Anti-sulfatide/galactocerebroside antibodies in immunoglobulin M paraproteinemic neuropathies
Autor: | Claudia Giannotta, Mario Ermani, Marta Campagnolo, Girolama Alessandra Marfia, S. Ruggero, Eduardo Nobile-Orazio, Alessandro Salvalaggio, Marta Ruiz, Giorgia Mataluni, Francesca Gallia, F. Boso, Andrea Visentin, Laura Benedetti, Chiara Briani, Mariangela Bianco, C. De Michelis |
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Jazyk: | angličtina |
Rok vydání: | 2017 |
Předmět: |
Adult
Male 0301 basic medicine sulfatide Galactosylceramides Young Adult 03 medical and health sciences 0302 clinical medicine Glycolipid paraproteinemic neuropathy antibody Humans Medicine Clinical significance galactocerebroside neuropathy Neurology Neurology (clinical) Aged Autoantibodies chemistry.chemical_classification Sulfoglycosphingolipids biology business.industry Peripheral Nervous System Diseases Middle Aged IgM Monoclonal Gammopathy Myelin-Associated Glycoprotein Titer 030104 developmental biology Immunoglobulin M chemistry Immunology biology.protein Female Galactocerebroside Settore MED/26 - Neurologia Antibody business Glycoprotein 030217 neurology & neurosurgery |
Popis: | BACKGROUND AND PURPOSE: Anti-sulfatide antibodies have been observed in heterogeneous neuropathies and their clinical relevance is still controversial. Whether the combination of sulfatide with galactocerebroside would increase sensitivity or specificity of enzyme-linked immunosorbent assay testing compared to sulfatide alone was assessed. METHODS: Immunoglobulin M (IgM) antibodies to sulfatides, galactocerebroside and combined sulfatide and galactocerebroside (Sulf/GalC) were measured in 229 neuropathy patients, including 73 with IgM paraproteinemic neuropathy [62 with anti-myelin-associated glycoprotein (anti-MAG) antibody] and 156 with other neuropathies. Results from 27 patients with IgM monoclonal gammopathy without neuropathy and 28 healthy subjects served as control. RESULTS: Thirty-three patients showed increased titers of anti-sulfatide antibodies, 28 of whom had an IgM paraproteinemic neuropathy (P < 0.0001). When evaluating the reactivity for the combination Sulf/GalC, 57/229 patients were found to be positive, including 36/73 (49%) with IgM paraproteinemic neuropathy (P < 0.0001). Patients with known anti-sulfatide antibodies also showed anti-Sulf/GalC reactivity, with increased titers in 48.5% of the cases. Testing for anti-Sulf/GalC antibodies allowed 24 additional patients to be detected (eight with IgM paraproteinemic neuropathies), who had no reactivity to the individual glycolipids. Amongst the 11 subjects with IgM paraproteinemic neuropathy who were negative for anti-MAG antibodies, only two were reactive to sulfatide, whilst six (55%) were found to be positive when tested against the combination of sulfatide and galactocerebroside. CONCLUSIONS: Testing for both sulfatide and galactocerebroside in IgM paraproteinemic neuropathies seems to increase the sensitivity compared to anti-sulfatide antibodies alone (49% and 39%, respectively, with a slightly reduced specificity, from 97% to 87%), helping the characterization of otherwise undefined neuropathy that could benefit from immunomodulatory therapy. |
Databáze: | OpenAIRE |
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