Journal Article

DZNE-2022-01094

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Spectrum of Novel Anti–Central Nervous System Autoantibodies in the Cerebrospinal Fluid of 119 Patients With Schizophreniform and Affective Disorders

Endres, D. ; von Zedtwitz, K. ; Matteit, I. ; Bünger, I.DZNE* ; Foverskov Rasmussen, H.DZNE* ; Runge, K. ; Feige, B. ; Schlump, A. ; Maier, S. ; Nickel, K. ; Berger, B. ; Schiele, M. A. ; Cunningham, J. L. ; Domschke, K. ; Prüß, H.DZNE* ; Tebartz van Elst, L.

2022
Elsevier Science Amsterdam [u.a.]

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Please use a persistent id in citations: doi:10.1016/j.biopsych.2022.02.010

Abstract: Autoimmune psychosis may be caused by well-characterized anti-neuronal autoantibodies, such as those against the NMDA receptor. However, the presence of additional anti–central nervous system (CNS) autoantibodies in these patients has not been systematically assessed.MethodsSerum and cerebrospinal fluid (CSF) from patients with schizophreniform and affective syndromes were analyzed for immunoglobulin G anti-CNS autoantibodies using tissue-based assays with indirect immunofluorescence on unfixed murine brain tissue as part of an extended routine clinical practice. After an initial assessment of patients with red flags for autoimmune psychosis (n = 30), tissue-based testing was extended to a routine procedure (n = 89).ResultsBased on the findings from all 119 patients, anti-CNS immunoglobulin G autoantibodies against brain tissue were detected in 18% (n = 22) of patients (serum 9%, CSF 18%) following five principal patterns: 1) against vascular structures, most likely endothelial cells (serum 3%, CSF 8%); 2) against granule cells in the cerebellum and/or hippocampus (serum 4%, CSF 6%); 3) against myelinated fibers (serum 2%, CSF 2%); 4) against cerebellar Purkinje cells (serum 0%, CSF 2%); and 5) against astrocytes (serum 1%, CSF 1%). The patients with novel anti-CNS autoantibodies showed increased albumin quotients (p = .026) and white matter changes (p = .020) more frequently than those who tested negative for autoantibodies.ConclusionsThe study demonstrates five novel autoantibody-binding patterns on brain tissue of patients with schizophreniform and affective syndromes. CSF yielded positive findings more frequently than serum analysis. The frequency and spectrum of autoantibodies in these patient groups may be broader than previously thought.

Keyword(s): Animals (MeSH) ; Autoantibodies (MeSH) ; Brain (MeSH) ; Endothelial Cells (MeSH) ; Granulocyte-Macrophage Colony-Stimulating Factor (MeSH) ; Humans (MeSH) ; Immunoglobulin G (MeSH) ; Mice (MeSH) ; Mood Disorders (MeSH) ; Anti-neuronal autoantibody ; Autoantibody ; Autoimmune psychosis ; Blood-brain barrier ; Cerebrospinal fluid ; Endothelial cells ; Granule cells ; Schizophrenia ; Autoantibodies ; Immunoglobulin G ; Granulocyte-Macrophage Colony-Stimulating Factor

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Contributing Institute(s):

1. Autoimmune Encephalopathies (AG Prüß)

Research Program(s):

1. 353 - Clinical and Health Care Research (POF4-353) (POF4-353)

Appears in the scientific report 2022

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Database coverage:
; BIOSIS Previews ; Biological Abstracts ; Clarivate Analytics Master Journal List ; Current Contents - Life Sciences ; Ebsco Academic Search ; Essential Science Indicators ; IF >= 10 ; JCR ; Nationallizenz ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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