40 years of autoantibody research in paraneoplastic neurological syndromes

IF 2.8 4区 医学 Q2 CLINICAL NEUROLOGY Revue neurologique Pub Date : 2024-11-01 DOI:10.1016/j.neurol.2024.07.003
F. Graus
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Abstract

Paraneoplastic neurologic syndromes (PNS) are a group of disorders that affect the central and the peripheral nervous system and frequently occur in patients with cancer which usually still is undiagnosed by the time the patient presents the first neurological manifestations. The discovery in the serum and cerebrospinal fluid of PNS patients of antibodies that target tumor antigens that also are normally expressed in the nervous system had a significant impact. First, the research on neuronal antibodies confirmed that most PNS are autoimmune disorders triggered by the underlying cancer supporting the use of immunotherapy to treat them; second, although the first antibodies described recognized intracellular neuronal antigens and therefore they were not pathogenic, these antibodies became robust biomarkers for the strict diagnosis of PNS; and third, the methodological approach used to characterize the first neuronal antibodies paved the way to the identification of antibodies against neuronal surface antigens that are pathogenic and responsible for some PNS and non-paraneoplastic encephalitis. Future studies should address several issues: (1) to improve the efficiency of commercial kits; (2) to provide strict criteria to select which neural antibodies should be used for the diagnosis of PNS; and (3) define in more detail the autoimmune mechanisms responsible for the brain injury in the PNS.
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副肿瘤性神经综合征自身抗体研究 40 年。
副肿瘤性神经综合征(PNS)是一组影响中枢和周围神经系统的疾病,经常发生在癌症患者身上,通常在患者首次出现神经系统表现时仍未确诊。在 PNS 患者的血清和脑脊液中发现了针对肿瘤抗原的抗体,而这些抗原通常也在神经系统中表达,这对研究产生了重大影响。首先,对神经元抗体的研究证实,大多数 PNS 都是由潜在癌症引发的自身免疫性疾病,这为使用免疫疗法治疗 PNS 提供了支持;其次,尽管第一种被描述的抗体能识别细胞内神经元抗原,因此不具有致病性,但这些抗体已成为严格诊断 PNS 的可靠生物标志物;第三,描述第一种神经元抗体特征的方法为鉴定神经元表面抗原抗体铺平了道路,这些抗体具有致病性,是某些 PNS 和非副肿瘤性脑炎的病原体。未来的研究应解决几个问题:(1)提高商业试剂盒的效率;(2)提供严格的标准来选择哪些神经抗体应被用于 PNS 的诊断;(3)更详细地定义导致 PNS 脑损伤的自身免疫机制。
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来源期刊
Revue neurologique
Revue neurologique 医学-临床神经学
CiteScore
4.80
自引率
0.00%
发文量
598
审稿时长
55 days
期刊介绍: The first issue of the Revue Neurologique, featuring an original article by Jean-Martin Charcot, was published on February 28th, 1893. Six years later, the French Society of Neurology (SFN) adopted this journal as its official publication in the year of its foundation, 1899. The Revue Neurologique was published throughout the 20th century without interruption and is indexed in all international databases (including Current Contents, Pubmed, Scopus). Ten annual issues provide original peer-reviewed clinical and research articles, and review articles giving up-to-date insights in all areas of neurology. The Revue Neurologique also publishes guidelines and recommendations. The Revue Neurologique publishes original articles, brief reports, general reviews, editorials, and letters to the editor as well as correspondence concerning articles previously published in the journal in the correspondence column.
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