Adult-onset temporal lobe epilepsy suspicious for autoimmune pathogenesis: Autoantibody prevalence and clinical correlates

Autor: Julika Pitsch, Susanne Schoch, Carolin Meschede, Christoph Helmstaedter, Julia C. Kuehn, Rainer Surges, Randi von Wrede, Albert J. Becker, Hartmut Vatter, Elke Hattingen, Christian E. Elger
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Male
0301 basic medicine
Physiology
medicine.disease_cause
Nervous System
Hippocampus
Diagnostic Radiology
Serology
Autoimmunity
Pathogenesis
Epilepsy
Medical Conditions
Cognition
Learning and Memory
0302 clinical medicine
Infectious Diseases of the Nervous System
Antibody Specificity
Breast Tumors
Medicine and Health Sciences
Prevalence
Cerebrospinal Fluid
Multidisciplinary
Radiology and Imaging
Limbic encephalitis
Brain
Middle Aged
Magnetic Resonance Imaging
Body Fluids
Infectious Diseases
Neurology
Oncology
Encephalitis
Medicine
Female
Anatomy
Research Article
Adult
Imaging Techniques
Science
Immunoblotting
Molecular Probe Techniques
Context (language use)
Research and Analysis Methods
Autoimmune Diseases
03 medical and health sciences
Diagnostic Medicine
Memory
Breast Cancer
medicine
Humans
Molecular Biology Techniques
Molecular Biology
Autoantibodies
business.industry
Autoantibody
Biology and Life Sciences
Cancers and Neoplasms
medicine.disease
030104 developmental biology
Epilepsy
Temporal Lobe
Immunology
Cognitive Science
business
030217 neurology & neurosurgery
Neuroscience
Zdroj: PLoS ONE, Vol 15, Iss 10, p e0241289 (2020)
PLoS ONE
ISSN: 1932-6203
Popis: Temporal lobe adult-onset seizures (TAOS) related to autoimmunity represent an increasingly recognized disease syndrome within the spectrum of epilepsies. In this context, certain autoantibodies (autoABs) were often associated with limbic encephalitis (LE). Here, we aimed to gain insights into (a) the distribution of 'neurological' autoABs (neuroABs, defined as autoABs targeting neuronal surface structures or 'onconeuronal' ABs or anti-glutamate acid decarboxylase 65 (GAD65) autoABs) in a large consecutive TAOS patient cohort, to characterize (b) clinical profiles of seropositive versus seronegative individuals and to find (c) potential evidence for other autoABs. Blood sera/cerebrospinal fluid (CSF) of TAOS patients (n = 800) and healthy donors (n = 27) were analyzed for neuroABs and screened for other autoABs by indirect immunofluorescence on hippocampal/cerebellar sections and immunoblots of whole brain and synaptosome lysates. Serological results were correlated with clinico-neuropsychological features. 13% of TAOS patients (n = 105) were neuroAB+, with anti-GAD65 and anti-N-methyl-D-aspartate receptors (NMDAR) as most frequent autoABs in this group. In our screening tests 25% of neuroAB- patients (n = 199) were positive (screening+), whereas all control samples were negative (n = 27). Intriguingly, key clinico-neuropsychological characteristics including magnetic resonance imaging (MRI) findings, epileptiform electroencephalographic (EEG) activity, and inflammatory cellular infiltrates in CSF were shared to a greater extent by neuroAB+ with neuroAB-/screening+ patients than with neuroAB-/screening- patients. Serological testing in a large consecutive TAOS patient series revealed seropositivity for anti-GAD65 autoABs as the most frequent neuroAB. Intriguingly, neuroAB+ individuals were virtually indistinguishable from neuroAB-/screening+ patients in several major clinical features. In contrast, neuroAB-/screening- TAOS patients differed in many parameters. These data support the potential presence of so far unrecognized autoABs in patients with TAOS.
Databáze: OpenAIRE
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