1
|
Greguletz P, Plötz M, Baade-Büttner C, Bien CG, Eisenhut K, Geis C, Handreka R, Klausewitz J, Körtvelyessy P, Kovac S, Kraft A, Lewerenz J, Malter M, Nagel M, von Podewils F, Prüß H, Rada A, Rau J, Rauer S, Rößling R, Seifert-Held T, Siebenbrodt K, Sühs KW, Tauber SC, Thaler F, Wagner J, Wickel J, Leypoldt F, Rittner HL, Sommer C, Villmann C, Doppler K. Different pain phenotypes are associated with anti- Caspr2 autoantibodies. J Neurol 2024; 271:2736-2744. [PMID: 38386048 DOI: 10.1007/s00415-024-12224-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/22/2024] [Accepted: 01/24/2024] [Indexed: 02/23/2024]
Abstract
Autoantibodies against contactin-associated protein 2 (Caspr2) not only induce limbic autoimmune encephalitis but are also associated with pain conditions. Here, we analyzed clinical data on pain in a large cohort of patients included into the German Network for Research in Autoimmune Encephalitis. Out of 102 patients in our cohort, pain was a frequent symptom (36% of all patients), often severe (63.6% of the patients with pain) and/or even the major symptom (55.6% of the patients with pain). Pain phenotypes differed between patients. Cluster analysis revealed two major phenotypes including mostly distal-symmetric burning pain and widespread pain with myalgia and cramps. Almost all patients had IgG4 autoantibodies and some additional IgG1, 2, and/or 3 autoantibodies, but IgG subclasses, titers, and presence or absence of intrathecal synthesis were not associated with the occurrence of pain. However, certain pre-existing risk factors for chronic pain like diabetes mellitus, peripheral neuropathy, or preexisting chronic back pain tended to occur more frequently in patients with anti-Caspr2 autoantibodies and pain. Our data show that pain is a relevant symptom in patients with anti-Caspr2 autoantibodies and support the idea of decreased algesic thresholds leading to pain. Testing for anti-Caspr2 autoantibodies needs to be considered in patients with various pain phenotypes.
Collapse
Affiliation(s)
- Patrik Greguletz
- Department of Neurology, University Hospital Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany
- Institute of Clinical Neurobiology, University Hospital Würzburg, Würzburg, Germany
| | - Maria Plötz
- Department of Neurology, University Hospital Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany
| | - Carolin Baade-Büttner
- Section Translational Neuroimmunology, Department for Neurology, Jena University Hospital, Jena, Germany
| | - Christian G Bien
- Department of Epileptology (Krankenhaus Mara), Medical School, Bielefeld University, Campus Bielefeld-Bethel, Bielefeld, Germany
- Laboratory Krone, Bad Salzuflen, Germany
| | - Katharina Eisenhut
- Institute of Clinical Neuroimmunology, University Hospital, Ludwig-Maximilians-Universität Munich, Munich, Germany
- Biomedical Center (BMC), Medical Faculty, Ludwig-Maximilians-Universität Munich, Martinsried, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Christian Geis
- Section Translational Neuroimmunology, Department for Neurology, Jena University Hospital, Jena, Germany
| | | | - Jaqueline Klausewitz
- Department of Neurology, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Peter Körtvelyessy
- Department of Neurology, University Hospital Magdeburg, Magdeburg, Germany
- Department of Neurology and Experimental Neurology, Charité Berlin, and German Center for Neurodegenerative Diseases (DZNE),, Berlin, Germany
| | - Stjepana Kovac
- Department of Neurology with Institute of Translational Neurology, University Hospital Münster, Münster, Germany
| | - Andrea Kraft
- Department of Neurology, Martha-Maria Hospital Halle, Halle, Germany
| | - Jan Lewerenz
- Department of Neurology, University of Ulm, Ulm, Germany
| | - Michael Malter
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Michael Nagel
- Department of Neurology, Klinikum Osnabrück, Osnabrück, Germany
| | - Felix von Podewils
- Department of Neurology, University Hospital Greifswald, Greifswald, Germany
| | - Harald Prüß
- Department of Neurology and Experimental Neurology, Charité Berlin, and German Center for Neurodegenerative Diseases (DZNE),, Berlin, Germany
| | - Anna Rada
- Department of Epileptology (Krankenhaus Mara), Medical School, Bielefeld University, Campus Bielefeld-Bethel, Bielefeld, Germany
| | - Johanna Rau
- Department of Neurology with Institute of Translational Neurology, University Hospital Münster, Münster, Germany
| | - Sebastian Rauer
- Department of Neurology, University of Freiburg, Freiburg im Breisgau, Germany
| | - Rosa Rößling
- Department of Neurology and Experimental Neurology, Charité Berlin, and German Center for Neurodegenerative Diseases (DZNE),, Berlin, Germany
| | - Thomas Seifert-Held
- Department of Neurology, Medical University of Graz, Graz, Austria
- Department of Neurology, Hospital Murtal, Knittelfeld, Austria
| | - Kai Siebenbrodt
- Department of Neurology, University Hospital Frankfurt, Frankfurt, Germany
| | | | - Simone C Tauber
- Department of Neurology, RWTH University Hospital Aachen, Aachen, Germany
| | - Franziska Thaler
- Institute of Clinical Neuroimmunology, University Hospital, Ludwig-Maximilians-Universität Munich, Munich, Germany
- Biomedical Center (BMC), Medical Faculty, Ludwig-Maximilians-Universität Munich, Martinsried, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Judith Wagner
- Department of Neurology, Kepler University Hospital Linz, Linz, Austria
- Department of Neurology, Evangelisches Klinikum Gelsenkirchen, Academic Hospital University Essen-Duisburg, Gelsenkirchen, Germany
| | - Jonathan Wickel
- Section Translational Neuroimmunology, Department for Neurology, Jena University Hospital, Jena, Germany
| | - Frank Leypoldt
- Department of Neurology, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Heike L Rittner
- Department of Anesthesiology, Intensive Care, Emergency Medicine and Pain Medicine, Centre for Interdisciplinary Pain Medicine, University Hospital Würzburg, Würzburg, Germany
| | - Claudia Sommer
- Department of Neurology, University Hospital Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany
| | - Carmen Villmann
- Institute of Clinical Neurobiology, University Hospital Würzburg, Würzburg, Germany
| | - Kathrin Doppler
- Department of Neurology, University Hospital Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany.
| |
Collapse
|
2
|
Robinson BG, Oster BA, Robertson K, Kaltschmidt JA. Loss of ASD-related molecule Cntnap2 affects colonic motility in mice. Front Neurosci 2023; 17:1287057. [PMID: 38027494 PMCID: PMC10665486 DOI: 10.3389/fnins.2023.1287057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 10/24/2023] [Indexed: 12/01/2023] Open
Abstract
Gastrointestinal (GI) symptoms are highly prevalent among individuals with autism spectrum disorder (ASD), but the molecular link between ASD and GI dysfunction remains poorly understood. The enteric nervous system (ENS) is critical for normal GI motility and has been shown to be altered in mouse models of ASD and other neurological disorders. Contactin-associated protein-like 2 (Cntnap2) is an ASD-related synaptic cell-adhesion molecule important for sensory processing. In this study, we examine the role of Cntnap2 in GI motility by characterizing Cntnap2's expression in the ENS and assessing GI function in Cntnap2 mutant mice. We find Cntnap2 expression predominately in enteric sensory neurons. We further assess in vivo and ex vivo GI motility in Cntnap2 mutants and show altered transit time and colonic motility patterns. The overall organization of the ENS appears undisturbed. Our results suggest that Cntnap2 plays a role in GI function and may provide a molecular link between ASD and GI dysfunction.
Collapse
Affiliation(s)
- Beatriz G. Robinson
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, United States
- Neurosciences IDP Graduate Program, Stanford University School of Medicine, Stanford, CA, United States
| | - Beau A. Oster
- Nevada ENDURE Program, University of Nevada, Reno, Reno, NV, United States
| | - Keiramarie Robertson
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, United States
- Neurosciences IDP Graduate Program, Stanford University School of Medicine, Stanford, CA, United States
| | - Julia A. Kaltschmidt
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, United States
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, United States
| |
Collapse
|
3
|
Robinson BG, Oster BA, Robertson K, Kaltschmidt JA. Loss of ASD-Related Molecule Cntnap2 Affects Colonic Motility in Mice. bioRxiv 2023:2023.04.17.537221. [PMID: 37131706 PMCID: PMC10153124 DOI: 10.1101/2023.04.17.537221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Gastrointestinal (GI) symptoms are highly prevalent among individuals with autism spectrum disorder (ASD), but the molecular link between ASD and GI dysfunction remains poorly understood. The enteric nervous system (ENS) is critical for normal GI motility and has been shown to be altered in mouse models of ASD and other neurological disorders. Contactin-associated protein-like 2 (Cntnap2) is an ASD-related synaptic cell-adhesion molecule important for sensory processing. In this study, we examine the role of Cntnap2 in GI motility by characterizing Cntnap2's expression in the ENS and assessing GI function in Cntnap2 mutant mice. We find Cntnap2 expression predominately in enteric sensory neurons. We further assess in-vivo and ex-vivo GI motility in Cntnap2 mutants and show altered transit time and colonic motility patterns. The overall organization of the ENS appears undisturbed. Our results suggest that Cntnap2 plays a role in GI function and may provide a molecular link between ASD and GI dysfunction.
Collapse
Affiliation(s)
- Beatriz G. Robinson
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA 94305, USA
- Neurosciences IDP Graduate Program, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Beau A. Oster
- Nevada ENDURE Program, University of Nevada, Reno, Reno, NV 89557, USA
| | - Keiramarie Robertson
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA 94305, USA
- Neurosciences IDP Graduate Program, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Julia A. Kaltschmidt
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA 94305, USA
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| |
Collapse
|
4
|
Hänsel M, Schmitz-Peiffer H, Hähner A, Reichmann H, Schneider H. Olfactory dysfunction after autoimmune encephalitis depending on the antibody type and limbic MRI pathologies. Front Neurol 2023; 14:1225975. [PMID: 37693764 PMCID: PMC10486887 DOI: 10.3389/fneur.2023.1225975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 08/01/2023] [Indexed: 09/12/2023] Open
Abstract
Objective Patients' olfactory function after autoimmune encephalitis (AE) involving limbic structures may be impaired. This study aimed to characterize olfactory function in patients after autoimmune encephalitides. Methods A case-control study was performed including 11 AE patients with antibodies against NMDAR (n = 4), GAD (n = 3), VGKC (n = 3) and antibody-negative AE (n = 1) and a control group of 12 patients with pneumococcal meningo-encephalitis (PC). In subgroup analyses, AE patients with and without NMDAR-antibodies were compared. Olfactory function was assessed using the Sniffin Sticks test and the resulting TDI-score (threshold, discrimination, identification). Involvement of limbic structures was evaluated on imaging data (MRI). Statistical analyses were performed to test for correlations of TDI-score and MRI results. Results The overall olfactory function of the AE-group and the PC-group was comparable (mean TDI 32.0 [CI 27.3-36.7], 32.3 [CI 28.5-36.0)]. The proportions of hyposmic patients were similar compared to the general population. However, AE patients of the non-NMDAR group had significantly lower TDI-scores (28.9 ± 6,8) than NMDAR patients (37.4 ± 3.5) (p = 0.046) and a significantly lower discrimination capability than the NMDAR patients (9.9 ± 2.0 vs. 14.5 ± 0.6) (p = 0.002). The non-NMDAR patients had significantly more limbic MRI pathologies (6/7) compared to the NMDAR patients (0/4) (p = 0.015). Furthermore, a correlation between limbic MRI pathologies and worse capability of smelling discrimination was found (p = 0.016, r = -0.704, n = 11). Conclusion Our results indicate that patients with NMDAR autoimmune encephalitis have normal long term olfactory function. However, patients with non-NMDAR autoimmune encephalitis appear to have a persistently impaired olfactory function, probably mediated by encephalitic damage to limbic structures.
Collapse
Affiliation(s)
- Martin Hänsel
- Department of Neurology, University of Dresden, Dresden, Germany
- Department of Internal Medicine, GZO – Zurich Regional Health Center, Wetzikon, Switzerland
| | | | - Antje Hähner
- Smell and Taste Clinic, Department of Otorhinolaryngology, Medical Faculty Carl-Gustav Carus, Technical University of Dresden, Dresden, Germany
| | - Heinz Reichmann
- Department of Neurology, University of Dresden, Dresden, Germany
| | - Hauke Schneider
- Department of Neurology, University of Dresden, Dresden, Germany
- Department of Neurology, Augsburg University Hospital, Augsburg, Germany
| |
Collapse
|
5
|
Cifuentes-Diaz C, Canali G, Garcia M, Druart M, Manett T, Savariradjane M, Guillaume C, Le Magueresse C, Goutebroze L. Differential impacts of Cntnap2 heterozygosity and Cntnap2 null homozygosity on axon and myelinated fiber development in mouse. Front Neurosci 2023; 17:1100121. [PMID: 36793543 PMCID: PMC9922869 DOI: 10.3389/fnins.2023.1100121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 01/09/2023] [Indexed: 01/31/2023] Open
Abstract
Over the last decade, a large variety of alterations of the Contactin Associated Protein 2 (CNTNAP2) gene, encoding Caspr2, have been identified in several neuronal disorders, including neurodevelopmental disorders and peripheral neuropathies. Some of these alterations are homozygous but most are heterozygous, and one of the current challenges is to estimate to what extent they could affect the functions of Caspr2 and contribute to the development of these pathologies. Notably, it is not known whether the disruption of a single CNTNAP2 allele could be sufficient to perturb the functions of Caspr2. To get insights into this issue, we questioned whether Cntnap2 heterozygosity and Cntnap2 null homozygosity in mice could both impact, either similarly or differentially, some specific functions of Caspr2 during development and in adulthood. We focused on yet poorly explored functions of Caspr2 in axon development and myelination, and performed a morphological study from embryonic day E17.5 to adulthood of two major brain interhemispheric myelinated tracts, the anterior commissure (AC) and the corpus callosum (CC), comparing wild-type (WT), Cntnap2 -/- and Cntnap2 +/- mice. We also looked for myelinated fiber abnormalities in the sciatic nerves of mutant mice. Our work revealed that Caspr2 controls the morphology of the CC and AC throughout development, axon diameter at early developmental stages, cortical neuron intrinsic excitability at the onset of myelination, and axon diameter and myelin thickness at later developmental stages. Changes in axon diameter, myelin thickness and node of Ranvier morphology were also detected in the sciatic nerves of the mutant mice. Importantly, most of the parameters analyzed were affected in Cntnap2 +/- mice, either specifically, more severely, or oppositely as compared to Cntnap2 -/- mice. In addition, Cntnap2 +/- mice, but not Cntnap2 -/- mice, showed motor/coordination deficits in the grid-walking test. Thus, our observations show that both Cntnap2 heterozygosity and Cntnap2 null homozygosity impact axon and central and peripheral myelinated fiber development, but in a differential manner. This is a first step indicating that CNTNAP2 alterations could lead to a multiplicity of phenotypes in humans, and raising the need to evaluate the impact of Cntnap2 heterozygosity on the other neurodevelopmental functions of Caspr2.
Collapse
Affiliation(s)
- Carmen Cifuentes-Diaz
- Inserm, Unité Mixte de Recherche (UMR)-S 1270, Paris, France,Faculté des Sciences et Ingénierie, Sorbonne University, Paris, France,Institut du Fer à Moulin, Paris, France
| | - Giorgia Canali
- Inserm, Unité Mixte de Recherche (UMR)-S 1270, Paris, France,Faculté des Sciences et Ingénierie, Sorbonne University, Paris, France,Institut du Fer à Moulin, Paris, France
| | - Marta Garcia
- Inserm, Unité Mixte de Recherche (UMR)-S 1270, Paris, France,Faculté des Sciences et Ingénierie, Sorbonne University, Paris, France,Institut du Fer à Moulin, Paris, France
| | - Mélanie Druart
- Inserm, Unité Mixte de Recherche (UMR)-S 1270, Paris, France,Faculté des Sciences et Ingénierie, Sorbonne University, Paris, France,Institut du Fer à Moulin, Paris, France
| | - Taylor Manett
- Inserm, Unité Mixte de Recherche (UMR)-S 1270, Paris, France,Faculté des Sciences et Ingénierie, Sorbonne University, Paris, France,Institut du Fer à Moulin, Paris, France
| | - Mythili Savariradjane
- Inserm, Unité Mixte de Recherche (UMR)-S 1270, Paris, France,Faculté des Sciences et Ingénierie, Sorbonne University, Paris, France,Institut du Fer à Moulin, Paris, France
| | - Camille Guillaume
- Inserm, Unité Mixte de Recherche (UMR)-S 1270, Paris, France,Faculté des Sciences et Ingénierie, Sorbonne University, Paris, France,Institut du Fer à Moulin, Paris, France
| | - Corentin Le Magueresse
- Inserm, Unité Mixte de Recherche (UMR)-S 1270, Paris, France,Faculté des Sciences et Ingénierie, Sorbonne University, Paris, France,Institut du Fer à Moulin, Paris, France
| | - Laurence Goutebroze
- Inserm, Unité Mixte de Recherche (UMR)-S 1270, Paris, France,Faculté des Sciences et Ingénierie, Sorbonne University, Paris, France,Institut du Fer à Moulin, Paris, France,*Correspondence: Laurence Goutebroze,
| |
Collapse
|
6
|
Berek K, Beer R, Grams A, Helbok R, Lindner A, Pfausler B, Schiefecker A, Deisenhammer F, Hegen H. Caspr2 antibodies in herpes simplex encephalitis: an extension of the spectrum of virus induced autoimmunity? - A case report. BMC Neurol 2022; 22:131. [PMID: 35382753 PMCID: PMC8981196 DOI: 10.1186/s12883-022-02637-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 03/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Post herpes simplex virus (HSV) autoimmune encephalitis has been reported mainly in association with NMDA receptor antibodies, however, never with Caspr2 antibodies. CASE PRESENTATION We report an 82-year old female patient with encephalitis who presented with aphasia, left temporo-mesial hyperintense lesion on MRI, epileptiform discharges on spot electroencephalography, cerebrospinal fluid (CSF) lymphocytic pleocytosis and who showed positive HSV polymerase chain reaction in CSF as well as antibodies against contactin-associated protein-like 2 (Caspr2). CONCLUSION This is the first report of a patient with encephalitis who tested positive for HSV as well as for Caspr2 antibodies.
Collapse
Affiliation(s)
- Klaus Berek
- Department of Neurology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - Ronny Beer
- Department of Neurology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - Astrid Grams
- Department of Neuroradiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Raimund Helbok
- Department of Neurology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - Anna Lindner
- Department of Neurology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - Bettina Pfausler
- Department of Neurology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - Alois Schiefecker
- Department of Neurology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - Florian Deisenhammer
- Department of Neurology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - Harald Hegen
- Department of Neurology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria.
| |
Collapse
|
7
|
Endmayr V, Tunc C, Ergin L, De Rosa A, Weng R, Wagner L, Yu TY, Fichtenbaum A, Perkmann T, Haslacher H, Kozakowski N, Schwaiger C, Ricken G, Hametner S, Klotz S, Dutra LA, Lechner C, de Simoni D, Poppert KN, Müller GJ, Pirker S, Pirker W, Angelovski A, Valach M, Maestri M, Guida M, Ricciardi R, Frommlet F, Sieghart D, Pinter M, Kircher K, Artacker G, Höftberger R, Koneczny I. Anti-Neuronal IgG4 Autoimmune Diseases and IgG4-Related Diseases May Not Be Part of the Same Spectrum: A Comparative Study. Front Immunol 2022; 12:785247. [PMID: 35095860 PMCID: PMC8795769 DOI: 10.3389/fimmu.2021.785247] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 12/15/2021] [Indexed: 12/18/2022] Open
Abstract
Background IgG4 is associated with two emerging groups of rare diseases: 1) IgG4 autoimmune diseases (IgG4-AID) and 2) IgG4-related diseases (IgG4-RLD). Anti-neuronal IgG4-AID include MuSK myasthenia gravis, LGI1- and Caspr2-encephalitis and autoimmune nodo-/paranodopathies (CNTN1/Caspr1 or NF155 antibodies). IgG4-RLD is a multiorgan disease hallmarked by tissue-destructive fibrotic lesions with lymphocyte and IgG4 plasma cell infiltrates and increased serum IgG4 concentrations. It is unclear whether IgG4-AID and IgG4-RLD share relevant clinical and immunopathological features. Methods We collected and analyzed clinical, serological, and histopathological data in 50 patients with anti-neuronal IgG4-AID and 19 patients with IgG4-RLD. Results A significantly higher proportion of IgG4-RLD patients had serum IgG4 elevation when compared to IgG4-AID patients (52.63% vs. 16%, p = .004). Moreover, those IgG4-AID patients with elevated IgG4 did not meet the diagnostic criteria of IgG4-RLD, and their autoantibody titers did not correlate with their serum IgG4 concentrations. In addition, patients with IgG4-RLD were negative for anti-neuronal/neuromuscular autoantibodies and among these patients, men showed a significantly higher propensity for IgG4 elevation, when compared to women (p = .005). Last, a kidney biopsy from a patient with autoimmune paranodopathy due to CNTN1/Caspr1-complex IgG4 autoantibodies and concomitant nephrotic syndrome did not show fibrosis or IgG4+ plasma cells, which are diagnostic hallmarks of IgG4-RLD. Conclusion Our observations suggest that anti-neuronal IgG4-AID and IgG4-RLD are most likely distinct disease entities.
Collapse
Affiliation(s)
- Verena Endmayr
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Cansu Tunc
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Lara Ergin
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Anna De Rosa
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy
| | - Rosa Weng
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Lukas Wagner
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Thin-Yau Yu
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Andreas Fichtenbaum
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Thomas Perkmann
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Helmuth Haslacher
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | | | - Carmen Schwaiger
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Gerda Ricken
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Simon Hametner
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Sigrid Klotz
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Lívia Almeida Dutra
- Department of Neurology and Neurosurgery, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Christian Lechner
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Vienna, Austria
- Pediatric Neurology, Department of Pediatric and Adolescent Medicine, Medical University of Innsbruck, Innsbruck, Austria
| | - Désirée de Simoni
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Vienna, Austria
- Department of Neurology, University Hospital St. Poelten, St. Poelten, Austria
| | - Kai-Nicolas Poppert
- Department of Neurology, Christian Doppler University Hospital, Paracelsus Medical University, Salzburg, Austria
| | - Georg Johannes Müller
- Department of Neurology and Karl Landsteiner Institute for Neuroimmunological and Neurodegenerative Disorders, Klinik Donaustadt, Vienna, Austria
| | - Susanne Pirker
- Department of Neurology, Klinik Hietzing, Vienna, Austria
| | - Walter Pirker
- Department of Neurology, Klinik Ottakring, Vienna, Austria
| | | | - Matus Valach
- Department of Pathology, Klinik Landstrasse, Vienna, Austria
| | - Michelangelo Maestri
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy
| | - Melania Guida
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy
| | - Roberta Ricciardi
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy
| | - Florian Frommlet
- Center for Medical Statistics, Informatics and Intelligent Systems, Section for Medical Statistics, Medical University of Vienna, Vienna, Austria
| | - Daniela Sieghart
- Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Miklos Pinter
- Wiener Privatklinik – Health Center, Vienna, Austria
| | - Karl Kircher
- Department of Ophthalmology, Medical University of Vienna, Vienna, Austria
| | - Gottfried Artacker
- Department of Pediatrics and Adolescent Medicine, Klinik Donaustadt, Vienna, Austria
| | - Romana Höftberger
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Inga Koneczny
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Vienna, Austria
| |
Collapse
|
8
|
Qin X, Yang H, Zhu F, Wang Q, Shan W. Clinical Character of CASPR2 Autoimmune Encephalitis: A Multiple Center Retrospective Study. Front Immunol 2021; 12:652864. [PMID: 34054814 PMCID: PMC8159154 DOI: 10.3389/fimmu.2021.652864] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 04/23/2021] [Indexed: 12/17/2022] Open
Abstract
Objective To examine the clinical characteristics of autoimmune encephalitis associated with the contactin-associated protein-2 (CASPR2) antibody. Materials and Methods Medical records of all patients diagnosed with CASPR2 antibody-associated encephalitis were retrospectively analysed. Data regarding demographic features, neurological symptoms and signs, laboratory tests, imaging results, treatments, and prognosis were collected. Results A total of 25 patients aged from 3 to 79 years old were enrolled in this study, with a median age of 43. Eight of 25 (32%) were female, and 17 of 25 (68%) were male. The median age of symptom onset was 42 years old with the course of disease from onset to hospital admission ranging from 2 days to 6 months (median was 17 days). Six patients (6/25) had fever as an onset symptom. During the course of disease, cognitive disturbance was the most common symptom, which was observed in 17 patients (17/25) in total. Eight patients (8/25) met the criteria for limbic encephalitis. Epileptic seizure occurred in six of these eight patients. Four patients (4/25) were diagnosed as Morvan syndrome. All patients were positive for anti-CASPR2 antibody in the serum (1:10-1:300). In six patients, antibodies were detected both in the blood and CSF (1:32-1:100). White blood cell (WBC) counts in the CSF were elevated in eight patients (8/25). The concentration of proteins in CSF increased in 10 patients (ranging from 480 to 1,337.6 mg/dl), decreased in seven patients (ranging from 23.2 to 130.5 mg/dl) and remained at a normal range in the other eight patients (ranging from 150 to 450 mg/dl). Abnormal electroencephalogram (EEG) activities included slow background activity and epileptic patterns. Abnormal signals in the bilateral hippocampus were detected by magnetic resonance imaging (MRI) in three patients presenting cognitive disturbance. In one patient who had limbic encephalitis, increased metabolism of bilateral basal ganglia and the mesial temporal lobe was revealed by PET-CT. Eleven of 15 patients receiving immunotherapy experienced varying degrees of improvement. Relapse occurred in four of 25 patients (4/25) after 2 months. Conclusion CASPR-antibody-mediated autoimmune encephalitis is characterized by diverse clinical manifestations. The most prominent conclusion revealed by this retrospective analysis is the involvement of both central and peripheral nerve systems, as well as a lower relapse rate, a good response to immunotherapy, and favorable short-term prognosis after treatment was also demonstrated. Besides, additional work is necessary to evaluate the long-term prognosis.
Collapse
Affiliation(s)
- Xiaoxiao Qin
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Huajun Yang
- Neurology Department, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Fei Zhu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Neuromodulation, Beijing, China
| | - Qun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Neuromodulation, Beijing, China
| | - Wei Shan
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Neuromodulation, Beijing, China
| |
Collapse
|
9
|
Masrori P, Vaesen Bentein H, Raskin J, Montagna M, De Picker L, De Volder I, Van Schil PE, Janssens A, Mercelis R. Caspr2 autoantibody-associated Morvan syndrome predating thymoma relapse by 30 months. Lung Cancer 2021; 153:117-119. [PMID: 33485137 DOI: 10.1016/j.lungcan.2021.01.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 01/10/2021] [Indexed: 11/30/2022]
Abstract
Morvan's syndrome (MoS) is a rare autoimmune disorder characterized by central nervous system involvement, autonomic dysfunction and peripheral nerve hyperexcitability. MoS is believed to be caused by autoantibodies targeting contactin-associated protein 2 (Caspr2), a subunit of the neuronal voltage-gated potassium channel (VGKC) complex, usually in association with thymoma, less commonly with other malignancies. This case highlights an exceptional case of severe sleep disturbances and behavioural changes due to MoS, in a patient who would present with and be treated successfully for a second relapse of thymoma 30 months later. Originally he suffered from ocular myasthenia, another autoimmune disorder, which led to diagnosis of his original thymoma and first relapse.
Collapse
Affiliation(s)
- Pegah Masrori
- Department of Neurology, Antwerp University Hospital, Edegem, Belgium
| | | | - Jo Raskin
- Department of Pulmonology and Thoracic Oncology, Antwerp University Hospital, Edegem, Belgium.
| | | | - Livia De Picker
- Department of Psychiatry, Antwerp University Hospital, Edegem, Belgium
| | - Ilse De Volder
- Department of Psychiatry, Antwerp University Hospital, Edegem, Belgium; Centre for Sleep, Antwerp University Hospital, Edegem, Belgium
| | - Paul E Van Schil
- Department of Thoracovascular Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Annelies Janssens
- Department of Pulmonology and Thoracic Oncology, Antwerp University Hospital, Edegem, Belgium
| | - Rudy Mercelis
- Department of Neurology, Antwerp University Hospital, Edegem, Belgium
| |
Collapse
|
10
|
Pinatel D, Faivre-Sarrailh C. Assembly and Function of the Juxtaparanodal Kv1 Complex in Health and Disease. Life (Basel) 2020; 11:8. [PMID: 33374190 DOI: 10.3390/life11010008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 12/21/2020] [Accepted: 12/23/2020] [Indexed: 02/07/2023] Open
Abstract
The precise axonal distribution of specific potassium channels is known to secure the shape and frequency of action potentials in myelinated fibers. The low-threshold voltage-gated Kv1 channels located at the axon initial segment have a significant influence on spike initiation and waveform. Their role remains partially understood at the juxtaparanodes where they are trapped under the compact myelin bordering the nodes of Ranvier in physiological conditions. However, the exposure of Kv1 channels in de- or dys-myelinating neuropathy results in alteration of saltatory conduction. Moreover, cell adhesion molecules associated with the Kv1 complex, including Caspr2, Contactin2, and LGI1, are target antigens in autoimmune diseases associated with hyperexcitability such as encephalitis, neuromyotonia, or neuropathic pain. The clustering of Kv1.1/Kv1.2 channels at the axon initial segment and juxtaparanodes is based on interactions with cell adhesion molecules and cytoskeletal linkers. This review will focus on the trafficking and assembly of the axonal Kv1 complex in the peripheral and central nervous system (PNS and CNS), during development, and in health and disease.
Collapse
|
11
|
Argent L, Winter F, Prickett I, Carrasquero-Ordaz M, Olsen AL, Kramer H, Lancaster E, Becker EBE. Caspr2 interacts with type 1 inositol 1,4,5-trisphosphate receptor in the developing cerebellum and regulates Purkinje cell morphology. J Biol Chem 2020; 295:12716-12726. [PMID: 32675284 PMCID: PMC7476715 DOI: 10.1074/jbc.ra120.012655] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 07/01/2020] [Indexed: 12/18/2022] Open
Abstract
Contactin-associated protein-like 2 (Caspr2) is a neurexin-like protein that has been associated with numerous neurological conditions. However, the specific functional roles that Caspr2 plays in the central nervous system and their underlying mechanisms remain incompletely understood. Here, we report on a functional role for Caspr2 in the developing cerebellum. Using a combination of confocal microscopy, biochemical analyses, and behavioral testing, we show that loss of Caspr2 in the Cntnap2-/- knockout mouse results in impaired Purkinje cell dendritic development, altered intracellular signaling, and motor coordination deficits. We also find that Caspr2 is highly enriched at synaptic specializations in the cerebellum. Using a proteomics approach, we identify type 1 inositol 1,4,5-trisphosphate receptor (IP3R1) as a specific synaptic interaction partner of the Caspr2 extracellular domain in the molecular layer of the developing cerebellum. The interaction of the Caspr2 extracellular domain with IP3R1 inhibits IP3R1-mediated changes in cellular morphology. Together, our work defines a mechanism by which Caspr2 controls the development and function of the cerebellum and advances our understanding of how Caspr2 dysfunction might lead to specific brain disorders.
Collapse
Affiliation(s)
- Liam Argent
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, United Kingdom
| | - Friederike Winter
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, United Kingdom
| | - Imogen Prickett
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, United Kingdom
| | | | - Abby L Olsen
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Holger Kramer
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, United Kingdom
| | - Eric Lancaster
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Esther B E Becker
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, United Kingdom
| |
Collapse
|
12
|
Abstract
BACKGROUND Cytokines are effective molecules of immune reactions. They work in inflammatory sites as well as circulate in the blood. Cytokines in the cerebrospinal fluid have been suggested to be markers of autoimmune encephalitis and reflect disease progression. However, studies on blood cytokines in autoimmune encephalitis are scarce. We report a case presenting with serial changes in blood cytokine levels in a male patient with anti-contactin-associated protein 2 (Caspr2) encephalitis. CASE PRESENTATION A 61-year-old man without systemic disease presented with ataxia and speech disturbance 1 week. After admission, he further developed visual hallucinations, psychosis, and consciousness deterioration. Brain magnetic resonance imaging and infection and tumor surveillances were negative. 18F-fluorodeoxyglucose positron emission tomography of brain revealed frontal and occipital hypometabolism and anterior cingulate gyrus and mesial temporal hypermetabolism. Autoimmune studies confirmed Caspr2 antibodies in his blood. After receiving a diagnosis of anti-Caspr2 encephalitis, the patient received steroids, plasmapheresis, and zonisamide. He recovered well and was totally independent 6 months after disease onset. A cytokine profiler array kit was used to investigate neuroimmune mechanisms during the disease course. Several cytokines showed significant changes in plasma levels, such as B cell activating factor for B cell proliferation; thymus and activation-regulated chemokine for T cell chemoattraction; soluble CD40 ligand for Th2 cell mediation; C5/C5a for complement activation; brain-derived neurotrophic factor for neuronal survival response; and dipeptidyl peptidase 4, retinol binding protein, dickkopf-related protein, and epidermal growth factor for response to environmental provocation. The concentration of cytokines was verified using Luminex multiplexing assay. CONCLUSIONS Due to their easy accessibility, blood cytokines are potential biomarkers of autoimmune encephalitis. Based on the investigating platform of this single case study, future larger scale studies are warranted.
Collapse
Affiliation(s)
- Yi-Chia Wei
- Department of Neurology, Chang Gung Memorial Hospital, No. 222, Maijin Rd., Anle Dist, Keelung City, 204, Taiwan. .,Community Medicine Research Center, Chang Gung Memorial, Hospital, Keelung, Taiwan. .,Collage of Medicine, Chang Gung University, Taoyuan, Taiwan.
| | - Chia-Lun Wu
- Department of Neurology, Chang Gung Memorial Hospital, No. 222, Maijin Rd., Anle Dist, Keelung City, 204, Taiwan.,Collage of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Wei-Chieh Weng
- Department of Neurology, Chang Gung Memorial Hospital, No. 222, Maijin Rd., Anle Dist, Keelung City, 204, Taiwan.,Collage of Medicine, Chang Gung University, Taoyuan, Taiwan
| |
Collapse
|
13
|
Pérez CA, Shah EG, Butler IJ. Mercury-induced autoimmunity: Report of two adolescent siblings with Morvan syndrome "plus" and review of the literature. J Neuroimmunol 2020; 342:577197. [PMID: 32126315 DOI: 10.1016/j.jneuroim.2020.577197] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 02/08/2020] [Accepted: 02/21/2020] [Indexed: 02/06/2023]
Abstract
Heavy metal toxicity is a global health concern. Mercury intoxication has been implicated in the etiology and pathogenesis of autoimmune disease, including Morvan syndrome. We describe two siblings with overlapping features of distinct autoimmune syndromes following accidental exposure to elemental mercury. Morvan syndrome was the predominant clinical phenotype. In addition to the characteristic anti-leucine-rich glioma-inactivated protein 1 (LGI1) and anti-contactin-associated protein-like 2 (Caspr2) autoantibodies, glutamic acid decarboxylase 65-kilodalton isoform (GAD65), and N-type and P/Q-type voltage-gated calcium channel (VGCC) antibodies were detected. Treatment with chelation therapy, glucocorticoids, and intravenous immunoglobulin was unsuccessful, but complete resolution of symptoms was achieved following treatment with rituximab. Herein, we perform an extensive review of the literature with a focus on the emerging concepts of mercury-induced autoimmunity and the role of mercury in the etiopathogenesis of autoimmune diseases of the nervous system.
Collapse
Affiliation(s)
- Carlos A Pérez
- Division of Multiple Sclerosis and Neuroimmunology, Department of Neurology, University of Texas Health Science Center at Houston, Houston, TX, USA.
| | - Ekta G Shah
- Division of Child and Adolescent Neurology, Department of Pediatrics, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Ian J Butler
- Division of Child and Adolescent Neurology, Department of Pediatrics, University of Texas Health Science Center at Houston, Houston, TX, USA
| |
Collapse
|
14
|
Bonetto G, Hivert B, Goutebroze L, Karagogeos D, Crépel V, Faivre-Sarrailh C. Selective Axonal Expression of the Kv1 Channel Complex in Pre-myelinated GABAergic Hippocampal Neurons. Front Cell Neurosci 2019; 13:222. [PMID: 31164806 PMCID: PMC6535494 DOI: 10.3389/fncel.2019.00222] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 05/02/2019] [Indexed: 01/01/2023] Open
Abstract
In myelinated fibers, the voltage-gated sodium channels Nav1 are concentrated at the nodal gap to ensure the saltatory propagation of action potentials. The voltage-gated potassium channels Kv1 are segregated at the juxtaparanodes under the compact myelin sheath and may stabilize axonal conduction. It has been recently reported that hippocampal GABAergic neurons display high density of Nav1 channels remarkably in clusters along the axon before myelination (Freeman et al., 2015). In inhibitory neurons, the Nav1 channels are trapped by the ankyrinG scaffold at the axon initial segment (AIS) as observed in pyramidal and granule neurons, but are also forming “pre-nodes,” which may accelerate conduction velocity in pre-myelinated axons. However, the distribution of the Kv1 channels along the pre-myelinated inhibitory axons is still unknown. In the present study, we show that two subtypes of hippocampal GABAergic neurons, namely the somatostatin and parvalbumin positive cells, display a selective high expression of Kv1 channels at the AIS and all along the unmyelinated axons. These inhibitory axons are also highly enriched in molecules belonging to the juxtaparanodal Kv1 complex, including the cell adhesion molecules (CAMs) TAG-1, Caspr2, and ADAM22 and the scaffolding protein 4.1B. Here, taking advantage of hippocampal cultures from 4.1B and TAG-1 knock-out mice, we observed that 4.1B is required for the proper positioning of Caspr2 and TAG-1 along the distal axon, and that TAG-1 deficiency induces alterations in the axonal distribution of Caspr2. However, the axonal expression of Kv1 channels and clustering of ankyrinG were not modified. In conclusion, this study allowed the analysis of the hierarchy between channels, CAMs and scaffolding proteins for their expression along hippocampal inhibitory axons before myelination. The early steps of channel compartmentalization preceding myelination may be crucial for stabilizing nerve impulses switching from a continuous to saltatory conduction during network development.
Collapse
Affiliation(s)
- Giulia Bonetto
- INSERM UMR1249, Institut de Neurobiologie de la Méditerranée, Aix-Marseille Université, Marseille, France
| | - Bruno Hivert
- INSERM UMR1249, Institut de Neurobiologie de la Méditerranée, Aix-Marseille Université, Marseille, France
| | - Laurence Goutebroze
- INSERM UMR-S 1270, Institut du Fer à Moulin, Faculté des Sciences et Ingénierie, Sorbonne Université, Paris, France
| | - Domna Karagogeos
- Department of Basic Sciences, Institute of Molecular Biology and Biotechnology, Foundation for Research and Technology, University of Crete Medical School - University of Crete, Heraklion, Greece
| | - Valérie Crépel
- INSERM UMR1249, Institut de Neurobiologie de la Méditerranée, Aix-Marseille Université, Marseille, France
| | - Catherine Faivre-Sarrailh
- INSERM UMR1249, Institut de Neurobiologie de la Méditerranée, Aix-Marseille Université, Marseille, France
| |
Collapse
|
15
|
Canali G, Goutebroze L. CNTNAP2 Heterozygous Missense Variants: Risk Factors for Autism Spectrum Disorder and/or Other Pathologies? J Exp Neurosci 2018; 12:1179069518809666. [PMID: 30450007 PMCID: PMC6236484 DOI: 10.1177/1179069518809666] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Accepted: 10/06/2018] [Indexed: 11/16/2022] Open
Abstract
The CNTNAP2 gene has been proposed to be one of the major susceptibility genes for neurodevelopmental disorders, in which numerous heterozygous missense variants have been identified in patients with autism spectrum disorder (ASD). The contribution of these variants to the manifestations of ASD is however highly controversial because numerous heterozygous missense variants have also been identified in control subjects. In a recent study, we set up a sensitive developmental in vitro cell assay to clarify the potential functional impact of these variants in a heterozygous Cntnap2 background relevant for CNTNAP2 heterozygosity in patients with ASD. We showed that the cell adhesion glycoprotein Caspr2 encoded by CNTNAP2 plays a dose-dependent role in cortical neuron axon growth and provided a proof of principle that some variants have functional consequences, either a loss of function or a dominant-negative effect. This indicates that phenotypes mimicking CNTNAP2 heterozygous and homozygous null mutation may exist in humans. Our observations further suggest that more variants than originally expected could be functionally deleterious and induce a high heterogeneity of phenotypes at the scale of the whole brain. This raises the interesting possibility that CNTNAP2 heterozygous missense variants could define an overall endophenotype shaping a risk for ASD and questions whether, beyond ASD, the variants could contribute to the development of other neurodevelopmental disorders and/or genetically less complex pathologies.
Collapse
Affiliation(s)
- Giorgia Canali
- UMR-S 839, Inserm, Paris, France.,Faculté des Sciences et Ingénierie, Sorbonne Université, Paris, France.,Institut du Fer à Moulin, Paris, France
| | - Laurence Goutebroze
- UMR-S 839, Inserm, Paris, France.,Faculté des Sciences et Ingénierie, Sorbonne Université, Paris, France.,Institut du Fer à Moulin, Paris, France
| |
Collapse
|
16
|
Liang W, Zhang W, Zhao S, Liang H, Zhang J, Wang L. Alterations of Caspr2 and Nav1.6 on myelinated axon damage in a rat model of chronic cerebral hypoperfusion. Exp Ther Med 2017; 13:2468-2472. [PMID: 28565865 PMCID: PMC5443296 DOI: 10.3892/etm.2017.4228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 01/11/2017] [Indexed: 11/19/2022] Open
Abstract
Myelinated axons require the correct localization of key proteins that are essential for nerve conduction and cognitive function. Little is known regarding the altered expression of contactin-associated protein 2 (Caspr2) at the juxtaparanodal regions and Nav1.6 at the node of Ranvier in response to chronic cerebral hypoperfusion (CCH). The aim of the present study was to examine the alterations in the key protein of myelinated axons and the potential mechanisms that may follow CCH. We established a rat model of CCH by controllable partial narrowing of bilateral common carotid arteries. Then, we detected cerebral blood flow (CBF) after surgery. We also evaluated motor-evoked potentials (MEPs), assessed the Morris water maze test, analyzed Caspr2 expression through immunohistochemistry and Nav1.6 protein expression through western blot analysis at 2, 4 and 12 weeks. The results revealed that the mean CBF value was significantly decreased to 33.90±5.48%. The MEP latencies and the escaping latencies were significantly prolonged. There was also an elongation of the first time passing of the hidden platform with a reduction of crossing platform times in spatial probing. Furthermore, the Caspr2 immunoreactivity demonstrated that the Caspr2 level was significantly downregulated with abnormal locations in the corpus callosum. The western blot analysis of Nav1.6 protein revealed that the level was reduced significantly over time. The results demonstrate that CCH leads to central conductive function loss, cognitive function damage and alterations in the key protein of myelinated axons, which may provide a molecular basis and key link for white matter damage.
Collapse
Affiliation(s)
- Weihua Liang
- No. 263 Clinic of PLA Army General Hospital, Beijing 101149, P.R. China.,Department of Neurology, Xinqiao Hospital, The Third Military Medical University, Chongqing 400038, P.R. China
| | - Weiwei Zhang
- PLA Army General Hospital, Beijing 100700, P.R. China
| | - Shifu Zhao
- Department of Neurology, Xinqiao Hospital, The Third Military Medical University, Chongqing 400038, P.R. China
| | - Hua Liang
- The 66083rd of PLA, Beijing 102488, P.R. China
| | - Jinli Zhang
- No. 263 Clinic of PLA Army General Hospital, Beijing 101149, P.R. China
| | - Luyan Wang
- No. 263 Clinic of PLA Army General Hospital, Beijing 101149, P.R. China
| |
Collapse
|
17
|
Gordon A, Salomon D, Barak N, Pen Y, Tsoory M, Kimchi T, Peles E. Expression of Cntnap2 ( Caspr2) in multiple levels of sensory systems. Mol Cell Neurosci 2015; 70:42-53. [PMID: 26647347 DOI: 10.1016/j.mcn.2015.11.012] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 10/01/2015] [Accepted: 11/27/2015] [Indexed: 01/09/2023] Open
Abstract
Genome-wide association studies and copy number variation analyses have linked contactin associated protein 2 (Caspr2, gene name Cntnap2) with autism spectrum disorder (ASD). In line with these findings, mice lacking Caspr2 (Cntnap2(-/-)) were shown to have core autism-like deficits including abnormal social behavior and communication, and behavior inflexibility. However the role of Caspr2 in ASD pathogenicity remains unclear. Here we have generated a new Caspr2:tau-LacZ knock-in reporter line (Cntnap2(tlacz/tlacz)), which enabled us to monitor the neuronal circuits in the brain expressing Caspr2. We show that Caspr2 is expressed in many brain regions and produced a comprehensive report of Caspr2 expression. Moreover, we found that Caspr2 marks all sensory modalities: it is expressed in distinct brain regions involved in different sensory processings and is present in all primary sensory organs. Olfaction-based behavioral tests revealed that mice lacking Caspr2 exhibit abnormal response to sensory stimuli and lack preference for novel odors. These results suggest that loss of Caspr2 throughout the sensory system may contribute to the sensory manifestations frequently observed in ASD.
Collapse
Affiliation(s)
- Aaron Gordon
- Department of Molecular Cell Biology, Weizmann Institute of Science, Rehovot 76100, Israel
| | - Daniela Salomon
- Department of Molecular Cell Biology, Weizmann Institute of Science, Rehovot 76100, Israel
| | - Noy Barak
- Department of Neurobiology, Weizmann Institute of Science, Rehovot 76100, Israel
| | - Yefim Pen
- Department of Neurobiology, Weizmann Institute of Science, Rehovot 76100, Israel
| | - Michael Tsoory
- Department of Veterinary Resources, Weizmann Institute of Science, Rehovot 76100, Israel
| | - Tali Kimchi
- Department of Neurobiology, Weizmann Institute of Science, Rehovot 76100, Israel
| | - Elior Peles
- Department of Molecular Cell Biology, Weizmann Institute of Science, Rehovot 76100, Israel.
| |
Collapse
|
18
|
Chen N, Koopmans F, Gordon A, Paliukhovich I, Klaassen RV, van der Schors RC, Peles E, Verhage M, Smit AB, Li KW. Interaction proteomics of canonical Caspr2 (CNTNAP2) reveals the presence of two Caspr2 isoforms with overlapping interactomes. Biochim Biophys Acta 2015; 1854:827-33. [PMID: 25707359 DOI: 10.1016/j.bbapap.2015.02.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Revised: 01/31/2015] [Accepted: 02/11/2015] [Indexed: 11/21/2022]
Abstract
Autism is a human developmental brain disorder characterized by impaired social interaction and communication. Contactin-associated protein-like 2 (Caspr2, CNTNAP2) is a known genetic risk factor of autism. However, how this protein might contribute to pathology is unclear. In this study, we demonstrate that Caspr2 is abundantly present in lipid raft and in the synaptic membrane but is highly depleted in the postsynaptic density. The Caspr2 protein level in hippocampus is present at a constant level during synapse formation and myelination from P0 to P84. Interaction proteomics revealed the interactors of Caspr2, including CNTN2, KCNAs, members of the ADAM family (ADAM22, ADAM23 and ADAM11), members of LGI family and MAGUKs (DLGs and MPPs). Interestingly, a short form of Caspr2 was detected, which lacks most of the extracellular domains, however, is still associated with ADAM22 and to a lesser extent LGI1 and Kv1 channels. The comprehensive Caspr2 interactome revealed here might aid in understanding the molecular mechanisms underlying autism. This article is part of a Special Issue titled Neuroproteomics: Applications in Neuroscience and Neurology.
Collapse
|
19
|
Condro MC, White SA. Distribution of language-related Cntnap2 protein in neural circuits critical for vocal learning. J Comp Neurol 2014; 522:169-85. [PMID: 23818387 DOI: 10.1002/cne.23394] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Revised: 04/11/2013] [Accepted: 06/19/2013] [Indexed: 11/12/2022]
Abstract
Variants of the contactin associated protein-like 2 (Cntnap2) gene are risk factors for language-related disorders including autism spectrum disorder, specific language impairment, and stuttering. Songbirds are useful models for study of human speech disorders due to their shared capacity for vocal learning, which relies on similar cortico-basal ganglia circuitry and genetic factors. Here we investigate Cntnap2 protein expression in the brain of the zebra finch, a songbird species in which males, but not females, learn their courtship songs. We hypothesize that Cntnap2 has overlapping functions in vocal learning species, and expect to find protein expression in song-related areas of the zebra finch brain. We further expect that the distribution of this membrane-bound protein may not completely mirror its mRNA distribution due to the distinct subcellular localization of the two molecular species. We find that Cntnap2 protein is enriched in several song control regions relative to surrounding tissues, particularly within the adult male, but not female, robust nucleus of the arcopallium (RA), a cortical song control region analogous to human layer 5 primary motor cortex. The onset of this sexually dimorphic expression coincides with the onset of sensorimotor learning in developing males. Enrichment in male RA appears due to expression in projection neurons within the nucleus, as well as to additional expression in nerve terminals of cortical projections to RA from the lateral magnocellular nucleus of the nidopallium. Cntnap2 protein expression in zebra finch brain supports the hypothesis that this molecule affects neural connectivity critical for vocal learning across taxonomic classes.
Collapse
Affiliation(s)
- Michael C Condro
- Molecular, Cellular & Integrative Physiology Interdepartmental Program, University of California, Los Angeles, California, 90095
| | | |
Collapse
|
20
|
von Hohenberg CC, Wigand MC, Kubicki M, Leicht G, Giegling I, Karch S, Hartmann AM, Konte B, Friedl M, Ballinger T, Eckbo R, Bouix S, Jäger L, Shenton ME, Rujescu D, Mulert C. CNTNAP2 polymorphisms and structural brain connectivity: a diffusion-tensor imaging study. J Psychiatr Res 2013; 47:1349-56. [PMID: 23871450 PMCID: PMC3780783 DOI: 10.1016/j.jpsychires.2013.07.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2013] [Revised: 06/27/2013] [Accepted: 07/02/2013] [Indexed: 11/16/2022]
Abstract
CNTNAP2 is a gene on chromosome 7 that has shown associations with autism and schizophrenia, and there is evidence that it plays an important role for neuronal synchronization and brain connectivity. In this study, we assessed the relationship between Diffusion Tensor Imaging (DTI), a putative marker of anatomical brain connectivity, and multiple single nucleotide polymorphisms (SNPs) spread out over this large gene. 81 healthy controls and 44 patients with schizophrenia (all Caucasian) underwent DTI and genotyping of 31 SNPs within CNTNAP2. We employed Tract-based Spatial Statistics (TBSS) for inter-subject brain registration and computed average diffusivity values for six major white matter tracts. Analyses of Covariance (ANCOVAs) were computed to test for possible associations with genotypes. The strongest association, which survived rigorous Bonferroni correction, was between rs2710126 genotype and Fractional Anisotropy (FA) in the uncinate fasciculus (p = .00003). This anatomical location is particularly interesting given the enriched fronto-temporal expression of CNTNAP2 in the developing brain. For this SNP, no phenotype association has been reported before. There were several further genotype-DTI associations that were nominally significant but did not survive Bonferroni correction, including an association between axial diffusivity in the dorsal cingulum bundle and a region in intron 13 (represented by rs2710102, rs759178, rs2538991), which has previously been reported to be associated with anterior-posterior functional connectivity. We present new evidence about the effects of CNTNAP2 on brain connectivity, whose disruption has been hypothesized to be central to schizophrenia pathophysiology.
Collapse
Affiliation(s)
- Christian Clemm von Hohenberg
- Psychiatry Neuroimaging Laboratory, Brigham and Women's
Hospital and Harvard Medical School, Boston, MA,Department of Psychiatry, Faculty of Medicine,
Ludwig-Maximilians-Universität, Munich, Germany,Psychiatry Neuroimaging Branch, Imaging Center NeuroImage Nord and
Department of Psychiatry and Psychotherapy, University Medical Center
Hamburg-Eppendorf, Germany
| | - Marlene C. Wigand
- Psychiatry Neuroimaging Laboratory, Brigham and Women's
Hospital and Harvard Medical School, Boston, MA,Department of Psychiatry, Faculty of Medicine,
Ludwig-Maximilians-Universität, Munich, Germany,Psychiatry Neuroimaging Branch, Imaging Center NeuroImage Nord and
Department of Psychiatry and Psychotherapy, University Medical Center
Hamburg-Eppendorf, Germany
| | - Marek Kubicki
- Psychiatry Neuroimaging Laboratory, Brigham and Women's
Hospital and Harvard Medical School, Boston, MA,Departments of Psychiatry and Radiology, Harvard Medical School,
Boston, MA
| | - Gregor Leicht
- Psychiatry Neuroimaging Branch, Imaging Center NeuroImage Nord and
Department of Psychiatry and Psychotherapy, University Medical Center
Hamburg-Eppendorf, Germany
| | - Ina Giegling
- Department of Psychiatry, Faculty of Medicine,
Ludwig-Maximilians-Universität, Munich, Germany
| | - Susanne Karch
- Department of Psychiatry, Faculty of Medicine,
Ludwig-Maximilians-Universität, Munich, Germany
| | - Annette M. Hartmann
- Department of Psychiatry, Faculty of Medicine,
Ludwig-Maximilians-Universität, Munich, Germany
| | - Bettina Konte
- Department of Psychiatry, Faculty of Medicine,
Ludwig-Maximilians-Universität, Munich, Germany
| | - Marion Friedl
- Department of Psychiatry, Faculty of Medicine,
Ludwig-Maximilians-Universität, Munich, Germany
| | - Thomas Ballinger
- Psychiatry Neuroimaging Laboratory, Brigham and Women's
Hospital and Harvard Medical School, Boston, MA
| | - Ryan Eckbo
- Psychiatry Neuroimaging Laboratory, Brigham and Women's
Hospital and Harvard Medical School, Boston, MA
| | - Sylvain Bouix
- Psychiatry Neuroimaging Laboratory, Brigham and Women's
Hospital and Harvard Medical School, Boston, MA,Departments of Psychiatry and Radiology, Harvard Medical School,
Boston, MA
| | - Lorenz Jäger
- Department of Radiology, Faculty of Medicine,
Ludwig-Maximilians-Universität, Munich, Germany
| | - Martha E. Shenton
- Psychiatry Neuroimaging Laboratory, Brigham and Women's
Hospital and Harvard Medical School, Boston, MA,Departments of Psychiatry and Radiology, Harvard Medical School,
Boston, MA,Clinical Neuroscience Division, Laboratory of Neuroscience, Veterans
Affairs Boston Healthcare System, Brockton Division, Brockton, MA
| | - Dan Rujescu
- Department of Psychiatry, Faculty of Medicine,
Ludwig-Maximilians-Universität, Munich, Germany,Department of Psychiatry, University Hospital and Faculty of
Medicine, Martin-Luther-Universität Halle-Wittenberg, Germany
| | - Christoph Mulert
- Psychiatry Neuroimaging Branch, Imaging Center NeuroImage Nord and
Department of Psychiatry and Psychotherapy, University Medical Center
Hamburg-Eppendorf, Germany
| |
Collapse
|
21
|
Martinez-Martinez P, Molenaar PC, Losen M, Stevens J, Baets MHD, Szoke A, Honnorat J, Tamouza R, Leboyer M, Os JV, Rutten BPF. Autoantibodies to neurotransmitter receptors and ion channels: from neuromuscular to neuropsychiatric disorders. Front Genet 2013; 4:181. [PMID: 24065983 PMCID: PMC3778371 DOI: 10.3389/fgene.2013.00181] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Accepted: 08/27/2013] [Indexed: 01/17/2023] Open
Abstract
Changes of voltage-gated ion channels and ligand-gated receptor channels caused by mutation or autoimmune attack are the cause of so-called channelopathies in the central and peripheral nervous system. We present the pathophysiology of channelopathies of the neuromuscular junction in terms of loss-of-function and gain-of-function principles. Autoantibodies generally have reduced access to the central nervous system, but in some cases this is enough to cause disease. A review is provided of recent findings implicating autoantibodies against ligand-activated receptor channels and potassium channels in psychiatric and neurological disorders, including schizophrenia and limbic encephalitis. The emergence of channelopathy-related neuropsychiatric disorders has implications for research and practice.
Collapse
Affiliation(s)
- Pilar Martinez-Martinez
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University Maastricht, Netherlands
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|