurology, University of California, San Francisco, California
| | - Sergio Muñiz-Castrillo
- French Reference Center on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis, Hospices Civils de Lyon and SynatAc Team, Institut MELiS, INSERM U1314/CNRS UMR 5284, Universités de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Bonny D. Alvarenga
- Weill Institute for Neurosciences, University of California, San Francisco, California
- Department of Neurology, University of California, San Francisco, California
| | - Kelsey C. Zorn
- Department of Biochemistry and Biophysics, University of California, San Francisco, California
| | - Asritha Tubati
- Weill Institute for Neurosciences, University of California, San Francisco, California
- Department of Neurology, University of California, San Francisco, California
| | - Anne-Laurie Pinto
- French Reference Center on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis, Hospices Civils de Lyon and SynatAc Team, Institut MELiS, INSERM U1314/CNRS UMR 5284, Universités de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Weston D. Browne
- Weill Institute for Neurosciences, University of California, San Francisco, California
- Department of Neurology, University of California, San Francisco, California
| | - Patrick W. Hullett
- Weill Institute for Neurosciences, University of California, San Francisco, California
- Department of Neurology, University of California, San Francisco, California
| | - Mark Terrelonge
- Weill Institute for Neurosciences, University of California, San Francisco, California
- Department of Neurology, University of California, San Francisco, California
| | - Ryan D. Schubert
- Weill Institute for Neurosciences, University of California, San Francisco, California
- Department of Neurology, University of California, San Francisco, California
| | - Amanda L. Piquet
- Department of Neurology, University of Colorado Anschutz Medical Campus, School of Medicine, Aurora, Colorado
| | - Binxia Yang
- Department of Laboratory Medicine and Pathology, Mayo Clinic
| | | | - Andrew F. Kung
- University of California San Francisco, School of Medicine, San Francisco, California
| | - Sabrina A. Mann
- Chan Zuckerberg Biohub, San Francisco, California
- Department of Biochemistry and Biophysics, University of California, San Francisco, California
| | - Maulik P. Shah
- Weill Institute for Neurosciences, University of California, San Francisco, California
- Department of Neurology, University of California, San Francisco, California
| | - Michael D. Geschwind
- Weill Institute for Neurosciences, University of California, San Francisco, California
- Department of Neurology, University of California, San Francisco, California
| | - Jeffrey M. Gelfand
- Weill Institute for Neurosciences, University of California, San Francisco, California
- Department of Neurology, University of California, San Francisco, California
| | - Joseph L. DeRisi
- Chan Zuckerberg Biohub, San Francisco, California
- Department of Biochemistry and Biophysics, University of California, San Francisco, California
| | - Sean J. Pittock
- Department of Neurology, Center MS and Autoimmune Neurology, Mayo Clinic
- Department of Laboratory Medicine and Pathology, Mayo Clinic
| | - Jérôme Honnorat
- French Reference Center on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis, Hospices Civils de Lyon and SynatAc Team, Institut MELiS, INSERM U1314/CNRS UMR 5284, Universités de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Samuel J. Pleasure
- Weill Institute for Neurosciences, University of California, San Francisco, California
- Department of Neurology, University of California, San Francisco, California
| | - Michael R. Wilson
- Weill Institute for Neurosciences, University of California, San Francisco, California
- Department of Neurology, University of California, San Francisco, California
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Passeri M, Matthews E, Kammeyer R, Piquet AL. Update in autoimmune and paraneoplastic myelopathies: Newly described antigen targets and antibody testing. Front Neurol 2022; 13:972143. [PMID: 35968301 PMCID: PMC9366192 DOI: 10.3389/fneur.2022.972143] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 07/11/2022] [Indexed: 11/13/2022] Open
Abstract
Myelopathy is an increasingly recognized presentation of many antibody-mediated neuroinflammatory disorders. While specific features of certain autoimmune myelopathies such as aquaporin-4 antibody associated neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein associated disorder (MOGAD) are well-characterized, other less commonly seen antibody-associated myelopathies are not as well-defined. These include but are not limited to, Hu/ANNA1, anti-glial fibrillary acidic protein (GFAP), anti-CV2/collapsin response mediator protein (CRMP5), and amphiphysin. Here, we review the mentioned more common antibody mediated myelopathies as well those that as less common, followed by a review of differentials that may mimic these disorders.
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Affiliation(s)
- Michlene Passeri
- Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Elizabeth Matthews
- Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Ryan Kammeyer
- Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
- Department of Pediatrics and Neurology, Children's Hospital Anschutz Medical Campus, Aurora, CO, United States
| | - Amanda L. Piquet
- Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
- *Correspondence: Amanda L. Piquet
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