Screening for autoantibodies in inflammatory neurological syndrome using fluorescence pattern in a tissue-based assay: Cerebrospinal fluid findings from 793 patients
Screening for autoantibodies in inflammatory neurological syndrome using fluorescence pattern in a tissue-based assay: Cerebrospinal fluid findings from 793 patients
复制标题
在基于组织的检测中使用荧光模式筛选炎症神经系统综合征中的自身抗体：793 名患者的脑脊液检查结果
DOI：
10.1016/j.msard.2018.12.036
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发表时间：
2019-02-01
影响因子：
4
通讯作者：
Gao Cong
中科院分区：
文献类型：
--
作者：
Liu Tianni;Chen Baikeng;Gao Cong
背景资料：目的：应用组织免疫荧光法（TBA）检测脑脊液（CSF）中抗免疫球蛋白G（IgG）的自身抗体和靶抗原。结果：110例（13.9%）脑脊液标本特异性抗体阳性。其中，37个样本显示神经元模式，57个样本显示星形胶质细胞模式，7个样本显示神经元和星形胶质细胞模式，9个样本显示少突胶质细胞模式。在神经元抗体组中，16例患者具有NMDAR-IgG，3例具有LGi 1-IgG，2例具有AMPA 2-IgG，2例具有GAD 65-IgG，1例具有GABA-IgG，1例具有重叠的NMDAR-IgG和AQP 4-IgG。在未鉴定的神经元抗体中，2种为细胞表面抗体，3种为细胞表面和细胞质抗体，3种为细胞质抗体，4种为细胞核和细胞质抗体。在57例星形胶质细胞型患者中，28例AQP 4-IgG阳性，21例GFAP-IgG阳性，5例AQP 4和GFAP-IgG重叠，3例抗原不明。7例患者同时显示神经元和星形胶质细胞模式，其中4例有未知的神经元抗体。在少突胶质细胞模式的患者中，MOG-IgGs. Conclusions和MBP-IgGs.Conclusions：TBA是有助于诊断自身免疫性神经综合征，特别是在未知的抗体和抗原的患者。存在针对神经元或神经胶质细胞的未鉴定抗体可能是一个有趣的发现，但应在未来的研究中进行研究，其中包括适当IgG稀释度的平行血清样本。
Background: To evaluate indirect immunofluorescence patterns of auto-antibodies and the targeting antigens to Immunoglobulin Gs (IgGs) in the cerebrospinal fluid (CSF) by a tissue-based assay(TBA).Methods: CSF samples were collected from 793 patients. Auto-antibody levels were measured via an immunofluorescence assay.Results: 110 (13.9%) CSF samples with a specific response were confirmed. Of these, 37 showed a neuronal pattern, 57 an astrocyte pattern, 7 a neuronal and astrocyte pattern, and 9 samples showed an oligodendrocyte pattern. In the neuronal antibody group, 16 patients had NMDAR-IgGs, 3 had LGi1-IgGs, 2 had AMPA2-IgGs, 2 had GAD65-IgGs, 1 patient had GABA-IgGs, and 1 patient had overlapping NMDAR-IgGs and AQP4-IgGs. Of the unidentified neuronal antibodies, two were cellular surface antibodies, three were cellular surface and cytoplasm antibodies, three were cytoplasm antibodies, and four were nuclear and cytoplasm antibodies. Among the 57 patients with the astrocyte pattern, 28 patients were positive for AQP4-IgGs, 21 were positive for GFAP-IgGs, 5 patients had overlapping AQP4 and GFAP-IgGs, and 3 patients had an unidentified antigen. Seven patients showed neuronal and astrocyte patterns simultaneously; four of them had unknown neuronal antibodies. In the patients with an oligodendrocyte pattern, one was positive for MOG-IgGs and four for MBP-IgGs.Conclusions: The TBA is helpful for diagnosing autoimmune neurological syndrome, especially in patients with unknown antibodies and antigens. Presence of unidentified antibodies against neuronal or glial cells could be an interesting finding, but should be investigated in future studies which incorporate parallel serum samples at an appropriate IgG dilution.