Neuronal surface antigen antibodies in limbic encephalitis: clinical-immunologic associations

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RECERCAT Home > Universitat de Barcelona > IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer > Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer) > View document

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dc.contributor.author	Graus Ribas, Francesc
dc.contributor.author	Saiz Hinajeros, Albert
dc.contributor.author	Lai, Marina
dc.contributor.author	Bruna, Jordi
dc.contributor.author	López, Francisca
dc.contributor.author	Sabater, Lidia
dc.contributor.author	Blanco, Yolanda
dc.contributor.author	Rey, María Jesús
dc.contributor.author	Ribalta Farrés, Teresa María
dc.contributor.author	Dalmau Obrador, Josep
dc.date	2019-01-23T10:53:58Z
dc.date	2019-01-23T10:53:58Z
dc.date	2008-09-16
dc.date	2019-01-23T10:53:58Z
dc.identifier	0028-3878
dc.identifier	612250
dc.identifier	18794496
dc.identifier.uri	http://hdl.handle.net/2445/127545
dc.description	Objective: To report the frequency and type of antibodies against neuronal surface antigens (NSA-ab) in limbic encephalitis (LE). Methods: Analysis of clinical features, neuropathologic findings, and detection of NSA-ab using immunochemistry on rat tissue and neuronal cultures in a series of 45 patients with paraneoplastic (23) or idiopathic (22) LE. Results: NSA-ab were identified in 29 patients (64%; 12 paraneoplastic, 17 idiopathic). Thirteen patients had voltage-gated potassium channels (VGKC)-ab, 11 novel NSA (nNSA)-ab, and 5 NMDA receptor (NMDAR)-ab. nNSA-ab did not identify a common antigen and were more frequent in paraneoplastic than idiopathic LE (39% vs 9%; p = 0.03). When compared with VGKC-ab or NMDAR-ab, the nNSA associated more frequently with intraneuronal antibodies (11% vs 73%; p = 0.001). Of 12 patients (9 nNSA-ab, 2 VGKC-ab, 1 NMDAR-ab) with paraneoplastic LE and NSA-ab, concomitant intraneuronal antibodies occurred in 9 (75%). None of these 12 patients improved with immunotherapy. The autopsy of three of them showed neuronal loss, microgliosis, and cytotoxic T cell infiltrates in the hippocampus and amygdala. These findings were compatible with a T-cell mediated neuronal damage. In contrast, 13 of 17 (76%) patients with idiopathic LE and NSA-ab (8 VGKC-ab, 4 NMDAR-ab, 1 nNSA-ab) and 1 of 5 (20%) without antibodies had clinical improvement (p = 0.04). Conclusions: In paraneoplastic limbic encephalitis (LE), novel antibodies against neuronal surface antigens (nNSA-ab) occur frequently, coexist with antibodies against intracellular antigens, and these cases are refractory to immunotherapy. In idiopathic LE, the likelihood of improvement is significantly higher in patients with NSA-ab than in those without antibodies.
dc.format	7 p.
dc.format	application/pdf
dc.language	eng
dc.publisher	Lippincott, Williams & Wilkins. Wolters Kluwer Health
dc.relation	Reproducció del document publicat a: https://doi.org/10.1212/01.wnl.0000325917.48466.55
dc.relation	Neurology, 2008, vol. 71, num. 12, p. 930-936
dc.relation	https://doi.org/10.1212/01.wnl.0000325917.48466.55
dc.rights	(c) American Academy of Neurology, 2008
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	Encefalitis
dc.subject	Immunoglobulines
dc.subject	Immunoteràpia
dc.subject	Encephalitis
dc.subject	Immunoglobulins
dc.subject	Immunotheraphy
dc.title	Neuronal surface antigen antibodies in limbic encephalitis: clinical-immunologic associations
dc.type	info:eu-repo/semantics/article
dc.type	info:eu-repo/semantics/publishedVersion

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